NU 185 Exam 2: Med-Surg II - Galen College of Nursing
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with left-sided heart failure is being assessed. Which clinical manifestation should the nurse
expect to find?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Splenomegaly
Correct Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion as the left ventricle fails to pump
blood efficiently to the body. This backflow causes increased pressure in the pulmonary vessels, leading
to fluid leaking into the alveoli. The presence of crackles or rales is a primary sign of pulmonary edema
associated with this condition. Other signs include dyspnea and orthopnea due to poor gas exchange.
Options A, B, and D are typically associated with right-sided heart failure.
2. A patient is diagnosed with COPD and requires oxygen therapy. Which delivery method and flow rate is
safest to prevent suppressing the hypoxic drive?
A. Simple face mask at 8 L/min
B. Non-rebreather mask at 15 L/min
C. Nasal cannula at 2-3 L/min
D. Venturi mask at 50% FiO2
Correct Answer: C
,Rationale: Patients with chronic COPD often rely on low oxygen levels to stimulate their drive to breathe.
Providing excessively high concentrations of oxygen can decrease their respiratory effort and lead to
carbon dioxide retention. A low-flow nasal cannula is generally the safest starting point for stable COPD
patients. The goal is typically to maintain oxygen saturation between 88% and 92%. Monitoring the
patient’s respiratory rate and effort remains a critical nursing priority during therapy.
3. A nurse is caring for a patient with Type 1 Diabetes Mellitus who presents with Kussmaul respirations and
fruity-smelling breath. Which condition is the patient likely experiencing?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Hyperglycemic Hyperosmolar State (HHS)
D. Metabolic Alkalosis
Correct Answer: A
Rationale: DKA is a serious complication of Type 1 Diabetes characterized by the breakdown of fats for
energy. This process produces ketones, which are acidic and result in metabolic acidosis. Kussmaul
respirations are the body’s compensatory mechanism to blow off excess carbon dioxide. The fruity odor
on the breath is caused by the presence of acetone. Immediate treatment includes IV fluids and regular
insulin infusion to stabilize the patient.
4. The nurse is monitoring a patient receiving Digoxin for heart failure. Which laboratory value should the
nurse prioritize checking to prevent toxicity?
A. Sodium level
B. Calcium level
C. Potassium level
,D. Chloride level
Correct Answer: C
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites. If potassium levels are low, more digoxin binds to the
sodium-potassium ATPase pump. This can lead to dangerous cardiac dysrhythmias even if the digoxin
level is within the therapeutic range. Nurses must monitor for signs of toxicity such as visual
disturbances and nausea. Ensuring the patient maintains a normal serum potassium level is a vital safety
intervention.
5. A patient has been prescribed Albuterol for exercise-induced asthma. What is the primary purpose of this
medication?
A. Reduce long-term inflammation
B. Provide rapid bronchodilation
C. Thickening of the mucus secretions
D. Suppression of the immune response
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used as a rescue medication. It works by
relaxing the smooth muscles in the airway to allow for easier breathing. It is typically taken 15 to 30
minutes before exercise to prevent bronchospasms. Common side effects include tachycardia, tremors,
and nervousness. Patients should be taught that this medication does not replace long-term controller
medications like inhaled corticosteroids.
, 6. A patient with hypothyroidism is prescribed Levothyroxine. Which instruction is most important for the
nurse to provide?
A. Take the medication with a high-calcium meal.
B. Take the medication at bedtime with a snack.
C. Discontinue the medication once symptoms improve.
D. Take the medication on an empty stomach in the morning.
Correct Answer: D
Rationale: Levothyroxine absorption is best when the stomach is empty and free of interfering
substances. Taking it in the morning 30 to 60 minutes before breakfast ensures optimal bioavailability.
Patients should avoid taking it with calcium or iron supplements as these can hinder absorption. This
medication is usually a lifelong replacement therapy for hypothyroidism. Monitoring TSH levels regularly
is necessary to ensure the dosage is appropriate.
7. A patient reports chest pain that is relieved by rest and sublingual Nitroglycerin. How should the nurse
classify this condition?
A. Unstable Angina
B. Myocardial Infarction
C. Stable Angina
D. Prinzmetal’s Angina
Correct Answer: C
Rationale: Stable angina occurs predictably with exertion and is consistently relieved by rest or
nitroglycerin. It is caused by chronic coronary artery disease and narrowed vessels. Unlike unstable
angina, the symptoms do not change in frequency or severity over time. Nitroglycerin works by dilating
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with left-sided heart failure is being assessed. Which clinical manifestation should the nurse
expect to find?
A. Peripheral edema
B. Jugular venous distention
C. Crackles in the lungs
D. Splenomegaly
Correct Answer: C
Rationale: Left-sided heart failure results in pulmonary congestion as the left ventricle fails to pump
blood efficiently to the body. This backflow causes increased pressure in the pulmonary vessels, leading
to fluid leaking into the alveoli. The presence of crackles or rales is a primary sign of pulmonary edema
associated with this condition. Other signs include dyspnea and orthopnea due to poor gas exchange.
Options A, B, and D are typically associated with right-sided heart failure.
2. A patient is diagnosed with COPD and requires oxygen therapy. Which delivery method and flow rate is
safest to prevent suppressing the hypoxic drive?
A. Simple face mask at 8 L/min
B. Non-rebreather mask at 15 L/min
C. Nasal cannula at 2-3 L/min
D. Venturi mask at 50% FiO2
Correct Answer: C
,Rationale: Patients with chronic COPD often rely on low oxygen levels to stimulate their drive to breathe.
Providing excessively high concentrations of oxygen can decrease their respiratory effort and lead to
carbon dioxide retention. A low-flow nasal cannula is generally the safest starting point for stable COPD
patients. The goal is typically to maintain oxygen saturation between 88% and 92%. Monitoring the
patient’s respiratory rate and effort remains a critical nursing priority during therapy.
3. A nurse is caring for a patient with Type 1 Diabetes Mellitus who presents with Kussmaul respirations and
fruity-smelling breath. Which condition is the patient likely experiencing?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Hyperglycemic Hyperosmolar State (HHS)
D. Metabolic Alkalosis
Correct Answer: A
Rationale: DKA is a serious complication of Type 1 Diabetes characterized by the breakdown of fats for
energy. This process produces ketones, which are acidic and result in metabolic acidosis. Kussmaul
respirations are the body’s compensatory mechanism to blow off excess carbon dioxide. The fruity odor
on the breath is caused by the presence of acetone. Immediate treatment includes IV fluids and regular
insulin infusion to stabilize the patient.
4. The nurse is monitoring a patient receiving Digoxin for heart failure. Which laboratory value should the
nurse prioritize checking to prevent toxicity?
A. Sodium level
B. Calcium level
C. Potassium level
,D. Chloride level
Correct Answer: C
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites. If potassium levels are low, more digoxin binds to the
sodium-potassium ATPase pump. This can lead to dangerous cardiac dysrhythmias even if the digoxin
level is within the therapeutic range. Nurses must monitor for signs of toxicity such as visual
disturbances and nausea. Ensuring the patient maintains a normal serum potassium level is a vital safety
intervention.
5. A patient has been prescribed Albuterol for exercise-induced asthma. What is the primary purpose of this
medication?
A. Reduce long-term inflammation
B. Provide rapid bronchodilation
C. Thickening of the mucus secretions
D. Suppression of the immune response
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used as a rescue medication. It works by
relaxing the smooth muscles in the airway to allow for easier breathing. It is typically taken 15 to 30
minutes before exercise to prevent bronchospasms. Common side effects include tachycardia, tremors,
and nervousness. Patients should be taught that this medication does not replace long-term controller
medications like inhaled corticosteroids.
, 6. A patient with hypothyroidism is prescribed Levothyroxine. Which instruction is most important for the
nurse to provide?
A. Take the medication with a high-calcium meal.
B. Take the medication at bedtime with a snack.
C. Discontinue the medication once symptoms improve.
D. Take the medication on an empty stomach in the morning.
Correct Answer: D
Rationale: Levothyroxine absorption is best when the stomach is empty and free of interfering
substances. Taking it in the morning 30 to 60 minutes before breakfast ensures optimal bioavailability.
Patients should avoid taking it with calcium or iron supplements as these can hinder absorption. This
medication is usually a lifelong replacement therapy for hypothyroidism. Monitoring TSH levels regularly
is necessary to ensure the dosage is appropriate.
7. A patient reports chest pain that is relieved by rest and sublingual Nitroglycerin. How should the nurse
classify this condition?
A. Unstable Angina
B. Myocardial Infarction
C. Stable Angina
D. Prinzmetal’s Angina
Correct Answer: C
Rationale: Stable angina occurs predictably with exertion and is consistently relieved by rest or
nitroglycerin. It is caused by chronic coronary artery disease and narrowed vessels. Unlike unstable
angina, the symptoms do not change in frequency or severity over time. Nitroglycerin works by dilating
