NU 185
Medical-Surgical Nursing II Exam
4 Comprehensive Assessment
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 Comprehensive Assessment 2026/2027 UPDATE –
Galen
1. A client with a history of COPD is admitted with acute respiratory failure. The ABG results
are: pH 7.28, PaCO2 52, HCO3 28. How should the nurse interpret these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated metabolic acidosis
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
high (compensatory mechanism), indicating partial compensation as the pH has not yet
returned to normal range.
2. The nurse is caring for a client with a chest tube following a lobectomy. Which observation
requires immediate intervention?
A. Continuous bubbling in the water-seal chamber
B. Intermittent bubbling in the water-seal chamber during coughing
C. Fluctuation of the water level in the water-seal chamber with respiration
D. Drainage of 70 mL of serosanguinous fluid in the first hour
, Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system, which requires immediate troubleshooting. Fluctuation (tidaling) and intermittent
bubbling during coughing are normal.
3. A client is in the compensatory stage of shock. Which clinical manifestation should the
nurse expect to find?
A. Decreased heart rate and increased urine output
B. Narrowing pulse pressure and cold, clammy skin
C. Metabolic acidosis and lethargy
D. Hypotension and anuria
Answer: B
Rationale: In the compensatory stage, the body attempts to maintain homeostasis through
vasoconstriction, resulting in narrowing pulse pressure and shunting of blood from the
skin (cold/clammy).
4. Which lab value is most critical for the nurse to monitor in a client receiving Total
Parenteral Nutrition (TPN)?
A. Serum sodium
B. Serum calcium
C. Serum glucose
Medical-Surgical Nursing II Exam
4 Comprehensive Assessment
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 Comprehensive Assessment 2026/2027 UPDATE –
Galen
1. A client with a history of COPD is admitted with acute respiratory failure. The ABG results
are: pH 7.28, PaCO2 52, HCO3 28. How should the nurse interpret these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Uncompensated metabolic acidosis
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
high (compensatory mechanism), indicating partial compensation as the pH has not yet
returned to normal range.
2. The nurse is caring for a client with a chest tube following a lobectomy. Which observation
requires immediate intervention?
A. Continuous bubbling in the water-seal chamber
B. Intermittent bubbling in the water-seal chamber during coughing
C. Fluctuation of the water level in the water-seal chamber with respiration
D. Drainage of 70 mL of serosanguinous fluid in the first hour
, Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system, which requires immediate troubleshooting. Fluctuation (tidaling) and intermittent
bubbling during coughing are normal.
3. A client is in the compensatory stage of shock. Which clinical manifestation should the
nurse expect to find?
A. Decreased heart rate and increased urine output
B. Narrowing pulse pressure and cold, clammy skin
C. Metabolic acidosis and lethargy
D. Hypotension and anuria
Answer: B
Rationale: In the compensatory stage, the body attempts to maintain homeostasis through
vasoconstriction, resulting in narrowing pulse pressure and shunting of blood from the
skin (cold/clammy).
4. Which lab value is most critical for the nurse to monitor in a client receiving Total
Parenteral Nutrition (TPN)?
A. Serum sodium
B. Serum calcium
C. Serum glucose
