NUR 242 Exam 3 – Med-Surg Concepts (2026) Galen College of Nursing | Actual Questions & Answers with Rationales

NUR 242 Exam 3 – Med-Surg Concepts (2026)
Galen College of Nursing | Actual Questions &
Answers with Rationales


Section 1: Neurological Disorders – Stroke and Seizures (Questions
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1-50)
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1. A patient is admitted with sudden onset of right-sided weakness
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band aphasia. The nurse suspects an ischemic stroke. Which
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bassessment finding is most consistent with this diagnosis?
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A. Gradual onset of symptoms over several days
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B. Sudden onset of focal neurologic deficits
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C. Headache preceding the event b b b



D. Seizure activity at onset b b b




Answer: B. Sudden onset of focal neurologic deficits
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Rationale: Ischemic stroke typically presents with sudden
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onset of focal neurologic deficits (weakness, aphasia, sensory
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loss) corresponding to a vascular territory .
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2. A patient with ischemic stroke presents within 3 hours of
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symptom onset. Which intervention is most urgent?
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A. Administer aspirin b



B. Prepare for IV tPA (alteplase) b b b b



C. Obtain CT head b b



D. Start IV fluids b b




Answer: C. Obtain CT headb b b b



Rationale: Non-contrast CT head must be obtained
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,immediately to rule out hemorrhagic stroke before b b b b b b



badministering tPA . b b




3. A patient with ischemic stroke receives IV tPA (alteplase). Which
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finding requires immediate action?
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A. Blood pressure 150/90 mmHg
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B. Headache and neurologic deterioration b b b



C. Heart rate 90 bpm b b b



D. Oxygen saturation 95% b b




Answer: B. Headache and neurologic deterioration
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Rationale: Headache and neurologic deterioration may
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indicate intracranial hemorrhage, a serious complication
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of tPA .
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4. A patient with a stroke has left-sided neglect. Which nursing
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intervention is most appropriate?
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A. Approach from the left side b b b b



B. Place objects on the right side
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C. Approach from the right side b b b b



D. Ignore the neglect b b




Answer: C. Approach from the right side
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Rationale: Patients with neglect are unaware of the affected
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side. Approach from the unaffected side and place objects in
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the unaffected visual field .
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5. A patient with a stroke has dysphagia. Which assessment is most
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important before oral intake?
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A. Swallow evaluation b



B. Gag reflex b

,C. Ability to cough b b



D. All of the above
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Answer: D. All of the above b b b b b



Rationale: Swallow evaluation, gag reflex, and cough ability
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all assess aspiration risk. Formal swallow evaluation by
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speech therapy is essential .
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6. A patient with a stroke is at risk for aspiration. Which feeding
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position is safest?
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A. Supine
B. Side-lying with chin tucked b b b



C. Trendelenburg
D. Prone
Answer: B. Side-lying with chin tucked
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Rationale: Upright positioning with chin tuck reduces
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aspiration risk .
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7. A patient with a stroke has right-sided weakness. The nurse
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understands that this indicates damage to the:
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A. Left hemisphere
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B. Right hemisphere b



C. Brainstem
D. Cerebellum
Answer: A. Left hemisphere b b b



Rationale: Motor pathways cross at the medulla; right-sided
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weakness indicates left hemisphere damage .
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8. A patient with a stroke has expressive aphasia (Broca's aphasia).
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Which finding is expected?
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, A. Difficulty speaking but intact comprehension b b b b



B. Fluent speech with poor comprehension
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C. No speech output
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D. Normal speech b




Answer: A. Difficulty speaking but intact comprehension
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Rationale: Expressive aphasia involves difficulty producing
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speech with preserved comprehension. Receptive aphasia
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involves poor comprehension with fluent speech .
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9. A patient with a stroke has receptive aphasia (Wernicke's
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aphasia). Which finding is expected?
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A. Difficulty understanding speech b b



B. Difficulty speaking b



C. Normal comprehension b



D. No speech output
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Answer: A. Difficulty understanding speech
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Rationale: Receptive aphasia involves impaired
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comprehension with fluent but nonsensical speech .
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10. A patient with a stroke has homonymous hemianopia
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b(blindness in half of the visual field). Which intervention is most
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bappropriate?
A. Place objects in the unaffected visual field
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B. Place objects in the affected visual field
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C. Keep the room dark
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D. Use eye patches
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Answer: A. Place objects in the unaffected visual field
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Rationale: Place objects in the intact visual field to help the
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patient compensate for visual loss .
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