NUR242 Final Exam V3 | NUR 242 Med-Surg
Exam Q&A | Galen College of Nursing
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This comprehensive final exam preparation material is designed to strengthen understanding of
advanced medical-surgical nursing concepts, critical care management, and complex adult
patient interventions. The content focuses on integrating nursing knowledge into real-world
clinical scenarios and healthcare decision-making.
The questions are structured to closely mirror actual nursing final exams while reinforcing
analytical reasoning, prioritization, and nursing intervention strategies. Detailed expert
explanations are included to support concept mastery and academic success.
════════════════════════════════════
The Exam Covers:
• Multisystem adult disorders
• Advanced nursing assessment
• Adult emergency and trauma care
• Critical care pharmacology
• Complex patient management
• Comprehensive nursing interventions
• Patient-centered nursing care
• Final medical-surgical review
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1. A patient presents to the emergency department with a suspected tension pneumothorax.
Which clinical finding should the nurse anticipate first?
A. Tracheal deviation to the unaffected side
B. Increased breath sounds on the affected side
C. Bradycardia and hypertension
,D. Flattened neck veins
Correct Answer: A
Expert Explanation: Tension pneumothorax causes a shift in the mediastinum, leading to
tracheal deviation toward the unaffected side. This is a life-threatening emergency because
the building pressure collapses the lung and compresses the heart. Rapid decompression
via needle thoracostomy or chest tube insertion is necessary to restore cardiac output and
ventilation.
2. When assessing a patient with a Glasgow Coma Scale (GCS) score of 7, which nursing
intervention is the highest priority?
A. Preparing for endotracheal intubation
B. Monitoring hourly urine output
C. Administering intravenous pain medication
D. Assessing the patient’s deep tendon reflexes
Correct Answer: A
Expert Explanation: A GCS score of 8 or less is typically the threshold for considering the
patient’s airway to be unprotected. The nurse must prioritize airway management to
prevent aspiration and ensure adequate oxygenation. Maintaining a patent airway is the
first step in the ABCs of emergency nursing for a neurologically impaired patient.
,3. A patient in the ICU is being monitored for Mean Arterial Pressure (MAP). What is the
minimum MAP required to maintain adequate perfusion to the brain and kidneys?
A. 40 mmHg
B. 50 mmHg
C. 90 mmHg
D. 65 mmHg
Correct Answer: D
Expert Explanation: A Mean Arterial Pressure (MAP) of at least 65 mmHg is generally
required to ensure that vital organs such as the brain and kidneys receive sufficient blood
flow. If the MAP falls below this level, the patient is at high risk for ischemia and multi-
organ dysfunction syndrome. Clinical interventions such as fluid boluses or vasopressors
are often titrated based on this specific metric.
4. A client is admitted with Diabetic Ketoacidosis (DKA). Which laboratory result does the
nurse expect to find?
A. Blood glucose 150 mg/dL and pH 7.45
B. Blood glucose 200 mg/dL and pH 7.40
C. Blood glucose 800 mg/dL and pH 7.35
D. Blood glucose 450 mg/dL and pH 7.20
Correct Answer: D
, Expert Explanation: DKA is characterized by hyperglycemia, metabolic acidosis, and the
presence of ketones in the blood or urine. A blood glucose level of 450 mg/dL and a low pH
of 7.20 are classic indicators of this life-threatening diabetic complication. Treatment
involves intensive hydration, insulin infusion, and monitoring of electrolyte balances,
particularly potassium.
5. Which phase of the burn injury process is characterized by a massive fluid shift from the
intravascular to the interstitial space?
A. Emergent phase
B. Rehabilitative phase
C. Acute phase
D. Restorative phase
Correct Answer: A
Expert Explanation: The emergent phase occurs immediately after the burn and lasts for
approximately 24 to 48 hours. During this time, increased capillary permeability leads to
‘third-spacing,’ causing significant edema and potential hypovolemic shock. Fluid
resuscitation using the Parkland formula is a critical nursing priority during this specific
window of care.
6. A patient is experiencing Autonomic Dysreflexia. What is the nurse’s first action?
A. Administer an antihypertensive medication
B. Place the patient in a supine position
Exam Q&A | Galen College of Nursing
────────────────────────────────────
This comprehensive final exam preparation material is designed to strengthen understanding of
advanced medical-surgical nursing concepts, critical care management, and complex adult
patient interventions. The content focuses on integrating nursing knowledge into real-world
clinical scenarios and healthcare decision-making.
The questions are structured to closely mirror actual nursing final exams while reinforcing
analytical reasoning, prioritization, and nursing intervention strategies. Detailed expert
explanations are included to support concept mastery and academic success.
════════════════════════════════════
The Exam Covers:
• Multisystem adult disorders
• Advanced nursing assessment
• Adult emergency and trauma care
• Critical care pharmacology
• Complex patient management
• Comprehensive nursing interventions
• Patient-centered nursing care
• Final medical-surgical review
════════════════════════════════════
1. A patient presents to the emergency department with a suspected tension pneumothorax.
Which clinical finding should the nurse anticipate first?
A. Tracheal deviation to the unaffected side
B. Increased breath sounds on the affected side
C. Bradycardia and hypertension
,D. Flattened neck veins
Correct Answer: A
Expert Explanation: Tension pneumothorax causes a shift in the mediastinum, leading to
tracheal deviation toward the unaffected side. This is a life-threatening emergency because
the building pressure collapses the lung and compresses the heart. Rapid decompression
via needle thoracostomy or chest tube insertion is necessary to restore cardiac output and
ventilation.
2. When assessing a patient with a Glasgow Coma Scale (GCS) score of 7, which nursing
intervention is the highest priority?
A. Preparing for endotracheal intubation
B. Monitoring hourly urine output
C. Administering intravenous pain medication
D. Assessing the patient’s deep tendon reflexes
Correct Answer: A
Expert Explanation: A GCS score of 8 or less is typically the threshold for considering the
patient’s airway to be unprotected. The nurse must prioritize airway management to
prevent aspiration and ensure adequate oxygenation. Maintaining a patent airway is the
first step in the ABCs of emergency nursing for a neurologically impaired patient.
,3. A patient in the ICU is being monitored for Mean Arterial Pressure (MAP). What is the
minimum MAP required to maintain adequate perfusion to the brain and kidneys?
A. 40 mmHg
B. 50 mmHg
C. 90 mmHg
D. 65 mmHg
Correct Answer: D
Expert Explanation: A Mean Arterial Pressure (MAP) of at least 65 mmHg is generally
required to ensure that vital organs such as the brain and kidneys receive sufficient blood
flow. If the MAP falls below this level, the patient is at high risk for ischemia and multi-
organ dysfunction syndrome. Clinical interventions such as fluid boluses or vasopressors
are often titrated based on this specific metric.
4. A client is admitted with Diabetic Ketoacidosis (DKA). Which laboratory result does the
nurse expect to find?
A. Blood glucose 150 mg/dL and pH 7.45
B. Blood glucose 200 mg/dL and pH 7.40
C. Blood glucose 800 mg/dL and pH 7.35
D. Blood glucose 450 mg/dL and pH 7.20
Correct Answer: D
, Expert Explanation: DKA is characterized by hyperglycemia, metabolic acidosis, and the
presence of ketones in the blood or urine. A blood glucose level of 450 mg/dL and a low pH
of 7.20 are classic indicators of this life-threatening diabetic complication. Treatment
involves intensive hydration, insulin infusion, and monitoring of electrolyte balances,
particularly potassium.
5. Which phase of the burn injury process is characterized by a massive fluid shift from the
intravascular to the interstitial space?
A. Emergent phase
B. Rehabilitative phase
C. Acute phase
D. Restorative phase
Correct Answer: A
Expert Explanation: The emergent phase occurs immediately after the burn and lasts for
approximately 24 to 48 hours. During this time, increased capillary permeability leads to
‘third-spacing,’ causing significant edema and potential hypovolemic shock. Fluid
resuscitation using the Parkland formula is a critical nursing priority during this specific
window of care.
6. A patient is experiencing Autonomic Dysreflexia. What is the nurse’s first action?
A. Administer an antihypertensive medication
B. Place the patient in a supine position
