NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 28
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 28 | 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 28 | 2026/2027 UPDATE
Question 1
A patient in the ICU with a suspected tension pneumothorax displays tracheal deviation to the left. Which clinical finding
should the nurse expect to observe first?
A. Diminished breath sounds on the right side
B. Hyperresonance on the left side
C. Bradycardia and hypertension
D. Flattened neck veins
Answer: A
Rationale
In a tension pneumothorax, air enters the pleural space but cannot escape, causing the affected lung to collapse and shifting
mediastinal structures to the opposite side. If the trachea deviates to the left, the pneumothorax is on the right, meaning breath
sounds will be absent or diminished on the right side.
Question 2
When assessing a patient with a suspected pheochromocytoma, which of the following assessments should the nurse
avoid?
A. Palpating the abdomen
B. Monitoring for orthostatic hypotension
C. Checking the blood glucose level
D. Measuring urinary catecholamines
Answer: A
Rationale
Palpation of the abdomen can cause a sudden release of catecholamines from the tumor, leading to a severe hypertensive
crisis in patients with pheochromocytoma. 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 patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical ventilation with High Positive
End-Expiratory Pressure (PEEP). The nurse should monitor for which adverse effect?
A. Increased cardiac output
B. Respiratory alkalosis
C. Decreased intracranial pressure
D. Pneumothorax due to barotrauma
Answer: D
Rationale
High levels of PEEP can lead to barotrauma (lung injury from pressure), potentially causing a pneumothorax or subcutaneous
emphysema. It also increases intrathoracic pressure, which can decrease venous return and cardiac output.
Page 3
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 28
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 28 | 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 28 | 2026/2027 UPDATE
Question 1
A patient in the ICU with a suspected tension pneumothorax displays tracheal deviation to the left. Which clinical finding
should the nurse expect to observe first?
A. Diminished breath sounds on the right side
B. Hyperresonance on the left side
C. Bradycardia and hypertension
D. Flattened neck veins
Answer: A
Rationale
In a tension pneumothorax, air enters the pleural space but cannot escape, causing the affected lung to collapse and shifting
mediastinal structures to the opposite side. If the trachea deviates to the left, the pneumothorax is on the right, meaning breath
sounds will be absent or diminished on the right side.
Question 2
When assessing a patient with a suspected pheochromocytoma, which of the following assessments should the nurse
avoid?
A. Palpating the abdomen
B. Monitoring for orthostatic hypotension
C. Checking the blood glucose level
D. Measuring urinary catecholamines
Answer: A
Rationale
Palpation of the abdomen can cause a sudden release of catecholamines from the tumor, leading to a severe hypertensive
crisis in patients with pheochromocytoma. 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 patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical ventilation with High Positive
End-Expiratory Pressure (PEEP). The nurse should monitor for which adverse effect?
A. Increased cardiac output
B. Respiratory alkalosis
C. Decreased intracranial pressure
D. Pneumothorax due to barotrauma
Answer: D
Rationale
High levels of PEEP can lead to barotrauma (lung injury from pressure), potentially causing a pneumothorax or subcutaneous
emphysema. It also increases intrathoracic pressure, which can decrease venous return and cardiac output.
Page 3
