NU 185 Exam 4 Medical-Surgical Nursing II 2026/20… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Exam 4 Medical-Surgical Nursing II 2026/2027 UPDATE
|Galen College
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 2026/20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with a spinal cord injury at T4 reports a sudden, severe headache and nasal
congestion. The nurse notes a blood pressure of 190/100 mmHg and bradycardia. What is
the priority nursing action?
A. Place the patient in a high-Fowler’s position.
B. Administer an antihypertensive medication as ordered.
C. Check the patient’s bladder for distension.
D. Perform a digital rectal exam to check for impaction.
Answer: A
Rationale: Autonomic Dysreflexia is a medical emergency. The first priority is to sit the patient upright
to help lower the blood pressure through orthostatic changes before addressing the stimulus. This
knowledge supports safe care and helps the nurse teach the client and family clearly and simply. Clear
teaching improves cooperation and reduces anxiety. Knowing the reason behind the correct answer
makes it easier to rule out the wrong options quickly. Look for the choice that protects the client and
matches the priority need.
2. A patient in the ICU is diagnosed with ARDS. The ventilator is set to deliver PEEP (Positive
End-Expiratory Pressure). Which complication should the nurse monitor for most closely?
A. Decreased cardiac output
B. Respiratory alkalosis
C. Hyperthermia
D. Increased urine output
Answer: A
Rationale: PEEP increases intrathoracic pressure, which can decrease venous return to the heart,
leading to reduced cardiac output and hypotension. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Exam 4 Medical-Surgical Nursing II 2026/20… 2026/2027 • Verified • Assured Grade A+
3. A nurse is caring for a patient with Acute Kidney Injury (AKI) in the oliguric phase. Which
electrolyte abnormality is the nurse most likely to find?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypophosphatemia
Answer: A
Rationale: In the oliguric phase of AKI, the kidneys cannot excrete potassium, leading to
hyperkalemia, which carries a risk of cardiac dysrhythmias. Exam questions often test whether you can
pick the most practical and safe choice for the client in real situations. Focus on what the nurse can
actually do right now. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities.
4. A patient with liver cirrhosis and hepatic encephalopathy is receiving Lactulose. Which
finding indicates the medication is effective?
A. The patient has one soft bowel movement daily.
B. Improved orientation and decreased flapping tremors.
C. The patient’s skin is less jaundiced.
D. Serum albumin levels have increased to 4.0 g/dL.
Answer: B
Rationale: Lactulose is used to reduce ammonia levels. Improvement in neurological status
(orientation) and reduction of asterixis (flapping tremors) indicate efficacy. 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. In practice, this guides the nurse to set priorities and protect the
client from harm. Safety, nutrition, and clear communication are frequent priorities.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Exam 4 Medical-Surgical Nursing II 2026/2027 UPDATE
|Galen College
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 2026/20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with a spinal cord injury at T4 reports a sudden, severe headache and nasal
congestion. The nurse notes a blood pressure of 190/100 mmHg and bradycardia. What is
the priority nursing action?
A. Place the patient in a high-Fowler’s position.
B. Administer an antihypertensive medication as ordered.
C. Check the patient’s bladder for distension.
D. Perform a digital rectal exam to check for impaction.
Answer: A
Rationale: Autonomic Dysreflexia is a medical emergency. The first priority is to sit the patient upright
to help lower the blood pressure through orthostatic changes before addressing the stimulus. This
knowledge supports safe care and helps the nurse teach the client and family clearly and simply. Clear
teaching improves cooperation and reduces anxiety. Knowing the reason behind the correct answer
makes it easier to rule out the wrong options quickly. Look for the choice that protects the client and
matches the priority need.
2. A patient in the ICU is diagnosed with ARDS. The ventilator is set to deliver PEEP (Positive
End-Expiratory Pressure). Which complication should the nurse monitor for most closely?
A. Decreased cardiac output
B. Respiratory alkalosis
C. Hyperthermia
D. Increased urine output
Answer: A
Rationale: PEEP increases intrathoracic pressure, which can decrease venous return to the heart,
leading to reduced cardiac output and hypotension. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Exam 4 Medical-Surgical Nursing II 2026/20… 2026/2027 • Verified • Assured Grade A+
3. A nurse is caring for a patient with Acute Kidney Injury (AKI) in the oliguric phase. Which
electrolyte abnormality is the nurse most likely to find?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypophosphatemia
Answer: A
Rationale: In the oliguric phase of AKI, the kidneys cannot excrete potassium, leading to
hyperkalemia, which carries a risk of cardiac dysrhythmias. Exam questions often test whether you can
pick the most practical and safe choice for the client in real situations. Focus on what the nurse can
actually do right now. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities.
4. A patient with liver cirrhosis and hepatic encephalopathy is receiving Lactulose. Which
finding indicates the medication is effective?
A. The patient has one soft bowel movement daily.
B. Improved orientation and decreased flapping tremors.
C. The patient’s skin is less jaundiced.
D. Serum albumin levels have increased to 4.0 g/dL.
Answer: B
Rationale: Lactulose is used to reduce ammonia levels. Improvement in neurological status
(orientation) and reduction of asterixis (flapping tremors) indicate efficacy. 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. In practice, this guides the nurse to set priorities and protect the
client from harm. Safety, nutrition, and clear communication are frequent priorities.
Exam (Elaborations) • Detailed Rationales Page 3
