Galen College NU 185 Exam 2 (pdf) | 2026/2027 | Med-Surg II Q&A |
Medical-Surgical Nursing
1. Which layer of the heart is responsible for the forceful contractions that
pump blood throughout the body?
A) Epicardium
B) Myocardium
C) Endocardium
D) Pericardium
Correct Answer: Myocardium
Rationale: The myocardium is the thick muscular middle layer responsible for
the heart's contractions and pumping action. The epicardium is the outer
layer, the endocardium lines the interior, and the pericardium is the sac
enclosing the heart.
2. Which of the following correctly describes the flow of oxygenated blood?
A) Right atrium → right ventricle → pulmonary artery
B) Pulmonary veins → left atrium → left ventricle
C) Superior vena cava → right atrium → right ventricle
D) Left ventricle → right atrium → lungs
Correct Answer: Pulmonary veins → left atrium → left ventricle
Rationale: Oxygenated blood returns from the lungs through the pulmonary
veins to the left atrium, then moves to the left ventricle before being
pumped to the rest of the body. The other options describe deoxygenated
blood flow or incorrect pathways.
,3. Which vessel type is responsible for gas exchange at the tissue level?
A) Arteries
B) Veins
C) Capillaries
D) Venules
Correct Answer: Capillaries
Rationale: Capillaries are the smallest blood vessels where oxygen and
carbon dioxide exchange occurs between blood and tissues. Arteries carry
blood away from the heart, veins return blood to the heart, and venules are
small veins.
4. The nurse is assessing a client for signs of a mild transfusion reaction.
Which finding would the nurse expect?
A) Fever and chills
B) Rash, hives, itching, and facial flushing
C) Hypotension and tachycardia
D) Low back pain and hematuria
Correct Answer: Rash, hives, itching, and facial flushing
Rationale: Mild transfusion reactions typically present with rash, hives,
itching, and facial flushing. The nurse should slow the transfusion and
administer Benadryl as prescribed. Fever, chills, hypotension, tachycardia,
low back pain, and hematuria indicate a more severe reaction.
5. Which action should the nurse take if a client is having a severe
transfusion reaction?
,A) Slow the transfusion and give Benadryl
B) Stop the transfusion immediately, get new IV tubing, and hook to normal
saline
C) Continue the transfusion and monitor vital signs
D) Administer epinephrine
Correct Answer: Stop the transfusion immediately, get new IV tubing, and
hook to normal saline
Rationale: For a severe transfusion reaction, the nurse should stop the
transfusion, obtain new IV tubing, and administer normal saline. The provider
should be notified immediately. Mild reactions may be managed by slowing
the rate and giving Benadryl.
6. A client is prescribed warfarin for the prevention of thromboembolism.
Which laboratory value should the nurse monitor?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Correct Answer: INR
Rationale: Warfarin therapy is monitored using the International Normalized
Ratio (INR), with a therapeutic range typically between 2.0 and 3.0 for most
indications. aPTT is used to monitor heparin therapy. Platelet count and
hemoglobin are not specific monitoring parameters for warfarin.
7. A client is receiving a continuous heparin infusion. The nurse should
assess for which adverse effect?
, A) Hypertension
B) Bleeding
C) Hyperglycemia
D) Bradycardia
Correct Answer: Bleeding
Rationale: Heparin is an anticoagulant that increases the risk of bleeding.
The nurse should monitor for signs of bleeding, including bruising, petechiae,
bleeding from mucous membranes, and hematuria. Hypotension, not
hypertension, may occur with significant blood loss.
8. Which HDL level would be considered normal for a male client?
A) 40 mg/dL
B) 35 mg/dL
C) 55 mg/dL
D) 25 mg/dL
Correct Answer: 55 mg/dL
Rationale: Normal HDL for males is greater than 45 mg/dL. A value of 55
mg/dL is within the desired range. Levels below 40 mg/dL are considered a
risk factor for cardiovascular disease.
9. The nurse is teaching a client about proper cane use. Which instruction is
correct?
A) The cane should be held in the ipsilateral hand
B) The cane height should be adjusted so the elbow is flexed 20-30 degrees
C) The cane should be moved forward with the uninvolved extremity
Medical-Surgical Nursing
1. Which layer of the heart is responsible for the forceful contractions that
pump blood throughout the body?
A) Epicardium
B) Myocardium
C) Endocardium
D) Pericardium
Correct Answer: Myocardium
Rationale: The myocardium is the thick muscular middle layer responsible for
the heart's contractions and pumping action. The epicardium is the outer
layer, the endocardium lines the interior, and the pericardium is the sac
enclosing the heart.
2. Which of the following correctly describes the flow of oxygenated blood?
A) Right atrium → right ventricle → pulmonary artery
B) Pulmonary veins → left atrium → left ventricle
C) Superior vena cava → right atrium → right ventricle
D) Left ventricle → right atrium → lungs
Correct Answer: Pulmonary veins → left atrium → left ventricle
Rationale: Oxygenated blood returns from the lungs through the pulmonary
veins to the left atrium, then moves to the left ventricle before being
pumped to the rest of the body. The other options describe deoxygenated
blood flow or incorrect pathways.
,3. Which vessel type is responsible for gas exchange at the tissue level?
A) Arteries
B) Veins
C) Capillaries
D) Venules
Correct Answer: Capillaries
Rationale: Capillaries are the smallest blood vessels where oxygen and
carbon dioxide exchange occurs between blood and tissues. Arteries carry
blood away from the heart, veins return blood to the heart, and venules are
small veins.
4. The nurse is assessing a client for signs of a mild transfusion reaction.
Which finding would the nurse expect?
A) Fever and chills
B) Rash, hives, itching, and facial flushing
C) Hypotension and tachycardia
D) Low back pain and hematuria
Correct Answer: Rash, hives, itching, and facial flushing
Rationale: Mild transfusion reactions typically present with rash, hives,
itching, and facial flushing. The nurse should slow the transfusion and
administer Benadryl as prescribed. Fever, chills, hypotension, tachycardia,
low back pain, and hematuria indicate a more severe reaction.
5. Which action should the nurse take if a client is having a severe
transfusion reaction?
,A) Slow the transfusion and give Benadryl
B) Stop the transfusion immediately, get new IV tubing, and hook to normal
saline
C) Continue the transfusion and monitor vital signs
D) Administer epinephrine
Correct Answer: Stop the transfusion immediately, get new IV tubing, and
hook to normal saline
Rationale: For a severe transfusion reaction, the nurse should stop the
transfusion, obtain new IV tubing, and administer normal saline. The provider
should be notified immediately. Mild reactions may be managed by slowing
the rate and giving Benadryl.
6. A client is prescribed warfarin for the prevention of thromboembolism.
Which laboratory value should the nurse monitor?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Correct Answer: INR
Rationale: Warfarin therapy is monitored using the International Normalized
Ratio (INR), with a therapeutic range typically between 2.0 and 3.0 for most
indications. aPTT is used to monitor heparin therapy. Platelet count and
hemoglobin are not specific monitoring parameters for warfarin.
7. A client is receiving a continuous heparin infusion. The nurse should
assess for which adverse effect?
, A) Hypertension
B) Bleeding
C) Hyperglycemia
D) Bradycardia
Correct Answer: Bleeding
Rationale: Heparin is an anticoagulant that increases the risk of bleeding.
The nurse should monitor for signs of bleeding, including bruising, petechiae,
bleeding from mucous membranes, and hematuria. Hypotension, not
hypertension, may occur with significant blood loss.
8. Which HDL level would be considered normal for a male client?
A) 40 mg/dL
B) 35 mg/dL
C) 55 mg/dL
D) 25 mg/dL
Correct Answer: 55 mg/dL
Rationale: Normal HDL for males is greater than 45 mg/dL. A value of 55
mg/dL is within the desired range. Levels below 40 mg/dL are considered a
risk factor for cardiovascular disease.
9. The nurse is teaching a client about proper cane use. Which instruction is
correct?
A) The cane should be held in the ipsilateral hand
B) The cane height should be adjusted so the elbow is flexed 20-30 degrees
C) The cane should be moved forward with the uninvolved extremity
