Herzing University
3 MAXE 322 GSN
★
★ ★
H School of Nursing — Career-Focused + Convenient + Caring
C A R E E R- F O CU S E D • CO N V E N I E N T • C A R I N G
EST. 1965
NSG 223 — Medical-Surgical Nursing II
E X A M 3 — L AT E ST 2 0 2 0 2 7 U P D AT E | 1 0 0 % V E R I F I E D Q & A
INSTITUTION Herzing University — School of COURSE NSG 223 – Medical-Surgical
Nursing Nursing II
EXAM VERSION Latest 2026/2027 Update TOTAL QUESTIONS 118 Q&A with Clinical Rationale
FORMAT Multiple Choice – Select the GRADE A – 100% Correct Verified
Single Best Answer Answers
EXAMINATION REVIEW GUIDE
▸ This document contains verified Q&A for NSG 223 Med Surg II Exam 3 (2026/2027 Update).
▸ Covers oncology, cardiac, respiratory, GI, GU, endocrine, infectious disease, and critical care nursing concepts.
▸ Each answer includes clinical rationale and key teaching points for nursing practice.
▸ Use this guide to prepare for the exam and for clinical application in medical-surgical nursing.
SECTION I — ONCOLOGY, HEMATOLOGY & CANCER CARE Q1–Q18
1. Which preexisting dx places a pt at greatest risk of developing superior vena cava syndrome?
CORRECT ANSWER: Cancer (metastatic, especially lung cancer, lymphoma).
RATIONALE: Superior vena cava obstruction most commonly from lung cancer (especially small cell). Lymphoma is
2nd most common cause. Facial/upper extremity edema, dilated neck veins, dyspnea.
2. A man who smokes 2 packs/day wants to know if smoking contributes to infertility. What info can the
nurse provide?
CORRECT ANSWER: Smoking decreases sperm quantity/quality; semen analysis should be repeated;
cessation improves general health and fertility.
RATIONALE: Smoking reduces sperm count, motility, and increases abnormal morphology. Semen analysis should
be repeated (one abnormal result needs confirmation). Smoking cessation improves fertility outcomes.
3. Pt with chronic cough with blood-tinged sputum returns after bronchoscopy. What intervention in
immediate post-procedure period?
CORRECT ANSWER: Patient is to remain NPO until the gag reflex returns.
RATIONALE: Topical anesthetic used during bronchoscopy numbs the throat. Risk of aspiration if oral intake before
gag reflex returns. Check gag reflex before offering fluids/food.
,4. Pt with hx of HTN, MI, CHF admitted after CABG. Serum K+ is 4.5 mEq/L. What action?
CORRECT ANSWER: Document the finding (normal potassium 3.5-5.0 mEq/L).
RATIONALE: Potassium level is within normal range. No intervention needed; continue monitoring. Post-op cardiac
patients need potassium in normal range to prevent arrhythmias.
5. The nurse completes visual inspection of abdomen. What technique should the nurse perform next?
CORRECT ANSWER: Auscultation, then percussion, then palpation.
RATIONALE: Correct abdominal assessment sequence: inspection → auscultation → percussion → palpation.
Auscultate before palpation/percussion to avoid altering bowel sounds.
6. Which method elicits most accurate info during physical exam of an older client?
CORRECT ANSWER: Use assessment tools (standardized geriatric assessment).
RATIONALE: Standardized tools ensure comprehensive assessment. Examples: Katz ADL, Lawton IADL, MMSE, GDS.
Accommodate sensory and mobility limitations.
7. Pt with fractured right radius reports severe pain unresponsive to analgesics, worse with passive
movement. What condition?
CORRECT ANSWER: Compartment syndrome (acute).
RATIONALE: Pain out of proportion to injury is earliest sign. Pain with passive stretch is hallmark. Neurovascular
compromise requires emergency fasciotomy.
8. Pt has fungal infection (candidiasis) under both breasts. To prevent nosocomial infection, which
protocol?
CORRECT ANSWER: Wash hands after patient care.
RATIONALE: Hand hygiene prevents transmission to other patients. Candidiasis can spread via contact. Maintain
good skin hygiene, keep skin folds dry.
9. Pt receiving whole blood transfusion develops chills, fever, headache 30 min after start. What
reaction?
CORRECT ANSWER: Febrile transfusion reaction.
RATIONALE: Febrile reaction: fever, chills, headache, no hypotension. Caused by antibodies against donor WBCs.
Stop transfusion, notify provider, send blood bag and tubing to lab.
, 10. Pt with type II diabetes has BS 50 mg/dL. Nurse gives 6 oz OJ. In 15 min BS is 74. What action?
CORRECT ANSWER: Give a snack of bread and cheese (complex carb + protein).
RATIONALE: Rule of 15: treat with 15g carbs, recheck in 15 min. After BG returns to >70, give snack with
protein/complex carb to prevent recurrence. Prevents rebound hypoglycemia.
11. Client admitted for chest pain x4d. CK-MB and troponin levels obtained. What rationale to evaluate lab
findings?
CORRECT ANSWER: Myocardial damage several days earlier best validated by serum troponin levels.
RATIONALE: Troponin remains elevated for 10-14 days after MI. CK-MB returns to normal within 48-72 hours.
Troponin is more sensitive and specific for MI.
12. Couple coping with infertility. What can preserve emotional equilibrium? Best response?
CORRECT ANSWER: Get involved with a support group. I will give you some names.
RATIONALE: Support groups provide emotional support and normalize experiences. Reduces isolation, improves
coping. Connects couples with others facing similar struggles.
13. Post-mastectomy instructions. What info should the nurse include?
CORRECT ANSWER: Report inflammation of incision/affected arm; avoid lifting >10lb or reaching above
head.
RATIONALE: Signs of infection/inflammation require prompt evaluation. Arm restrictions prevent lymphedema.
Avoid BP, IV, injections on affected arm.
14. Assessing middle-aged man for chronic illness risk factors. Which finding needs further assessment?
CORRECT ANSWER: Increase in abdominal fat deposits (android obesity).
RATIONALE: Central obesity is risk factor for metabolic syndrome, CVD, diabetes. Waist circumference >40 inches in
men indicates increased risk. Assess for hypertension, dyslipidemia, hyperglycemia.
15. Male client had inguinal herniorrhaphy 3 hrs ago. Lower abdomen distended, dullness to percussion.
Priority action?
CORRECT ANSWER: Determine the time the client last voided.
RATIONALE: Abdominal distension after hernia surgery may indicate urinary retention. Dullness to percussion
suggests distended bladder. Palpate suprapubic area; may need catheterization.
3 MAXE 322 GSN
★
★ ★
H School of Nursing — Career-Focused + Convenient + Caring
C A R E E R- F O CU S E D • CO N V E N I E N T • C A R I N G
EST. 1965
NSG 223 — Medical-Surgical Nursing II
E X A M 3 — L AT E ST 2 0 2 0 2 7 U P D AT E | 1 0 0 % V E R I F I E D Q & A
INSTITUTION Herzing University — School of COURSE NSG 223 – Medical-Surgical
Nursing Nursing II
EXAM VERSION Latest 2026/2027 Update TOTAL QUESTIONS 118 Q&A with Clinical Rationale
FORMAT Multiple Choice – Select the GRADE A – 100% Correct Verified
Single Best Answer Answers
EXAMINATION REVIEW GUIDE
▸ This document contains verified Q&A for NSG 223 Med Surg II Exam 3 (2026/2027 Update).
▸ Covers oncology, cardiac, respiratory, GI, GU, endocrine, infectious disease, and critical care nursing concepts.
▸ Each answer includes clinical rationale and key teaching points for nursing practice.
▸ Use this guide to prepare for the exam and for clinical application in medical-surgical nursing.
SECTION I — ONCOLOGY, HEMATOLOGY & CANCER CARE Q1–Q18
1. Which preexisting dx places a pt at greatest risk of developing superior vena cava syndrome?
CORRECT ANSWER: Cancer (metastatic, especially lung cancer, lymphoma).
RATIONALE: Superior vena cava obstruction most commonly from lung cancer (especially small cell). Lymphoma is
2nd most common cause. Facial/upper extremity edema, dilated neck veins, dyspnea.
2. A man who smokes 2 packs/day wants to know if smoking contributes to infertility. What info can the
nurse provide?
CORRECT ANSWER: Smoking decreases sperm quantity/quality; semen analysis should be repeated;
cessation improves general health and fertility.
RATIONALE: Smoking reduces sperm count, motility, and increases abnormal morphology. Semen analysis should
be repeated (one abnormal result needs confirmation). Smoking cessation improves fertility outcomes.
3. Pt with chronic cough with blood-tinged sputum returns after bronchoscopy. What intervention in
immediate post-procedure period?
CORRECT ANSWER: Patient is to remain NPO until the gag reflex returns.
RATIONALE: Topical anesthetic used during bronchoscopy numbs the throat. Risk of aspiration if oral intake before
gag reflex returns. Check gag reflex before offering fluids/food.
,4. Pt with hx of HTN, MI, CHF admitted after CABG. Serum K+ is 4.5 mEq/L. What action?
CORRECT ANSWER: Document the finding (normal potassium 3.5-5.0 mEq/L).
RATIONALE: Potassium level is within normal range. No intervention needed; continue monitoring. Post-op cardiac
patients need potassium in normal range to prevent arrhythmias.
5. The nurse completes visual inspection of abdomen. What technique should the nurse perform next?
CORRECT ANSWER: Auscultation, then percussion, then palpation.
RATIONALE: Correct abdominal assessment sequence: inspection → auscultation → percussion → palpation.
Auscultate before palpation/percussion to avoid altering bowel sounds.
6. Which method elicits most accurate info during physical exam of an older client?
CORRECT ANSWER: Use assessment tools (standardized geriatric assessment).
RATIONALE: Standardized tools ensure comprehensive assessment. Examples: Katz ADL, Lawton IADL, MMSE, GDS.
Accommodate sensory and mobility limitations.
7. Pt with fractured right radius reports severe pain unresponsive to analgesics, worse with passive
movement. What condition?
CORRECT ANSWER: Compartment syndrome (acute).
RATIONALE: Pain out of proportion to injury is earliest sign. Pain with passive stretch is hallmark. Neurovascular
compromise requires emergency fasciotomy.
8. Pt has fungal infection (candidiasis) under both breasts. To prevent nosocomial infection, which
protocol?
CORRECT ANSWER: Wash hands after patient care.
RATIONALE: Hand hygiene prevents transmission to other patients. Candidiasis can spread via contact. Maintain
good skin hygiene, keep skin folds dry.
9. Pt receiving whole blood transfusion develops chills, fever, headache 30 min after start. What
reaction?
CORRECT ANSWER: Febrile transfusion reaction.
RATIONALE: Febrile reaction: fever, chills, headache, no hypotension. Caused by antibodies against donor WBCs.
Stop transfusion, notify provider, send blood bag and tubing to lab.
, 10. Pt with type II diabetes has BS 50 mg/dL. Nurse gives 6 oz OJ. In 15 min BS is 74. What action?
CORRECT ANSWER: Give a snack of bread and cheese (complex carb + protein).
RATIONALE: Rule of 15: treat with 15g carbs, recheck in 15 min. After BG returns to >70, give snack with
protein/complex carb to prevent recurrence. Prevents rebound hypoglycemia.
11. Client admitted for chest pain x4d. CK-MB and troponin levels obtained. What rationale to evaluate lab
findings?
CORRECT ANSWER: Myocardial damage several days earlier best validated by serum troponin levels.
RATIONALE: Troponin remains elevated for 10-14 days after MI. CK-MB returns to normal within 48-72 hours.
Troponin is more sensitive and specific for MI.
12. Couple coping with infertility. What can preserve emotional equilibrium? Best response?
CORRECT ANSWER: Get involved with a support group. I will give you some names.
RATIONALE: Support groups provide emotional support and normalize experiences. Reduces isolation, improves
coping. Connects couples with others facing similar struggles.
13. Post-mastectomy instructions. What info should the nurse include?
CORRECT ANSWER: Report inflammation of incision/affected arm; avoid lifting >10lb or reaching above
head.
RATIONALE: Signs of infection/inflammation require prompt evaluation. Arm restrictions prevent lymphedema.
Avoid BP, IV, injections on affected arm.
14. Assessing middle-aged man for chronic illness risk factors. Which finding needs further assessment?
CORRECT ANSWER: Increase in abdominal fat deposits (android obesity).
RATIONALE: Central obesity is risk factor for metabolic syndrome, CVD, diabetes. Waist circumference >40 inches in
men indicates increased risk. Assess for hypertension, dyslipidemia, hyperglycemia.
15. Male client had inguinal herniorrhaphy 3 hrs ago. Lower abdomen distended, dullness to percussion.
Priority action?
CORRECT ANSWER: Determine the time the client last voided.
RATIONALE: Abdominal distension after hernia surgery may indicate urinary retention. Dullness to percussion
suggests distended bladder. Palpate suprapubic area; may need catheterization.
