NU 185 EXAM 3 (GALEN) NEWEST 2026/2027 ACTUAL EXAM |
NU185 MEDICAL-SURGICAL NURSING II EXAM 3 REVIEW WITH
COMPLETE REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
Core Domains
Acid-Base Balance and Arterial Blood Gas Interpretation
Respiratory Disorders and Mechanical Ventilation
Cardiovascular Disorders and Heart Failure
Endocrine Disorders and Diabetic Emergencies
Gastrointestinal and Hepatic Disorders
Renal Disorders and Electrolyte Imbalances
Shock States and Emergency Management
Perioperative Care and Wound Management
Introduction
The NU 185 Medical-Surgical Nursing II Examination assesses a
candidate’s mastery of advanced nursing concepts in critical care
and complex medical-surgical systems. This examination evaluates
knowledge of acid-base interpretation, respiratory failure
management, cardiovascular emergencies, diabetic ketoacidosis,
hepatic encephalopathy, acute kidney injury, and shock states. The
exam employs multiple-choice and scenario-based questions that
test foundational theory and applied clinical decision-making.
Emphasis is placed on prioritization, real-world application, and the
,professional judgment required to provide safe, evidence-based
nursing care to acutely ill adult patients.
SECTION ONE: QUESTIONS 1–100
1. A patient’s ABG results are: pH 7.25, PaCO2 60 mmHg, and
HCO3 26 mEq/L. Which condition does this reflect?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
🟢 D. Respiratory Acidosis
🔴 RATIONALE: A pH below 7.35 indicates acidosis. A PaCO2
above 45 mmHg indicates a respiratory cause. Since the
bicarbonate is normal, this is uncompensated respiratory acidosis.
2. A client is in the ICU for ARDS. Which assessment finding
most clearly indicates that the patient’s condition is
deteriorating despite high levels of oxygen?
A. Refractory hypoxemia
B. Increase in respiratory rate
C. Crackles in the lung bases
,D. Oxygen saturation of 92% on 4L nasal cannula
🟢 A. Refractory hypoxemia
🔴 RATIONALE: Refractory hypoxemia, where oxygen levels do
not improve despite increasing the Fraction of Inspired Oxygen
(FiO2), is a hallmark sign of ARDS progression.
3. The ventilator’s high-pressure alarm is sounding. What is the
nurse’s first action?
A. Assess the patient’s breath sounds and respiratory status
B. Suction the patient’s airway
C. Check for a disconnection in the circuit
D. Check for kinks in the tubing
🟢 A. Assess the patient’s breath sounds and respiratory status
🔴 RATIONALE: While checking for kinks or suctioning may be
necessary, the priority nursing action is always to assess the
patient first to ensure safety and identify the cause.
4. Which pharmacological intervention is considered the ‘gold
standard’ for treating a patient in anaphylactic shock?
A. Diphenhydramine IV
B. Epinephrine IM/IV
, C. Methylprednisolone IV
D. Albuterol nebulizer
🟢 B. Epinephrine IM/IV
🔴 RATIONALE: Epinephrine is the first-line and gold standard
treatment for anaphylaxis, acting rapidly to reverse bronchospasm
and vasodilation.
5. A patient with a history of heart failure presents with a
potassium level of 6.2 mEq/L. Which medication should the
nurse expect to administer first to protect the heart from
dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Regular insulin and D50W
D. Furosemide
🟢 B. Calcium gluconate
🔴 RATIONALE: Calcium gluconate does not lower potassium but
is administered first in severe hyperkalemia to stabilize the
myocardial cell membrane and prevent life-threatening
arrhythmias.
6. When assessing a patient with a chest tube, the nurse notes
continuous bubbling in the water-seal chamber. What is the
NU185 MEDICAL-SURGICAL NURSING II EXAM 3 REVIEW WITH
COMPLETE REAL EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
Core Domains
Acid-Base Balance and Arterial Blood Gas Interpretation
Respiratory Disorders and Mechanical Ventilation
Cardiovascular Disorders and Heart Failure
Endocrine Disorders and Diabetic Emergencies
Gastrointestinal and Hepatic Disorders
Renal Disorders and Electrolyte Imbalances
Shock States and Emergency Management
Perioperative Care and Wound Management
Introduction
The NU 185 Medical-Surgical Nursing II Examination assesses a
candidate’s mastery of advanced nursing concepts in critical care
and complex medical-surgical systems. This examination evaluates
knowledge of acid-base interpretation, respiratory failure
management, cardiovascular emergencies, diabetic ketoacidosis,
hepatic encephalopathy, acute kidney injury, and shock states. The
exam employs multiple-choice and scenario-based questions that
test foundational theory and applied clinical decision-making.
Emphasis is placed on prioritization, real-world application, and the
,professional judgment required to provide safe, evidence-based
nursing care to acutely ill adult patients.
SECTION ONE: QUESTIONS 1–100
1. A patient’s ABG results are: pH 7.25, PaCO2 60 mmHg, and
HCO3 26 mEq/L. Which condition does this reflect?
A. Respiratory Alkalosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
🟢 D. Respiratory Acidosis
🔴 RATIONALE: A pH below 7.35 indicates acidosis. A PaCO2
above 45 mmHg indicates a respiratory cause. Since the
bicarbonate is normal, this is uncompensated respiratory acidosis.
2. A client is in the ICU for ARDS. Which assessment finding
most clearly indicates that the patient’s condition is
deteriorating despite high levels of oxygen?
A. Refractory hypoxemia
B. Increase in respiratory rate
C. Crackles in the lung bases
,D. Oxygen saturation of 92% on 4L nasal cannula
🟢 A. Refractory hypoxemia
🔴 RATIONALE: Refractory hypoxemia, where oxygen levels do
not improve despite increasing the Fraction of Inspired Oxygen
(FiO2), is a hallmark sign of ARDS progression.
3. The ventilator’s high-pressure alarm is sounding. What is the
nurse’s first action?
A. Assess the patient’s breath sounds and respiratory status
B. Suction the patient’s airway
C. Check for a disconnection in the circuit
D. Check for kinks in the tubing
🟢 A. Assess the patient’s breath sounds and respiratory status
🔴 RATIONALE: While checking for kinks or suctioning may be
necessary, the priority nursing action is always to assess the
patient first to ensure safety and identify the cause.
4. Which pharmacological intervention is considered the ‘gold
standard’ for treating a patient in anaphylactic shock?
A. Diphenhydramine IV
B. Epinephrine IM/IV
, C. Methylprednisolone IV
D. Albuterol nebulizer
🟢 B. Epinephrine IM/IV
🔴 RATIONALE: Epinephrine is the first-line and gold standard
treatment for anaphylaxis, acting rapidly to reverse bronchospasm
and vasodilation.
5. A patient with a history of heart failure presents with a
potassium level of 6.2 mEq/L. Which medication should the
nurse expect to administer first to protect the heart from
dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Regular insulin and D50W
D. Furosemide
🟢 B. Calcium gluconate
🔴 RATIONALE: Calcium gluconate does not lower potassium but
is administered first in severe hyperkalemia to stabilize the
myocardial cell membrane and prevent life-threatening
arrhythmias.
6. When assessing a patient with a chest tube, the nurse notes
continuous bubbling in the water-seal chamber. What is the
