NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 7
UPDATE
50 Multiple-Choice Questions
Complete Answers with Detailed Rationales
Aligned with Medical-Surgical Nursing Standards
Galen College | NU 185 | Medical-Surgical Nursing II
Cardiac • Respiratory • Endocrine • GI • Renal • Neurological • Perioperative
For academic study and exam review • Verify with current course materials
,NU 185 | Review 7 | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical topics of NU 185
Medical-Surgical Nursing II. Each item is followed by the correct answer and an expanded rationale that explains the
underlying pathophysiology or nursing priority, why the correct option is preferred, and why the distractors are incorrect.
Topics span cardiovascular, respiratory, endocrine, gastrointestinal, renal, neurological, and perioperative care. Study tip:
Attempt each question before reading the answer. Then carefully review the detailed rationale and relate the concepts to
clinical practice.
Topic Index (Selected High-Yield Areas)
• Heart failure (left vs right), ACS, arrhythmias, hypertension management
• COPD, asthma, pneumonia, respiratory failure, ABG interpretation
• Diabetes mellitus, thyroid disorders, adrenal crises and emergencies
• GI bleeding, pancreatitis, liver disease, bowel obstruction priorities
• Acute kidney injury, CKD, fluid & electrolyte imbalances
• Stroke, increased ICP, seizures, neurological assessment
• Perioperative care, post-op complications, pain management
• Infection, sepsis, shock states, and priority nursing interventions
Page 2
, NU 185 | Review 7 | 2026/2027 UPDATE
Question 1
A patient with a spinal cord injury at T6 reports a sudden, throbbing headache and nasal congestion. Their blood
pressure is 210/110 mmHg. Which is the nurse’s priority action?
A. Sit the patient upright and lower the legs.
B. Administer the prescribed PRN hydralazine.
C. Perform a digital rectal exam to check for impaction.
D. Check the urinary catheter for kinks or obstruction.
Answer: A
Rationale
The patient is exhibiting signs of autonomic dysreflexia. The first priority is to sit the patient up to utilize orthostatic changes to
lower blood pressure, followed immediately by identifying the noxious stimulus (bladder/bowel).
Question 2
In a patient with Acute Respiratory Distress Syndrome (ARDS), which pathophysiological change leads to the
development of non-cardiogenic pulmonary edema?
A. Decreased capillary hydrostatic pressure.
B. Increased pulmonary artery wedge pressure.
C. Increased alveolar-capillary membrane permeability.
D. Decreased alveolar surface tension due to excess surfactant.
Answer: C
Rationale
ARDS is characterized by damage to the alveolar-capillary membrane, allowing fluid, proteins, and cells to leak into the alveoli,
causing severe hypoxia despite supplemental oxygen. Understanding this concept is essential for safe clinical
decision-making. Incorrect choices often reflect common misconceptions about pathophysiology or prioritization. Always link
assessment data to the primary disease process and anticipated complications.
Question 3
A patient is admitted with a Glascow Coma Scale (GCS) score of 7. Which nursing intervention is the most critical
priority?
A. Preparing for immediate endotracheal intubation.
B. Assessing pupillary response every hour.
C. Inserting a nasogastric tube for enteral feeding.
D. Initiating a cooling blanket for therapeutic hypothermia.
Answer: A
Rationale
A GCS score of 8 or less indicates severe brain injury and the inability to maintain a patent airway. ‘GCS of 8, intubate’ is the
clinical standard. Understanding this concept is essential for safe clinical decision-making. Incorrect choices often reflect
common misconceptions about pathophysiology or prioritization. Always link assessment data to the primary disease process
and anticipated complications.
Page 3
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 7
UPDATE
50 Multiple-Choice Questions
Complete Answers with Detailed Rationales
Aligned with Medical-Surgical Nursing Standards
Galen College | NU 185 | Medical-Surgical Nursing II
Cardiac • Respiratory • Endocrine • GI • Renal • Neurological • Perioperative
For academic study and exam review • Verify with current course materials
,NU 185 | Review 7 | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical topics of NU 185
Medical-Surgical Nursing II. Each item is followed by the correct answer and an expanded rationale that explains the
underlying pathophysiology or nursing priority, why the correct option is preferred, and why the distractors are incorrect.
Topics span cardiovascular, respiratory, endocrine, gastrointestinal, renal, neurological, and perioperative care. Study tip:
Attempt each question before reading the answer. Then carefully review the detailed rationale and relate the concepts to
clinical practice.
Topic Index (Selected High-Yield Areas)
• Heart failure (left vs right), ACS, arrhythmias, hypertension management
• COPD, asthma, pneumonia, respiratory failure, ABG interpretation
• Diabetes mellitus, thyroid disorders, adrenal crises and emergencies
• GI bleeding, pancreatitis, liver disease, bowel obstruction priorities
• Acute kidney injury, CKD, fluid & electrolyte imbalances
• Stroke, increased ICP, seizures, neurological assessment
• Perioperative care, post-op complications, pain management
• Infection, sepsis, shock states, and priority nursing interventions
Page 2
, NU 185 | Review 7 | 2026/2027 UPDATE
Question 1
A patient with a spinal cord injury at T6 reports a sudden, throbbing headache and nasal congestion. Their blood
pressure is 210/110 mmHg. Which is the nurse’s priority action?
A. Sit the patient upright and lower the legs.
B. Administer the prescribed PRN hydralazine.
C. Perform a digital rectal exam to check for impaction.
D. Check the urinary catheter for kinks or obstruction.
Answer: A
Rationale
The patient is exhibiting signs of autonomic dysreflexia. The first priority is to sit the patient up to utilize orthostatic changes to
lower blood pressure, followed immediately by identifying the noxious stimulus (bladder/bowel).
Question 2
In a patient with Acute Respiratory Distress Syndrome (ARDS), which pathophysiological change leads to the
development of non-cardiogenic pulmonary edema?
A. Decreased capillary hydrostatic pressure.
B. Increased pulmonary artery wedge pressure.
C. Increased alveolar-capillary membrane permeability.
D. Decreased alveolar surface tension due to excess surfactant.
Answer: C
Rationale
ARDS is characterized by damage to the alveolar-capillary membrane, allowing fluid, proteins, and cells to leak into the alveoli,
causing severe hypoxia despite supplemental oxygen. Understanding this concept is essential for safe clinical
decision-making. Incorrect choices often reflect common misconceptions about pathophysiology or prioritization. Always link
assessment data to the primary disease process and anticipated complications.
Question 3
A patient is admitted with a Glascow Coma Scale (GCS) score of 7. Which nursing intervention is the most critical
priority?
A. Preparing for immediate endotracheal intubation.
B. Assessing pupillary response every hour.
C. Inserting a nasogastric tube for enteral feeding.
D. Initiating a cooling blanket for therapeutic hypothermia.
Answer: A
Rationale
A GCS score of 8 or less indicates severe brain injury and the inability to maintain a patent airway. ‘GCS of 8, intubate’ is the
clinical standard. Understanding this concept is essential for safe clinical decision-making. Incorrect choices often reflect
common misconceptions about pathophysiology or prioritization. Always link assessment data to the primary disease process
and anticipated complications.
Page 3
