N212 EXAM 2 REVISED STUDY
GUIDE | UPDATE WITH
COMPLETE SOLUTIONS.
PRENIUM EXAM
150 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
N212 EXAM 2 REVISED STUDY GUIDE | UPDATE WITH COMPLETE SOLUTIONS.. It contains 150 carefully
selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 150 Questions
Foundations - Application - N212 2 Revised Study Guide Update WITH Complete Solutions Nursing N212
Medical-surgical Nursing II Undergraduate YEAR 3 / Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Pharmacological Therapies 1-25 Acute, Failure, Medication, Heart, Finding
Reduction OF RISK Potential 26-50 Finding, Appropriate, Therapy, Concentration, Medication
Physiological Adaptation 51-75 Diabetes, Prescribed, Medication, Finding, Heart
Basic CARE AND Comfort 76-100 Appropriate, Acute, Heart Failure, Finding, Medication
Safety AND Infection Control 101-125 Explains, Prescribed, Digoxin, Mechanism, Warfarin
Health Promotion AND 126-150 Appropriate, Acute, Medication, Therapy, Prescribed
Maintenance
TOTAL 150 All questions include answers and detailed rationales
,Section A - Pharmacological Therapies
Q1.
In a patient with septic shock and acute respiratory distress syndrome (ARDS), which
hemodynamic profile is most consistent with combined distributive and obstructive shock
due to high intrathoracic pressure from mechanical ventilation?
A. Low cardiac output, high systemic B. High cardiac output, low systemic
vascular resistance, low central venous vascular resistance, low central venous
pressure pressure
C. Low cardiac output, high systemic D. High cardiac output, low systemic
vascular resistance, high central venous vascular resistance, high central venous
pressure pressure
Correct: D - High cardiac output, low systemic vascular resistance, high central venous
pressure
Rationale:Septic shock typically presents with high cardiac output and low SVR (distributive).
However, high intrathoracic pressure from mechanical ventilation (especially with PEEP)
impedes venous return, raising CVP. Thus, the combination of high CO, low SVR, and high
CVP reflects the mixed picture. Other options misrepresent either the distributive or
obstructive component.
Q2.
Which finding most reliably indicates that a patient with acute kidney injury is progressing
from the oliguric phase to the diuretic phase?
A. Serum creatinine begins to decrease B. Urine output increases to >400 mL/day
while urine output remains low but serum creatinine continues to rise
C. Urine output increases and serum D. Fractional excretion of sodium drops
creatinine normalizes rapidly below 1%
Correct: B - Urine output increases to >400 mL/day but serum creatinine continues to rise
Rationale:The diuretic phase of AKI is marked by a gradual increase in urine output, but
glomerular filtration is still recovering; therefore, serum creatinine may continue to rise initially.
Option A is incorrect because urine output is still low. Option C is too rapid. Option D
indicates prerenal physiology, not a phase transition.
Q3.
A patient with type 2 diabetes on metformin develops contrast-induced nephropathy after
coronary angiography. Which intervention is most important to prevent lactic acidosis?
Page 3
, Section A - Pharmacological Therapies
A. Administer sodium bicarbonate B. Hold metformin for 48 hours after the
intravenously procedure
C. Increase metformin dose to maintain D. Switch metformin to insulin immediately
glycemic control
Correct: B - Hold metformin for 48 hours after the procedure
Rationale:Metformin is contraindicated in significant renal impairment due to the risk of lactic
acidosis. Holding it for 48 hours post-contrast or until renal function is reassessed is standard.
Sodium bicarbonate is not routinely recommended. Increasing the dose is dangerous. Insulin
may be needed but not immediately unless hyperglycemia is severe.
Q4.
In a patient with acute liver failure and hepatic encephalopathy, which medication should
be used with extreme caution due to the risk of precipitating cerebral edema?
A. Lactulose B. Rifaximin
C. Midazolam D. Naloxone
Correct: C - Midazolam
Rationale:Benzodiazepines like midazolam can exacerbate encephalopathy and increase
intracranial pressure. Lactulose and rifaximin are treatments for encephalopathy. Naloxone is
not indicated. Thus, midazolam is the correct answer.
Q5.
A patient with pneumonia develops a fever and a new heart murmur. Which additional
finding would most strongly support a diagnosis of infective endocarditis?
A. Elevated C-reactive protein B. Positive blood culture for Staphylococcus
aureus
C. History of recent dental work D. Presence of Roth spots on fundoscopic
exam
Correct: B - Positive blood culture for Staphylococcus aureus
Rationale:Persistent bacteremia with a typical organism is a major Duke criterion. Roth spots
are minor criteria. Elevated CRP and dental work are nonspecific. A positive blood culture for
S. aureus is highly suggestive of infective endocarditis in the context of a new murmur.
Q6.
In a mechanically ventilated patient with ARDS, which ventilator setting change is most
likely to improve oxygenation without significantly increasing the risk of
ventilator-induced lung injury?
Page 4
GUIDE | UPDATE WITH
COMPLETE SOLUTIONS.
PRENIUM EXAM
150 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
N212 EXAM 2 REVISED STUDY GUIDE | UPDATE WITH COMPLETE SOLUTIONS.. It contains 150 carefully
selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 150 Questions
Foundations - Application - N212 2 Revised Study Guide Update WITH Complete Solutions Nursing N212
Medical-surgical Nursing II Undergraduate YEAR 3 / Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Pharmacological Therapies 1-25 Acute, Failure, Medication, Heart, Finding
Reduction OF RISK Potential 26-50 Finding, Appropriate, Therapy, Concentration, Medication
Physiological Adaptation 51-75 Diabetes, Prescribed, Medication, Finding, Heart
Basic CARE AND Comfort 76-100 Appropriate, Acute, Heart Failure, Finding, Medication
Safety AND Infection Control 101-125 Explains, Prescribed, Digoxin, Mechanism, Warfarin
Health Promotion AND 126-150 Appropriate, Acute, Medication, Therapy, Prescribed
Maintenance
TOTAL 150 All questions include answers and detailed rationales
,Section A - Pharmacological Therapies
Q1.
In a patient with septic shock and acute respiratory distress syndrome (ARDS), which
hemodynamic profile is most consistent with combined distributive and obstructive shock
due to high intrathoracic pressure from mechanical ventilation?
A. Low cardiac output, high systemic B. High cardiac output, low systemic
vascular resistance, low central venous vascular resistance, low central venous
pressure pressure
C. Low cardiac output, high systemic D. High cardiac output, low systemic
vascular resistance, high central venous vascular resistance, high central venous
pressure pressure
Correct: D - High cardiac output, low systemic vascular resistance, high central venous
pressure
Rationale:Septic shock typically presents with high cardiac output and low SVR (distributive).
However, high intrathoracic pressure from mechanical ventilation (especially with PEEP)
impedes venous return, raising CVP. Thus, the combination of high CO, low SVR, and high
CVP reflects the mixed picture. Other options misrepresent either the distributive or
obstructive component.
Q2.
Which finding most reliably indicates that a patient with acute kidney injury is progressing
from the oliguric phase to the diuretic phase?
A. Serum creatinine begins to decrease B. Urine output increases to >400 mL/day
while urine output remains low but serum creatinine continues to rise
C. Urine output increases and serum D. Fractional excretion of sodium drops
creatinine normalizes rapidly below 1%
Correct: B - Urine output increases to >400 mL/day but serum creatinine continues to rise
Rationale:The diuretic phase of AKI is marked by a gradual increase in urine output, but
glomerular filtration is still recovering; therefore, serum creatinine may continue to rise initially.
Option A is incorrect because urine output is still low. Option C is too rapid. Option D
indicates prerenal physiology, not a phase transition.
Q3.
A patient with type 2 diabetes on metformin develops contrast-induced nephropathy after
coronary angiography. Which intervention is most important to prevent lactic acidosis?
Page 3
, Section A - Pharmacological Therapies
A. Administer sodium bicarbonate B. Hold metformin for 48 hours after the
intravenously procedure
C. Increase metformin dose to maintain D. Switch metformin to insulin immediately
glycemic control
Correct: B - Hold metformin for 48 hours after the procedure
Rationale:Metformin is contraindicated in significant renal impairment due to the risk of lactic
acidosis. Holding it for 48 hours post-contrast or until renal function is reassessed is standard.
Sodium bicarbonate is not routinely recommended. Increasing the dose is dangerous. Insulin
may be needed but not immediately unless hyperglycemia is severe.
Q4.
In a patient with acute liver failure and hepatic encephalopathy, which medication should
be used with extreme caution due to the risk of precipitating cerebral edema?
A. Lactulose B. Rifaximin
C. Midazolam D. Naloxone
Correct: C - Midazolam
Rationale:Benzodiazepines like midazolam can exacerbate encephalopathy and increase
intracranial pressure. Lactulose and rifaximin are treatments for encephalopathy. Naloxone is
not indicated. Thus, midazolam is the correct answer.
Q5.
A patient with pneumonia develops a fever and a new heart murmur. Which additional
finding would most strongly support a diagnosis of infective endocarditis?
A. Elevated C-reactive protein B. Positive blood culture for Staphylococcus
aureus
C. History of recent dental work D. Presence of Roth spots on fundoscopic
exam
Correct: B - Positive blood culture for Staphylococcus aureus
Rationale:Persistent bacteremia with a typical organism is a major Duke criterion. Roth spots
are minor criteria. Elevated CRP and dental work are nonspecific. A positive blood culture for
S. aureus is highly suggestive of infective endocarditis in the context of a new murmur.
Q6.
In a mechanically ventilated patient with ARDS, which ventilator setting change is most
likely to improve oxygenation without significantly increasing the risk of
ventilator-induced lung injury?
Page 4
