NU 185
Exam 4 Medical-Surgical Nursing II Comprehensive
Review
Exam Review • High-Yield Practice
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 Review 2026/2027 UPDATED –
Galen
1. A patient with Chronic Kidney Disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which of the following is the priority intervention for the nurse to perform first?
A. Place the patient on a continuous cardiac monitor.
B. Prepare the patient for an emergency hemodialysis session.
C. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally.
D. Administer intravenous regular insulin and 50% dextrose.
Answer: A
Rationale: Hyperkalemia (K+ > 6.0) poses an immediate risk for lethal cardiac
arrhythmias. The nurse’s first priority is to monitor the heart’s rhythm to detect changes
like peaked T waves or widened QRS complexes while other treatments are being
prepared.
2. A patient in the emergent phase of a major burn injury has a blood pressure of 88/50
mmHg and a heart rate of 120 bpm. Which pathophysiology explains these findings?
A. Increased systemic vascular resistance due to catecholamine release.
B. Decreased cardiac output due to burn-induced myocardial depression.
C. Hypovolemia resulting from excessive evaporative water loss.
, D. Fluid shift from the intravascular to the interstitial space.
Answer: D
Rationale: During the emergent phase (first 24-48 hours), increased capillary permeability
causes a massive fluid shift (third-spacing) from the intravascular space to the interstitial
space, leading to hypovolemic shock.
3. Which arterial blood gas (ABG) result would the nurse expect to find in a patient who is in
the early stages of Septic Shock?
A. pH 7.32, PaCO2 48, HCO3 24
B. pH 7.35, PaCO2 40, HCO3 24
C. pH 7.25, PaCO2 35, HCO3 18
D. pH 7.49, PaCO2 30, HCO3 22
Answer: D
Rationale: Early septic shock often causes respiratory alkalosis due to tachypnea and
hyperventilation as the body attempts to compensate for early cellular hypoxia.
4. A nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory finding is consistent with this diagnosis?
A. Serum sodium 128 mEq/L
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
Exam 4 Medical-Surgical Nursing II Comprehensive
Review
Exam Review • High-Yield Practice
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 Review 2026/2027 UPDATED –
Galen
1. A patient with Chronic Kidney Disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which of the following is the priority intervention for the nurse to perform first?
A. Place the patient on a continuous cardiac monitor.
B. Prepare the patient for an emergency hemodialysis session.
C. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally.
D. Administer intravenous regular insulin and 50% dextrose.
Answer: A
Rationale: Hyperkalemia (K+ > 6.0) poses an immediate risk for lethal cardiac
arrhythmias. The nurse’s first priority is to monitor the heart’s rhythm to detect changes
like peaked T waves or widened QRS complexes while other treatments are being
prepared.
2. A patient in the emergent phase of a major burn injury has a blood pressure of 88/50
mmHg and a heart rate of 120 bpm. Which pathophysiology explains these findings?
A. Increased systemic vascular resistance due to catecholamine release.
B. Decreased cardiac output due to burn-induced myocardial depression.
C. Hypovolemia resulting from excessive evaporative water loss.
, D. Fluid shift from the intravascular to the interstitial space.
Answer: D
Rationale: During the emergent phase (first 24-48 hours), increased capillary permeability
causes a massive fluid shift (third-spacing) from the intravascular space to the interstitial
space, leading to hypovolemic shock.
3. Which arterial blood gas (ABG) result would the nurse expect to find in a patient who is in
the early stages of Septic Shock?
A. pH 7.32, PaCO2 48, HCO3 24
B. pH 7.35, PaCO2 40, HCO3 24
C. pH 7.25, PaCO2 35, HCO3 18
D. pH 7.49, PaCO2 30, HCO3 22
Answer: D
Rationale: Early septic shock often causes respiratory alkalosis due to tachypnea and
hyperventilation as the body attempts to compensate for early cellular hypoxia.
4. A nurse is caring for a patient with Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which laboratory finding is consistent with this diagnosis?
A. Serum sodium 128 mEq/L
B. Serum osmolality 310 mOsm/kg
C. Urine specific gravity 1.002
