NIGHTINGALE BSN 346 MEDICAL SURG II EXAM
2|QUESTIONS AND ANSWERS|GARDED A+|2026
UPDATE|100% CORRECT
1. CHF patient priority assessment
A patient with heart failure reports dyspnea. What is the priority action?
A. Give oral fluids
B. Assess lung sounds
C. Check bowel sounds
D. Encourage ambulation
Answer: B
Rationale: Crackles indicate pulmonary congestion and worsening CHF; respiratory assessment
is priority.
2. COPD oxygen therapy
What oxygen level is appropriate for a COPD patient?
A. 1–2 L/min
B. 5–6 L/min
C. 10 L/min
D. Room air only
Answer: A
Rationale: COPD patients retain CO₂; high oxygen may suppress respiratory drive.
3. MI initial sign
Which is the earliest sign of myocardial infarction?
A. Severe chest pain
B. Elevated troponin
C. ST elevation
D. Nausea and anxiety
Answer: D
Rationale: Sympathetic activation causes early nonspecific symptoms.
,4. Stroke assessment tool
Best tool for acute stroke?
A. APGAR
B. NIH Stroke Scale
C. Braden Scale
D. Glasgow Coma Scale
Answer: B
Rationale: NIHSS evaluates severity of neurological deficits.
5. Hyperkalemia ECG
Expected ECG change?
A. U waves
B. Tall peaked T waves
C. ST depression
D. Prolonged PR
Answer: B
Rationale: Hyperkalemia causes peaked T waves and widened QRS.
6. Hypoglycemia symptom
A. Fruity breath
B. Tremors and sweating
C. Kussmaul breathing
D. Hypertension
Answer: B
Rationale: Adrenergic response to low glucose.
7. DKA sign
A. Bradycardia
B. Deep rapid respirations
C. Hypothermia
D. Decreased urination
Answer: B
Rationale: Kussmaul respirations compensate for acidosis.
, 8. Priority in shock
First action?
A. Start antibiotics
B. Maintain airway
C. Give vasodilators
D. Encourage fluids orally
Answer: B
Rationale: Airway is always first priority.
9. Pulmonary embolism sign
A. Bradycardia
B. Sudden dyspnea
C. Weight gain
D. Hypertension
Answer: B
Rationale: Sudden hypoxia is hallmark.
10. DVT prevention
Best intervention?
A. Bed rest
B. SCDs
C. High salt diet
D. Elevate head only
Answer: B
Rationale: Sequential compression devices promote venous return.
11. Pulmonary edema sign
A. Bradycardia
B. Pink frothy sputum
C. Dry cough
D. Hypotension only
Answer: B
Rationale: Pink frothy sputum indicates alveolar fluid flooding in acute pulmonary edema.
2|QUESTIONS AND ANSWERS|GARDED A+|2026
UPDATE|100% CORRECT
1. CHF patient priority assessment
A patient with heart failure reports dyspnea. What is the priority action?
A. Give oral fluids
B. Assess lung sounds
C. Check bowel sounds
D. Encourage ambulation
Answer: B
Rationale: Crackles indicate pulmonary congestion and worsening CHF; respiratory assessment
is priority.
2. COPD oxygen therapy
What oxygen level is appropriate for a COPD patient?
A. 1–2 L/min
B. 5–6 L/min
C. 10 L/min
D. Room air only
Answer: A
Rationale: COPD patients retain CO₂; high oxygen may suppress respiratory drive.
3. MI initial sign
Which is the earliest sign of myocardial infarction?
A. Severe chest pain
B. Elevated troponin
C. ST elevation
D. Nausea and anxiety
Answer: D
Rationale: Sympathetic activation causes early nonspecific symptoms.
,4. Stroke assessment tool
Best tool for acute stroke?
A. APGAR
B. NIH Stroke Scale
C. Braden Scale
D. Glasgow Coma Scale
Answer: B
Rationale: NIHSS evaluates severity of neurological deficits.
5. Hyperkalemia ECG
Expected ECG change?
A. U waves
B. Tall peaked T waves
C. ST depression
D. Prolonged PR
Answer: B
Rationale: Hyperkalemia causes peaked T waves and widened QRS.
6. Hypoglycemia symptom
A. Fruity breath
B. Tremors and sweating
C. Kussmaul breathing
D. Hypertension
Answer: B
Rationale: Adrenergic response to low glucose.
7. DKA sign
A. Bradycardia
B. Deep rapid respirations
C. Hypothermia
D. Decreased urination
Answer: B
Rationale: Kussmaul respirations compensate for acidosis.
, 8. Priority in shock
First action?
A. Start antibiotics
B. Maintain airway
C. Give vasodilators
D. Encourage fluids orally
Answer: B
Rationale: Airway is always first priority.
9. Pulmonary embolism sign
A. Bradycardia
B. Sudden dyspnea
C. Weight gain
D. Hypertension
Answer: B
Rationale: Sudden hypoxia is hallmark.
10. DVT prevention
Best intervention?
A. Bed rest
B. SCDs
C. High salt diet
D. Elevate head only
Answer: B
Rationale: Sequential compression devices promote venous return.
11. Pulmonary edema sign
A. Bradycardia
B. Pink frothy sputum
C. Dry cough
D. Hypotension only
Answer: B
Rationale: Pink frothy sputum indicates alveolar fluid flooding in acute pulmonary edema.
