NU 185
MEDICAL-SURGICAL NURSING II
Exam 3 Comprehensive Review
UPDATE
51 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 patient with SIADH is presenting with a serum sodium level of 118 mEq/L. Which nursing intervention is the highest
priority?
A. Administering a bolus of 0.45% normal saline
B. Encouraging increased intake of oral free water
C. Implementing seizure precautions and limiting fluid intake
D. Administering subcutaneous vasopressin as ordered
Answer: C
Rationale
In SIADH, excessive ADH leads to water retention and dilutional hyponatremia. A sodium level of 118 mEq/L puts the patient
at high risk for cerebral edema and seizures. Fluid restriction is the primary treatment, and safety (seizure precautions) is the
priority.
Question 2
A patient who underwent a transsphenoidal hypophysectomy for a pituitary tumor reports a persistent ‘salty taste’ in the
back of their throat and a frequent urge to swallow. What should the nurse do first?
A. Test the drainage for glucose using a reagent strip
B. Position the patient in a flat supine position
C. Apply a pressure dressing to the nasal area
D. Administer an oral analgesic for post-operative pain
Answer: A
Rationale
Frequent swallowing or a salty taste after this surgery suggests a Cerebrospinal Fluid (CSF) leak. CSF contains glucose, and
testing the drainage can help confirm the leak. The patient should be kept in a high-Fowler’s position, not supine.
Question 3
Which clinical manifestation would the nurse expect to find in a patient experiencing an Addisonian crisis?
A. Bradycardia, truncal obesity, and moon face
B. Hypertension, hypokalemia, and hyperglycemia
C. Severe hypotension, hyperkalemia, and hypoglycemia
D. Polyuria, polydipsia, and low urine specific gravity
Answer: C
Rationale
Addisonian crisis is an acute adrenal insufficiency resulting in a critical lack of cortisol and aldosterone. This leads to profound
hypotension (due to fluid loss), hyperkalemia (due to lack of aldosterone), and hypoglycemia (due to lack of cortisol).
Page 3
MEDICAL-SURGICAL NURSING II
Exam 3 Comprehensive Review
UPDATE
51 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 patient with SIADH is presenting with a serum sodium level of 118 mEq/L. Which nursing intervention is the highest
priority?
A. Administering a bolus of 0.45% normal saline
B. Encouraging increased intake of oral free water
C. Implementing seizure precautions and limiting fluid intake
D. Administering subcutaneous vasopressin as ordered
Answer: C
Rationale
In SIADH, excessive ADH leads to water retention and dilutional hyponatremia. A sodium level of 118 mEq/L puts the patient
at high risk for cerebral edema and seizures. Fluid restriction is the primary treatment, and safety (seizure precautions) is the
priority.
Question 2
A patient who underwent a transsphenoidal hypophysectomy for a pituitary tumor reports a persistent ‘salty taste’ in the
back of their throat and a frequent urge to swallow. What should the nurse do first?
A. Test the drainage for glucose using a reagent strip
B. Position the patient in a flat supine position
C. Apply a pressure dressing to the nasal area
D. Administer an oral analgesic for post-operative pain
Answer: A
Rationale
Frequent swallowing or a salty taste after this surgery suggests a Cerebrospinal Fluid (CSF) leak. CSF contains glucose, and
testing the drainage can help confirm the leak. The patient should be kept in a high-Fowler’s position, not supine.
Question 3
Which clinical manifestation would the nurse expect to find in a patient experiencing an Addisonian crisis?
A. Bradycardia, truncal obesity, and moon face
B. Hypertension, hypokalemia, and hyperglycemia
C. Severe hypotension, hyperkalemia, and hypoglycemia
D. Polyuria, polydipsia, and low urine specific gravity
Answer: C
Rationale
Addisonian crisis is an acute adrenal insufficiency resulting in a critical lack of cortisol and aldosterone. This leads to profound
hypotension (due to fluid loss), hyperkalemia (due to lack of aldosterone), and hypoglycemia (due to lack of cortisol).
Page 3
