• 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 client with a history of heart failure is being discharged. Which priority instruction will assist the client in the
prevention of complications associated with heart failure?
A) "Eat six small meals daily instead of three larger meals."
B) "When you feel short of breath, take an additional diuretic."
C) "Avoid drinking more than 3 quarts of liquids each day."
D) "Weigh yourself daily while wearing the same amount of clothing." –
Correct Answer :D
Clients with heart failure are instructed to weigh themselves daily to detect worsening heart failure early, and
thus avoid complications. Other signs of worsening heart failure include increasing dyspnea, exercise intolerance,
cold symptoms, and nocturia.
P 1
, • NUR 6001 09/15/2026
The nurse assesses a client's legs. Which assessment finding indicates arterial insufficiency?
A) Pain with activity but not while resting
B) Dependent mottling and absence of hair
C) Full veins present in dependent extremity
D) Ankle discoloration and pitting edema - Correct Answer :B
Dependent mottling and absence of hair is an indication of arterial insufficiency. Pain may be present with
activity and at rest. Edema and ankle discoloration would be indicative of venous insufficiency.
The nurse is teaching a client with pneumonia ways to clear secretions. Which intervention is the most effective?
A) Administering an antiemetic medication
B) Increasing fluids to 2 L/day if tolerated
C) Administering an antitussive medication
D) Having the client cough and deep breathe hourly - Correct Answer :B
Increasing fluids has been proven to decrease the thickness of secretions, thus allowing them to be
expectorated quickly. The other interventions would not be as effective.
The nurse is assessing a client with left-sided heart failure. What conditions does the nurse assess for? (Select all
that apply.)
A) S3/S4 summation gallop
B) Cough worsens at night
C) Dependent edema
D) Pulmonary crackles
E) Confusion, restlessness
F) Pulmonary hypertension - Correct Answer :A,B,D,E
P 2
, • NUR 6001 09/15/2026
Left-sided failure occurs with a decrease in contractility of the heart or an increase in afterload. Most of the signs
will be noted in the respiratory system. Right-sided failure occurs with problems from the pulmonary vasculature
onward. Signs will be noted before the right atrium or ventricle.
The nurse assesses the patient and notes all of the following. Select all of the findings that indicate the systemic
manifestations of inflammation.
A) Oral temperature 38.6 F
B) WBC 20
C) Thick, green nasal discharge
D) Patient reports, "I'm tired all the time. I haven't felt like myself in days"
E) Patient complaint of pain at 6 on a 0 to 10 scale on palpation of frontal and maxillary sinuses –
Correct Answer :A,B,D
Systemic manifestations of inflammatory response include elevated temperature, leukocytosis, and malaise and
fatigue. Purulent exudates and pain are both considered local manifestations of inflammation.
A client with chronic obstructive pulmonary disease (COPD) reports social isolation. What does the nurse
encourage the client to do?
A) Participate in community activities.
B) Verbalize his or her thoughts and feelings.
C) Ask the client's physician for an antianxiety agent.
D) Join a support group for people with COPD. - Correct Answer :B
Many clients with moderate to severe COPD become socially isolated because they are embarrassed by frequent
coughing and mucus production. They also can experience fatigue, which limits their activities. The nurse needs
to encourage the client to verbalize thoughts and feelings so that appropriate interventions can be selected.
Joining a support group would not decrease feelings of social isolation if the client does not verbalize feelings.
Antianxiety agents will not help the client with social isolation. Encouraging a client to participate in activities
without verbalizing concerns also would not be an effective strategy for decreasing social isolation.
P 3
, • NUR 6001 09/15/2026
The nurse is assessing a client with lung disease. Which symptom does the nurse intervene for first?
A) The client's anterior-posterior chest diameter is 2:2.
B) Clubbing of the finger tips is noted.
C) The client is pale.
D) The client has bilateral dependent leg edema. - Correct Answer :D
The client with bilateral dependent edema may be developing right-sided heart failure in response to respiratory
disease. This symptom should be investigated right away and reported to the health care provider. Further
assessment is needed. The client with chronic lung disease may develop increased anterior-posterior diameter
and clubbing as responses to chronic hypoxia. These symptoms do not require immediate intervention. The
client is often pale or has a dusky appearance; this also would not warrant immediate intervention.
A patient is diagnosed with a sprain to her right ankle after a fall. The patient asks the nurse about using ice on
her injured ankle. The nurse should tell the patient that:
A) ice is not recommended for use on the sprain because it would inhibit the inflammatory response.
B) ice should be applied for 15 to 20 minutes every 2 to 3 hours over the next 1 to 2 days.
C) she should use ice only when the ankle hurts.
D) she should wrap an ice pack around the injured ankle for the next 24 to 48 hours. - Correct Answer :B
Ice is used on areas of injury during the first 24 to 48 hours after the injury occurs to prevent damage to
surrounding tissues from excessive inflammation. Ice should be used for a maximum of 20 minutes at a time
every 2 to 3 hours. Ice must be used according to a schedule for it to be effective and not be overused. Using ice
more often or for longer periods of time can cause additional tissue damage. Ice is recommended to inhibit the
inflammatory process from damaging surrounding tissue.
The nurse is assessing a patient for the adequacy of ventilation. What assessment findings would indicate the
patient has good ventilation? (Select all that apply.)
A) There is presence of quiet, effortless breath sounds at lung base bilaterally.
B) Nail beds are pink with good capillary refill.
C) Trachea is just to the left of the sternal notch.
P 4
NU 185 Medical-Surgical Nursing II Comprehensive
Exam Prep Comprehensive Study Guide
UPDATE Actual Questions & Verified Answers with
Detailed Clinical Rationales
A client with a history of heart failure is being discharged. Which priority instruction will assist the client in the
prevention of complications associated with heart failure?
A) "Eat six small meals daily instead of three larger meals."
B) "When you feel short of breath, take an additional diuretic."
C) "Avoid drinking more than 3 quarts of liquids each day."
D) "Weigh yourself daily while wearing the same amount of clothing." –
Correct Answer :D
Clients with heart failure are instructed to weigh themselves daily to detect worsening heart failure early, and
thus avoid complications. Other signs of worsening heart failure include increasing dyspnea, exercise intolerance,
cold symptoms, and nocturia.
P 1
, • NUR 6001 09/15/2026
The nurse assesses a client's legs. Which assessment finding indicates arterial insufficiency?
A) Pain with activity but not while resting
B) Dependent mottling and absence of hair
C) Full veins present in dependent extremity
D) Ankle discoloration and pitting edema - Correct Answer :B
Dependent mottling and absence of hair is an indication of arterial insufficiency. Pain may be present with
activity and at rest. Edema and ankle discoloration would be indicative of venous insufficiency.
The nurse is teaching a client with pneumonia ways to clear secretions. Which intervention is the most effective?
A) Administering an antiemetic medication
B) Increasing fluids to 2 L/day if tolerated
C) Administering an antitussive medication
D) Having the client cough and deep breathe hourly - Correct Answer :B
Increasing fluids has been proven to decrease the thickness of secretions, thus allowing them to be
expectorated quickly. The other interventions would not be as effective.
The nurse is assessing a client with left-sided heart failure. What conditions does the nurse assess for? (Select all
that apply.)
A) S3/S4 summation gallop
B) Cough worsens at night
C) Dependent edema
D) Pulmonary crackles
E) Confusion, restlessness
F) Pulmonary hypertension - Correct Answer :A,B,D,E
P 2
, • NUR 6001 09/15/2026
Left-sided failure occurs with a decrease in contractility of the heart or an increase in afterload. Most of the signs
will be noted in the respiratory system. Right-sided failure occurs with problems from the pulmonary vasculature
onward. Signs will be noted before the right atrium or ventricle.
The nurse assesses the patient and notes all of the following. Select all of the findings that indicate the systemic
manifestations of inflammation.
A) Oral temperature 38.6 F
B) WBC 20
C) Thick, green nasal discharge
D) Patient reports, "I'm tired all the time. I haven't felt like myself in days"
E) Patient complaint of pain at 6 on a 0 to 10 scale on palpation of frontal and maxillary sinuses –
Correct Answer :A,B,D
Systemic manifestations of inflammatory response include elevated temperature, leukocytosis, and malaise and
fatigue. Purulent exudates and pain are both considered local manifestations of inflammation.
A client with chronic obstructive pulmonary disease (COPD) reports social isolation. What does the nurse
encourage the client to do?
A) Participate in community activities.
B) Verbalize his or her thoughts and feelings.
C) Ask the client's physician for an antianxiety agent.
D) Join a support group for people with COPD. - Correct Answer :B
Many clients with moderate to severe COPD become socially isolated because they are embarrassed by frequent
coughing and mucus production. They also can experience fatigue, which limits their activities. The nurse needs
to encourage the client to verbalize thoughts and feelings so that appropriate interventions can be selected.
Joining a support group would not decrease feelings of social isolation if the client does not verbalize feelings.
Antianxiety agents will not help the client with social isolation. Encouraging a client to participate in activities
without verbalizing concerns also would not be an effective strategy for decreasing social isolation.
P 3
, • NUR 6001 09/15/2026
The nurse is assessing a client with lung disease. Which symptom does the nurse intervene for first?
A) The client's anterior-posterior chest diameter is 2:2.
B) Clubbing of the finger tips is noted.
C) The client is pale.
D) The client has bilateral dependent leg edema. - Correct Answer :D
The client with bilateral dependent edema may be developing right-sided heart failure in response to respiratory
disease. This symptom should be investigated right away and reported to the health care provider. Further
assessment is needed. The client with chronic lung disease may develop increased anterior-posterior diameter
and clubbing as responses to chronic hypoxia. These symptoms do not require immediate intervention. The
client is often pale or has a dusky appearance; this also would not warrant immediate intervention.
A patient is diagnosed with a sprain to her right ankle after a fall. The patient asks the nurse about using ice on
her injured ankle. The nurse should tell the patient that:
A) ice is not recommended for use on the sprain because it would inhibit the inflammatory response.
B) ice should be applied for 15 to 20 minutes every 2 to 3 hours over the next 1 to 2 days.
C) she should use ice only when the ankle hurts.
D) she should wrap an ice pack around the injured ankle for the next 24 to 48 hours. - Correct Answer :B
Ice is used on areas of injury during the first 24 to 48 hours after the injury occurs to prevent damage to
surrounding tissues from excessive inflammation. Ice should be used for a maximum of 20 minutes at a time
every 2 to 3 hours. Ice must be used according to a schedule for it to be effective and not be overused. Using ice
more often or for longer periods of time can cause additional tissue damage. Ice is recommended to inhibit the
inflammatory process from damaging surrounding tissue.
The nurse is assessing a patient for the adequacy of ventilation. What assessment findings would indicate the
patient has good ventilation? (Select all that apply.)
A) There is presence of quiet, effortless breath sounds at lung base bilaterally.
B) Nail beds are pink with good capillary refill.
C) Trachea is just to the left of the sternal notch.
P 4
