NU 185
Medical-Surgical Nursing II Exam 3 Study Guide
Exam 3 • 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 3 Study Guide 2026/2027 UPDATED – Galen
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L.
Which electrocardiogram (ECG) change should the nurse prioritize for immediate
intervention?
A. Tall, peaked T waves
B. Prominent U waves
C. Shortened PR interval
D. ST-segment depression
Answer: A
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) causes peaked T waves, widening QRS
complexes, and potentially V-fib. U waves are seen in hypokalemia.
2. When assessing a patient with a suspected pulmonary embolism (PE), which clinical finding
is most suggestive of an obstructive shock state?
A. Bradycardia and hypertension
B. Increased Pulmonary Artery Wedge Pressure (PAWP)
C. Peripheral vasodilation and warm extremities
D. Increased Central Venous Pressure (CVP) with decreased Cardiac Output (CO)
, Answer: D
Rationale: Obstructive shock from a massive PE causes right heart strain, increasing CVP
while decreasing the output to the left side of the heart.
3. A nurse is caring for a patient on mechanical ventilation with Positive End-Expiratory
Pressure (PEEP) of 15 cm H2O. Which complication should the nurse monitor for most
closely?
A. Respiratory alkalosis
B. Increased venous return
C. Pneumothorax due to barotrauma
D. Hypervolemia
Answer: C
Rationale: High levels of PEEP increase the risk of barotrauma, which can lead to a
pneumothorax or subcutaneous emphysema.
4. A patient in the oliguric phase of Acute Kidney Injury (AKI) has a 24-hour urine output of
350 mL. Which acid-base imbalance is the nurse most likely to observe in the laboratory
results?
A. Respiratory Alkalosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
Medical-Surgical Nursing II Exam 3 Study Guide
Exam 3 • 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 3 Study Guide 2026/2027 UPDATED – Galen
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L.
Which electrocardiogram (ECG) change should the nurse prioritize for immediate
intervention?
A. Tall, peaked T waves
B. Prominent U waves
C. Shortened PR interval
D. ST-segment depression
Answer: A
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) causes peaked T waves, widening QRS
complexes, and potentially V-fib. U waves are seen in hypokalemia.
2. When assessing a patient with a suspected pulmonary embolism (PE), which clinical finding
is most suggestive of an obstructive shock state?
A. Bradycardia and hypertension
B. Increased Pulmonary Artery Wedge Pressure (PAWP)
C. Peripheral vasodilation and warm extremities
D. Increased Central Venous Pressure (CVP) with decreased Cardiac Output (CO)
, Answer: D
Rationale: Obstructive shock from a massive PE causes right heart strain, increasing CVP
while decreasing the output to the left side of the heart.
3. A nurse is caring for a patient on mechanical ventilation with Positive End-Expiratory
Pressure (PEEP) of 15 cm H2O. Which complication should the nurse monitor for most
closely?
A. Respiratory alkalosis
B. Increased venous return
C. Pneumothorax due to barotrauma
D. Hypervolemia
Answer: C
Rationale: High levels of PEEP increase the risk of barotrauma, which can lead to a
pneumothorax or subcutaneous emphysema.
4. A patient in the oliguric phase of Acute Kidney Injury (AKI) has a 24-hour urine output of
350 mL. Which acid-base imbalance is the nurse most likely to observe in the laboratory
results?
A. Respiratory Alkalosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
