NUR 242 Exam 2 – Med-Surg Concepts (2026) Galen College of Nursing | Actual Questions & Answers with Rationales

NUR 242 Exam 2 – Med-Surg Concepts (2026)
Galen College of Nursing | Actual Questions &
Answers with Rationales


Section 1: Cardiovascular Disorders – Hypertension and Heart Failure
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(Questions 1-70)
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1. A patient with hypertension has a blood pressure of 150/95 mmHg.
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bThe nurse understands that this reading is classified as:
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A. Normal
B. Elevated
C. Stage 1 hypertension
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D. Stage 2 hypertension
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Answer: C. Stage 1 hypertension
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Rationale: Stage 1 hypertension is defined as systolic 130-139 or
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diastolic 80-89. Stage 2 is ≥140/90 .
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2. A patient with hypertension is prescribed lisinopril (Zestril).
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Which finding indicates an adverse effect that should be reported?
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A. Dry, nonproductive cough
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B. Weight gain of 2 pounds in 2 days
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C. Dizziness when standing b b


D. All of the above
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Answer: D. All of the above
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Rationale: Dry cough is a common side effect of ACE inhibitors (due to
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bradykinin accumulation). Weight gain may indicate fluid retention.
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Dizziness may indicate hypotension .b b b b




3. A patient with hypertension is prescribed hydrochlorothiazide (HCTZ).
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Which electrolyte imbalance should the nurse monitor?
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A. Hypokalemia

,B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: A. Hypokalemia b b



Rationale: Thiazide diuretics cause potassium wasting. Hypokalemia
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can cause muscle weakness and cardiac arrhythmias .
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4. A patient with hypertension is prescribed spironolactone (Aldactone).
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Which finding requires immediate intervention?
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A. Serum potassium 5.8 mEq/L
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B. Serum sodium 138 mEq/L
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C. Blood pressure 130/80 mmHg
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D. Weight loss of 2 pounds b b b b




Answer: A. Serum potassium 5.8 mEq/L
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Rationale: Spironolactone is a potassium-sparing diuretic.
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Hyperkalemia (K+ >5.0) is a serious adverse effect .
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5. A patient with heart failure has an ejection fraction of 30%. The
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nurse understands that this indicates:
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A. Heart failure with reduced ejection fraction (HFrEF)
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B. Heart failure with preserved ejection fraction (HFpEF)
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C. Normal heart function b b


D. Diastolic heart failure b b




Answer: A. Heart failure with reduced ejection fraction (HFrEF)
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Rationale: HFrEF is defined by EF ≤40%. HFpEF has EF ≥50% .
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6. A patient with heart failure has jugular venous distention (JVD)
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and peripheral edema. These findings indicate:
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A. Right-sided heart failure b b


B. Left-sided heart failure b b


C. Pericarditis
D. Myocardial infarction b

,Answer: A. Right-sided heart failure
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Rationale: Right-sided heart failure causes systemic venous
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congestion, resulting in JVD, peripheral edema, and hepatomegaly .
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7. A patient with heart failure has crackles in the lung bases and
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orthopnea. These findings indicate:
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A. Left-sided heart failure b b


B. Right-sided heart failure b b


C. Pericarditis
D. Myocardial infarction b




Answer: A. Left-sided heart failure
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Rationale: Left-sided heart failure causes pulmonary congestion,
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leading to crackles, dyspnea, and orthopnea .
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8. A patient with heart failure is prescribed furosemide (Lasix).
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Which assessment is most important?
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A. Daily weight b


B. Intake and output b b


C. Potassium level b


D. All of the above
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Answer: D. All of the above
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Rationale: Furosemide causes diuresis and potassium loss; monitor
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weight, I&O, and electrolytes .
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9. A patient with heart failure is on a 2,000 mL fluid restriction.
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Which breakfast choice is most appropriate?
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A. Dry toast, eggs, coffee (4 oz)
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B. Cereal with milk, orange juice
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C. Oatmeal, milk, tea b b


D. Smoothie, yogurt b




Answer: A. Dry toast, eggs, coffee (4 oz)
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Rationale: Fluids include all liquids; dry toast and eggs have minimal
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fluid content .
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, 10. A patient with heart failure is prescribed digoxin (Lanoxin). Which
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bsign of toxicity should the patient report?
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A. Yellow-green halos around lights b b b


B. Increased appetite b


C. Weight gain b


D. Constipation

Answer: A. Yellow-green halos around lights
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Rationale: Visual disturbances (yellow-green halos) are classic signs of
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digoxin toxicity .
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11. A patient taking digoxin has a potassium level of 3.0 mEq/L. The nurse
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bis concerned because:
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A. Hypokalemia increases risk of digoxin toxicity b b b b b


B. Hypokalemia decreases digoxin effect b b b


C. Hyperkalemia increases risk of toxicity b b b b


D. No effect on digoxin
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Answer: A. Hypokalemia increases risk of digoxin toxicity
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Rationale: Hypokalemia enhances digoxin binding to cardiac Na+/K+
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ATPase, increasing toxicity risk .
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12. A patient with heart failure is prescribed carvedilol (Coreg). The
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bnurse understands that beta-blockers in heart failure:
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A. Decrease myocardial oxygen demand and reduce remodeling
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B. Increase heart rate b b


C. Increase contractility b


D. Cause bronchodilation b




Answer: A. Decrease myocardial oxygen demand and reduce remodeling
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Rationale: Beta-blockers decrease heart rate and contractility, reducing
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oxygen demand and preventing adverse remodeling .
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13. A patient with heart failure is prescribed an ACE inhibitor. Which
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bfinding indicates a therapeutic effect?
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A. Decreased blood pressure, decreased dyspnea b b b b