,NU 189 Exam 1 | Medical-Surgical Nursing II
(2026/2027) PDF | Nursing | Galen College
1. Which of the following best describes the primary purpose of the nursing
process?
A) To ensure all patients receive identical care regardless of individual needs
B) To provide a systematic, problem-solving framework for delivering
individualized nursing care
C) To delegate all care decisions to the physician
D) To document patient outcomes after discharge
Correct Answer: To provide a systematic, problem-solving framework for
delivering individualized nursing care
Rationale: The nursing process (ADPIE) is a critical thinking method that guides
assessment, diagnosis, planning, implementation, and evaluation. It ensures
care is tailored to each patient's unique needs, not a one-size-fits-all approach,
and forms the foundation of clinical decision-making.
2. A nurse is assessing a patient who reports joint pain, stiffness, and a "bull's-
eye" rash on the thigh. Which condition should the nurse suspect?
A) Osteoarthritis
B) Rheumatoid arthritis
C) Lyme disease
D) Gout
,Correct Answer: Lyme disease
Rationale: Lyme disease is an inflammatory disorder of connective tissue
transmitted by tick bites. It is characterized by a bull's-eye rash (erythema
migrans), swollen lymph nodes, joint pain and stiffness, fever, and headache.
The other conditions present with different symptom patterns.
3. What kind of disorder is osteoarthritis?
A) Inflammatory disorder of connective tissue
B) Autoimmune disorder
C) Degenerative joint disease
D) Systemic metabolic disorder
Correct Answer: Degenerative joint disease
Rationale: Osteoarthritis is a degenerative joint disease characterized by the
breakdown of articular cartilage, leading to joint pain, stiffness, and decreased
range of motion. It is not autoimmune or inflammatory in nature.
4. A patient is diagnosed with gout. The nurse understands that gout is caused
by:
A) Autoimmune destruction of joint tissue
B) The buildup of uric acid crystals in the joints
, C) Degeneration of articular cartilage
D) Bacterial infection of the synovial fluid
Correct Answer: The buildup of uric acid crystals in the joints
Rationale: Gout is a systemic disease caused by hyperuricemia (excessive uric
acid in the blood), which leads to the deposition of urate crystals in joints and
soft tissues. This causes painful inflammation. It is not caused by autoimmune
destruction, cartilage degeneration, or infection.
5. The earliest sign of increased intracranial pressure (ICP) is:
A) Bradycardia
B) Lethargy and decreased level of consciousness
C) Hypertension with a widening pulse pressure
D) Irregular respirations
Correct Answer: Lethargy and decreased level of consciousness
Rationale: A change in level of consciousness, such as lethargy or delayed
responses, is the earliest and most sensitive indicator of rising ICP. Cushing's
triad (hypertension, bradycardia, irregular respirations) is a late, ominous sign.
6. A patient with Lyme disease presents with a characteristic skin lesion. The
nurse expects to find:
(2026/2027) PDF | Nursing | Galen College
1. Which of the following best describes the primary purpose of the nursing
process?
A) To ensure all patients receive identical care regardless of individual needs
B) To provide a systematic, problem-solving framework for delivering
individualized nursing care
C) To delegate all care decisions to the physician
D) To document patient outcomes after discharge
Correct Answer: To provide a systematic, problem-solving framework for
delivering individualized nursing care
Rationale: The nursing process (ADPIE) is a critical thinking method that guides
assessment, diagnosis, planning, implementation, and evaluation. It ensures
care is tailored to each patient's unique needs, not a one-size-fits-all approach,
and forms the foundation of clinical decision-making.
2. A nurse is assessing a patient who reports joint pain, stiffness, and a "bull's-
eye" rash on the thigh. Which condition should the nurse suspect?
A) Osteoarthritis
B) Rheumatoid arthritis
C) Lyme disease
D) Gout
,Correct Answer: Lyme disease
Rationale: Lyme disease is an inflammatory disorder of connective tissue
transmitted by tick bites. It is characterized by a bull's-eye rash (erythema
migrans), swollen lymph nodes, joint pain and stiffness, fever, and headache.
The other conditions present with different symptom patterns.
3. What kind of disorder is osteoarthritis?
A) Inflammatory disorder of connective tissue
B) Autoimmune disorder
C) Degenerative joint disease
D) Systemic metabolic disorder
Correct Answer: Degenerative joint disease
Rationale: Osteoarthritis is a degenerative joint disease characterized by the
breakdown of articular cartilage, leading to joint pain, stiffness, and decreased
range of motion. It is not autoimmune or inflammatory in nature.
4. A patient is diagnosed with gout. The nurse understands that gout is caused
by:
A) Autoimmune destruction of joint tissue
B) The buildup of uric acid crystals in the joints
, C) Degeneration of articular cartilage
D) Bacterial infection of the synovial fluid
Correct Answer: The buildup of uric acid crystals in the joints
Rationale: Gout is a systemic disease caused by hyperuricemia (excessive uric
acid in the blood), which leads to the deposition of urate crystals in joints and
soft tissues. This causes painful inflammation. It is not caused by autoimmune
destruction, cartilage degeneration, or infection.
5. The earliest sign of increased intracranial pressure (ICP) is:
A) Bradycardia
B) Lethargy and decreased level of consciousness
C) Hypertension with a widening pulse pressure
D) Irregular respirations
Correct Answer: Lethargy and decreased level of consciousness
Rationale: A change in level of consciousness, such as lethargy or delayed
responses, is the earliest and most sensitive indicator of rising ICP. Cushing's
triad (hypertension, bradycardia, irregular respirations) is a late, ominous sign.
6. A patient with Lyme disease presents with a characteristic skin lesion. The
nurse expects to find:
