NU 185 Exam 4 Medical-Surgical Nursing II Compreh… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Exam 4 Medical-Surgical Nursing II Comprehensive
Review 2026/2027 UPDATE |Galen
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NU 185 Exam 4 Medical-Surgical Nursing II Compreh… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS).
Which clinical finding most accurately reflects the hallmark pathophysiology of this
condition?
A. Respiratory alkalosis due to hyperventilation
B. Pulmonary edema caused by left-sided heart failure
C. Increased lung compliance with decreased peak inspiratory pressure
D. Hypoxemia that does not respond to increased oxygen concentrations
Answer: D
Rationale: The hallmark of ARDS is refractory hypoxemia, which is hypoxemia that persists even
when 100% oxygen is delivered, due to intrapulmonary shunting. Remembering this point will help you
decide the best nursing action when similar questions appear on the exam. Link the answer to the
client’s current condition and risk level. This is important because the nurse must choose the action
that keeps the client safest while still meeting their basic needs. Always think about safety first when
answering these questions.
2. A client with a T6 spinal cord injury reports a sudden, throbbing headache and is found to
be hypertensive (190/110 mmHg) and bradycardic. What is the nurse’s priority action?
A. Administer a prescribed bolus of IV antihypertensives
B. Elevate the head of the bed to 45 degrees or higher
C. Check the patient’s temperature for signs of infection
D. Perform a digital rectal exam to check for impaction
Answer: B
Rationale: The symptoms suggest autonomic dysreflexia. The priority action is to sit the patient up to
utilize orthostatic pressure to lower blood pressure before assessing for the cause (e.g., bladder
distension or impaction). Understanding this helps the nurse notice early warning signs and act before
the problem gets worse. Early action often prevents bigger complications for the client. This is
important because the nurse must choose the action that keeps the client safest while still meeting
their basic needs. Always think about safety first when answering these questions.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Exam 4 Medical-Surgical Nursing II Compreh… 2026/2027 • Verified • Assured Grade A+
3. During the emergent phase of a 45% total body surface area (TBSA) burn injury, which
laboratory result is most expected?
A. burn injury, which laboratory result is most expected?
B. Hematocrit of 32%
C. Blood urea nitrogen (BUN) of 10 mg/dL
D. Serum potassium of 6.2 mEq/L
Answer: D
Rationale: Hyperkalemia occurs during the emergent phase of burns due to massive cell destruction
releasing potassium into the extracellular fluid. Remembering this point will help you decide the best
nursing action when similar questions appear on the exam. Link the answer to the client’s current
condition and risk level. Clear understanding of this concept improves both test performance and
everyday clinical judgment. Practice applying it to short case scenarios to lock the idea in place.
4. A patient with liver cirrhosis and esophageal varices is prescribed lactulose. Which
outcome indicates the medication is achieving its therapeutic goal?
A. The patient’s prothrombin time (PT) returns to normal limits
B. The patient has 2-3 soft stools per day and improved mental status
C. The patient’s abdominal girth decreases by 2 cm
D. The patient’s serum ALT and AST levels decrease
Answer: B
Rationale: Lactulose is used in hepatic encephalopathy to trap ammonia in the gut and expel it via
stool; the goal is improved mentation and 2-3 soft stools daily. This is important because the nurse
must choose the action that keeps the client safest while still meeting their basic needs. Always think
about safety first when answering these questions. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Exam 4 Medical-Surgical Nursing II Comprehensive
Review 2026/2027 UPDATE |Galen
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NU 185 Exam 4 Medical-Surgical Nursing II Compreh… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS).
Which clinical finding most accurately reflects the hallmark pathophysiology of this
condition?
A. Respiratory alkalosis due to hyperventilation
B. Pulmonary edema caused by left-sided heart failure
C. Increased lung compliance with decreased peak inspiratory pressure
D. Hypoxemia that does not respond to increased oxygen concentrations
Answer: D
Rationale: The hallmark of ARDS is refractory hypoxemia, which is hypoxemia that persists even
when 100% oxygen is delivered, due to intrapulmonary shunting. Remembering this point will help you
decide the best nursing action when similar questions appear on the exam. Link the answer to the
client’s current condition and risk level. This is important because the nurse must choose the action
that keeps the client safest while still meeting their basic needs. Always think about safety first when
answering these questions.
2. A client with a T6 spinal cord injury reports a sudden, throbbing headache and is found to
be hypertensive (190/110 mmHg) and bradycardic. What is the nurse’s priority action?
A. Administer a prescribed bolus of IV antihypertensives
B. Elevate the head of the bed to 45 degrees or higher
C. Check the patient’s temperature for signs of infection
D. Perform a digital rectal exam to check for impaction
Answer: B
Rationale: The symptoms suggest autonomic dysreflexia. The priority action is to sit the patient up to
utilize orthostatic pressure to lower blood pressure before assessing for the cause (e.g., bladder
distension or impaction). Understanding this helps the nurse notice early warning signs and act before
the problem gets worse. Early action often prevents bigger complications for the client. This is
important because the nurse must choose the action that keeps the client safest while still meeting
their basic needs. Always think about safety first when answering these questions.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Exam 4 Medical-Surgical Nursing II Compreh… 2026/2027 • Verified • Assured Grade A+
3. During the emergent phase of a 45% total body surface area (TBSA) burn injury, which
laboratory result is most expected?
A. burn injury, which laboratory result is most expected?
B. Hematocrit of 32%
C. Blood urea nitrogen (BUN) of 10 mg/dL
D. Serum potassium of 6.2 mEq/L
Answer: D
Rationale: Hyperkalemia occurs during the emergent phase of burns due to massive cell destruction
releasing potassium into the extracellular fluid. Remembering this point will help you decide the best
nursing action when similar questions appear on the exam. Link the answer to the client’s current
condition and risk level. Clear understanding of this concept improves both test performance and
everyday clinical judgment. Practice applying it to short case scenarios to lock the idea in place.
4. A patient with liver cirrhosis and esophageal varices is prescribed lactulose. Which
outcome indicates the medication is achieving its therapeutic goal?
A. The patient’s prothrombin time (PT) returns to normal limits
B. The patient has 2-3 soft stools per day and improved mental status
C. The patient’s abdominal girth decreases by 2 cm
D. The patient’s serum ALT and AST levels decrease
Answer: B
Rationale: Lactulose is used in hepatic encephalopathy to trap ammonia in the gut and expel it via
stool; the goal is improved mentation and 2-3 soft stools daily. This is important because the nurse
must choose the action that keeps the client safest while still meeting their basic needs. Always think
about safety first when answering these questions. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
Exam (Elaborations) • Detailed Rationales Page 3
