NSG 223 MED SURG 2 EXAM 2 |
QUESTIONS AND ANSWERS |
2026 UPDATED | 100% CORRECT
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NSG 223 MED SURG 2 EXAM 2 | QUESTIONS AND ANSWERS | 2026 UPDATED | 100% CORRECT. It
contains 190 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NSG 223 MED SURG 2 2 AND 2026 Updated 100 Correct Medical-surgical
Nursing II Undergraduate YEAR 3 / Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-32 Acute, Appropriate, Kidney, Failure, Develops
Safety AND Infection Control 33-64 Acute, Intervention, Appropriate, Finding, Syndrome
Health Promotion AND 65-96 Finding, Acute, Intervention, Laboratory, Syndrome
Maintenance
Psychosocial Integrity 97-128 Acute, Finding, Potassium, Appropriate, Intervention
Basic CARE AND Comfort 129-160 Acute, Finding, Intervention, Indicates, Syndrome
Pharmacological Therapies 161-190 Acute, Intervention, Finding, Appropriate, Potassium
TOTAL 190 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
In a patient with septic shock and refractory hypotension, which hemodynamic profile
best indicates the need for adding norepinephrine to the current vasopressin infusion?
A. Cardiac index 2.1 L/min/m2, SVR 650 B. Cardiac index 4.5 L/min/m2, SVR 800
dynes/sec/cm-5, CVP 14 mmHg dynes/sec/cm-5, CVP 8 mmHg
C. Cardiac index 3.2 L/min/m2, SVR 1200 D. Cardiac index 2.8 L/min/m2, SVR 1400
dynes/sec/cm-5, CVP 6 mmHg dynes/sec/cm-5, CVP 12 mmHg
Correct: B - Cardiac index 4.5 L/min/m2, SVR 800 dynes/sec/cm-5, CVP 8 mmHg
Rationale:In septic shock, vasopressin is added when MAP remains low despite
norepinephrine. A low SVR with adequate cardiac output indicates vasoplegia, which
responds to vasopressin. Option B shows low SVR and high cardiac output, the classic
hyperdynamic profile. Options with high SVR (C, D) suggest excessive vasoconstriction;
option A shows low cardiac output, which would require inotropic support.
Q2.
A patient with acute liver failure develops asterixis and confusion. Which intervention is
most appropriate to prevent further neurologic deterioration?
A. Administer lactulose to reduce serum B. Initiate continuous renal replacement
ammonia levels therapy (CRRT)
C. Restrict dietary protein to less than 0.5 D. Administer flumazenil to reverse
g/kg/day benzodiazepine effects
Correct: A - Administer lactulose to reduce serum ammonia levels
Rationale:Asterixis and confusion in acute liver failure indicate hepatic encephalopathy.
Lactulose reduces ammonia production and absorption, improving neurologic status. CRRT
may be used for refractory hyperammonemia, but lactulose is the first-line intervention.
Protein restriction is no longer routinely recommended; flumazenil is only if
benzodiazepine-induced.
Q3.
Which finding on a 12-lead ECG is most indicative of hyperkalemia in a patient with acute
kidney injury?
A. Prolonged PR interval B. Tall, peaked T waves
C. ST-segment depression D. Presence of U waves
Page 3
, Section A - Management OF CARE
Correct: B - Tall, peaked T waves
Rationale:Tall, peaked T waves are the earliest ECG sign of hyperkalemia. As potassium
rises, QRS widening and sine wave pattern occur. Prolonged PR interval can occur but is not
specific. ST depression may indicate ischemia; U waves are associated with hypokalemia.
Q4.
A patient with neutropenic fever has a new pulmonary infiltrate on chest x-ray. Which
antimicrobial combination provides the most appropriate empiric coverage?
A. Cefepime plus vancomycin B. Ciprofloxacin plus metronidazole
C. Piperacillin-tazobactam plus azithromycin D. Meropenem plus amphotericin B
Correct: A - Cefepime plus vancomycin
Rationale:In neutropenic fever with pulmonary infiltrate, empiric therapy should cover
Pseudomonas and gram-positive organisms, including MRSA. Cefepime (antipseudomonal)
plus vancomycin is appropriate. Ciprofloxacin plus metronidazole lacks MRSA coverage;
piperacillin-tazobactam plus azithromycin may cover atypicals but not MRSA; meropenem
plus amphotericin is broad but antifungal coverage is not first-line without suspicion of
invasive fungal infection.
Q5.
A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is being treated
with fluid restriction and demeclocycline. Which laboratory value indicates a therapeutic
response?
A. Serum sodium 132 mEq/L and urine B. Serum sodium 138 mEq/L and urine
osmolality 500 mOsm/kg osmolality 150 mOsm/kg
C. Serum sodium 126 mEq/L and urine D. Serum sodium 140 mEq/L and urine
osmolality 300 mOsm/kg osmolality 700 mOsm/kg
Correct: B - Serum sodium 138 mEq/L and urine osmolality 150 mOsm/kg
Rationale:In SIADH, demeclocycline induces nephrogenic diabetes insipidus, reducing urine
osmolality and increasing serum sodium. A serum sodium near normal with low urine
osmolality indicates effective therapy. Options with high urine osmolality (A, D) suggest
persistent ADH effect; option C shows worsening hyponatremia.
Q6.
For a patient with acute pancreatitis and persistent organ failure, which intervention has
been shown to reduce mortality when initiated within 72 hours of admission?
A. Early enteral nutrition via nasojejunal B. Prophylactic intravenous antibiotics
tube
Page 4
QUESTIONS AND ANSWERS |
2026 UPDATED | 100% CORRECT
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NSG 223 MED SURG 2 EXAM 2 | QUESTIONS AND ANSWERS | 2026 UPDATED | 100% CORRECT. It
contains 190 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NSG 223 MED SURG 2 2 AND 2026 Updated 100 Correct Medical-surgical
Nursing II Undergraduate YEAR 3 / Graduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Management OF CARE 1-32 Acute, Appropriate, Kidney, Failure, Develops
Safety AND Infection Control 33-64 Acute, Intervention, Appropriate, Finding, Syndrome
Health Promotion AND 65-96 Finding, Acute, Intervention, Laboratory, Syndrome
Maintenance
Psychosocial Integrity 97-128 Acute, Finding, Potassium, Appropriate, Intervention
Basic CARE AND Comfort 129-160 Acute, Finding, Intervention, Indicates, Syndrome
Pharmacological Therapies 161-190 Acute, Intervention, Finding, Appropriate, Potassium
TOTAL 190 All questions include answers and detailed rationales
,Section A - Management OF CARE
Q1.
In a patient with septic shock and refractory hypotension, which hemodynamic profile
best indicates the need for adding norepinephrine to the current vasopressin infusion?
A. Cardiac index 2.1 L/min/m2, SVR 650 B. Cardiac index 4.5 L/min/m2, SVR 800
dynes/sec/cm-5, CVP 14 mmHg dynes/sec/cm-5, CVP 8 mmHg
C. Cardiac index 3.2 L/min/m2, SVR 1200 D. Cardiac index 2.8 L/min/m2, SVR 1400
dynes/sec/cm-5, CVP 6 mmHg dynes/sec/cm-5, CVP 12 mmHg
Correct: B - Cardiac index 4.5 L/min/m2, SVR 800 dynes/sec/cm-5, CVP 8 mmHg
Rationale:In septic shock, vasopressin is added when MAP remains low despite
norepinephrine. A low SVR with adequate cardiac output indicates vasoplegia, which
responds to vasopressin. Option B shows low SVR and high cardiac output, the classic
hyperdynamic profile. Options with high SVR (C, D) suggest excessive vasoconstriction;
option A shows low cardiac output, which would require inotropic support.
Q2.
A patient with acute liver failure develops asterixis and confusion. Which intervention is
most appropriate to prevent further neurologic deterioration?
A. Administer lactulose to reduce serum B. Initiate continuous renal replacement
ammonia levels therapy (CRRT)
C. Restrict dietary protein to less than 0.5 D. Administer flumazenil to reverse
g/kg/day benzodiazepine effects
Correct: A - Administer lactulose to reduce serum ammonia levels
Rationale:Asterixis and confusion in acute liver failure indicate hepatic encephalopathy.
Lactulose reduces ammonia production and absorption, improving neurologic status. CRRT
may be used for refractory hyperammonemia, but lactulose is the first-line intervention.
Protein restriction is no longer routinely recommended; flumazenil is only if
benzodiazepine-induced.
Q3.
Which finding on a 12-lead ECG is most indicative of hyperkalemia in a patient with acute
kidney injury?
A. Prolonged PR interval B. Tall, peaked T waves
C. ST-segment depression D. Presence of U waves
Page 3
, Section A - Management OF CARE
Correct: B - Tall, peaked T waves
Rationale:Tall, peaked T waves are the earliest ECG sign of hyperkalemia. As potassium
rises, QRS widening and sine wave pattern occur. Prolonged PR interval can occur but is not
specific. ST depression may indicate ischemia; U waves are associated with hypokalemia.
Q4.
A patient with neutropenic fever has a new pulmonary infiltrate on chest x-ray. Which
antimicrobial combination provides the most appropriate empiric coverage?
A. Cefepime plus vancomycin B. Ciprofloxacin plus metronidazole
C. Piperacillin-tazobactam plus azithromycin D. Meropenem plus amphotericin B
Correct: A - Cefepime plus vancomycin
Rationale:In neutropenic fever with pulmonary infiltrate, empiric therapy should cover
Pseudomonas and gram-positive organisms, including MRSA. Cefepime (antipseudomonal)
plus vancomycin is appropriate. Ciprofloxacin plus metronidazole lacks MRSA coverage;
piperacillin-tazobactam plus azithromycin may cover atypicals but not MRSA; meropenem
plus amphotericin is broad but antifungal coverage is not first-line without suspicion of
invasive fungal infection.
Q5.
A patient with syndrome of inappropriate antidiuretic hormone (SIADH) is being treated
with fluid restriction and demeclocycline. Which laboratory value indicates a therapeutic
response?
A. Serum sodium 132 mEq/L and urine B. Serum sodium 138 mEq/L and urine
osmolality 500 mOsm/kg osmolality 150 mOsm/kg
C. Serum sodium 126 mEq/L and urine D. Serum sodium 140 mEq/L and urine
osmolality 300 mOsm/kg osmolality 700 mOsm/kg
Correct: B - Serum sodium 138 mEq/L and urine osmolality 150 mOsm/kg
Rationale:In SIADH, demeclocycline induces nephrogenic diabetes insipidus, reducing urine
osmolality and increasing serum sodium. A serum sodium near normal with low urine
osmolality indicates effective therapy. Options with high urine osmolality (A, D) suggest
persistent ADH effect; option C shows worsening hyponatremia.
Q6.
For a patient with acute pancreatitis and persistent organ failure, which intervention has
been shown to reduce mortality when initiated within 72 hours of admission?
A. Early enteral nutrition via nasojejunal B. Prophylactic intravenous antibiotics
tube
Page 4
