NU 185
MEDICAL-SURGICAL NURSING II
Exam 3 Comprehensive Review
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 | Exam 3 Review | 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 | Exam 3 Review | 2026/2027 UPDATE
Question 1
A client in the ICU is being treated for DKA. Which assessment finding requires immediate intervention by the nurse?
A. Blood glucose level of 350 mg/dL
B. Bicarbonate level of 15 mEq/L
C. Potassium level of 3.2 mEq/L
D. pH of 7.28
Answer: C
Rationale
In DKA, insulin therapy shifts potassium back into cells, potentially causing severe hypokalemia. A potassium level of 3.2 is
critically low and increases the risk of fatal dysrhythmias; it must be addressed before or during insulin administration.
Question 2
The nurse is caring for a patient with SIADH. Which physician order should the nurse clarify?
A. Fluid restriction of 800 mL/day
B. Administration of 3% sodium chloride IV
C. Daily weights and strict I&Os
D. Administration of Desmopressin (DDAVP) subcutaneous
Answer: D
Rationale
Desmopressin (DDAVP) is a synthetic form of ADH used to treat Diabetes Insipidus (DI), not SIADH. SIADH involves too
much ADH; giving DDAVP would worsen the fluid retention and hyponatremia. 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 client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L. Which medication should the
nurse expect to administer first to protect the heart?
A. Calcium Gluconate
B. Sodium Polystyrene Sulfonate
C. Regular Insulin and Dextrose
D. Furosemide
Answer: A
Rationale
Calcium gluconate does not lower potassium, but it antagonizes the effect of hyperkalemia on the myocardium, stabilizing the
cardiac membrane to prevent lethal arrhythmias while other methods work to lower the K+ level. 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
Exam 3 Comprehensive Review
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 | Exam 3 Review | 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 | Exam 3 Review | 2026/2027 UPDATE
Question 1
A client in the ICU is being treated for DKA. Which assessment finding requires immediate intervention by the nurse?
A. Blood glucose level of 350 mg/dL
B. Bicarbonate level of 15 mEq/L
C. Potassium level of 3.2 mEq/L
D. pH of 7.28
Answer: C
Rationale
In DKA, insulin therapy shifts potassium back into cells, potentially causing severe hypokalemia. A potassium level of 3.2 is
critically low and increases the risk of fatal dysrhythmias; it must be addressed before or during insulin administration.
Question 2
The nurse is caring for a patient with SIADH. Which physician order should the nurse clarify?
A. Fluid restriction of 800 mL/day
B. Administration of 3% sodium chloride IV
C. Daily weights and strict I&Os
D. Administration of Desmopressin (DDAVP) subcutaneous
Answer: D
Rationale
Desmopressin (DDAVP) is a synthetic form of ADH used to treat Diabetes Insipidus (DI), not SIADH. SIADH involves too
much ADH; giving DDAVP would worsen the fluid retention and hyponatremia. 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 client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.8 mEq/L. Which medication should the
nurse expect to administer first to protect the heart?
A. Calcium Gluconate
B. Sodium Polystyrene Sulfonate
C. Regular Insulin and Dextrose
D. Furosemide
Answer: A
Rationale
Calcium gluconate does not lower potassium, but it antagonizes the effect of hyperkalemia on the myocardium, stabilizing the
cardiac membrane to prevent lethal arrhythmias while other methods work to lower the K+ level. 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
