NU 185
MEDICAL-SURGICAL NURSING II
Exam 4 Comprehensive Study Guide
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 4 Study Guide | 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 4 Study Guide | 2026/2027 UPDATE
Question 1
A patient with a T6 spinal cord injury reports a throbbing headache and is found to have a blood pressure of 210/110
mmHg. What is the nurse’s priority action?
A. Administer prescribed PRN hydralazine intravenously.
B. Perform a digital rectal exam to assess for fecal impaction.
C. Notify the rapid response team and prepare for intubation.
D. Place the patient in a high-Fowler’s position and check for bladder distension.
Answer: D
Rationale
Autonomic dysreflexia is a medical emergency. The priority is to sit the patient up to lower blood pressure and identify/remove
the noxious stimulus, usually a distended bladder or impacted bowel. 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
In the management of Acute Respiratory Distress Syndrome (ARDS), why is Positive End- Expiratory Pressure (PEEP)
utilized?
A. To increase the fraction of inspired oxygen (FiO2) without toxicity.
B. To prevent the occurrence of pneumothorax during mechanical ventilation.
C. To keep alveoli open and improve gas exchange across the alveolar-capillary membrane.
D. To decrease the work of breathing by providing pressure support during inspiration.
Answer: C
Rationale
PEEP prevents alveolar collapse at the end of expiration, increasing functional residual capacity and improving oxygenation in
patients with ARDS. 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 4 Comprehensive Study Guide
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 4 Study Guide | 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 4 Study Guide | 2026/2027 UPDATE
Question 1
A patient with a T6 spinal cord injury reports a throbbing headache and is found to have a blood pressure of 210/110
mmHg. What is the nurse’s priority action?
A. Administer prescribed PRN hydralazine intravenously.
B. Perform a digital rectal exam to assess for fecal impaction.
C. Notify the rapid response team and prepare for intubation.
D. Place the patient in a high-Fowler’s position and check for bladder distension.
Answer: D
Rationale
Autonomic dysreflexia is a medical emergency. The priority is to sit the patient up to lower blood pressure and identify/remove
the noxious stimulus, usually a distended bladder or impacted bowel. 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
In the management of Acute Respiratory Distress Syndrome (ARDS), why is Positive End- Expiratory Pressure (PEEP)
utilized?
A. To increase the fraction of inspired oxygen (FiO2) without toxicity.
B. To prevent the occurrence of pneumothorax during mechanical ventilation.
C. To keep alveoli open and improve gas exchange across the alveolar-capillary membrane.
D. To decrease the work of breathing by providing pressure support during inspiration.
Answer: C
Rationale
PEEP prevents alveolar collapse at the end of expiration, increasing functional residual capacity and improving oxygenation in
patients with ARDS. 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
