NUR 242 MEDICAL-SURGICAL NURSING FINAL EXAM
2026/2027 | Questions and Verified Answers | 100% Correct
Grade A | Galen College | Pass Guaranteed
Part 1: Foundations of Med-Surg Nursing (Safety, Infection Control,
Oxygenation, Fluid/Electrolyte/Acid-Base, Pain, Perioperative,
Immunology) (Questions 1–20)
Q1: A nurse is assessing a patient admitted after a fall at home. Using the Morse Fall
Scale, which factor would contribute most significantly to the patient's risk score?
A. Patient has a history of osteoporosis but walks independently without assistance
B. Patient uses a walker, has IV therapy in progress, and has fallen twice in the past
three months [CORRECT]
C. Patient is alert and oriented with no previous falls but takes antihypertensive
medications
D. Patient is under 65 years old with normal gait and no comorbidities
Correct Answer: B
Rationale: The Morse Fall Scale assigns points for: history of falling (25 points),
secondary diagnosis (15), ambulatory aid (15), IV/heparin lock (20), gait/transferring
(0-20), and mental status (0-15). The patient in B has multiple high-risk factors:
ambulatory aid, IV therapy, and recent fall history, significantly increasing risk score.
Independent walking (A) reduces risk. Single antihypertensive (C) is lower risk. Young
age with normal status (D) is minimal risk.
,Q2: A nurse enters a patient's room to administer morning medications. Which action
demonstrates proper hand hygiene according to WHO guidelines?
A. Applying alcohol-based hand rub after removing gloves used for a dressing change
B. Washing hands with soap and water for 20 seconds before touching the patient
[CORRECT]
C. Wearing gloves throughout the entire medication administration process without
hand hygiene
D. Using hand sanitizer only after completing all morning medication rounds
Correct Answer: B
Rationale: WHO "5 Moments for Hand Hygiene" includes before touching a patient. Soap
and water for 20 seconds (or alcohol-based rub if hands not visibly soiled) is required
before patient contact. Hand hygiene after glove removal (A) is correct but doesn't
address the "before patient contact" moment. Gloves don't replace hand hygiene (C).
Sanitizing only after rounds (D) misses multiple required moments.
Q3: A patient with suspected tuberculosis is admitted to the hospital. Which isolation
precautions are required?
A. Contact precautions with gown and gloves for all room entries
B. Droplet precautions with surgical mask within three feet of patient
C. Airborne precautions with N95 respirator or PAPR and negative pressure room
[CORRECT]
,D. Standard precautions only with hand hygiene and gloves for blood/body fluid
exposure
Correct Answer: C
Rationale: Tuberculosis (TB) requires airborne precautions: N95 respirator or powered
air-purifying respirator (PAPR), negative pressure room with 6-12 air exchanges/hour,
and door closed. TB bacilli are <5 microns and remain suspended in air. Contact (A) is
for organisms spread by touch. Droplet (B) is for larger particles (>5 microns) traveling
short distances. Standard precautions (D) are baseline but insufficient for TB.
Q4: A patient has the following arterial blood gas results: pH 7.32, PaCO2 48 mmHg,
HCO3- 24 mEq/L. Which acid-base disorder is present?
A. Metabolic acidosis with respiratory compensation
B. Respiratory acidosis without metabolic compensation [CORRECT]
C. Metabolic alkalosis with respiratory compensation
D. Respiratory alkalosis without metabolic compensation
Correct Answer: B
Rationale: pH 7.32 (<7.35) indicates acidosis. PaCO2 48 (>45) indicates respiratory
acidosis (retained CO2). HCO3- 24 is normal (22-26), indicating no metabolic
compensation has occurred yet (acute respiratory acidosis). If chronic, HCO3- would be
elevated (>26). Metabolic acidosis (A) would show low HCO3-. Metabolic alkalosis (C)
shows high pH and HCO3-. Respiratory alkalosis (D) shows high pH and low PaCO2.
, Q5: A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which SpO2 target range is appropriate for this patient?
A. 94-98% to ensure adequate tissue oxygenation
B. 88-92% to avoid suppressing hypoxic respiratory drive [CORRECT]
C. 80-85% to minimize oxygen toxicity
D. 100% to maximize oxygen-carrying capacity
Correct Answer: B
Rationale: COPD patients with chronic hypercapnia rely on hypoxic drive (low O2) rather
than hypercapnic drive (high CO2) for respiration. Target SpO2 88-92% prevents
respiratory depression from excessive oxygen. Normal targets (A) may cause CO2
retention and respiratory acidosis. 80-85% (C) is too low for tissue needs. 100% (D) is
dangerous for COPD patients and unnecessary.
Q6: A postoperative patient reports pain rated 8/10 on the numeric rating scale. The
patient is receiving PCA morphine with a basal rate of 1 mg/hour and demand dose of 1
mg with 10-minute lockout. Which finding indicates the PCA is ineffective?
A. Patient presses the demand button 3 times per hour and receives 3 demand doses
B. Patient presses the demand button 6 times per hour but receives only 2 demand
doses [CORRECT]
C. Patient reports pain reduction to 4/10 within 30 minutes of activation
D. Patient experiences mild sedation with respiratory rate of 14 breaths per minute
Correct Answer: B
2026/2027 | Questions and Verified Answers | 100% Correct
Grade A | Galen College | Pass Guaranteed
Part 1: Foundations of Med-Surg Nursing (Safety, Infection Control,
Oxygenation, Fluid/Electrolyte/Acid-Base, Pain, Perioperative,
Immunology) (Questions 1–20)
Q1: A nurse is assessing a patient admitted after a fall at home. Using the Morse Fall
Scale, which factor would contribute most significantly to the patient's risk score?
A. Patient has a history of osteoporosis but walks independently without assistance
B. Patient uses a walker, has IV therapy in progress, and has fallen twice in the past
three months [CORRECT]
C. Patient is alert and oriented with no previous falls but takes antihypertensive
medications
D. Patient is under 65 years old with normal gait and no comorbidities
Correct Answer: B
Rationale: The Morse Fall Scale assigns points for: history of falling (25 points),
secondary diagnosis (15), ambulatory aid (15), IV/heparin lock (20), gait/transferring
(0-20), and mental status (0-15). The patient in B has multiple high-risk factors:
ambulatory aid, IV therapy, and recent fall history, significantly increasing risk score.
Independent walking (A) reduces risk. Single antihypertensive (C) is lower risk. Young
age with normal status (D) is minimal risk.
,Q2: A nurse enters a patient's room to administer morning medications. Which action
demonstrates proper hand hygiene according to WHO guidelines?
A. Applying alcohol-based hand rub after removing gloves used for a dressing change
B. Washing hands with soap and water for 20 seconds before touching the patient
[CORRECT]
C. Wearing gloves throughout the entire medication administration process without
hand hygiene
D. Using hand sanitizer only after completing all morning medication rounds
Correct Answer: B
Rationale: WHO "5 Moments for Hand Hygiene" includes before touching a patient. Soap
and water for 20 seconds (or alcohol-based rub if hands not visibly soiled) is required
before patient contact. Hand hygiene after glove removal (A) is correct but doesn't
address the "before patient contact" moment. Gloves don't replace hand hygiene (C).
Sanitizing only after rounds (D) misses multiple required moments.
Q3: A patient with suspected tuberculosis is admitted to the hospital. Which isolation
precautions are required?
A. Contact precautions with gown and gloves for all room entries
B. Droplet precautions with surgical mask within three feet of patient
C. Airborne precautions with N95 respirator or PAPR and negative pressure room
[CORRECT]
,D. Standard precautions only with hand hygiene and gloves for blood/body fluid
exposure
Correct Answer: C
Rationale: Tuberculosis (TB) requires airborne precautions: N95 respirator or powered
air-purifying respirator (PAPR), negative pressure room with 6-12 air exchanges/hour,
and door closed. TB bacilli are <5 microns and remain suspended in air. Contact (A) is
for organisms spread by touch. Droplet (B) is for larger particles (>5 microns) traveling
short distances. Standard precautions (D) are baseline but insufficient for TB.
Q4: A patient has the following arterial blood gas results: pH 7.32, PaCO2 48 mmHg,
HCO3- 24 mEq/L. Which acid-base disorder is present?
A. Metabolic acidosis with respiratory compensation
B. Respiratory acidosis without metabolic compensation [CORRECT]
C. Metabolic alkalosis with respiratory compensation
D. Respiratory alkalosis without metabolic compensation
Correct Answer: B
Rationale: pH 7.32 (<7.35) indicates acidosis. PaCO2 48 (>45) indicates respiratory
acidosis (retained CO2). HCO3- 24 is normal (22-26), indicating no metabolic
compensation has occurred yet (acute respiratory acidosis). If chronic, HCO3- would be
elevated (>26). Metabolic acidosis (A) would show low HCO3-. Metabolic alkalosis (C)
shows high pH and HCO3-. Respiratory alkalosis (D) shows high pH and low PaCO2.
, Q5: A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which SpO2 target range is appropriate for this patient?
A. 94-98% to ensure adequate tissue oxygenation
B. 88-92% to avoid suppressing hypoxic respiratory drive [CORRECT]
C. 80-85% to minimize oxygen toxicity
D. 100% to maximize oxygen-carrying capacity
Correct Answer: B
Rationale: COPD patients with chronic hypercapnia rely on hypoxic drive (low O2) rather
than hypercapnic drive (high CO2) for respiration. Target SpO2 88-92% prevents
respiratory depression from excessive oxygen. Normal targets (A) may cause CO2
retention and respiratory acidosis. 80-85% (C) is too low for tissue needs. 100% (D) is
dangerous for COPD patients and unnecessary.
Q6: A postoperative patient reports pain rated 8/10 on the numeric rating scale. The
patient is receiving PCA morphine with a basal rate of 1 mg/hour and demand dose of 1
mg with 10-minute lockout. Which finding indicates the PCA is ineffective?
A. Patient presses the demand button 3 times per hour and receives 3 demand doses
B. Patient presses the demand button 6 times per hour but receives only 2 demand
doses [CORRECT]
C. Patient reports pain reduction to 4/10 within 30 minutes of activation
D. Patient experiences mild sedation with respiratory rate of 14 breaths per minute
Correct Answer: B
