NU 155 Medical-Surgical Nursing I Exam 3
Prep 2026 | Galen College Study Guide |
Practice Questions & Answers with
Rationales
• This -question Med-Surg I Exam 3 prep guide for Galen College covers
cardiovascular, respiratory, hematologic, neurological, endocrine, renal, and
perioperative nursing — with bolded questions, bolded correct answers, and
concise evidence-based EXPERT RATIONALE for every item.
• For best results, cover the answer section and attempt each question
independently before checking — active recall and repetition are your most
powerful study tools.
NU 155 MEDICAL-SURGICAL NURSING I — EXAM 3 PREP 2026
Galen College of Nursing | Practice Questions & EXPERT RATIONALE
SECTION 1: CARDIOVASCULAR DISORDERS
1. A nurse is assessing a patient with left-sided heart failure. Which finding
does the nurse most expect?
A. Peripheral pitting edema
B. Jugular vein distension
C. Hepatomegaly
D. Bilateral crackles in the lungs
E. Ascites
✓ Correct Answer: D. Bilateral crackles in the lungs
EXPERT RATIONALE: Left-sided heart failure causes blood to back up into the
pulmonary vasculature, resulting in pulmonary congestion and crackles upon
,auscultation. Peripheral edema, JVD, hepatomegaly, and ascites are characteristic of
right-sided heart failure.
2. A patient with right-sided heart failure is most likely to exhibit which
symptom?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Pulmonary edema
D. Peripheral edema and weight gain
E. Frothy pink sputum
✓ Correct Answer: D. Peripheral edema and weight gain
EXPERT RATIONALE: Right-sided heart failure causes fluid to accumulate in the
systemic circulation, leading to peripheral edema, JVD, hepatomegaly, and weight
gain. Orthopnea, PND, and frothy pink sputum are signs of left-sided failure.
3. The nurse is caring for a patient with acute myocardial infarction (MI).
Which laboratory value is most specific for cardiac muscle damage?
A. Myoglobin
B. C-reactive protein (CRP)
C. Troponin I
D. Creatine kinase-MM (CK-MM)
E. Lactate dehydrogenase (LDH)
✓ Correct Answer: C. Troponin I
EXPERT RATIONALE: Troponin I and Troponin T are the most specific and sensitive
biomarkers for myocardial damage. They rise within 3–6 hours of MI, peak at 14–18
,hours, and remain elevated for 5–14 days. CK-MM is skeletal muscle specific;
myoglobin is non-specific.
4. A patient is diagnosed with unstable angina. Which characteristic best
distinguishes it from stable angina?
A. It is relieved with rest and nitroglycerin
B. It is predictable and follows a consistent pattern
C. It occurs at rest and is unpredictable
D. It is caused by exercise
E. It resolves spontaneously without intervention
✓ Correct Answer: C. It occurs at rest and is unpredictable
EXPERT RATIONALE: Unstable angina is unpredictable, may occur at rest, and is
not reliably relieved by nitroglycerin or rest. It represents an acute coronary
syndrome and is a medical emergency. Stable angina is predictable, triggered by
exertion, and relieved by rest or nitroglycerin.
5. A nurse is educating a patient prescribed sublingual nitroglycerin. Which
instruction is most important?
A. "Swallow the tablet with a full glass of water."
B. "Take up to 5 tablets if pain persists."
C. "Place the tablet under your tongue and call 911 if pain is not relieved after 3
doses in 15 minutes."
D. "Store the medication in a clear container on your nightstand."
E. "Take the medication only when the pain becomes unbearable."
✓ Correct Answer: C. "Place the tablet under your tongue and call 911 if pain is
not relieved after 3 doses in 15 minutes."
, EXPERT RATIONALE: The standard teaching is to place one tablet under the
tongue, wait 5 minutes, and repeat up to 3 doses. If pain is not relieved after the
third dose, the patient should call emergency services as an MI may be occurring.
The medication is absorbed sublingually and should never be swallowed.
6. A patient with hypertension has a blood pressure reading of 170/105
mmHg. This is classified as which stage?
A. Elevated blood pressure
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Hypertensive urgency
E. Normal blood pressure
✓ Correct Answer: C. Stage 2 hypertension
EXPERT RATIONALE: Stage 2 hypertension is defined as systolic BP ≥140 mmHg or
diastolic BP ≥90 mmHg (JNC 7). A reading of 170/105 mmHg clearly falls into Stage 2
and requires pharmacological treatment in addition to lifestyle modifications.
7. Which dietary instruction is the priority for a patient with hypertension?
A. Increase calcium intake
B. Follow a DASH diet and limit sodium to less than 2.4 g/day
C. Increase protein intake
D. Avoid all dietary fat
E. Drink at least 3 liters of fluid daily
✓ Correct Answer: B. Follow a DASH diet and limit sodium to less than 2.4
g/day
Prep 2026 | Galen College Study Guide |
Practice Questions & Answers with
Rationales
• This -question Med-Surg I Exam 3 prep guide for Galen College covers
cardiovascular, respiratory, hematologic, neurological, endocrine, renal, and
perioperative nursing — with bolded questions, bolded correct answers, and
concise evidence-based EXPERT RATIONALE for every item.
• For best results, cover the answer section and attempt each question
independently before checking — active recall and repetition are your most
powerful study tools.
NU 155 MEDICAL-SURGICAL NURSING I — EXAM 3 PREP 2026
Galen College of Nursing | Practice Questions & EXPERT RATIONALE
SECTION 1: CARDIOVASCULAR DISORDERS
1. A nurse is assessing a patient with left-sided heart failure. Which finding
does the nurse most expect?
A. Peripheral pitting edema
B. Jugular vein distension
C. Hepatomegaly
D. Bilateral crackles in the lungs
E. Ascites
✓ Correct Answer: D. Bilateral crackles in the lungs
EXPERT RATIONALE: Left-sided heart failure causes blood to back up into the
pulmonary vasculature, resulting in pulmonary congestion and crackles upon
,auscultation. Peripheral edema, JVD, hepatomegaly, and ascites are characteristic of
right-sided heart failure.
2. A patient with right-sided heart failure is most likely to exhibit which
symptom?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Pulmonary edema
D. Peripheral edema and weight gain
E. Frothy pink sputum
✓ Correct Answer: D. Peripheral edema and weight gain
EXPERT RATIONALE: Right-sided heart failure causes fluid to accumulate in the
systemic circulation, leading to peripheral edema, JVD, hepatomegaly, and weight
gain. Orthopnea, PND, and frothy pink sputum are signs of left-sided failure.
3. The nurse is caring for a patient with acute myocardial infarction (MI).
Which laboratory value is most specific for cardiac muscle damage?
A. Myoglobin
B. C-reactive protein (CRP)
C. Troponin I
D. Creatine kinase-MM (CK-MM)
E. Lactate dehydrogenase (LDH)
✓ Correct Answer: C. Troponin I
EXPERT RATIONALE: Troponin I and Troponin T are the most specific and sensitive
biomarkers for myocardial damage. They rise within 3–6 hours of MI, peak at 14–18
,hours, and remain elevated for 5–14 days. CK-MM is skeletal muscle specific;
myoglobin is non-specific.
4. A patient is diagnosed with unstable angina. Which characteristic best
distinguishes it from stable angina?
A. It is relieved with rest and nitroglycerin
B. It is predictable and follows a consistent pattern
C. It occurs at rest and is unpredictable
D. It is caused by exercise
E. It resolves spontaneously without intervention
✓ Correct Answer: C. It occurs at rest and is unpredictable
EXPERT RATIONALE: Unstable angina is unpredictable, may occur at rest, and is
not reliably relieved by nitroglycerin or rest. It represents an acute coronary
syndrome and is a medical emergency. Stable angina is predictable, triggered by
exertion, and relieved by rest or nitroglycerin.
5. A nurse is educating a patient prescribed sublingual nitroglycerin. Which
instruction is most important?
A. "Swallow the tablet with a full glass of water."
B. "Take up to 5 tablets if pain persists."
C. "Place the tablet under your tongue and call 911 if pain is not relieved after 3
doses in 15 minutes."
D. "Store the medication in a clear container on your nightstand."
E. "Take the medication only when the pain becomes unbearable."
✓ Correct Answer: C. "Place the tablet under your tongue and call 911 if pain is
not relieved after 3 doses in 15 minutes."
, EXPERT RATIONALE: The standard teaching is to place one tablet under the
tongue, wait 5 minutes, and repeat up to 3 doses. If pain is not relieved after the
third dose, the patient should call emergency services as an MI may be occurring.
The medication is absorbed sublingually and should never be swallowed.
6. A patient with hypertension has a blood pressure reading of 170/105
mmHg. This is classified as which stage?
A. Elevated blood pressure
B. Stage 1 hypertension
C. Stage 2 hypertension
D. Hypertensive urgency
E. Normal blood pressure
✓ Correct Answer: C. Stage 2 hypertension
EXPERT RATIONALE: Stage 2 hypertension is defined as systolic BP ≥140 mmHg or
diastolic BP ≥90 mmHg (JNC 7). A reading of 170/105 mmHg clearly falls into Stage 2
and requires pharmacological treatment in addition to lifestyle modifications.
7. Which dietary instruction is the priority for a patient with hypertension?
A. Increase calcium intake
B. Follow a DASH diet and limit sodium to less than 2.4 g/day
C. Increase protein intake
D. Avoid all dietary fat
E. Drink at least 3 liters of fluid daily
✓ Correct Answer: B. Follow a DASH diet and limit sodium to less than 2.4
g/day
