NUR242 Final Exam V1 | NUR 242 Med-Surg
Exam Q&A | Galen College of Nursing
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This final exam preparation resource is designed to provide a comprehensive review of medical-
surgical nursing concepts, adult patient care management, and evidence-based nursing
interventions covered throughout the course. The material integrates major nursing concepts
into a realistic exam-style format.
The questions included in this version are structured to closely mirror actual final exam
assessments and strengthen clinical reasoning and nursing decision-making skills. Detailed
expert explanations are included to improve concept integration and exam readiness.
════════════════════════════════════
The Exam Covers:
• Cardiovascular and respiratory disorders
• Neurological nursing care
• Renal and endocrine disorders
• Gastrointestinal nursing management
• Critical care nursing concepts
• Adult pharmacology review
• Patient safety and prioritization
• Comprehensive medical-surgical review
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1. A nurse is caring for a patient who is 4 hours post-operative following a total
thyroidectomy. Which clinical manifestation is the priority for the nurse to report?
A. A hoarse voice when speaking
B. Pain level of 5 on a 1-10 scale
C. Serum calcium level of 9.0 mg/dL
,D. Laryngeal stridor and respiratory distress
Correct Answer: D
Expert Explanation: Laryngeal stridor indicates an acute airway obstruction which is a
life-threatening complication following neck surgery. This can be caused by edema, tetany
from hypocalcemia, or laryngeal nerve damage. The nurse must immediately notify the
provider and prepare for emergency intubation or tracheostomy.
2. A patient with heart failure is prescribed Digoxin 0.125 mg daily. Which assessment finding
indicates a potential toxic effect of the medication?
A. Increased urinary output
B. Yellow-green halos in visual fields
C. Heart rate of 82 beats per minute
D. Increased appetite and thirst
Correct Answer: B
Expert Explanation: Visual disturbances such as yellow-green halos are a classic sign of
digoxin toxicity. Other signs include nausea, vomiting, and cardiac arrhythmias like
bradycardia. Digoxin has a narrow therapeutic window, so these symptoms require
immediate blood level testing.
3. The nurse is evaluating the Arterial Blood Gas (ABG) results for a patient: pH 7.28, PaCO2
50, HCO3 24. How should the nurse interpret these findings?
A. Metabolic Acidosis
, B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Correct Answer: B
Expert Explanation: The pH is low (under 7.35) indicating acidosis, and the PaCO2 is high
(over 45) indicating a respiratory cause. The HCO3 is within normal range, suggesting no
compensation has occurred yet. This pattern is consistent with uncompensated respiratory
acidosis.
4. A patient with a spinal cord injury at T4 reports a sudden, throbbing headache and has a
blood pressure of 190/100 mmHg. What is the priority nursing action?
A. Administer a PRN dose of hydralazine
B. Place the patient in a high-Fowler’s position
C. Assess the patient for a full bladder
D. Check the patient’s skin for pressure areas
Correct Answer: B
Expert Explanation: The symptoms describe autonomic dysreflexia, a medical emergency.
The first priority is to sit the patient upright (high-Fowler’s) to trigger an orthostatic
reduction in blood pressure. Only after positioning should the nurse assess for triggers like
bladder distention or fecal impaction.
Exam Q&A | Galen College of Nursing
────────────────────────────────────
This final exam preparation resource is designed to provide a comprehensive review of medical-
surgical nursing concepts, adult patient care management, and evidence-based nursing
interventions covered throughout the course. The material integrates major nursing concepts
into a realistic exam-style format.
The questions included in this version are structured to closely mirror actual final exam
assessments and strengthen clinical reasoning and nursing decision-making skills. Detailed
expert explanations are included to improve concept integration and exam readiness.
════════════════════════════════════
The Exam Covers:
• Cardiovascular and respiratory disorders
• Neurological nursing care
• Renal and endocrine disorders
• Gastrointestinal nursing management
• Critical care nursing concepts
• Adult pharmacology review
• Patient safety and prioritization
• Comprehensive medical-surgical review
════════════════════════════════════
1. A nurse is caring for a patient who is 4 hours post-operative following a total
thyroidectomy. Which clinical manifestation is the priority for the nurse to report?
A. A hoarse voice when speaking
B. Pain level of 5 on a 1-10 scale
C. Serum calcium level of 9.0 mg/dL
,D. Laryngeal stridor and respiratory distress
Correct Answer: D
Expert Explanation: Laryngeal stridor indicates an acute airway obstruction which is a
life-threatening complication following neck surgery. This can be caused by edema, tetany
from hypocalcemia, or laryngeal nerve damage. The nurse must immediately notify the
provider and prepare for emergency intubation or tracheostomy.
2. A patient with heart failure is prescribed Digoxin 0.125 mg daily. Which assessment finding
indicates a potential toxic effect of the medication?
A. Increased urinary output
B. Yellow-green halos in visual fields
C. Heart rate of 82 beats per minute
D. Increased appetite and thirst
Correct Answer: B
Expert Explanation: Visual disturbances such as yellow-green halos are a classic sign of
digoxin toxicity. Other signs include nausea, vomiting, and cardiac arrhythmias like
bradycardia. Digoxin has a narrow therapeutic window, so these symptoms require
immediate blood level testing.
3. The nurse is evaluating the Arterial Blood Gas (ABG) results for a patient: pH 7.28, PaCO2
50, HCO3 24. How should the nurse interpret these findings?
A. Metabolic Acidosis
, B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Correct Answer: B
Expert Explanation: The pH is low (under 7.35) indicating acidosis, and the PaCO2 is high
(over 45) indicating a respiratory cause. The HCO3 is within normal range, suggesting no
compensation has occurred yet. This pattern is consistent with uncompensated respiratory
acidosis.
4. A patient with a spinal cord injury at T4 reports a sudden, throbbing headache and has a
blood pressure of 190/100 mmHg. What is the priority nursing action?
A. Administer a PRN dose of hydralazine
B. Place the patient in a high-Fowler’s position
C. Assess the patient for a full bladder
D. Check the patient’s skin for pressure areas
Correct Answer: B
Expert Explanation: The symptoms describe autonomic dysreflexia, a medical emergency.
The first priority is to sit the patient upright (high-Fowler’s) to trigger an orthostatic
reduction in blood pressure. Only after positioning should the nurse assess for triggers like
bladder distention or fecal impaction.
