NU 185
Exam 3 Medical-Surgical Nursing II
Advanced Critical Care and Complex Systems
Exam 3 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NU 185 Exam 3 | Medical-Surgical Nursing II | Advanced Critical Care and Complex Systems
2026/2027 UPDATE – Galen
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L.
Which medication should the nurse expect to administer first to protect the heart from
dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Regular insulin and D50W
D. Furosemide
Answer: B
Rationale: Calcium gluconate does not lower potassium but is administered first in severe
hyperkalemia to stabilize the myocardial cell membrane and prevent life-threatening
arrhythmias.
2. When assessing a patient with a chest tube, the nurse notes continuous bubbling in the
water-seal chamber. What is the nurse’s priority action?
A. Document this as a normal finding for a patient with a pneumothorax.
B. Check the system for an air leak.
C. Increase the suction pressure on the regulator.
, D. Clamp the chest tube immediately.
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or at the insertion site; intermittent bubbling is normal for a pneumothorax.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse notes a blood glucose of
650 mg/dL and a pH of 7.25. Which order should the nurse prioritize?
A. Administer Sodium Bicarbonate IV push.
B. Administer 10 units of Regular Insulin IV bolus.
C. Start a Potassium chloride infusion.
D. Begin an IV infusion of 0.9% Normal Saline.
Answer: D
Rationale: The first priority in DKA is fluid resuscitation to restore perfusion and dilute
glucose levels before insulin is administered.
4. A patient with a T4 spinal cord injury reports a sudden, severe pounding headache and is
found to have a blood pressure of 190/110 mmHg. What is the initial nursing action?
A. Administer an antihypertensive medication.
B. Check the patient’s bladder for distension.
C. Elevate the head of the bed to 45 to 90 degrees.
D. Assess for a fecal impaction.
Exam 3 Medical-Surgical Nursing II
Advanced Critical Care and Complex Systems
Exam 3 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NU 185 Exam 3 | Medical-Surgical Nursing II | Advanced Critical Care and Complex Systems
2026/2027 UPDATE – Galen
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L.
Which medication should the nurse expect to administer first to protect the heart from
dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Regular insulin and D50W
D. Furosemide
Answer: B
Rationale: Calcium gluconate does not lower potassium but is administered first in severe
hyperkalemia to stabilize the myocardial cell membrane and prevent life-threatening
arrhythmias.
2. When assessing a patient with a chest tube, the nurse notes continuous bubbling in the
water-seal chamber. What is the nurse’s priority action?
A. Document this as a normal finding for a patient with a pneumothorax.
B. Check the system for an air leak.
C. Increase the suction pressure on the regulator.
, D. Clamp the chest tube immediately.
Answer: B
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or at the insertion site; intermittent bubbling is normal for a pneumothorax.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). The nurse notes a blood glucose of
650 mg/dL and a pH of 7.25. Which order should the nurse prioritize?
A. Administer Sodium Bicarbonate IV push.
B. Administer 10 units of Regular Insulin IV bolus.
C. Start a Potassium chloride infusion.
D. Begin an IV infusion of 0.9% Normal Saline.
Answer: D
Rationale: The first priority in DKA is fluid resuscitation to restore perfusion and dilute
glucose levels before insulin is administered.
4. A patient with a T4 spinal cord injury reports a sudden, severe pounding headache and is
found to have a blood pressure of 190/110 mmHg. What is the initial nursing action?
A. Administer an antihypertensive medication.
B. Check the patient’s bladder for distension.
C. Elevate the head of the bed to 45 to 90 degrees.
D. Assess for a fecal impaction.
