1
NU 155 Exams 1-3 & Final Medical Surgical
Nursing I Galen College Actual Exam 2026/2027
– Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
[EXAM 1: Cardiovascular & Respiratory Disorders — Questions 1-50]
Q1: A patient with heart failure presents with dyspnea, orthopnea, and bilateral crackles in the
lung bases. The nurse recognizes that these symptoms are primarily caused by which
physiological mechanism?
A. Decreased cardiac output leading to hypotension.
B. Left ventricular failure causing pulmonary congestion. [CORRECT]
C. Right ventricular failure causing systemic edema.
D. Increased contractility of the myocardium.
Correct Answer: B
Rationale: The symptoms of dyspnea, orthopnea, and crackles are classic signs of pulmonary
fluid overload resulting from the left ventricle's inability to pump blood forward effectively. This
backup increases pressure in the pulmonary vasculature, forcing fluid into the alveoli. Right-
sided heart failure typically causes systemic edema and jugular venous distension, not pulmonary
congestion.
Q2: A nurse is teaching a patient recently diagnosed with hypertension about lifestyle
modifications. Which statement by the patient indicates a need for further teaching?
A. "I will limit my sodium intake to no more than 2,300 mg per day."
B. "I will aim to exercise for at least 30 minutes most days of the week."
C. "I can stop taking my medication if my blood pressure stays normal for a week." [CORRECT]
D. "I will limit my alcohol intake to one drink a day if I'm a man."
Correct Answer: C
,2
Rationale: Hypertension is a chronic condition that typically requires lifelong medication
management; stopping medication abruptly without physician supervision can lead to a rebound
hypertensive crisis. Lifestyle changes and medication work together to maintain blood pressure
goals, but "normal" readings often result from the medication's effect. The patient should consult
the provider before altering the medication regimen.
Q3: A patient admitted with unstable angina is prescribed nitroglycerin tablets sublingual. What
instruction should the nurse include regarding the administration of this drug?
A. Swallow the tablet with a full glass of water to prevent esophageal irritation.
B. Take the tablet only when chest pain is severe and radiating to the arm.
C. Call 911 immediately if pain is not relieved after taking 3 doses spaced 5 minutes apart.
[CORRECT]
D. Store the tablets in a humid environment, such as the bathroom medicine cabinet.
Correct Answer: C
Rationale: Standard guidelines for nitroglycerin use in angina involve taking one dose every 5
minutes for chest pain. If the pain persists after three doses (15 minutes), the patient should seek
emergency medical attention, as this may indicate an evolving myocardial infarction.
Nitroglycerin should be taken sublingually (not swallowed) and stored in a cool, dry place (not
the bathroom).
Q4: The nurse is caring for a patient 2 days post-myocardial infarction (MI). The patient
suddenly reports sharp, stabbing chest pain that increases with inspiration and leaning forward.
Which complication should the nurse suspect?
A. Reinfarction
B. Ventricular aneurysm
C. Pericarditis [CORRECT]
D. Pulmonary embolism
Correct Answer: C
,3
Rationale: The classic symptom of pericarditis, a common complication of MI (Dressler's
syndrome or early pericarditis), is sharp, pleuritic chest pain that worsens with inspiration and
sitting up/leaning forward, and improves with leaning forward. Reinfarction pain typically
mimics the original MI pressure-like pain. Pulmonary embolism also causes pleuritic pain but is
usually associated with dyspnea and tachycardia, without relief from leaning forward.
Q5: When auscultating the heart sounds of a patient with mitral stenosis, the nurse expects to
hear which sound?
A. Systolic ejection click
B. Diastolic murmur [CORRECT]
C. Continuous machinery murmur
D. Pericardial friction rub
Correct Answer: B
Rationale: Mitral stenosis impairs blood flow from the left atrium to the left ventricle during
diastole, creating a turbulent flow that produces a diastolic murmur best heard at the apex. A
systolic murmur is more associated with mitral regurgitation or aortic stenosis. A continuous
machinery murmur is indicative of a patent ductus arteriosus.
Q6: A patient with heart failure is prescribed Digoxin. The nurse monitors the patient for which
sign of Digoxin toxicity?
A. Hypertension
B. Hyperglycemia
C. Visual disturbances (yellow halos) [CORRECT]
D. Wheezing
Correct Answer: C
Rationale: Visual disturbances, such as seeing yellow halos around lights (xanthopsia), are a
classic and specific sign of Digoxin toxicity. Other signs include nausea, vomiting, bradycardia,
and cardiac dysrhythmias. Hypertension and wheezing are not typical signs of digoxin toxicity;
instead, bradycardia and arrhythmias are common cardiac symptoms.
, 4
Q7: A patient is admitted with a diagnosis of Deep Vein Thrombosis (DVT). Which assessment
finding is most commonly associated with this condition?
A. Positive Homans’ sign (pain on dorsiflexion)
C. Unilateral calf swelling and warmth [CORRECT]
D. Bilateral pitting edema
E. Pallor of the affected extremity
Correct Answer: C
Rationale: While Homans' sign was historically taught, it is unreliable and not recommended for
diagnosis. The most reliable clinical signs of DVT are unilateral swelling, warmth, redness, and
tenderness in the affected extremity. Bilateral edema suggests systemic issues like heart failure.
Pallor is more associated with arterial occlusion, not venous insufficiency.
Q8: The nurse is preparing to administer enoxaparin (Lovenox) subcutaneously to a patient.
What is the correct technique?
A. Massage the site after injection to facilitate absorption.
B. Aspirate before injecting to ensure a vessel has not been hit.
C. Inject into the abdominal tissue, pinching a fold of skin. [CORRECT]
D. Change the needle after drawing up the medication.
Correct Answer: C
Rationale: Low-molecular-weight heparins like enoxaparin are administered subcutaneously into
the abdominal fat, ensuring the needle is not injected into muscle. Massage should be avoided to
prevent bruising. Aspiration is not recommended for LMWHs. Prefilled syringes do not require
needle changes, though air bubbles should not be expelled prior to injection in some systems to
ensure full dose delivery.
Q9: Which electrocardiogram (ECG) change is most specific for a patient experiencing an acute
ST-elevation myocardial infarction (STEMI)?
NU 155 Exams 1-3 & Final Medical Surgical
Nursing I Galen College Actual Exam 2026/2027
– Complete Exam-Style Questions with Detailed
Rationales | Pass Guaranteed – A+ Graded
[EXAM 1: Cardiovascular & Respiratory Disorders — Questions 1-50]
Q1: A patient with heart failure presents with dyspnea, orthopnea, and bilateral crackles in the
lung bases. The nurse recognizes that these symptoms are primarily caused by which
physiological mechanism?
A. Decreased cardiac output leading to hypotension.
B. Left ventricular failure causing pulmonary congestion. [CORRECT]
C. Right ventricular failure causing systemic edema.
D. Increased contractility of the myocardium.
Correct Answer: B
Rationale: The symptoms of dyspnea, orthopnea, and crackles are classic signs of pulmonary
fluid overload resulting from the left ventricle's inability to pump blood forward effectively. This
backup increases pressure in the pulmonary vasculature, forcing fluid into the alveoli. Right-
sided heart failure typically causes systemic edema and jugular venous distension, not pulmonary
congestion.
Q2: A nurse is teaching a patient recently diagnosed with hypertension about lifestyle
modifications. Which statement by the patient indicates a need for further teaching?
A. "I will limit my sodium intake to no more than 2,300 mg per day."
B. "I will aim to exercise for at least 30 minutes most days of the week."
C. "I can stop taking my medication if my blood pressure stays normal for a week." [CORRECT]
D. "I will limit my alcohol intake to one drink a day if I'm a man."
Correct Answer: C
,2
Rationale: Hypertension is a chronic condition that typically requires lifelong medication
management; stopping medication abruptly without physician supervision can lead to a rebound
hypertensive crisis. Lifestyle changes and medication work together to maintain blood pressure
goals, but "normal" readings often result from the medication's effect. The patient should consult
the provider before altering the medication regimen.
Q3: A patient admitted with unstable angina is prescribed nitroglycerin tablets sublingual. What
instruction should the nurse include regarding the administration of this drug?
A. Swallow the tablet with a full glass of water to prevent esophageal irritation.
B. Take the tablet only when chest pain is severe and radiating to the arm.
C. Call 911 immediately if pain is not relieved after taking 3 doses spaced 5 minutes apart.
[CORRECT]
D. Store the tablets in a humid environment, such as the bathroom medicine cabinet.
Correct Answer: C
Rationale: Standard guidelines for nitroglycerin use in angina involve taking one dose every 5
minutes for chest pain. If the pain persists after three doses (15 minutes), the patient should seek
emergency medical attention, as this may indicate an evolving myocardial infarction.
Nitroglycerin should be taken sublingually (not swallowed) and stored in a cool, dry place (not
the bathroom).
Q4: The nurse is caring for a patient 2 days post-myocardial infarction (MI). The patient
suddenly reports sharp, stabbing chest pain that increases with inspiration and leaning forward.
Which complication should the nurse suspect?
A. Reinfarction
B. Ventricular aneurysm
C. Pericarditis [CORRECT]
D. Pulmonary embolism
Correct Answer: C
,3
Rationale: The classic symptom of pericarditis, a common complication of MI (Dressler's
syndrome or early pericarditis), is sharp, pleuritic chest pain that worsens with inspiration and
sitting up/leaning forward, and improves with leaning forward. Reinfarction pain typically
mimics the original MI pressure-like pain. Pulmonary embolism also causes pleuritic pain but is
usually associated with dyspnea and tachycardia, without relief from leaning forward.
Q5: When auscultating the heart sounds of a patient with mitral stenosis, the nurse expects to
hear which sound?
A. Systolic ejection click
B. Diastolic murmur [CORRECT]
C. Continuous machinery murmur
D. Pericardial friction rub
Correct Answer: B
Rationale: Mitral stenosis impairs blood flow from the left atrium to the left ventricle during
diastole, creating a turbulent flow that produces a diastolic murmur best heard at the apex. A
systolic murmur is more associated with mitral regurgitation or aortic stenosis. A continuous
machinery murmur is indicative of a patent ductus arteriosus.
Q6: A patient with heart failure is prescribed Digoxin. The nurse monitors the patient for which
sign of Digoxin toxicity?
A. Hypertension
B. Hyperglycemia
C. Visual disturbances (yellow halos) [CORRECT]
D. Wheezing
Correct Answer: C
Rationale: Visual disturbances, such as seeing yellow halos around lights (xanthopsia), are a
classic and specific sign of Digoxin toxicity. Other signs include nausea, vomiting, bradycardia,
and cardiac dysrhythmias. Hypertension and wheezing are not typical signs of digoxin toxicity;
instead, bradycardia and arrhythmias are common cardiac symptoms.
, 4
Q7: A patient is admitted with a diagnosis of Deep Vein Thrombosis (DVT). Which assessment
finding is most commonly associated with this condition?
A. Positive Homans’ sign (pain on dorsiflexion)
C. Unilateral calf swelling and warmth [CORRECT]
D. Bilateral pitting edema
E. Pallor of the affected extremity
Correct Answer: C
Rationale: While Homans' sign was historically taught, it is unreliable and not recommended for
diagnosis. The most reliable clinical signs of DVT are unilateral swelling, warmth, redness, and
tenderness in the affected extremity. Bilateral edema suggests systemic issues like heart failure.
Pallor is more associated with arterial occlusion, not venous insufficiency.
Q8: The nurse is preparing to administer enoxaparin (Lovenox) subcutaneously to a patient.
What is the correct technique?
A. Massage the site after injection to facilitate absorption.
B. Aspirate before injecting to ensure a vessel has not been hit.
C. Inject into the abdominal tissue, pinching a fold of skin. [CORRECT]
D. Change the needle after drawing up the medication.
Correct Answer: C
Rationale: Low-molecular-weight heparins like enoxaparin are administered subcutaneously into
the abdominal fat, ensuring the needle is not injected into muscle. Massage should be avoided to
prevent bruising. Aspiration is not recommended for LMWHs. Prefilled syringes do not require
needle changes, though air bubbles should not be expelled prior to injection in some systems to
ensure full dose delivery.
Q9: Which electrocardiogram (ECG) change is most specific for a patient experiencing an acute
ST-elevation myocardial infarction (STEMI)?
