1
Galen NUR 242 - Med-Surg Exam 2 Study Guide 2025-26 | Questions and
Answers | Latest Update
GALEN NUR 242 – MED-SURG EXAM 2
2025-26 LATEST UPDATED VERSION
Topic covered:
• Cardiovascular system (e.g., HF, MI, CAD, arrhythmias)
• Respiratory system (e.g., COPD, pneumonia, asthma)
• Hematology (e.g., anemia, clotÝng disorders)
• Endocrine (e.g., diabetes, thyroid disorders)
1. A client with heart failure reports sudden weight gain of 3 pounds in 2 days.
Which action should the nurse take first?
A. Encourage rest
B. Notify the provider
C. Check vital signs
D. Restrict fluid intake
Answer: C. Check vital signs
Rationale: Rapid weight gain may indicate fluid retention and worsening heart
failure. Checking vital signs helps assess the client’s current hemodynamic status
before taking further actions.
2. A client is admitted with a myocardial infarction. Which laboratory value is
most specific for confirming myocardial damage?
A. CK-MB
B. Troponin I
,2
C. Myoglobin
D. LDH
Answer: B. Troponin I
Rationale: Troponin I is highly specific for myocardial injury and remains elevated
longer than CK-MB, making it the most reliable marker for diagnosing MI.
3. A nurse is caring for a client with COPD who has oxygen prescribed at 2 L/min
via nasal cannula. The client’s SpO₂ is 85%. What is the nurse’s best action?
A. Increase O₂ to 4 L/min
B. Encourage pursed-lip breathing
C. Call the provider immediately
D. Place in high Fowler’s position
Answer: D. Place in high Fowler’s position
Rationale: Positioning in high Fowler’s promotes lung expansion and improves
oxygenation. Oxygen can be adjusted, but positioning is a safe first intervention.
4. A client with type 1 diabetes reports nausea, vomiting, and abdominal pain.
Which finding would the nurse expect?
A. Hypoglycemia
B. Hyperosmolar hyperglycemic state
C. Diabetic ketoacidosis (DKA)
D. Insulin shock
Answer: C. Diabetic ketoacidosis (DKA)
Rationale: DKA occurs in type 1 diabetes due to insulin deficiency, leading to
hyperglycemia, ketosis, and metabolic acidosis, often presenting with nausea,
vomiting, and abdominal pain.
5. A nurse is teaching a client about iron supplementation for iron-deficiency
anemia. Which instruction is most important?
,3
A. Take with milk to improve absorption
B. Take with vitamin C-rich foods
C. Take at bedtime
D. Avoid fluids during intake
Answer: B. Take with vitamin C-rich foods
Rationale: Vitamin C enhances iron absorption. Milk and calcium can inhibit
absorption, so they should be avoided at the time of taking iron supplements.
6. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A. PT/INR
Rationale: PT/INR measures the effectiveness of warfarin therapy and helps
prevent bleeding complications by ensuring the client’s anticoagulation is within
the therapeutic range.
7. A nurse is teaching a client with asthma about using a metered-dose inhaler
(MDI). Which statement by the client indicates correct understanding?
A. “I will take a deep breath after pressing the inhaler.”
B. “I should shake the inhaler before each use.”
C. “I only need to use it when I feel short of breath.”
D. “I can use it as frequently as I want.”
Answer: B. “I should shake the inhaler before each use.”
Rationale: Shaking the MDI ensures medication is properly mixed and delivered. It
should be used regularly as prescribed, not only during symptoms.
, 4
8. A client with chronic kidney disease has anemia. Which type of anemia is
most likely?
A. Iron-deficiency anemia
B. Pernicious anemia
C. Anemia of chronic disease
D. Hemolytic anemia
Answer: C. Anemia of chronic disease
Rationale: Chronic kidney disease reduces erythropoietin production, leading to
anemia of chronic disease.
9. A client with a pulmonary embolism is receiving heparin therapy. Which lab
value should the nurse monitor for therapeutic effect?
A. PT
B. aPTT
C. INR
D. Platelet count
Answer: B. aPTT
Rationale: Heparin therapy is monitored using aPTT to ensure anticoagulation is
therapeutic without causing excessive bleeding.
10. A client with hyperthyroidism reports palpitations, heat intolerance, and
weight loss. Which medication is commonly prescribed to manage symptoms?
A. Levothyroxine
B. Methimazole
C. Prednisone
D. Metoprolol
Answer: D. Metoprolol
Rationale: Beta-blockers like metoprolol help control tachycardia and palpitations
in hyperthyroidism. Methimazole treats the underlying condition.
Galen NUR 242 - Med-Surg Exam 2 Study Guide 2025-26 | Questions and
Answers | Latest Update
GALEN NUR 242 – MED-SURG EXAM 2
2025-26 LATEST UPDATED VERSION
Topic covered:
• Cardiovascular system (e.g., HF, MI, CAD, arrhythmias)
• Respiratory system (e.g., COPD, pneumonia, asthma)
• Hematology (e.g., anemia, clotÝng disorders)
• Endocrine (e.g., diabetes, thyroid disorders)
1. A client with heart failure reports sudden weight gain of 3 pounds in 2 days.
Which action should the nurse take first?
A. Encourage rest
B. Notify the provider
C. Check vital signs
D. Restrict fluid intake
Answer: C. Check vital signs
Rationale: Rapid weight gain may indicate fluid retention and worsening heart
failure. Checking vital signs helps assess the client’s current hemodynamic status
before taking further actions.
2. A client is admitted with a myocardial infarction. Which laboratory value is
most specific for confirming myocardial damage?
A. CK-MB
B. Troponin I
,2
C. Myoglobin
D. LDH
Answer: B. Troponin I
Rationale: Troponin I is highly specific for myocardial injury and remains elevated
longer than CK-MB, making it the most reliable marker for diagnosing MI.
3. A nurse is caring for a client with COPD who has oxygen prescribed at 2 L/min
via nasal cannula. The client’s SpO₂ is 85%. What is the nurse’s best action?
A. Increase O₂ to 4 L/min
B. Encourage pursed-lip breathing
C. Call the provider immediately
D. Place in high Fowler’s position
Answer: D. Place in high Fowler’s position
Rationale: Positioning in high Fowler’s promotes lung expansion and improves
oxygenation. Oxygen can be adjusted, but positioning is a safe first intervention.
4. A client with type 1 diabetes reports nausea, vomiting, and abdominal pain.
Which finding would the nurse expect?
A. Hypoglycemia
B. Hyperosmolar hyperglycemic state
C. Diabetic ketoacidosis (DKA)
D. Insulin shock
Answer: C. Diabetic ketoacidosis (DKA)
Rationale: DKA occurs in type 1 diabetes due to insulin deficiency, leading to
hyperglycemia, ketosis, and metabolic acidosis, often presenting with nausea,
vomiting, and abdominal pain.
5. A nurse is teaching a client about iron supplementation for iron-deficiency
anemia. Which instruction is most important?
,3
A. Take with milk to improve absorption
B. Take with vitamin C-rich foods
C. Take at bedtime
D. Avoid fluids during intake
Answer: B. Take with vitamin C-rich foods
Rationale: Vitamin C enhances iron absorption. Milk and calcium can inhibit
absorption, so they should be avoided at the time of taking iron supplements.
6. A client with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A. PT/INR
Rationale: PT/INR measures the effectiveness of warfarin therapy and helps
prevent bleeding complications by ensuring the client’s anticoagulation is within
the therapeutic range.
7. A nurse is teaching a client with asthma about using a metered-dose inhaler
(MDI). Which statement by the client indicates correct understanding?
A. “I will take a deep breath after pressing the inhaler.”
B. “I should shake the inhaler before each use.”
C. “I only need to use it when I feel short of breath.”
D. “I can use it as frequently as I want.”
Answer: B. “I should shake the inhaler before each use.”
Rationale: Shaking the MDI ensures medication is properly mixed and delivered. It
should be used regularly as prescribed, not only during symptoms.
, 4
8. A client with chronic kidney disease has anemia. Which type of anemia is
most likely?
A. Iron-deficiency anemia
B. Pernicious anemia
C. Anemia of chronic disease
D. Hemolytic anemia
Answer: C. Anemia of chronic disease
Rationale: Chronic kidney disease reduces erythropoietin production, leading to
anemia of chronic disease.
9. A client with a pulmonary embolism is receiving heparin therapy. Which lab
value should the nurse monitor for therapeutic effect?
A. PT
B. aPTT
C. INR
D. Platelet count
Answer: B. aPTT
Rationale: Heparin therapy is monitored using aPTT to ensure anticoagulation is
therapeutic without causing excessive bleeding.
10. A client with hyperthyroidism reports palpitations, heat intolerance, and
weight loss. Which medication is commonly prescribed to manage symptoms?
A. Levothyroxine
B. Methimazole
C. Prednisone
D. Metoprolol
Answer: D. Metoprolol
Rationale: Beta-blockers like metoprolol help control tachycardia and palpitations
in hyperthyroidism. Methimazole treats the underlying condition.
