NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 21
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 21 | 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 21 | 2026/2027 UPDATE
Question 1
A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L and the ECG shows peaked
T-waves. Which medication should the nurse prioritize to protect the myocardium before attempting to lower the
potassium?
A. Sodium polystyrene sulfonate
B. Regular insulin with D50
C. Calcium gluconate
D. Sodium bicarbonate
Answer: C
Rationale
Calcium gluconate is administered intravenously in hyperkalemic emergencies to stabilize the myocardial cell membrane and
prevent life-threatening arrhythmias, even though it does not lower the potassium level itself. 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 2
The nurse is caring for a patient in the oliguric phase of AKI. Which clinical finding is the most reliable indicator of fluid
volume excess?
A. Distended neck veins while sitting at 45 degrees
B. Pitting edema in the lower extremities
C. Crackles at the lung bases
D. Weight gain of 1 kg in 24 hours
Answer: D
Rationale
Daily weight is the most accurate and reliable indicator of fluid status; 1 kg of weight gain is equivalent to approximately 1000
mL of fluid retention. 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 21
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 21 | 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 21 | 2026/2027 UPDATE
Question 1
A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L and the ECG shows peaked
T-waves. Which medication should the nurse prioritize to protect the myocardium before attempting to lower the
potassium?
A. Sodium polystyrene sulfonate
B. Regular insulin with D50
C. Calcium gluconate
D. Sodium bicarbonate
Answer: C
Rationale
Calcium gluconate is administered intravenously in hyperkalemic emergencies to stabilize the myocardial cell membrane and
prevent life-threatening arrhythmias, even though it does not lower the potassium level itself. 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 2
The nurse is caring for a patient in the oliguric phase of AKI. Which clinical finding is the most reliable indicator of fluid
volume excess?
A. Distended neck veins while sitting at 45 degrees
B. Pitting edema in the lower extremities
C. Crackles at the lung bases
D. Weight gain of 1 kg in 24 hours
Answer: D
Rationale
Daily weight is the most accurate and reliable indicator of fluid status; 1 kg of weight gain is equivalent to approximately 1000
mL of fluid retention. 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
