• NUR 6001 09/15/2026
NU 185 Medical-Surgical Nursing II Comprehensive
Exam Prep Comprehensive Study Guide
UPDATE Actual Questions & Verified Answers with
Detailed Clinical Rationales
A patient with pneumonia in the right lower lobe is prescribed percussion and postural drainage. When
performing percussion and postural drainage, the nurse should position him:
A. in semi-Fowler's position with his knees bent.
B. in a right side-lying position with the foot of his bed elevated.
C. in a prone or supine position with the foot of his bed elevated higher than his head.
D. bent at the waist leaning slightly forward. –
Correct Answer :C. in a prone or supine position with the foot of his bed elevated higher than his head.
Rationale: The aim of percussion and postural drainage is to mobilize pulmonary secretions,
so they can be effectively expectorated. When a patient has pneumonia in the right lower lobe, the nurse should
position him with his right side up or lower lobes elevated above the upper lobes so that gravity can help
P 1
, • NUR 6001 09/15/2026
mobilize pulmonary secretions. Options A and D are incorrect because semi-Fowler's position and being bent
forward at the waist would hamper mobilization of secretions from the right lower lobe.
Option B is incorrect because the patient should be positioned with his right side up.
A patient with acquired immunodefi ciency syndrome (AIDS) develops P. jiroveci pneumonia. Which
nursing diagnosis has the highest priority for this patient?
A. Impaired gas exchange
B. Impaired oral mucous membranes
C. Imbalanced nutrition: Less than body requirements
D. Activity intolerance - Correct Answer :A. Impaired gas exchange
Rationale: Although all these nursing diagnoses are appropriate for a patient with AIDS,
Impaired gas exchange is the priority nursing diagnosis for the patient with P. jiroveci pneumonia.
Airway,breathing, and circulation take top priority for any patient.
A patient has chronic bronchitis. The nurse is teaching him breathing exercises. Which point should the
nurse include in her teaching?
A. Make inhalation longer than exhalation.
B. Exhale through an open mouth.
C. Use diaphragmatic breathing.
D. Use chest breathing. - Correct Answer :C. Use diaphragmatic breathing.
Rationale: In patients with chronic bronchitis, the diaphragm is fl at and weak. Diaphragmatic
breathing helps to strengthen the diaphragm and maximizes ventilation. Option A is incorrect because
exhalation should be no longer than inhalation to prevent collapse of the bronchioles. Because a patient with
chronic bronchitis should exhale through pursed lips to prolong expiration, keep the bronchioles from collapsing,
and prevent air trapping, Option B is incorrect. Option D is incorrect because diaphragmatic breathing, not chest
breathing, increases lung expansion
A patient with ARDS is intubated and placed on mechanical ventilation. His Pao2 is 60 mm Hg on 1.0 Fio2
P 2
, • NUR 6001 09/15/2026
To improve his Pao2 without ra ising the Fio2,the patient will most likely be placed on:
A. time-cycled ventilation.
B. volume-cycled ventilation.
C. pressure support.
D. PEEP. - Correct Answer :D. PEEP.
Rationale: PEEP is widely used during mechanical ventilation of the patient with ARDS to improve gas exchange
over the alveolar capillary membrane. Time- or volume-cycled ventilation,
Options A and B, are less likely to be used for a patient with ARDS than pressure-cycled ventilation. Pressure
support, Option C, depends on the patient's inspiratory effort and isn't as effective as PEEP in treating ARDS.
When auscultating the chest of a patient with pneumonia, the nurse should expect to hear which type of sounds
over areas of consolidation?
A. Bronchial
B. Bronchovesicular
C. Tubular
D. Vesicular - Correct Answer :A. Bronchial
Rationale: Chest auscultation reveals bronchial breath sounds over areas of consolidation.
Bronchovesicular breath sounds (Option B) are normal over midlobe lung regions, tubular sounds (Option C) are
commonly heard over large airways, and vesicular breath sounds (Option D) are commonly heard in the bases of
the lung fields.
A patient's history reveals that he suffers from daytime symptoms of asthma that occur 3 to 6 days a week.
How would his asthma severity be described?
A. Mild intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent - Correct Answer :B. Mild persistent
P 3
, • NUR 6001 09/15/2026
Rationale: In mild persistent asthma, the patient's daytime symptoms of asthma occur 3 to 6 days a week. In
mild intermittent asthma (Option A), the patient's daytime symptoms occur no more than twice a week. In
moderate persistent asthma (Option C), the patient has daily daytime symptoms. In severe persistent asthma
(Option D), the patient has continual daytime symptoms.
A 66-year-old patient has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He is
tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his
knees to support his chest and shoulders for breathing. This patient has signs and symptoms of which
respiratory
disorder?
A. ARDS
B. Asthma
C. Chronic obstructive bronchitis
D. Emphysema - Correct Answer :D. Emphysema
Rationale: These are classic signs and symptoms of a patient with emphysema. Patients with ARDS (Option A)
are acutely short of breath and require emergency care; those with asthma (option B) are also acutely short of
breath during an attack and appear very frightened. Patients with chronic obstructive bronchitis (Option C)
appear bloated and cyanotic
A nurse is preparing to reinforce the teaching plan for a patient who has recently been diagnosed with
squamous cell carcinoma of the left lung. Which statement by the nurse is correct?
A. "You have a slow-growing cancer that rarely spreads."
B. "In terms of prognosis, you may have only a few months to live."
C. "Squamous cell cancer is a very rapidly growing cancer."
D. "The cancer has generally metastasized by the time diagnosis is made." - Correct Answer :A. "You have a
slow-growing cancer that rarely spreads."
Rationale: Squamous cell carcinoma is a type of cancer that grows slowly and rarely metastasizes.
It has the best prognosis of all lung cancer types. It's not appropriate for the nurse to tell the patient how long
he has to live (Option B). Squamous cell carcinoma does not grow rapidly (Option C) and rarely metastasizes
(Option D).
P 4
NU 185 Medical-Surgical Nursing II Comprehensive
Exam Prep Comprehensive Study Guide
UPDATE Actual Questions & Verified Answers with
Detailed Clinical Rationales
A patient with pneumonia in the right lower lobe is prescribed percussion and postural drainage. When
performing percussion and postural drainage, the nurse should position him:
A. in semi-Fowler's position with his knees bent.
B. in a right side-lying position with the foot of his bed elevated.
C. in a prone or supine position with the foot of his bed elevated higher than his head.
D. bent at the waist leaning slightly forward. –
Correct Answer :C. in a prone or supine position with the foot of his bed elevated higher than his head.
Rationale: The aim of percussion and postural drainage is to mobilize pulmonary secretions,
so they can be effectively expectorated. When a patient has pneumonia in the right lower lobe, the nurse should
position him with his right side up or lower lobes elevated above the upper lobes so that gravity can help
P 1
, • NUR 6001 09/15/2026
mobilize pulmonary secretions. Options A and D are incorrect because semi-Fowler's position and being bent
forward at the waist would hamper mobilization of secretions from the right lower lobe.
Option B is incorrect because the patient should be positioned with his right side up.
A patient with acquired immunodefi ciency syndrome (AIDS) develops P. jiroveci pneumonia. Which
nursing diagnosis has the highest priority for this patient?
A. Impaired gas exchange
B. Impaired oral mucous membranes
C. Imbalanced nutrition: Less than body requirements
D. Activity intolerance - Correct Answer :A. Impaired gas exchange
Rationale: Although all these nursing diagnoses are appropriate for a patient with AIDS,
Impaired gas exchange is the priority nursing diagnosis for the patient with P. jiroveci pneumonia.
Airway,breathing, and circulation take top priority for any patient.
A patient has chronic bronchitis. The nurse is teaching him breathing exercises. Which point should the
nurse include in her teaching?
A. Make inhalation longer than exhalation.
B. Exhale through an open mouth.
C. Use diaphragmatic breathing.
D. Use chest breathing. - Correct Answer :C. Use diaphragmatic breathing.
Rationale: In patients with chronic bronchitis, the diaphragm is fl at and weak. Diaphragmatic
breathing helps to strengthen the diaphragm and maximizes ventilation. Option A is incorrect because
exhalation should be no longer than inhalation to prevent collapse of the bronchioles. Because a patient with
chronic bronchitis should exhale through pursed lips to prolong expiration, keep the bronchioles from collapsing,
and prevent air trapping, Option B is incorrect. Option D is incorrect because diaphragmatic breathing, not chest
breathing, increases lung expansion
A patient with ARDS is intubated and placed on mechanical ventilation. His Pao2 is 60 mm Hg on 1.0 Fio2
P 2
, • NUR 6001 09/15/2026
To improve his Pao2 without ra ising the Fio2,the patient will most likely be placed on:
A. time-cycled ventilation.
B. volume-cycled ventilation.
C. pressure support.
D. PEEP. - Correct Answer :D. PEEP.
Rationale: PEEP is widely used during mechanical ventilation of the patient with ARDS to improve gas exchange
over the alveolar capillary membrane. Time- or volume-cycled ventilation,
Options A and B, are less likely to be used for a patient with ARDS than pressure-cycled ventilation. Pressure
support, Option C, depends on the patient's inspiratory effort and isn't as effective as PEEP in treating ARDS.
When auscultating the chest of a patient with pneumonia, the nurse should expect to hear which type of sounds
over areas of consolidation?
A. Bronchial
B. Bronchovesicular
C. Tubular
D. Vesicular - Correct Answer :A. Bronchial
Rationale: Chest auscultation reveals bronchial breath sounds over areas of consolidation.
Bronchovesicular breath sounds (Option B) are normal over midlobe lung regions, tubular sounds (Option C) are
commonly heard over large airways, and vesicular breath sounds (Option D) are commonly heard in the bases of
the lung fields.
A patient's history reveals that he suffers from daytime symptoms of asthma that occur 3 to 6 days a week.
How would his asthma severity be described?
A. Mild intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent - Correct Answer :B. Mild persistent
P 3
, • NUR 6001 09/15/2026
Rationale: In mild persistent asthma, the patient's daytime symptoms of asthma occur 3 to 6 days a week. In
mild intermittent asthma (Option A), the patient's daytime symptoms occur no more than twice a week. In
moderate persistent asthma (Option C), the patient has daily daytime symptoms. In severe persistent asthma
(Option D), the patient has continual daytime symptoms.
A 66-year-old patient has marked dyspnea at rest, is thin, and uses accessory muscles to breathe. He is
tachypneic, with a prolonged expiratory phase. He has no cough. He leans forward with his arms braced on his
knees to support his chest and shoulders for breathing. This patient has signs and symptoms of which
respiratory
disorder?
A. ARDS
B. Asthma
C. Chronic obstructive bronchitis
D. Emphysema - Correct Answer :D. Emphysema
Rationale: These are classic signs and symptoms of a patient with emphysema. Patients with ARDS (Option A)
are acutely short of breath and require emergency care; those with asthma (option B) are also acutely short of
breath during an attack and appear very frightened. Patients with chronic obstructive bronchitis (Option C)
appear bloated and cyanotic
A nurse is preparing to reinforce the teaching plan for a patient who has recently been diagnosed with
squamous cell carcinoma of the left lung. Which statement by the nurse is correct?
A. "You have a slow-growing cancer that rarely spreads."
B. "In terms of prognosis, you may have only a few months to live."
C. "Squamous cell cancer is a very rapidly growing cancer."
D. "The cancer has generally metastasized by the time diagnosis is made." - Correct Answer :A. "You have a
slow-growing cancer that rarely spreads."
Rationale: Squamous cell carcinoma is a type of cancer that grows slowly and rarely metastasizes.
It has the best prognosis of all lung cancer types. It's not appropriate for the nurse to tell the patient how long
he has to live (Option B). Squamous cell carcinoma does not grow rapidly (Option C) and rarely metastasizes
(Option D).
P 4
