NU 185
Medical-Surgical Nursing II Exam 4 (2026)
Exam 4 • 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 4 (2026) UPDATED – Galen
1. A patient with Acute Kidney Injury (AKI) has a potassium level of 6.8 mEq/L and the ECG
shows peaked T waves. Which intervention is the highest priority?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Begin a scheduled dose of Furosemide (Lasix)
C. Administer Calcium Gluconate intravenously
D. Provide a low-potassium diet tray
Answer: C
Rationale: Intravenous calcium gluconate is the priority because it stabilizes the
myocardial muscle cell membrane to prevent lethal dysrhythmias caused by severe
hyperkalemia.
2. When assessing a patient with a T6 spinal cord injury, the nurse notes a blood pressure of
190/100 mmHg, a severe headache, and flushing above the level of injury. What is the
immediate nursing action?
A. Administer an antihypertensive medication
B. Place the patient in a supine position
C. Assess the patient for bladder distention
D. Notify the physician immediately
, Answer: C
Rationale: These are signs of Autonomic Dysreflexia, often caused by a full bladder or
impacted bowel. The first action is to identify and alleviate the stimulus while sitting the
patient up.
3. A patient in the compensatory stage of shock would exhibit which of the following clinical
manifestations?
A. Hypotension and bradycardia
B. Metabolic acidosis and cold, clammy skin
C. Anuria and lethargy
D. Narrowed pulse pressure and tachycardia
Answer: D
Rationale: In the compensatory stage, the body uses the sympathetic nervous system to
maintain cardiac output, leading to a narrowed pulse pressure and increased heart rate.
4. Which laboratory finding is most indicative of the ‘Cold Phase’ (Late/Hypodynamic) of
Septic Shock?
A. Decreased Mixed Venous Oxygen Saturation (SvO2)
B. Low Central Venous Pressure (CVP)
C. Hyperglycemia
D. Increased Cardiac Output
Medical-Surgical Nursing II Exam 4 (2026)
Exam 4 • 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 4 (2026) UPDATED – Galen
1. A patient with Acute Kidney Injury (AKI) has a potassium level of 6.8 mEq/L and the ECG
shows peaked T waves. Which intervention is the highest priority?
A. Administer Sodium Polystyrene Sulfonate (Kayexalate) orally
B. Begin a scheduled dose of Furosemide (Lasix)
C. Administer Calcium Gluconate intravenously
D. Provide a low-potassium diet tray
Answer: C
Rationale: Intravenous calcium gluconate is the priority because it stabilizes the
myocardial muscle cell membrane to prevent lethal dysrhythmias caused by severe
hyperkalemia.
2. When assessing a patient with a T6 spinal cord injury, the nurse notes a blood pressure of
190/100 mmHg, a severe headache, and flushing above the level of injury. What is the
immediate nursing action?
A. Administer an antihypertensive medication
B. Place the patient in a supine position
C. Assess the patient for bladder distention
D. Notify the physician immediately
, Answer: C
Rationale: These are signs of Autonomic Dysreflexia, often caused by a full bladder or
impacted bowel. The first action is to identify and alleviate the stimulus while sitting the
patient up.
3. A patient in the compensatory stage of shock would exhibit which of the following clinical
manifestations?
A. Hypotension and bradycardia
B. Metabolic acidosis and cold, clammy skin
C. Anuria and lethargy
D. Narrowed pulse pressure and tachycardia
Answer: D
Rationale: In the compensatory stage, the body uses the sympathetic nervous system to
maintain cardiac output, leading to a narrowed pulse pressure and increased heart rate.
4. Which laboratory finding is most indicative of the ‘Cold Phase’ (Late/Hypodynamic) of
Septic Shock?
A. Decreased Mixed Venous Oxygen Saturation (SvO2)
B. Low Central Venous Pressure (CVP)
C. Hyperglycemia
D. Increased Cardiac Output
