NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 8
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 8 | 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 8 | 2026/2027 UPDATE
Question 1
A patient with left-sided heart failure is admitted. Which clinical manifestation should the nurse prioritize during the
respiratory assessment?
A. Jugular venous distention
B. Peripheral edema in the lower extremities
C. Paroxysmal nocturnal dyspnea
D. Splenomegaly
Answer: C
Rationale
Left-sided heart failure causes pulmonary congestion. Paroxysmal nocturnal dyspnea is a classic sign of fluid shifting back into
the lungs when the patient lies flat. The other options are symptoms of right-sided heart failure.
Question 2
A nurse is caring for a patient receiving Digoxin for heart failure. Which laboratory value requires immediate notification
of the provider?
A. Serum Sodium 138 mEq/L
B. BUN 18 mg/dL
C. Serum Digoxin level 0.9 ng/mL
D. Serum Potassium 3.1 mEq/L
Answer: D
Rationale
Hypokalemia (potassium < 3.5 mEq/L) increases the risk of Digoxin toxicity, even if the Digoxin level is within the therapeutic
range (0.5–2.0 ng/mL). 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
An arterial blood gas (ABG) report shows: pH 7.31, PaCO2 52 mmHg, and HCO3 25 mEq/L. How should the nurse
interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale
The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45 mmHg), which is the respiratory component, while the
HCO3 is normal, indicating respiratory acidosis. 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 8
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 8 | 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 8 | 2026/2027 UPDATE
Question 1
A patient with left-sided heart failure is admitted. Which clinical manifestation should the nurse prioritize during the
respiratory assessment?
A. Jugular venous distention
B. Peripheral edema in the lower extremities
C. Paroxysmal nocturnal dyspnea
D. Splenomegaly
Answer: C
Rationale
Left-sided heart failure causes pulmonary congestion. Paroxysmal nocturnal dyspnea is a classic sign of fluid shifting back into
the lungs when the patient lies flat. The other options are symptoms of right-sided heart failure.
Question 2
A nurse is caring for a patient receiving Digoxin for heart failure. Which laboratory value requires immediate notification
of the provider?
A. Serum Sodium 138 mEq/L
B. BUN 18 mg/dL
C. Serum Digoxin level 0.9 ng/mL
D. Serum Potassium 3.1 mEq/L
Answer: D
Rationale
Hypokalemia (potassium < 3.5 mEq/L) increases the risk of Digoxin toxicity, even if the Digoxin level is within the therapeutic
range (0.5–2.0 ng/mL). 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
An arterial blood gas (ABG) report shows: pH 7.31, PaCO2 52 mmHg, and HCO3 25 mEq/L. How should the nurse
interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Rationale
The pH is low (< 7.35), indicating acidosis. The PaCO2 is high (> 45 mmHg), which is the respiratory component, while the
HCO3 is normal, indicating respiratory acidosis. 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
