NU 185
Medical-Surgical Nursing II - Advanced Comprehensive Ex
1
Exam 1 • 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 Medical-Surgical Nursing II - Advanced Comprehensive Exam 1 2026/2027 UPDATED –
Galen
1. A patient with ARDS is being mechanically ventilated with high PEEP. The nurse notes a
sudden drop in blood pressure and decreased breath sounds on the right side. What is the
priority intervention?
A. Increase the PEEP setting to improve oxygenation
B. Administer a bolus of intravenous fluids
C. Perform immediate needle decompression or prepare for chest tube insertion
D. Obtain a stat arterial blood gas (ABG) sample
Answer: C
Rationale: High PEEP levels increase the risk of barotrauma, such as tension
pneumothorax. A sudden drop in BP and unilateral decreased breath sounds are classic
signs, requiring immediate decompression.
2. A patient’s ABG results are: pH 7.28, PaCO2 55 mmHg, HCO3 28 mEq/L. Which
interpretation is correct?
A. Compensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Uncompensated respiratory alkalosis
, D. Fully compensated metabolic alkalosis
Answer: B
Rationale: The pH is acidic (< 7.35), PaCO2 is high (respiratory cause), and HCO3 is
elevated (indicating the kidneys are attempting to compensate), but since pH is not normal,
it is partially compensated.
3. When assessing a patient with a pulmonary artery catheter, the nurse notes a CVP of 12
mmHg and a PAWP of 18 mmHg. Which condition does this most likely indicate?
A. Hypovolemic shock
B. Dehydration
C. Septic shock (early phase)
D. Hypervolemia or Left-sided heart failure
Answer: D
Rationale: Elevated CVP (normal 2-8) and elevated PAWP (normal 6-12) indicate fluid
volume overload or cardiac pump failure leading to high pressures in the heart chambers.
4. A patient in the ICU is experiencing sustained Ventricular Tachycardia but remains
conscious with a palpable pulse. What is the first-line medical intervention?
A. Immediate unsynchronized defibrillation
B. Administration of Adenosine rapid IV push
C. Administration of Epinephrine 1mg IV
Medical-Surgical Nursing II - Advanced Comprehensive Ex
1
Exam 1 • 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 Medical-Surgical Nursing II - Advanced Comprehensive Exam 1 2026/2027 UPDATED –
Galen
1. A patient with ARDS is being mechanically ventilated with high PEEP. The nurse notes a
sudden drop in blood pressure and decreased breath sounds on the right side. What is the
priority intervention?
A. Increase the PEEP setting to improve oxygenation
B. Administer a bolus of intravenous fluids
C. Perform immediate needle decompression or prepare for chest tube insertion
D. Obtain a stat arterial blood gas (ABG) sample
Answer: C
Rationale: High PEEP levels increase the risk of barotrauma, such as tension
pneumothorax. A sudden drop in BP and unilateral decreased breath sounds are classic
signs, requiring immediate decompression.
2. A patient’s ABG results are: pH 7.28, PaCO2 55 mmHg, HCO3 28 mEq/L. Which
interpretation is correct?
A. Compensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Uncompensated respiratory alkalosis
, D. Fully compensated metabolic alkalosis
Answer: B
Rationale: The pH is acidic (< 7.35), PaCO2 is high (respiratory cause), and HCO3 is
elevated (indicating the kidneys are attempting to compensate), but since pH is not normal,
it is partially compensated.
3. When assessing a patient with a pulmonary artery catheter, the nurse notes a CVP of 12
mmHg and a PAWP of 18 mmHg. Which condition does this most likely indicate?
A. Hypovolemic shock
B. Dehydration
C. Septic shock (early phase)
D. Hypervolemia or Left-sided heart failure
Answer: D
Rationale: Elevated CVP (normal 2-8) and elevated PAWP (normal 6-12) indicate fluid
volume overload or cardiac pump failure leading to high pressures in the heart chambers.
4. A patient in the ICU is experiencing sustained Ventricular Tachycardia but remains
conscious with a palpable pulse. What is the first-line medical intervention?
A. Immediate unsynchronized defibrillation
B. Administration of Adenosine rapid IV push
C. Administration of Epinephrine 1mg IV
