NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 23
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 23 | 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 23 | 2026/2027 UPDATE
Question 1
A patient with ARDS is on mechanical ventilation with high PEEP. The nurse notes a sudden drop in blood pressure
and absent breath sounds on the right side. What is the priority action?
A. Increase the PEEP setting
B. Prepare for chest tube insertion
C. Suction the endotracheal tube
D. Obtain a 12-lead ECG
Answer: B
Rationale
High PEEP can cause barotrauma, leading to a tension pneumothorax. Absent breath sounds and hypotension indicate a
pneumothorax requiring immediate decompression via chest tube. 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
A patient in the oliguric phase of AKI has a potassium level of 6.8 mEq/L. Which ECG change should the nurse expect?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged QT interval
Answer: C
Rationale
Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves, widened QRS complexes, and eventually cardiac arrest.
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 23
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 23 | 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 23 | 2026/2027 UPDATE
Question 1
A patient with ARDS is on mechanical ventilation with high PEEP. The nurse notes a sudden drop in blood pressure
and absent breath sounds on the right side. What is the priority action?
A. Increase the PEEP setting
B. Prepare for chest tube insertion
C. Suction the endotracheal tube
D. Obtain a 12-lead ECG
Answer: B
Rationale
High PEEP can cause barotrauma, leading to a tension pneumothorax. Absent breath sounds and hypotension indicate a
pneumothorax requiring immediate decompression via chest tube. 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
A patient in the oliguric phase of AKI has a potassium level of 6.8 mEq/L. Which ECG change should the nurse expect?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Prolonged QT interval
Answer: C
Rationale
Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves, widened QRS complexes, and eventually cardiac arrest.
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
