2026 UPDATED QUESTIONS DOWNLOAD
NUR 325 Exam 2 Comprehensive 350-Question Study
Guide 2026
This guide provides a massive bank of 350 practice questions covering high-yield
nursing concepts for Health and Illness II. It focuses on critical topics like advanced
respiratory care, cardiac dysrhythmias, neurological emergencies, and renal-hepatic
failure. Every question includes a bolded answer and an italicized rationale to help
you master the "why" behind the nursing interventions.
1. A patient with a head injury has a widening pulse pressure and bradycardia. What is the
nurse's priority?
A. Administer a bolus of Normal Saline.
B. Notify the provider of signs of increased ICP.
C. Increase the room temperature.
D. Encourage the patient to cough and deep breathe.
Rationale: Widening pulse pressure and bradycardia are parts of Cushing’s Triad,
indicating late-stage increased intracranial pressure and potential brain herniation.
2. A patient with a chest tube is being transported. What should the nurse do with the
drainage system?
A. Clamp the chest tube during transport.
B. Keep the drainage system below the level of the chest.
C. Disconnect the suction and leave the tube open to air.
D. Carry the drainage unit on the patient's lap.
Rationale: Gravity is required to maintain drainage and prevent fluid from backflowing
into the pleural space; clamping is avoided as it can cause a tension pneumothorax.
3. Which rhythm is characterized by a "sawtooth" pattern on the EKG?
A. Atrial Fibrillation.
B. Atrial Flutter.
C. Ventricular Tachycardia.
D. Sinus Bradycardia.
Rationale: Atrial flutter is identified by regular, rapid "F-waves" that resemble the teeth of
a saw.
,2026 UPDATED QUESTIONS DOWNLOAD
4. A patient with Chronic Kidney Disease (CKD) has a potassium of 6.8. Which medication
does the nurse expect to give first for heart protection?
A. Kayexalate.
B. Calcium Gluconate IV.
C. Regular Insulin.
D. Furosemide.
Rationale: While insulin and Kayexalate lower potassium, Calcium Gluconate is the
priority to stabilize the cardiac membrane and prevent arrest.
5. A patient with a T3 spinal cord injury reports a sudden, severe headache. What is the
first action?
A. Check the patient's blood pressure.
B. Administer PRN Tylenol.
C. Dim the lights and close the door.
D. Perform a neurological assessment.
Rationale: A severe headache in an SCI patient above T6 is the classic sign of
Autonomic Dysreflexia; BP must be checked immediately.
6. What is the primary purpose of PEEP (Positive End-Expiratory Pressure) in ARDS?
A. To decrease the work of the heart.
B. To prevent alveolar collapse at the end of expiration.
C. To clear secretions from the bronchi.
D. To sedate the patient.
Rationale: PEEP keeps the alveoli open, improving gas exchange and functional
residual capacity in "stiff" lungs.
7. A patient with Cirrhosis has "Asterixis." How does the nurse assess this?
A. Ask the patient to walk across the room.
B. Ask the patient to extend their arms and dorsiflex their wrists.
C. Check for yellowing of the sclera.
D. Palpate the right upper quadrant.
Rationale: Asterixis is a "flapping tremor" of the hands, a classic sign of hepatic
encephalopathy due to high ammonia.
8. Which lab value is most critical to monitor for a patient on a Heparin drip?
A. PT/INR.
B. aPTT (activated Partial Thromboplastin Time).
C. Platelet count.
D. Hemoglobin.
,2026 UPDATED QUESTIONS DOWNLOAD
Rationale: aPTT is used to titrate the dose of Heparin to ensure therapeutic
anticoagulation.
9. A patient is in Ventricular Fibrillation (V-fib). What is the nurse's first action?
A. Administer Epinephrine.
B. Check for a carotid pulse.
C. Perform immediate defibrillation.
D. Start a synchronized cardioversion.
Rationale: V-fib is a non-perfusing rhythm; "D-fib for V-fib" is the only way to restore a
rhythm.
10. A patient with a stroke has "Hemianopsia." What is the best nursing intervention?
A. Keep the patient NPO.
B. Teach the patient to scan their environment by turning their head.
C. Place the call bell on the affected side.
D. Patch the unaffected eye.
Rationale: Hemianopsia is the loss of half the visual field; scanning helps the patient see
the "missing" side of their world.
11. Which medication is the "clot buster" used for an Ischemic Stroke?
A. Heparin.
B. Alteplase (tPA).
C. Warfarin.
D. Aspirin.
Rationale: tPA dissolves the existing clot to restore blood flow to the brain, but it must be
given within a specific timeframe.
12. A patient with a lumbar puncture has a severe headache while sitting up. What is the
nurse's priority?
A. Place the patient in a flat, supine position.
B. Increase the room lighting.
C. Offer a high-protein snack.
D. Encourage the patient to walk.
Rationale: A "spinal headache" is caused by CSF leakage; keeping the patient flat helps
equalize pressure and reduce pain.
13. What does the "QRS complex" represent on an EKG?
A. Atrial contraction.
B. Ventricular depolarization (contraction).
C. Ventricular resting phase.
, 2026 UPDATED QUESTIONS DOWNLOAD
D. SA node firing.
Rationale: The QRS reflects the electrical impulse traveling through the ventricles.
14. A patient has a "Positive Trousseau’s Sign." This indicates a deficiency in:
A. Sodium.
B. Potassium.
C. Calcium.
D. Magnesium.
Rationale: A carpal spasm induced by inflating a BP cuff is a hallmark sign of
hypocalcemia.
15. What is the goal of Lactulose therapy in a patient with Liver Failure?
A. To stop diarrhea.
B. To reduce ammonia levels via the stool.
C. To increase blood pressure.
D. To promote weight gain.
Rationale: Lactulose binds to ammonia in the gut and expels it, improving the patient's
mental status.
16. A nurse is assessing a chest tube and notes "Tidaling" in the water seal chamber. What
does this mean?
A. There is an air leak in the system.
B. The suction is too high.
C. The system is functioning normally.
D. The tube is obstructed.
Rationale: Tidaling (water moving up/down with breaths) shows the tube is patent and
open to the pleural space.
17. Which cranial nerve is responsible for the "Gag Reflex"?
A. CN V (Trigeminal).
B. CN IX (Glossopharyngeal) and CN X (Vagus).
C. CN VII (Facial).
D. CN XII (Hypoglossal).
Rationale: These nerves control the muscles of the throat; a missing gag reflex is a
major aspiration risk.
18. A patient is receiving Magnesium Sulfate. Which finding indicates toxicity?
A. Hyperactive reflexes.
B. Loss of Deep Tendon Reflexes (DTRs).
C. Rapid heart rate.
D. Increased urine output.
NUR 325 Exam 2 Comprehensive 350-Question Study
Guide 2026
This guide provides a massive bank of 350 practice questions covering high-yield
nursing concepts for Health and Illness II. It focuses on critical topics like advanced
respiratory care, cardiac dysrhythmias, neurological emergencies, and renal-hepatic
failure. Every question includes a bolded answer and an italicized rationale to help
you master the "why" behind the nursing interventions.
1. A patient with a head injury has a widening pulse pressure and bradycardia. What is the
nurse's priority?
A. Administer a bolus of Normal Saline.
B. Notify the provider of signs of increased ICP.
C. Increase the room temperature.
D. Encourage the patient to cough and deep breathe.
Rationale: Widening pulse pressure and bradycardia are parts of Cushing’s Triad,
indicating late-stage increased intracranial pressure and potential brain herniation.
2. A patient with a chest tube is being transported. What should the nurse do with the
drainage system?
A. Clamp the chest tube during transport.
B. Keep the drainage system below the level of the chest.
C. Disconnect the suction and leave the tube open to air.
D. Carry the drainage unit on the patient's lap.
Rationale: Gravity is required to maintain drainage and prevent fluid from backflowing
into the pleural space; clamping is avoided as it can cause a tension pneumothorax.
3. Which rhythm is characterized by a "sawtooth" pattern on the EKG?
A. Atrial Fibrillation.
B. Atrial Flutter.
C. Ventricular Tachycardia.
D. Sinus Bradycardia.
Rationale: Atrial flutter is identified by regular, rapid "F-waves" that resemble the teeth of
a saw.
,2026 UPDATED QUESTIONS DOWNLOAD
4. A patient with Chronic Kidney Disease (CKD) has a potassium of 6.8. Which medication
does the nurse expect to give first for heart protection?
A. Kayexalate.
B. Calcium Gluconate IV.
C. Regular Insulin.
D. Furosemide.
Rationale: While insulin and Kayexalate lower potassium, Calcium Gluconate is the
priority to stabilize the cardiac membrane and prevent arrest.
5. A patient with a T3 spinal cord injury reports a sudden, severe headache. What is the
first action?
A. Check the patient's blood pressure.
B. Administer PRN Tylenol.
C. Dim the lights and close the door.
D. Perform a neurological assessment.
Rationale: A severe headache in an SCI patient above T6 is the classic sign of
Autonomic Dysreflexia; BP must be checked immediately.
6. What is the primary purpose of PEEP (Positive End-Expiratory Pressure) in ARDS?
A. To decrease the work of the heart.
B. To prevent alveolar collapse at the end of expiration.
C. To clear secretions from the bronchi.
D. To sedate the patient.
Rationale: PEEP keeps the alveoli open, improving gas exchange and functional
residual capacity in "stiff" lungs.
7. A patient with Cirrhosis has "Asterixis." How does the nurse assess this?
A. Ask the patient to walk across the room.
B. Ask the patient to extend their arms and dorsiflex their wrists.
C. Check for yellowing of the sclera.
D. Palpate the right upper quadrant.
Rationale: Asterixis is a "flapping tremor" of the hands, a classic sign of hepatic
encephalopathy due to high ammonia.
8. Which lab value is most critical to monitor for a patient on a Heparin drip?
A. PT/INR.
B. aPTT (activated Partial Thromboplastin Time).
C. Platelet count.
D. Hemoglobin.
,2026 UPDATED QUESTIONS DOWNLOAD
Rationale: aPTT is used to titrate the dose of Heparin to ensure therapeutic
anticoagulation.
9. A patient is in Ventricular Fibrillation (V-fib). What is the nurse's first action?
A. Administer Epinephrine.
B. Check for a carotid pulse.
C. Perform immediate defibrillation.
D. Start a synchronized cardioversion.
Rationale: V-fib is a non-perfusing rhythm; "D-fib for V-fib" is the only way to restore a
rhythm.
10. A patient with a stroke has "Hemianopsia." What is the best nursing intervention?
A. Keep the patient NPO.
B. Teach the patient to scan their environment by turning their head.
C. Place the call bell on the affected side.
D. Patch the unaffected eye.
Rationale: Hemianopsia is the loss of half the visual field; scanning helps the patient see
the "missing" side of their world.
11. Which medication is the "clot buster" used for an Ischemic Stroke?
A. Heparin.
B. Alteplase (tPA).
C. Warfarin.
D. Aspirin.
Rationale: tPA dissolves the existing clot to restore blood flow to the brain, but it must be
given within a specific timeframe.
12. A patient with a lumbar puncture has a severe headache while sitting up. What is the
nurse's priority?
A. Place the patient in a flat, supine position.
B. Increase the room lighting.
C. Offer a high-protein snack.
D. Encourage the patient to walk.
Rationale: A "spinal headache" is caused by CSF leakage; keeping the patient flat helps
equalize pressure and reduce pain.
13. What does the "QRS complex" represent on an EKG?
A. Atrial contraction.
B. Ventricular depolarization (contraction).
C. Ventricular resting phase.
, 2026 UPDATED QUESTIONS DOWNLOAD
D. SA node firing.
Rationale: The QRS reflects the electrical impulse traveling through the ventricles.
14. A patient has a "Positive Trousseau’s Sign." This indicates a deficiency in:
A. Sodium.
B. Potassium.
C. Calcium.
D. Magnesium.
Rationale: A carpal spasm induced by inflating a BP cuff is a hallmark sign of
hypocalcemia.
15. What is the goal of Lactulose therapy in a patient with Liver Failure?
A. To stop diarrhea.
B. To reduce ammonia levels via the stool.
C. To increase blood pressure.
D. To promote weight gain.
Rationale: Lactulose binds to ammonia in the gut and expels it, improving the patient's
mental status.
16. A nurse is assessing a chest tube and notes "Tidaling" in the water seal chamber. What
does this mean?
A. There is an air leak in the system.
B. The suction is too high.
C. The system is functioning normally.
D. The tube is obstructed.
Rationale: Tidaling (water moving up/down with breaths) shows the tube is patent and
open to the pleural space.
17. Which cranial nerve is responsible for the "Gag Reflex"?
A. CN V (Trigeminal).
B. CN IX (Glossopharyngeal) and CN X (Vagus).
C. CN VII (Facial).
D. CN XII (Hypoglossal).
Rationale: These nerves control the muscles of the throat; a missing gag reflex is a
major aspiration risk.
18. A patient is receiving Magnesium Sulfate. Which finding indicates toxicity?
A. Hyperactive reflexes.
B. Loss of Deep Tendon Reflexes (DTRs).
C. Rapid heart rate.
D. Increased urine output.
