NU 185
Exam 4 Medical-Surgical Nursing II Comprehensive
Practice
Exam 4 • 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 4 Medical-Surgical Nursing II Comprehensive Practice 2026/2027 UPDATE –
Galen
1. A patient with a history of heart failure is admitted with acute pulmonary edema. Which
hemodynamic finding would the nurse most likely expect?
A. PAOP (Pulmonary Artery Occlusion Pressure) of 22 mmHg
B. CVP (Central Venous Pressure) of 2 mmHg
C. Cardiac Index of 4.5 L/min/m2
D. SVR (Systemic Vascular Resistance) of 800 dynes/sec/cm-5
Answer: A
Rationale: Normal PAOP is 8-12 mmHg. An elevated PAOP (greater than 18 mmHg)
indicates left ventricular failure and fluid backing up into the lungs, leading to pulmonary
edema.
2. The nurse is caring for a patient in the exudative phase of Acute Respiratory Distress
Syndrome (ARDS). What is the primary pathophysiological change occurring at this stage?
A. Proliferation of type II pneumocytes and collagen formation
B. Increase in lung compliance and functional residual capacity
C. Resolution of pulmonary edema and restoration of gas exchange
D. Damage to the alveolar-capillary membrane and increased permeability
, Answer: D
Rationale: The exudative phase of ARDS is characterized by injury to the capillary
endothelium and alveolar epithelium, leading to leakage of protein-rich fluid into the
alveoli.
3. A patient with a T4 spinal cord injury suddenly reports a severe headache and blurred
vision. The BP is 190/110 mmHg. Which action should the nurse take first?
A. Place the patient in a high-Fowler’s position
B. Administer a prescribed bolus of IV hydralazine
C. Check the patient’s urinary catheter for kinks or blockage
D. Notify the rapid response team immediately
Answer: A
Rationale: The symptoms suggest autonomic dysreflexia. The first priority is to sit the
patient upright (high-Fowler’s) to help lower blood pressure via orthostatic mechanism
before searching for the cause.
4. Using the Parkland Formula, calculate the total fluid requirement for the first 24 hours for a
70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 11,200 mL
B. 8,400 mL
C. 5,600 mL
Exam 4 Medical-Surgical Nursing II Comprehensive
Practice
Exam 4 • 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 4 Medical-Surgical Nursing II Comprehensive Practice 2026/2027 UPDATE –
Galen
1. A patient with a history of heart failure is admitted with acute pulmonary edema. Which
hemodynamic finding would the nurse most likely expect?
A. PAOP (Pulmonary Artery Occlusion Pressure) of 22 mmHg
B. CVP (Central Venous Pressure) of 2 mmHg
C. Cardiac Index of 4.5 L/min/m2
D. SVR (Systemic Vascular Resistance) of 800 dynes/sec/cm-5
Answer: A
Rationale: Normal PAOP is 8-12 mmHg. An elevated PAOP (greater than 18 mmHg)
indicates left ventricular failure and fluid backing up into the lungs, leading to pulmonary
edema.
2. The nurse is caring for a patient in the exudative phase of Acute Respiratory Distress
Syndrome (ARDS). What is the primary pathophysiological change occurring at this stage?
A. Proliferation of type II pneumocytes and collagen formation
B. Increase in lung compliance and functional residual capacity
C. Resolution of pulmonary edema and restoration of gas exchange
D. Damage to the alveolar-capillary membrane and increased permeability
, Answer: D
Rationale: The exudative phase of ARDS is characterized by injury to the capillary
endothelium and alveolar epithelium, leading to leakage of protein-rich fluid into the
alveoli.
3. A patient with a T4 spinal cord injury suddenly reports a severe headache and blurred
vision. The BP is 190/110 mmHg. Which action should the nurse take first?
A. Place the patient in a high-Fowler’s position
B. Administer a prescribed bolus of IV hydralazine
C. Check the patient’s urinary catheter for kinks or blockage
D. Notify the rapid response team immediately
Answer: A
Rationale: The symptoms suggest autonomic dysreflexia. The first priority is to sit the
patient upright (high-Fowler’s) to help lower blood pressure via orthostatic mechanism
before searching for the cause.
4. Using the Parkland Formula, calculate the total fluid requirement for the first 24 hours for a
70 kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 11,200 mL
B. 8,400 mL
C. 5,600 mL
