NU155 MEDICAL SURGICAL NURSING I
ACTUAL EXAM PAPER 2026 SOLVED
QUESTIONS WITH FULL SOLUTION
GRADED A+
◉ vesicular breath sounds Answer: -heard in the 6th intercostal space
over lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
◉ Bronchovescular breath sounds Answer: -heard main-stem bronchi,
below clavicles, beside sternum, posteriorly, between scapulae
-sounds like moderate high pitches hollow muffled
equal sounds on inspiration and expiration
◉ Bronchial breath sounds Answer: -heard over trachea above sternal
notch (often indicate atelectasis)
-sounds high pitched, loud harsh tubular quality, inspiration half as long
as expiration
◉ COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S,
N/I, pt. teaching) Answer: -combo of *chronic bronchitis, asthma, and
emphysema*
-caused by: *tobacco smoke (90%)*, occupational hazards like farming,
biomass fuels, firefighters
-*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG
, -*S/S*: dyspnea, barrel chest, polycythemia (high RBC), hypercapnia
(high CO2), coughing up in the morning
-*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated liquids
-teach pt: avoid over eating, smaller bites, increase fluid and calcium,
adequate protein, rest before eating and meds, and avoid lying down
after
◉ Thyroid Storm (thyroid crisis) Answer: -*causes*: drugs or dyes with
iodine, pregnancy/child birth, M.I. or cardiac emergencies, severe
emotional distress, trauma, surgery, levothyroxine overdose
-*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness,
agitation, confusion, if *untreated* delirium to coma to heart failure to
death
-*Tx*: MUST begin as soon as symptoms occur!, reduce temp. slow
HR, sedatives, increase fluid avoid dehydration
◉ DKA -VS- HHS Answer: +DKA (Type 1): hyperglycemic crisis
associated with elevated ketones!
+HHS (Type 2): hyperglycemic crisis without association of ketones!
-*DKA:* BS >300mg/dL *HHS:* BS > 600mg/dL
*DKA* Ketonuria
-*HHS* Older adults at higher risk, and higher mortality r/t severe
dehydration and extreme hyperglycemia (than DKA)
-*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO
KETOACIDOSIS
-*DKA:* Kussmaul breathing *HHS:* Seizures
ACTUAL EXAM PAPER 2026 SOLVED
QUESTIONS WITH FULL SOLUTION
GRADED A+
◉ vesicular breath sounds Answer: -heard in the 6th intercostal space
over lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
◉ Bronchovescular breath sounds Answer: -heard main-stem bronchi,
below clavicles, beside sternum, posteriorly, between scapulae
-sounds like moderate high pitches hollow muffled
equal sounds on inspiration and expiration
◉ Bronchial breath sounds Answer: -heard over trachea above sternal
notch (often indicate atelectasis)
-sounds high pitched, loud harsh tubular quality, inspiration half as long
as expiration
◉ COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S,
N/I, pt. teaching) Answer: -combo of *chronic bronchitis, asthma, and
emphysema*
-caused by: *tobacco smoke (90%)*, occupational hazards like farming,
biomass fuels, firefighters
-*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG
, -*S/S*: dyspnea, barrel chest, polycythemia (high RBC), hypercapnia
(high CO2), coughing up in the morning
-*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated liquids
-teach pt: avoid over eating, smaller bites, increase fluid and calcium,
adequate protein, rest before eating and meds, and avoid lying down
after
◉ Thyroid Storm (thyroid crisis) Answer: -*causes*: drugs or dyes with
iodine, pregnancy/child birth, M.I. or cardiac emergencies, severe
emotional distress, trauma, surgery, levothyroxine overdose
-*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness,
agitation, confusion, if *untreated* delirium to coma to heart failure to
death
-*Tx*: MUST begin as soon as symptoms occur!, reduce temp. slow
HR, sedatives, increase fluid avoid dehydration
◉ DKA -VS- HHS Answer: +DKA (Type 1): hyperglycemic crisis
associated with elevated ketones!
+HHS (Type 2): hyperglycemic crisis without association of ketones!
-*DKA:* BS >300mg/dL *HHS:* BS > 600mg/dL
*DKA* Ketonuria
-*HHS* Older adults at higher risk, and higher mortality r/t severe
dehydration and extreme hyperglycemia (than DKA)
-*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO
KETOACIDOSIS
-*DKA:* Kussmaul breathing *HHS:* Seizures
