NUR 242 Exam 4 Galen Med-Surg
Concepts Questions and Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified Explanation
, Verified ẉith trusted textbooks
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─
1. The nurse is caring for a client with a blood pressure of 90/60 mm Hg. The
mean arterial pressure (MAP) is calculated as 70 mm Hg. How should the nurse
interpret this finding?
A. MAP is too low to perfuse vital organs and requires immediate intervention.
B. MAP is adequate to maintain organ perfusion.
C. MAP indicates severe hypertension and risk for stroke.
D. MAP is not useful for assessing perfusion.
Correct Answer: B
Expert Explanation: MAP should be at least 60 mm Hg to maintain adequate
perfusion of vital organs such as the brain and kidneys; 70 mm Hg is above this
minimum threshold and is therefore acceptable even though the systolic blood
pressure is low . MAP is calculated using the formula: diastolic BP + 1/3
(systolic BP - diastolic BP). A MAP below 60 mm Hg indicates inadequate
perfusion and requires immediate intervention. A MAP above 100 mm Hg may
indicate hypertension. MAP is specifically used in clinical practice to assess
perfusion status, particularly in critically ill patients or those with shock . The
nurse should continue to monitor the client's blood pressure and assess for
signs of end-organ perfusion such as urine output, mental status, and
peripheral pulses.
2. Which assessment finding suggests the client is experiencing orthostatic
hypotension during vital sign measurement?
A. Systolic BP decreases 8 mm Hg when standing; HR remains unchanged.
B. Systolic BP decreases 22 mm Hg and HR increases 18 bpm when standing.
C. Diastolic BP increases 12 mm Hg when sitting; HR decreases 10 bpm.
D. Systolic BP increases 20 mm Hg and HR increases 5 bpm when standing.
Correct Answer: B
,Expert Explanation: Orthostatic hypotension is defined as a decrease in
systolic BP of at least 20 mm Hg or a decrease in diastolic BP of at least 10 mm
Hg within 3 minutes of standing, accompanied by an increase in heart rate as
the body attempts to compensate for the drop in blood pressure . A
compensatory heart rate increase of 10-20 bpm is expected. Option B meets
both criteria. Option A shows a subclinical BP drop with no heart rate response.
Option C shows an increase in diastolic BP with a decrease in heart rate, which
is not orthostatic hypotension. Option D shows an increase in both BP and HR,
which may indicate anxiety or another condition. The nurse should assess for
symptoms such as dizziness, lightheadedness, or syncope and implement fall
precautions.
3. A client is scheduled for a cardiac catheterization. Which action should the
nurse take before the procedure?
A. Encourage the client to drink clear liquids up to the procedure time.
B. Assess for allergy to iodine or shellfish.
C. Shave the client's entire body to prevent infection.
D. Administer a full breakfast to maintain energy.
Correct Answer: B
Expert Explanation: Before cardiac catheterization, it is essential to assess
the client for allergy to iodine or shellfish because the contrast dye used during
the procedure is iodine-based . An allergic reaction can range from mild rash to
anaphylaxis. The client is typically kept NPO for 6 to 8 hours before the
procedure to prevent aspiration and to ensure an empty stomach . Full-body
shaving is unnecessary and increases infection risk; only the catheter insertion
site may be clipped. Clear liquids are not encouraged before the procedure. The
nurse should also assess renal function (creatinine level) because the contrast
dye can be nephrotoxic, especially in clients with pre-existing kidney disease.
4. Post-cardiac catheterization, which nursing instruction is most important to
prevent complications at the insertion site?
A. Encourage leg flexion and extension exercises.
B. Keep the affected leg straight and on bedrest for the prescribed period.
C. Elevate the leg on several pillows.
D. Ambulate the client 1 hour after the procedure.
Correct Answer: B
, Expert Explanation: After cardiac catheterization via the femoral artery, the
client must keep the affected leg straight and remain on bedrest for the
prescribed period (typically 4 to 6 hours) to prevent bleeding and hematoma
formation at the puncture site . Flexion and extension exercises or early
ambulation can disrupt the clot that forms at the arterial puncture site, leading
to bleeding or pseudoaneurysm formation. While slight elevation of the head of
the bed is permitted, excessive leg elevation is not the priority. The nurse
should also monitor the insertion site for bleeding, hematoma, or
pseudoaneurysm, and assess distal pulses, color, temperature, and sensation in
the affected extremity.
5. The nurse reviews an echocardiogram report noting an ejection fraction (EF)
of 35%. How should the nurse interpret this finding?
A. EF is normal; no intervention is needed.
B. EF is low and indicates heart failure.
C. EF is dangerously high and indicates hypertensive crisis.
D. EF only reflects right-sided function and is not significant.
Correct Answer: B
Expert Explanation: Normal ejection fraction (EF) is approximately 55% to
65%. An EF of less than 40% indicates systolic heart failure (HFrEF) and requires
medical intervention such as ACE inhibitors, beta-blockers, and diuretics . The
ejection fraction represents the percentage of blood the left ventricle pumps
out with each contraction. A low EF means the heart is not pumping effectively,
leading to decreased cardiac output and symptoms of heart failure such as
dyspnea, fatigue, and fluid retention. An EF below 35% is associated with
increased morbidity and mortality. High EF is not associated with hypertensive
crisis; hypertensive crisis relates to severely elevated blood pressure. The EF
reflects left ventricular function, which is central to heart failure evaluation.
6. A client's telemetry shows sinus bradycardia at 45 bpm, and the client is
dizzy and hypotensive. Which order should the nurse anticipate implementing?
A. Administer prescribed atropine.
B. Begin cardiopulmonary resuscitation.
C. Prepare for synchronized cardioversion.
D. Instruct client to bear down (Valsalva maneuver).
Concepts Questions and Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified Explanation
, Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
1. The nurse is caring for a client with a blood pressure of 90/60 mm Hg. The
mean arterial pressure (MAP) is calculated as 70 mm Hg. How should the nurse
interpret this finding?
A. MAP is too low to perfuse vital organs and requires immediate intervention.
B. MAP is adequate to maintain organ perfusion.
C. MAP indicates severe hypertension and risk for stroke.
D. MAP is not useful for assessing perfusion.
Correct Answer: B
Expert Explanation: MAP should be at least 60 mm Hg to maintain adequate
perfusion of vital organs such as the brain and kidneys; 70 mm Hg is above this
minimum threshold and is therefore acceptable even though the systolic blood
pressure is low . MAP is calculated using the formula: diastolic BP + 1/3
(systolic BP - diastolic BP). A MAP below 60 mm Hg indicates inadequate
perfusion and requires immediate intervention. A MAP above 100 mm Hg may
indicate hypertension. MAP is specifically used in clinical practice to assess
perfusion status, particularly in critically ill patients or those with shock . The
nurse should continue to monitor the client's blood pressure and assess for
signs of end-organ perfusion such as urine output, mental status, and
peripheral pulses.
2. Which assessment finding suggests the client is experiencing orthostatic
hypotension during vital sign measurement?
A. Systolic BP decreases 8 mm Hg when standing; HR remains unchanged.
B. Systolic BP decreases 22 mm Hg and HR increases 18 bpm when standing.
C. Diastolic BP increases 12 mm Hg when sitting; HR decreases 10 bpm.
D. Systolic BP increases 20 mm Hg and HR increases 5 bpm when standing.
Correct Answer: B
,Expert Explanation: Orthostatic hypotension is defined as a decrease in
systolic BP of at least 20 mm Hg or a decrease in diastolic BP of at least 10 mm
Hg within 3 minutes of standing, accompanied by an increase in heart rate as
the body attempts to compensate for the drop in blood pressure . A
compensatory heart rate increase of 10-20 bpm is expected. Option B meets
both criteria. Option A shows a subclinical BP drop with no heart rate response.
Option C shows an increase in diastolic BP with a decrease in heart rate, which
is not orthostatic hypotension. Option D shows an increase in both BP and HR,
which may indicate anxiety or another condition. The nurse should assess for
symptoms such as dizziness, lightheadedness, or syncope and implement fall
precautions.
3. A client is scheduled for a cardiac catheterization. Which action should the
nurse take before the procedure?
A. Encourage the client to drink clear liquids up to the procedure time.
B. Assess for allergy to iodine or shellfish.
C. Shave the client's entire body to prevent infection.
D. Administer a full breakfast to maintain energy.
Correct Answer: B
Expert Explanation: Before cardiac catheterization, it is essential to assess
the client for allergy to iodine or shellfish because the contrast dye used during
the procedure is iodine-based . An allergic reaction can range from mild rash to
anaphylaxis. The client is typically kept NPO for 6 to 8 hours before the
procedure to prevent aspiration and to ensure an empty stomach . Full-body
shaving is unnecessary and increases infection risk; only the catheter insertion
site may be clipped. Clear liquids are not encouraged before the procedure. The
nurse should also assess renal function (creatinine level) because the contrast
dye can be nephrotoxic, especially in clients with pre-existing kidney disease.
4. Post-cardiac catheterization, which nursing instruction is most important to
prevent complications at the insertion site?
A. Encourage leg flexion and extension exercises.
B. Keep the affected leg straight and on bedrest for the prescribed period.
C. Elevate the leg on several pillows.
D. Ambulate the client 1 hour after the procedure.
Correct Answer: B
, Expert Explanation: After cardiac catheterization via the femoral artery, the
client must keep the affected leg straight and remain on bedrest for the
prescribed period (typically 4 to 6 hours) to prevent bleeding and hematoma
formation at the puncture site . Flexion and extension exercises or early
ambulation can disrupt the clot that forms at the arterial puncture site, leading
to bleeding or pseudoaneurysm formation. While slight elevation of the head of
the bed is permitted, excessive leg elevation is not the priority. The nurse
should also monitor the insertion site for bleeding, hematoma, or
pseudoaneurysm, and assess distal pulses, color, temperature, and sensation in
the affected extremity.
5. The nurse reviews an echocardiogram report noting an ejection fraction (EF)
of 35%. How should the nurse interpret this finding?
A. EF is normal; no intervention is needed.
B. EF is low and indicates heart failure.
C. EF is dangerously high and indicates hypertensive crisis.
D. EF only reflects right-sided function and is not significant.
Correct Answer: B
Expert Explanation: Normal ejection fraction (EF) is approximately 55% to
65%. An EF of less than 40% indicates systolic heart failure (HFrEF) and requires
medical intervention such as ACE inhibitors, beta-blockers, and diuretics . The
ejection fraction represents the percentage of blood the left ventricle pumps
out with each contraction. A low EF means the heart is not pumping effectively,
leading to decreased cardiac output and symptoms of heart failure such as
dyspnea, fatigue, and fluid retention. An EF below 35% is associated with
increased morbidity and mortality. High EF is not associated with hypertensive
crisis; hypertensive crisis relates to severely elevated blood pressure. The EF
reflects left ventricular function, which is central to heart failure evaluation.
6. A client's telemetry shows sinus bradycardia at 45 bpm, and the client is
dizzy and hypotensive. Which order should the nurse anticipate implementing?
A. Administer prescribed atropine.
B. Begin cardiopulmonary resuscitation.
C. Prepare for synchronized cardioversion.
D. Instruct client to bear down (Valsalva maneuver).
