MDC II EXAM 2 (RASMUSSEN) NEWEST 2026 ACTUAL
EXAM TEST BANK| MEDICAL SURGICAL NURSING II
EXAM 2 REVIEW WITH COMPLETE 300 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
1. A patient with heart failure (HF) presents with dyspnea on
exertion, weight gain of 3 kg in 3 days, and jugular venous
distension. Which medication does the nurse prepare to
administer first?
A. Furosemide
B. Digoxin
C. Metoprolol
D. Spironolactone
Answer: A
Rationale: Furosemide (loop diuretic) rapidly reduces preload
and relieves pulmonary congestion. Digoxin is for symptom
control but not acute decompensation. Beta-blockers are not
given in acute HF. Spironolactone is slow-acting.
2. Post-cardiac catheterization via femoral artery, the nurse
assesses a large, expanding hematoma at the insertion site. The
patient reports severe pain. Priority action?
1
,A. Apply firm pressure above the site
B. Elevate the leg
C. Administer morphine
D. Remove the dressing to assess
Answer: A
Rationale: Expanding hematoma suggests arterial bleed. Apply
pressure proximal to the site and notify provider. Elevation won’t
stop bleeding. Morphine masks symptoms. Removing dressing
may dislodge clot.
3. In a patient with acute respiratory distress syndrome (ARDS),
the nurse expects which arterial blood gas (ABG) finding in early
stages?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Uncompensated respiratory alkalosis
D. Normal ABG
Answer: C
Rationale: Early ARDS causes hypoxemia and tachypnea →
respiratory alkalosis (low PaCO₂, high pH). Later, respiratory
acidosis occurs as fatigue sets in.
2
,4. The nurse is caring for a patient with chest tube to water seal
for pneumothorax. Which finding requires immediate
intervention?
A. Tidaling in water seal chamber
B. Continuous bubbling in water seal chamber
C. Small amount of drainage in collection chamber
D. Pain at insertion site
Answer: B
Rationale: Continuous bubbling indicates an air leak (system leak
or lung defect). Tidaling is normal. Drainage small amount is
expected. Pain is expected but treatable.
5. A patient with chronic kidney disease (CKD) stage 4 has a
potassium level of 6.8 mEq/L. ECG shows peaked T waves. First-
line intervention?
A. IV calcium gluconate
B. IV insulin and dextrose
C. IV furosemide
D. Oral sodium polystyrene sulfonate
Answer: A
Rationale: IV calcium gluconate stabilizes cardiac membranes
immediately. Insulin/dextrose shifts K⁺ into cells but takes time.
3
, Furosemide excretes K⁺ slowly. Sodium polystyrene works over
hours.
6. Which assessment finding in a patient with diabetic
ketoacidosis (DKA) indicates that insulin therapy is effective?
A. Serum potassium increases
B. Blood glucose decreases by 50–100 mg/dL per hour
C. Anion gap widens
D. PaCO₂ increases
Answer: B
Rationale: Effective insulin lowers glucose gradually (50-100
mg/dL/hr). Too rapid drop risks cerebral edema. Potassium may
falsely drop. Widening anion gap indicates worsening acidosis.
PaCO₂ increases with hypoventilation (bad sign in DKA).
7. A post-op day 2 patient reports sudden sharp chest pain and
dyspnea. O₂ sat 88% on room air. HR 120. BP 100/70. What is
the priority action?
A. STAT chest x-ray
B. Administer IV heparin
C. Oxygen and prepare for CT angiography
D. Give morphine for pain
Answer: C
4
EXAM TEST BANK| MEDICAL SURGICAL NURSING II
EXAM 2 REVIEW WITH COMPLETE 300 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
1. A patient with heart failure (HF) presents with dyspnea on
exertion, weight gain of 3 kg in 3 days, and jugular venous
distension. Which medication does the nurse prepare to
administer first?
A. Furosemide
B. Digoxin
C. Metoprolol
D. Spironolactone
Answer: A
Rationale: Furosemide (loop diuretic) rapidly reduces preload
and relieves pulmonary congestion. Digoxin is for symptom
control but not acute decompensation. Beta-blockers are not
given in acute HF. Spironolactone is slow-acting.
2. Post-cardiac catheterization via femoral artery, the nurse
assesses a large, expanding hematoma at the insertion site. The
patient reports severe pain. Priority action?
1
,A. Apply firm pressure above the site
B. Elevate the leg
C. Administer morphine
D. Remove the dressing to assess
Answer: A
Rationale: Expanding hematoma suggests arterial bleed. Apply
pressure proximal to the site and notify provider. Elevation won’t
stop bleeding. Morphine masks symptoms. Removing dressing
may dislodge clot.
3. In a patient with acute respiratory distress syndrome (ARDS),
the nurse expects which arterial blood gas (ABG) finding in early
stages?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Uncompensated respiratory alkalosis
D. Normal ABG
Answer: C
Rationale: Early ARDS causes hypoxemia and tachypnea →
respiratory alkalosis (low PaCO₂, high pH). Later, respiratory
acidosis occurs as fatigue sets in.
2
,4. The nurse is caring for a patient with chest tube to water seal
for pneumothorax. Which finding requires immediate
intervention?
A. Tidaling in water seal chamber
B. Continuous bubbling in water seal chamber
C. Small amount of drainage in collection chamber
D. Pain at insertion site
Answer: B
Rationale: Continuous bubbling indicates an air leak (system leak
or lung defect). Tidaling is normal. Drainage small amount is
expected. Pain is expected but treatable.
5. A patient with chronic kidney disease (CKD) stage 4 has a
potassium level of 6.8 mEq/L. ECG shows peaked T waves. First-
line intervention?
A. IV calcium gluconate
B. IV insulin and dextrose
C. IV furosemide
D. Oral sodium polystyrene sulfonate
Answer: A
Rationale: IV calcium gluconate stabilizes cardiac membranes
immediately. Insulin/dextrose shifts K⁺ into cells but takes time.
3
, Furosemide excretes K⁺ slowly. Sodium polystyrene works over
hours.
6. Which assessment finding in a patient with diabetic
ketoacidosis (DKA) indicates that insulin therapy is effective?
A. Serum potassium increases
B. Blood glucose decreases by 50–100 mg/dL per hour
C. Anion gap widens
D. PaCO₂ increases
Answer: B
Rationale: Effective insulin lowers glucose gradually (50-100
mg/dL/hr). Too rapid drop risks cerebral edema. Potassium may
falsely drop. Widening anion gap indicates worsening acidosis.
PaCO₂ increases with hypoventilation (bad sign in DKA).
7. A post-op day 2 patient reports sudden sharp chest pain and
dyspnea. O₂ sat 88% on room air. HR 120. BP 100/70. What is
the priority action?
A. STAT chest x-ray
B. Administer IV heparin
C. Oxygen and prepare for CT angiography
D. Give morphine for pain
Answer: C
4
