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NSG233/ NSG 233 Exam 2: Medical-
Surgical Nursing III (Latest 2026/ 2027)
| Questions & Answers | Grade A|
(Verified Solutions)
Subject: Medical-Surgical & Critical Care Nursing (Cardiac, Neuro,
Vascular)
Format: Exam Practice Questions and Verified Answers
1. A cardiac ICU manager is reviewing types of pacemakers
with a group of newly hired nurses. Which of the following
statements by one of the nurses indicates the understanding of a
fixed pacemaker?
Answer: The pacemaker fires at a constant rate, not on demand
Rationale: A fixed-rate (asynchronous) pacemaker delivers electrical
impulses at a preset, constant rate regardless of the patient's own
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intrinsic heart rhythm. It does not sense or respond to the patient's
underlying activity.
2. The ICU nurse is checking the telemetry of a post-op
patient who has displayed normal sinus rhythm. The nurse notes
a recurrent pattern in which the patient's PR Interval has
become progressively longer followed by a P Wave that is not
conducted to the ventricles (No QRS). Which conduction
problem would the nurse identify for the patient?
Answer: 2nd degree
Rationale: This describes Mobitz Type I (Wenckebach) second-
degree heart block, characterized by a progressively lengthening PR
interval until a P wave is not conducted (a dropped QRS complex).
3. A patient is being discharged on digoxin after being
diagnosed with A Fib. When providing medication teaching, the
nurse should include which of the following instructions?
Answer: You need to check your pulse before taking this medication
Rationale: Patients on digoxin must monitor their pulse daily. A
heart rate below 60 bpm (or other parameters set by the provider)
can indicate toxicity and requires holding the dose and notifying the
healthcare provider.
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4. The nurse is performing a Glascow Coma Scale assessment
on a client who is unconscious. Which total score would indicate
to the nurse that the patient probably has a severe brain injury?
Answer: 5
Rationale: The Glasgow Coma Scale (GCS) ranges from 3 to 15. A
score of 8 or less is classified as a severe brain injury, coma, or
profound neurological deficit. A score of 5 falls within this severe
category.
5. The nurse is caring for a client with a closed head injury
who is emerging from a coma. Which of the following signs
would prompt the nurse to notify the HCP immediately?
Answer: Unequal Pupils
Rationale: Unequal pupils (anisocoria) in a patient with a head
injury is a critical sign suggesting increased intracranial pressure
(ICP), brain herniation, or a new intracranial bleed, requiring
immediate intervention.
6. The nurse is teaching a client with a spinal cord injury who
has a new prescription for Baclofen to treat muscle spasms.
Which of the following statements by the client indicates an
understanding of the teaching?
Answer: I won't be able to drink alcohol while taking this medicine
NSG233/ NSG 233 Exam 2: Medical-
Surgical Nursing III (Latest 2026/ 2027)
| Questions & Answers | Grade A|
(Verified Solutions)
Subject: Medical-Surgical & Critical Care Nursing (Cardiac, Neuro,
Vascular)
Format: Exam Practice Questions and Verified Answers
1. A cardiac ICU manager is reviewing types of pacemakers
with a group of newly hired nurses. Which of the following
statements by one of the nurses indicates the understanding of a
fixed pacemaker?
Answer: The pacemaker fires at a constant rate, not on demand
Rationale: A fixed-rate (asynchronous) pacemaker delivers electrical
impulses at a preset, constant rate regardless of the patient's own
,2|Page
intrinsic heart rhythm. It does not sense or respond to the patient's
underlying activity.
2. The ICU nurse is checking the telemetry of a post-op
patient who has displayed normal sinus rhythm. The nurse notes
a recurrent pattern in which the patient's PR Interval has
become progressively longer followed by a P Wave that is not
conducted to the ventricles (No QRS). Which conduction
problem would the nurse identify for the patient?
Answer: 2nd degree
Rationale: This describes Mobitz Type I (Wenckebach) second-
degree heart block, characterized by a progressively lengthening PR
interval until a P wave is not conducted (a dropped QRS complex).
3. A patient is being discharged on digoxin after being
diagnosed with A Fib. When providing medication teaching, the
nurse should include which of the following instructions?
Answer: You need to check your pulse before taking this medication
Rationale: Patients on digoxin must monitor their pulse daily. A
heart rate below 60 bpm (or other parameters set by the provider)
can indicate toxicity and requires holding the dose and notifying the
healthcare provider.
, 3|Page
4. The nurse is performing a Glascow Coma Scale assessment
on a client who is unconscious. Which total score would indicate
to the nurse that the patient probably has a severe brain injury?
Answer: 5
Rationale: The Glasgow Coma Scale (GCS) ranges from 3 to 15. A
score of 8 or less is classified as a severe brain injury, coma, or
profound neurological deficit. A score of 5 falls within this severe
category.
5. The nurse is caring for a client with a closed head injury
who is emerging from a coma. Which of the following signs
would prompt the nurse to notify the HCP immediately?
Answer: Unequal Pupils
Rationale: Unequal pupils (anisocoria) in a patient with a head
injury is a critical sign suggesting increased intracranial pressure
(ICP), brain herniation, or a new intracranial bleed, requiring
immediate intervention.
6. The nurse is teaching a client with a spinal cord injury who
has a new prescription for Baclofen to treat muscle spasms.
Which of the following statements by the client indicates an
understanding of the teaching?
Answer: I won't be able to drink alcohol while taking this medicine
