NU 185
Medical-Surgical Nursing II Exam 2 Practice
Exam 2 • 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)
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,NU 185 Medical-Surgical Nursing II Exam 2 Practice 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
20 to 10 breaths/min and they are becoming lethargic. What is the priority nursing action?
A. Increase the oxygen flow to 4 L/min to improve oxygenation.
B. Document the finding as an expected outcome of oxygen therapy.
C. Change the delivery device to a Non-rebreather mask.
D. Initiate a Rapid Response and prepare for bag-valve-mask ventilation.
Answer: D
Rationale: In COPD patients, excessive oxygen can suppress the hypoxic drive, leading to
carbon dioxide retention and respiratory depression. A significant drop in respiratory rate
and lethargy indicates oxygen-induced hypoventilation, requiring immediate intervention.
2. Which assessment finding should the nurse prioritize in a patient diagnosed with a large
pulmonary embolism?
A. Bilateral crackles in the lung bases.
B. Occasional premature ventricular contractions (PVCs).
C. Sudden onset of hypotension and jugular venous distention.
D. Hemoptysis and pleuritic chest pain.
, Answer: C
Rationale: Hypotension and JVD in a patient with a PE suggest obstructive shock and right
ventricular failure (cor pulmonale), which is a life-threatening emergency compared to the
other localized respiratory symptoms.
3. The nurse is caring for a patient with left-sided heart failure. Which clinical manifestation is
most characteristic of this condition?
A. Paroxysmal nocturnal dyspnea (PND).
B. Dependent edema in the lower extremities.
C. Hepatosplenomegaly and ascites.
D. Jugular venous distention (JVD).
Answer: A
Rationale: Left-sided heart failure results in pulmonary congestion. PND, orthopnea, and
crackles are classic signs. The other options (A, B, D) are characteristic of right-sided heart
failure.
4. A patient with a history of atrial fibrillation is prescribed Warfarin. Which lab value
indicates the medication is at a therapeutic level?
A. aPTT of 60 seconds.
B. INR of 2.5.
C. Platelet count of 150,000/mm3.
Medical-Surgical Nursing II Exam 2 Practice
Exam 2 • 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 2 Practice 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
20 to 10 breaths/min and they are becoming lethargic. What is the priority nursing action?
A. Increase the oxygen flow to 4 L/min to improve oxygenation.
B. Document the finding as an expected outcome of oxygen therapy.
C. Change the delivery device to a Non-rebreather mask.
D. Initiate a Rapid Response and prepare for bag-valve-mask ventilation.
Answer: D
Rationale: In COPD patients, excessive oxygen can suppress the hypoxic drive, leading to
carbon dioxide retention and respiratory depression. A significant drop in respiratory rate
and lethargy indicates oxygen-induced hypoventilation, requiring immediate intervention.
2. Which assessment finding should the nurse prioritize in a patient diagnosed with a large
pulmonary embolism?
A. Bilateral crackles in the lung bases.
B. Occasional premature ventricular contractions (PVCs).
C. Sudden onset of hypotension and jugular venous distention.
D. Hemoptysis and pleuritic chest pain.
, Answer: C
Rationale: Hypotension and JVD in a patient with a PE suggest obstructive shock and right
ventricular failure (cor pulmonale), which is a life-threatening emergency compared to the
other localized respiratory symptoms.
3. The nurse is caring for a patient with left-sided heart failure. Which clinical manifestation is
most characteristic of this condition?
A. Paroxysmal nocturnal dyspnea (PND).
B. Dependent edema in the lower extremities.
C. Hepatosplenomegaly and ascites.
D. Jugular venous distention (JVD).
Answer: A
Rationale: Left-sided heart failure results in pulmonary congestion. PND, orthopnea, and
crackles are classic signs. The other options (A, B, D) are characteristic of right-sided heart
failure.
4. A patient with a history of atrial fibrillation is prescribed Warfarin. Which lab value
indicates the medication is at a therapeutic level?
A. aPTT of 60 seconds.
B. INR of 2.5.
C. Platelet count of 150,000/mm3.
