NU185 MEDICAL-SURGICAL NURSING II – EXAM 2 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND REVISED|GALEN COLLEGE

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NU185 MEDICAL-SURGICAL NURSING II –
EXAM 2 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED|GALEN
COLLEGE

1. A nurse is assessing a client who has heart failure. Which of the
following findings should the nurse expect?
 A) Decreased central venous pressure
 B) Jugular vein distention and peripheral edema
 C) Decreased blood pressure and tachycardia
 D) Crackles only in the right lower lobe
Rationale: Jugular vein distention and peripheral edema are
classic signs of right-sided heart failure due to fluid volume
overload. Decreased central venous pressure would not be
expected. Hypotension and tachycardia are more associated with
cardiogenic shock. Crackles in a single lobe suggest pneumonia,
not heart failure.
2. A nurse is caring for a client who is 2 days post-myocardial
infarction (MI) and reports chest pain. Which of the following
actions should the nurse take first?
 A) Administer sublingual nitroglycerin
 B) Reposition the client to improve comfort
 C) Obtain a 12-lead electrocardiogram (ECG)

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 D) Notify the provider of the client's chest pain
Rationale: The nurse should first obtain a 12-lead ECG to assess
for ST-segment changes indicating recurrent ischemia or
infarction. Administering nitroglycerin may be appropriate, but
assessment is the priority. Repositioning may help but is not the
first action for chest pain post-MI.
3. A nurse is providing teaching to a client who has angina pectoris
about the use of sublingual nitroglycerin. Which of the following
statements by the client indicates an understanding of the teaching?
 A) "I will take one tablet every 10 minutes until the pain subsides."
 B) "I will take one tablet, and if the pain is not relieved in 5
minutes, I will call 911."
 C) "I will take three tablets at the onset of pain for rapid relief."
 D) "I will take the medication only if I have pain lasting more than
30 minutes."
Rationale: The correct protocol for sublingual nitroglycerin is to
take one tablet, and if the pain is not relieved in 5 minutes, call
911. The client may take a second tablet while waiting, but the
priority is to seek emergency care. Three tablets at onset is
incorrect, and waiting 30 minutes is dangerous.
4. A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which of the following findings should
the nurse expect?
 A) Increased oxygen saturation
 B) Decreased respiratory rate
 C) Increased breath sounds
 D) Barrel-shaped chest and use of accessory muscles
Rationale: A barrel-shaped chest and use of accessory muscles

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are common findings in clients with COPD due to hyperinflation
of the lungs and increased work of breathing. Oxygen saturation
is often decreased, respiratory rate is often increased, and breath
sounds are often diminished.
5. A nurse is caring for a client who is receiving oxygen via a nasal
cannula at 4 L/min. Which of the following actions should the nurse
take to prevent skin breakdown?
 A) Apply petroleum jelly to the nares
 B) Pad the tubing with gauze where it touches the client's skin
 C) Secure the tubing tightly to the client's face
 D) Change the nasal cannula every 24 hours
Rationale: Padding the tubing with gauze can reduce pressure on
the skin and prevent breakdown. Petroleum jelly should not be
used with oxygen due to fire risk. The tubing should be secured
but not tightly, and the cannula should be changed when soiled.
6. A nurse is providing teaching to a client who has a new diagnosis
of hypertension. Which of the following dietary recommendations
should the nurse include?
 A) Increase intake of red meat
 B) Increase intake of processed foods
 C) Decrease sodium intake to less than 2,300 mg per day
 D) Decrease intake of fresh fruits and vegetables
Rationale: The DASH diet (Dietary Approaches to Stop
Hypertension) recommends decreasing sodium intake to less
than 2,300 mg per day, and ideally to 1,500 mg per day.
Increasing red meat, processed foods, or decreasing fruits and
vegetables would be counterproductive.

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7. A nurse is assessing a client who has a potassium level of 5.8
mEq/L. Which of the following ECG changes should the nurse
expect?
 A) Flat T-waves
 B) Peaked T-waves
 C) Prolonged PR interval
 D) ST-segment elevation
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) causes
peaked T-waves on the ECG. Flat T-waves are associated with
hypokalemia. Prolonged PR interval can occur with hypokalemia
or other electrolyte imbalances. ST-segment elevation is
associated with myocardial injury.
8. A nurse is caring for a client who has a new prescription for
furosemide. Which of the following laboratory values should the
nurse monitor closely?
 A) Serum sodium
 B) Serum potassium
 C) Serum calcium
 D) Serum magnesium
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. The nurse should monitor serum potassium levels
closely for hypokalemia. Sodium, calcium, and magnesium may
also be affected but potassium is the primary concern.
9. A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take to prevent a
transfusion reaction?
 A) Administer the blood product rapidly to ensure timely infusion