NU 185 Medical-Surgical Nursing II Exam 2 Prep 20… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NU 185 Medical-Surgical Nursing II Exam 2 Prep 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 Medical-Surgical Nursing II Exam 2 Prep 20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted with an
exacerbation. The nurse notes the patient is confused and has a bounding pulse. Which
arterial blood gas (ABG) result would the nurse most likely expect?
A. pH 7.30, PaCO2 58 mmHg, HCO3 26 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
D. is admitted with an exacerbation. The nurse notes the patient is confused and has a bounding
pulse. Which arterial blood gas (ABG) result would the nurse most likely expect?
Answer: A
Rationale: Confused state and bounding pulse in a COPD patient often indicate CO2 narcosis or
respiratory acidosis. Result B shows a low pH and elevated PaCO2, consistent with respiratory
acidosis. 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.
2. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which clinical
finding is the hallmark of this condition despite the administration of high-flow oxygen?
A. Respiratory alkalosis
B. Hypoxemia refractory to oxygen therapy
C. Increased lung compliance
D. Hypercapnia with metabolic compensation
Answer: B
Rationale: The hallmark of ARDS is refractory hypoxemia, where the patient’s arterial oxygen levels
remain low even when receiving high concentrations of supplemental oxygen. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Medical-Surgical Nursing II Exam 2 Prep 20… 2026/2027 • Verified • Assured Grade A+
3. The nurse is caring for a patient post-permanent pacemaker insertion. Which discharge
instruction is the highest priority for patient safety?
A. Check the pulse rate daily at the same time.
B. Avoid lifting the arm on the operative side above the shoulder for 1-2 weeks.
C. Avoid using a microwave oven in the kitchen.
D. Keep the incision site dry for at least 4 weeks.
Answer: B
Rationale: Restricting arm movement prevents dislodgment of the newly placed pacemaker leads.
While checking the pulse is important, preventing lead displacement is a critical safety priority. 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. 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.
4. A patient with Atrial Fibrillation is prescribed Warfarin. Which lab value should the nurse
monitor to determine the effectiveness of this therapy?
A. Partial Thromboplastin Time (PTT)
B. Activated Clotting Time (ACT)
C. International Normalized Ratio (INR)
D. Platelet count
Answer: C
Rationale: INR is the standard measurement used to monitor the effectiveness of Warfarin
(Coumadin) therapy. 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 Medical-Surgical Nursing II Exam 2 Prep 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 Medical-Surgical Nursing II Exam 2 Prep 20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with chronic obstructive pulmonary disease (COPD) is admitted with an
exacerbation. The nurse notes the patient is confused and has a bounding pulse. Which
arterial blood gas (ABG) result would the nurse most likely expect?
A. pH 7.30, PaCO2 58 mmHg, HCO3 26 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
D. is admitted with an exacerbation. The nurse notes the patient is confused and has a bounding
pulse. Which arterial blood gas (ABG) result would the nurse most likely expect?
Answer: A
Rationale: Confused state and bounding pulse in a COPD patient often indicate CO2 narcosis or
respiratory acidosis. Result B shows a low pH and elevated PaCO2, consistent with respiratory
acidosis. 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.
2. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which clinical
finding is the hallmark of this condition despite the administration of high-flow oxygen?
A. Respiratory alkalosis
B. Hypoxemia refractory to oxygen therapy
C. Increased lung compliance
D. Hypercapnia with metabolic compensation
Answer: B
Rationale: The hallmark of ARDS is refractory hypoxemia, where the patient’s arterial oxygen levels
remain low even when receiving high concentrations of supplemental oxygen. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NU 185 Medical-Surgical Nursing II Exam 2 Prep 20… 2026/2027 • Verified • Assured Grade A+
3. The nurse is caring for a patient post-permanent pacemaker insertion. Which discharge
instruction is the highest priority for patient safety?
A. Check the pulse rate daily at the same time.
B. Avoid lifting the arm on the operative side above the shoulder for 1-2 weeks.
C. Avoid using a microwave oven in the kitchen.
D. Keep the incision site dry for at least 4 weeks.
Answer: B
Rationale: Restricting arm movement prevents dislodgment of the newly placed pacemaker leads.
While checking the pulse is important, preventing lead displacement is a critical safety priority. 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. 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.
4. A patient with Atrial Fibrillation is prescribed Warfarin. Which lab value should the nurse
monitor to determine the effectiveness of this therapy?
A. Partial Thromboplastin Time (PTT)
B. Activated Clotting Time (ACT)
C. International Normalized Ratio (INR)
D. Platelet count
Answer: C
Rationale: INR is the standard measurement used to monitor the effectiveness of Warfarin
(Coumadin) therapy. 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
