NU 185
Medical-Surgical Nursing II Exam
1 Advanced Study Quiz
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 Exam 1 Advanced Study Quiz 2026/2027 UPDATED – Galen
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via a
nasal cannula at 2 L/min. The nurse notes the patient’s respiratory rate has decreased from
18 to 10 breaths per minute and the patient is becoming lethargic. Which pathophysiological
process is likely occurring?
A. CO2 narcosis due to the elimination of the hypoxic drive
B. Oxygen toxicity affecting the lung parenchyma
C. Development of acute respiratory distress syndrome (ARDS)
D. Normal adaptation to increased oxygen saturation
Answer: A
Rationale: In some COPD patients, the respiratory center becomes insensitive to CO2, and
the drive to breathe is triggered by low oxygen levels. Providing too much oxygen can
eliminate this ‘hypoxic drive,’ leading to hypoventilation and CO2 retention (CO2 narcosis).
2. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and a cough with
hemoptysis. The nurse suspects a pulmonary embolism (PE). Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. D-dimer assay
B. Chest X-ray
, C. Computed tomography pulmonary angiography (CTPA)
D. Ventilation-perfusion (V/Q) scan
Answer: C
Rationale: CTPA is currently the preferred and most common diagnostic test for PE due to
its high sensitivity and specificity. While D-dimer is a screening tool and V/Q scans are used
when CT is contraindicated, CTPA is the gold standard.
3. When assessing a patient with a chest tube following a lobectomy, the nurse notes
continuous bubbling in the water-seal chamber. What is the priority nursing action?
A. Check the system for an air leak starting at the insertion site
B. Increase the suction pressure on the wall regulator
C. Document the finding as normal post-operative drainage
D. Clamp the chest tube immediately to prevent tension pneumothorax
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or the patient’s pleural space. Intermittent bubbling is normal during expiration or
coughing, but continuous bubbling requires troubleshooting for leaks.
Medical-Surgical Nursing II Exam
1 Advanced Study Quiz
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 Exam 1 Advanced Study Quiz 2026/2027 UPDATED – Galen
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via a
nasal cannula at 2 L/min. The nurse notes the patient’s respiratory rate has decreased from
18 to 10 breaths per minute and the patient is becoming lethargic. Which pathophysiological
process is likely occurring?
A. CO2 narcosis due to the elimination of the hypoxic drive
B. Oxygen toxicity affecting the lung parenchyma
C. Development of acute respiratory distress syndrome (ARDS)
D. Normal adaptation to increased oxygen saturation
Answer: A
Rationale: In some COPD patients, the respiratory center becomes insensitive to CO2, and
the drive to breathe is triggered by low oxygen levels. Providing too much oxygen can
eliminate this ‘hypoxic drive,’ leading to hypoventilation and CO2 retention (CO2 narcosis).
2. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and a cough with
hemoptysis. The nurse suspects a pulmonary embolism (PE). Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. D-dimer assay
B. Chest X-ray
, C. Computed tomography pulmonary angiography (CTPA)
D. Ventilation-perfusion (V/Q) scan
Answer: C
Rationale: CTPA is currently the preferred and most common diagnostic test for PE due to
its high sensitivity and specificity. While D-dimer is a screening tool and V/Q scans are used
when CT is contraindicated, CTPA is the gold standard.
3. When assessing a patient with a chest tube following a lobectomy, the nurse notes
continuous bubbling in the water-seal chamber. What is the priority nursing action?
A. Check the system for an air leak starting at the insertion site
B. Increase the suction pressure on the wall regulator
C. Document the finding as normal post-operative drainage
D. Clamp the chest tube immediately to prevent tension pneumothorax
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system or the patient’s pleural space. Intermittent bubbling is normal during expiration or
coughing, but continuous bubbling requires troubleshooting for leaks.
