NU189 | NU 189 Medical-Surgical Nursing II
Midterm v1 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A patient with left-sided heart failure is being assessed by the nurse. Which clinical
manifestation should the nurse expect to find?
A. Jugular venous distention
B. Crackles in the lungs
C. Peripheral edema
D. Abdominal distention
Correct Answer: B
Expert Explanation: Left-sided heart failure leads to pulmonary congestion
because the left ventricle cannot pump blood efficiently to the body. This results in
fluid backing up into the lungs, which manifests as crackles, dyspnea, and
orthopnea. Right-sided heart failure is more likely to cause systemic issues like
jugular venous distention and peripheral edema.
2. The nurse is caring for a patient with Chronic Obstructive Pulmonary Disease
(COPD) who is receiving oxygen therapy. What is the primary concern when
administering high concentrations of oxygen?
A. Oxygen toxicity syndrome
,B. Suppression of the respiratory drive
C. Development of pneumonia
D. Increased sputum production
Correct Answer: B
Expert Explanation: In patients with severe COPD, the stimulus to breathe is often
a low arterial oxygen level rather than a high carbon dioxide level. Administering
high levels of oxygen can remove this stimulus, leading to hypoventilation and
potential respiratory arrest. The nurse must carefully titrate oxygen to maintain an
appropriate saturation level, usually between 88 percent and 92 percent.
3. Which dietary modification is most appropriate for a patient diagnosed with
Chronic Kidney Disease (CKD) who is not yet on dialysis?
A. High protein, high potassium intake
B. Low carbohydrate, high fat intake
C. Restricted protein, sodium, and potassium
D. Increased fluid intake to flush the kidneys
Correct Answer: C
Expert Explanation: Chronic Kidney Disease requires limiting the intake of protein
to reduce the buildup of nitrogenous waste products. Sodium and potassium
,restrictions are necessary to prevent fluid overload and life-threatening
arrhythmias. Fluid restriction may also be required depending on the patient’s urine
output and stage of the disease.
4. A patient with Type 1 Diabetes Mellitus is found sweaty, shaky, and confused. What
is the nurse’s immediate priority action?
A. Administer 10 units of regular insulin
B. Call the healthcare provider immediately
C. Check the patient’s blood pressure
D. Check blood glucose and provide a fast-acting carbohydrate
Correct Answer: D
Expert Explanation: The patient is exhibiting classic signs of hypoglycemia, which
is a medical emergency that requires rapid intervention. Checking the blood glucose
confirms the condition, and providing 15 grams of simple carbohydrates like juice
or glucose tabs helps raise blood sugar quickly. Safety is the priority to prevent loss
of consciousness or seizures.
5. The nurse is assessing a patient with liver cirrhosis and significant ascites. Which
nursing intervention is most important for managing respiratory effort?
A. Place the patient in a semi-Fowler’s position
B. Encourage the patient to drink more fluids
, C. Perform vigorous chest physiotherapy
D. Keep the patient in a prone position
Correct Answer: A
Expert Explanation: Ascites increases intra-abdominal pressure, which pushes the
diaphragm upward and limits lung expansion. Placing the patient in a semi-Fowler’s
or high-Fowler’s position allows gravity to pull the abdominal contents down,
easing the work of breathing. The nurse should also monitor respiratory rate and
oxygen saturation closely.
6. A patient is suspected of having an ischemic stroke. Which diagnostic test is the
priority to perform first?
A. Lumbar puncture
B. Non-contrast Computed Tomography (CT) scan
C. Magnetic Resonance Imaging (MRI)
D. Electroencephalogram (EEG)
Correct Answer: B
Expert Explanation: A non-contrast CT scan is the gold standard for the initial
evaluation of a suspected stroke to rule out a brain hemorrhage. Determining
whether the stroke is ischemic or hemorrhagic is crucial because the treatments,
Midterm v1 | Questions with Correct Answers and
Expert Explanation for Each Question | Galen
1. A patient with left-sided heart failure is being assessed by the nurse. Which clinical
manifestation should the nurse expect to find?
A. Jugular venous distention
B. Crackles in the lungs
C. Peripheral edema
D. Abdominal distention
Correct Answer: B
Expert Explanation: Left-sided heart failure leads to pulmonary congestion
because the left ventricle cannot pump blood efficiently to the body. This results in
fluid backing up into the lungs, which manifests as crackles, dyspnea, and
orthopnea. Right-sided heart failure is more likely to cause systemic issues like
jugular venous distention and peripheral edema.
2. The nurse is caring for a patient with Chronic Obstructive Pulmonary Disease
(COPD) who is receiving oxygen therapy. What is the primary concern when
administering high concentrations of oxygen?
A. Oxygen toxicity syndrome
,B. Suppression of the respiratory drive
C. Development of pneumonia
D. Increased sputum production
Correct Answer: B
Expert Explanation: In patients with severe COPD, the stimulus to breathe is often
a low arterial oxygen level rather than a high carbon dioxide level. Administering
high levels of oxygen can remove this stimulus, leading to hypoventilation and
potential respiratory arrest. The nurse must carefully titrate oxygen to maintain an
appropriate saturation level, usually between 88 percent and 92 percent.
3. Which dietary modification is most appropriate for a patient diagnosed with
Chronic Kidney Disease (CKD) who is not yet on dialysis?
A. High protein, high potassium intake
B. Low carbohydrate, high fat intake
C. Restricted protein, sodium, and potassium
D. Increased fluid intake to flush the kidneys
Correct Answer: C
Expert Explanation: Chronic Kidney Disease requires limiting the intake of protein
to reduce the buildup of nitrogenous waste products. Sodium and potassium
,restrictions are necessary to prevent fluid overload and life-threatening
arrhythmias. Fluid restriction may also be required depending on the patient’s urine
output and stage of the disease.
4. A patient with Type 1 Diabetes Mellitus is found sweaty, shaky, and confused. What
is the nurse’s immediate priority action?
A. Administer 10 units of regular insulin
B. Call the healthcare provider immediately
C. Check the patient’s blood pressure
D. Check blood glucose and provide a fast-acting carbohydrate
Correct Answer: D
Expert Explanation: The patient is exhibiting classic signs of hypoglycemia, which
is a medical emergency that requires rapid intervention. Checking the blood glucose
confirms the condition, and providing 15 grams of simple carbohydrates like juice
or glucose tabs helps raise blood sugar quickly. Safety is the priority to prevent loss
of consciousness or seizures.
5. The nurse is assessing a patient with liver cirrhosis and significant ascites. Which
nursing intervention is most important for managing respiratory effort?
A. Place the patient in a semi-Fowler’s position
B. Encourage the patient to drink more fluids
, C. Perform vigorous chest physiotherapy
D. Keep the patient in a prone position
Correct Answer: A
Expert Explanation: Ascites increases intra-abdominal pressure, which pushes the
diaphragm upward and limits lung expansion. Placing the patient in a semi-Fowler’s
or high-Fowler’s position allows gravity to pull the abdominal contents down,
easing the work of breathing. The nurse should also monitor respiratory rate and
oxygen saturation closely.
6. A patient is suspected of having an ischemic stroke. Which diagnostic test is the
priority to perform first?
A. Lumbar puncture
B. Non-contrast Computed Tomography (CT) scan
C. Magnetic Resonance Imaging (MRI)
D. Electroencephalogram (EEG)
Correct Answer: B
Expert Explanation: A non-contrast CT scan is the gold standard for the initial
evaluation of a suspected stroke to rule out a brain hemorrhage. Determining
whether the stroke is ischemic or hemorrhagic is crucial because the treatments,
