NU 189/ NU189 EXAM 1 – MEDICAL-SURGICAL NURSING II GUIDE | COMPREHENSIVE
QUESTIONS AND ANSWERS | VERIFIED AND WELL-DETAILED ANSWERS | DETAILED
EXPLANATIONS AND RATIONALES | COMPLETE EXAM PREPARATION STUDY GUIDE |
PRACTICE QUESTIONS | LATEST EXAM UPDATE
CORE DOMAINS
1. Neurological disorders and neurological assessment
2. Cardiovascular disorders and perfusion
3. Respiratory disorders and oxygenation
4. Hematological disorders and blood-related complications
5. Immune, inflammatory, and autoimmune disorders
6. Infectious diseases and infection prevention
7. Musculoskeletal disorders and mobility
8. Fluid, electrolyte, and acid-base considerations
9. Pharmacological and nursing management
10. Patient safety, prioritization, and clinical decision-making
INTRODUCTION
This 100-question practice assessment is designed to support preparation for NU
189/NU189 Medical-Surgical Nursing II Exam 1. It emphasizes recognition of clinical
manifestations, interpretation of assessment findings, prioritization, nursing interventions,
safety, pathophysiology, and application of medical-surgical concepts. The questions are
original study-practice questions rather than claimed official or authentic examination items.
Galen College identifies its catalog and current course resources as the appropriate sources
for course-specific curriculum information.
SECTION ONE: QUESTIONS 1–100
Question 1. A patient with a head injury becomes increasingly lethargic and requires
repeated stimulation to answer questions. Which finding should the nurse recognize as
particularly concerning for increasing intracranial pressure?
A. Increased appetite
B. Decreased level of consciousness
C. Mild thirst
D. Increased urine output
Correct Answer: B. Decreased level of consciousness
,Explanation: A declining level of consciousness can be an early and sensitive indicator of
neurological deterioration. Increasing intracranial pressure can impair cerebral perfusion and
alter brain function. Cushing-type findings, including hypertension, bradycardia, and
abnormal respirations, generally represent later deterioration.
Question 2. A patient with suspected bacterial meningitis is admitted to the medical-surgical
unit. Which nursing action is the priority?
A. Encourage frequent ambulation
B. Initiate appropriate infection-control precautions
C. Place the patient in a brightly lit room
D. Encourage a high-fiber diet
Correct Answer: B. Initiate appropriate infection-control precautions
Explanation: Suspected bacterial meningitis can involve transmission of organisms through
respiratory secretions, depending on the causative pathogen. Appropriate precautions help
protect healthcare workers and other patients while diagnostic evaluation and antimicrobial
therapy are initiated.
Question 3. A patient reports a sudden, severe headache described as the “worst headache
of my life.” Which condition should the nurse consider most urgently?
A. Tension headache
B. Cluster headache
C. Subarachnoid hemorrhage
D. Chronic sinusitis
Correct Answer: C. Subarachnoid hemorrhage
Explanation: A sudden, extremely severe headache is a classic warning sign of subarachnoid
hemorrhage. Rapid neurological assessment and emergency evaluation are essential
because intracranial bleeding can rapidly threaten cerebral perfusion and life.
Question 4. A patient with a suspected stroke has facial drooping and difficulty speaking.
Which assessment should the nurse prioritize?
A. Airway and ability to protect secretions
B. Skin turgor
C. Bowel sounds
D. Nail-bed color only
,Correct Answer: A. Airway and ability to protect secretions
Explanation: Acute neurological injury can impair swallowing and protective airway reflexes.
Airway assessment is therefore a priority before oral intake or other nonurgent
interventions. Aspiration is a significant complication of acute stroke.
Question 5. A patient experiencing a generalized tonic-clonic seizure is actively convulsing.
What is the nurse's priority action?
A. Restrain the patient's extremities
B. Insert a tongue blade
C. Protect the patient from injury and maintain airway safety
D. Give oral fluids
Correct Answer: C. Protect the patient from injury and maintain airway safety
Explanation: During a seizure, the nurse should protect the patient from trauma, maintain a
safe environment, and monitor airway and breathing. The patient should not be restrained,
and nothing should be inserted into the mouth.
Question 6. Which finding is most consistent with a focal neurological deficit following a
stroke?
A. Bilateral equal hand strength
B. Unilateral weakness
C. Increased appetite
D. Generalized dry skin
Correct Answer: B. Unilateral weakness
Explanation: Stroke commonly produces neurological deficits corresponding to the affected
area of the brain. Unilateral weakness, facial asymmetry, sensory changes, visual changes,
and language impairment may occur.
Question 7. A patient with increased intracranial pressure requires positioning. Which
position is generally appropriate when not contraindicated?
A. Head elevated with the neck in neutral alignment
B. Flat with the neck sharply flexed
C. Trendelenburg position
D. Prone with the head turned sharply
Correct Answer: A. Head elevated with the neck in neutral alignment
, Explanation: Elevating the head and maintaining neutral neck alignment can promote
venous drainage from the brain. Excessive neck flexion or rotation can impede venous return
and potentially worsen intracranial pressure.
Question 8. A patient with Parkinson disease has difficulty initiating movement. Which
nursing intervention is most appropriate?
A. Encourage rushing during transfers
B. Provide adequate time for movement and use mobility cues
C. Keep the patient on complete bed rest
D. Discourage assistive devices
Correct Answer: B. Provide adequate time for movement and use mobility cues
Explanation: Bradykinesia and difficulty initiating movement are common in Parkinson
disease. Allowing extra time, reducing distractions, providing appropriate cues, and using
prescribed mobility aids can improve safety and independence.
Question 9. A patient with multiple sclerosis reports worsening weakness after becoming
overheated. Which nursing teaching is appropriate?
A. Increase exposure to extreme heat
B. Avoid overheating and plan activities around energy conservation
C. Stop all physical activity permanently
D. Restrict all fluids
Correct Answer: B. Avoid overheating and plan activities around energy conservation
Explanation: Heat can temporarily worsen neurological symptoms in multiple sclerosis.
Energy conservation, appropriate rest periods, and avoidance of excessive heat can help
manage fatigue and symptom exacerbation.
Question 10. A patient develops sudden unilateral weakness, facial drooping, and difficulty
speaking. What is the nurse's most appropriate response?
A. Reassure the patient and reassess tomorrow
B. Activate the facility's emergency stroke response
C. Give the patient a meal
D. Encourage the patient to sleep
Correct Answer: B. Activate the facility's emergency stroke response
QUESTIONS AND ANSWERS | VERIFIED AND WELL-DETAILED ANSWERS | DETAILED
EXPLANATIONS AND RATIONALES | COMPLETE EXAM PREPARATION STUDY GUIDE |
PRACTICE QUESTIONS | LATEST EXAM UPDATE
CORE DOMAINS
1. Neurological disorders and neurological assessment
2. Cardiovascular disorders and perfusion
3. Respiratory disorders and oxygenation
4. Hematological disorders and blood-related complications
5. Immune, inflammatory, and autoimmune disorders
6. Infectious diseases and infection prevention
7. Musculoskeletal disorders and mobility
8. Fluid, electrolyte, and acid-base considerations
9. Pharmacological and nursing management
10. Patient safety, prioritization, and clinical decision-making
INTRODUCTION
This 100-question practice assessment is designed to support preparation for NU
189/NU189 Medical-Surgical Nursing II Exam 1. It emphasizes recognition of clinical
manifestations, interpretation of assessment findings, prioritization, nursing interventions,
safety, pathophysiology, and application of medical-surgical concepts. The questions are
original study-practice questions rather than claimed official or authentic examination items.
Galen College identifies its catalog and current course resources as the appropriate sources
for course-specific curriculum information.
SECTION ONE: QUESTIONS 1–100
Question 1. A patient with a head injury becomes increasingly lethargic and requires
repeated stimulation to answer questions. Which finding should the nurse recognize as
particularly concerning for increasing intracranial pressure?
A. Increased appetite
B. Decreased level of consciousness
C. Mild thirst
D. Increased urine output
Correct Answer: B. Decreased level of consciousness
,Explanation: A declining level of consciousness can be an early and sensitive indicator of
neurological deterioration. Increasing intracranial pressure can impair cerebral perfusion and
alter brain function. Cushing-type findings, including hypertension, bradycardia, and
abnormal respirations, generally represent later deterioration.
Question 2. A patient with suspected bacterial meningitis is admitted to the medical-surgical
unit. Which nursing action is the priority?
A. Encourage frequent ambulation
B. Initiate appropriate infection-control precautions
C. Place the patient in a brightly lit room
D. Encourage a high-fiber diet
Correct Answer: B. Initiate appropriate infection-control precautions
Explanation: Suspected bacterial meningitis can involve transmission of organisms through
respiratory secretions, depending on the causative pathogen. Appropriate precautions help
protect healthcare workers and other patients while diagnostic evaluation and antimicrobial
therapy are initiated.
Question 3. A patient reports a sudden, severe headache described as the “worst headache
of my life.” Which condition should the nurse consider most urgently?
A. Tension headache
B. Cluster headache
C. Subarachnoid hemorrhage
D. Chronic sinusitis
Correct Answer: C. Subarachnoid hemorrhage
Explanation: A sudden, extremely severe headache is a classic warning sign of subarachnoid
hemorrhage. Rapid neurological assessment and emergency evaluation are essential
because intracranial bleeding can rapidly threaten cerebral perfusion and life.
Question 4. A patient with a suspected stroke has facial drooping and difficulty speaking.
Which assessment should the nurse prioritize?
A. Airway and ability to protect secretions
B. Skin turgor
C. Bowel sounds
D. Nail-bed color only
,Correct Answer: A. Airway and ability to protect secretions
Explanation: Acute neurological injury can impair swallowing and protective airway reflexes.
Airway assessment is therefore a priority before oral intake or other nonurgent
interventions. Aspiration is a significant complication of acute stroke.
Question 5. A patient experiencing a generalized tonic-clonic seizure is actively convulsing.
What is the nurse's priority action?
A. Restrain the patient's extremities
B. Insert a tongue blade
C. Protect the patient from injury and maintain airway safety
D. Give oral fluids
Correct Answer: C. Protect the patient from injury and maintain airway safety
Explanation: During a seizure, the nurse should protect the patient from trauma, maintain a
safe environment, and monitor airway and breathing. The patient should not be restrained,
and nothing should be inserted into the mouth.
Question 6. Which finding is most consistent with a focal neurological deficit following a
stroke?
A. Bilateral equal hand strength
B. Unilateral weakness
C. Increased appetite
D. Generalized dry skin
Correct Answer: B. Unilateral weakness
Explanation: Stroke commonly produces neurological deficits corresponding to the affected
area of the brain. Unilateral weakness, facial asymmetry, sensory changes, visual changes,
and language impairment may occur.
Question 7. A patient with increased intracranial pressure requires positioning. Which
position is generally appropriate when not contraindicated?
A. Head elevated with the neck in neutral alignment
B. Flat with the neck sharply flexed
C. Trendelenburg position
D. Prone with the head turned sharply
Correct Answer: A. Head elevated with the neck in neutral alignment
, Explanation: Elevating the head and maintaining neutral neck alignment can promote
venous drainage from the brain. Excessive neck flexion or rotation can impede venous return
and potentially worsen intracranial pressure.
Question 8. A patient with Parkinson disease has difficulty initiating movement. Which
nursing intervention is most appropriate?
A. Encourage rushing during transfers
B. Provide adequate time for movement and use mobility cues
C. Keep the patient on complete bed rest
D. Discourage assistive devices
Correct Answer: B. Provide adequate time for movement and use mobility cues
Explanation: Bradykinesia and difficulty initiating movement are common in Parkinson
disease. Allowing extra time, reducing distractions, providing appropriate cues, and using
prescribed mobility aids can improve safety and independence.
Question 9. A patient with multiple sclerosis reports worsening weakness after becoming
overheated. Which nursing teaching is appropriate?
A. Increase exposure to extreme heat
B. Avoid overheating and plan activities around energy conservation
C. Stop all physical activity permanently
D. Restrict all fluids
Correct Answer: B. Avoid overheating and plan activities around energy conservation
Explanation: Heat can temporarily worsen neurological symptoms in multiple sclerosis.
Energy conservation, appropriate rest periods, and avoidance of excessive heat can help
manage fatigue and symptom exacerbation.
Question 10. A patient develops sudden unilateral weakness, facial drooping, and difficulty
speaking. What is the nurse's most appropriate response?
A. Reassure the patient and reassess tomorrow
B. Activate the facility's emergency stroke response
C. Give the patient a meal
D. Encourage the patient to sleep
Correct Answer: B. Activate the facility's emergency stroke response
