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.
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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 in the intensive care unit is showing signs of septic shock. Which intervention
should the nurse prioritize first?
A. Administering broad-spectrum antibiotics
B. Obtaining blood cultures from two different sites
C. Starting a norepinephrine infusion to maintain MAP > 65 mmHg
,D. Initiating a fluid bolus of 30 mL/kg of isotonic crystalloids
Correct Answer: D
Expert Explanation: Initial resuscitation for sepsis and septic shock involves rapid fluid
administration to address hypovolemia and improve tissue perfusion. Blood cultures
should be obtained as soon as possible, but fluid resuscitation is the immediate priority to
stabilize the patient’s hemodynamic status. Antibiotics are critical but should follow the
initiation of fluids and culture collection.
2. A nurse is monitoring a patient on mechanical ventilation. The high-pressure alarm sounds.
Which of the following is the most likely cause?
A. A leak in the ventilator circuit
B. The patient is biting the endotracheal tube
C. The patient has become disconnected from the ventilator
D. The endotracheal tube cuff has deflated
Correct Answer: B
Expert Explanation: High-pressure alarms are triggered by increased resistance in the
system, such as a patient biting the tube, secretions in the airway, or bronchospasm. Low-
pressure alarms usually indicate a leak or disconnection in the circuit. The nurse must
assess the patient’s airway and the tube’s patency immediately to resolve the alarm.
, 3. A 70kg patient has sustained partial-thickness burns over 40% of their body. Using the
Parkland formula, how much fluid should be administered in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 11,200 mL
D. 4,200 mL
Correct Answer: B
Expert Explanation: The Parkland formula calculates total fluid requirements as 4 mL x
weight (kg) x % BSA burned. For this patient, the total is 4 x 70 x 40 = 11,200 mL over 24
hours. Since half is given in the first 8 hours, the nurse should administer 5,600 mL.
4. A patient with a head injury has an intracranial pressure (ICP) of 22 mmHg. Which nursing
action is most appropriate?
A. Place the patient in a Trendelenburg position
B. Encourage the patient to cough and deep breathe
C. Maintain the head of the bed at 30 to 45 degrees
D. Suction the patient frequently to maintain airway patency
Correct Answer: C
Expert Explanation: Elevating the head of the bed promotes venous drainage from the
brain, which helps lower intracranial pressure. Positions like Trendelenburg or excessive
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 in the intensive care unit is showing signs of septic shock. Which intervention
should the nurse prioritize first?
A. Administering broad-spectrum antibiotics
B. Obtaining blood cultures from two different sites
C. Starting a norepinephrine infusion to maintain MAP > 65 mmHg
,D. Initiating a fluid bolus of 30 mL/kg of isotonic crystalloids
Correct Answer: D
Expert Explanation: Initial resuscitation for sepsis and septic shock involves rapid fluid
administration to address hypovolemia and improve tissue perfusion. Blood cultures
should be obtained as soon as possible, but fluid resuscitation is the immediate priority to
stabilize the patient’s hemodynamic status. Antibiotics are critical but should follow the
initiation of fluids and culture collection.
2. A nurse is monitoring a patient on mechanical ventilation. The high-pressure alarm sounds.
Which of the following is the most likely cause?
A. A leak in the ventilator circuit
B. The patient is biting the endotracheal tube
C. The patient has become disconnected from the ventilator
D. The endotracheal tube cuff has deflated
Correct Answer: B
Expert Explanation: High-pressure alarms are triggered by increased resistance in the
system, such as a patient biting the tube, secretions in the airway, or bronchospasm. Low-
pressure alarms usually indicate a leak or disconnection in the circuit. The nurse must
assess the patient’s airway and the tube’s patency immediately to resolve the alarm.
, 3. A 70kg patient has sustained partial-thickness burns over 40% of their body. Using the
Parkland formula, how much fluid should be administered in the first 8 hours?
A. 2,800 mL
B. 5,600 mL
C. 11,200 mL
D. 4,200 mL
Correct Answer: B
Expert Explanation: The Parkland formula calculates total fluid requirements as 4 mL x
weight (kg) x % BSA burned. For this patient, the total is 4 x 70 x 40 = 11,200 mL over 24
hours. Since half is given in the first 8 hours, the nurse should administer 5,600 mL.
4. A patient with a head injury has an intracranial pressure (ICP) of 22 mmHg. Which nursing
action is most appropriate?
A. Place the patient in a Trendelenburg position
B. Encourage the patient to cough and deep breathe
C. Maintain the head of the bed at 30 to 45 degrees
D. Suction the patient frequently to maintain airway patency
Correct Answer: C
Expert Explanation: Elevating the head of the bed promotes venous drainage from the
brain, which helps lower intracranial pressure. Positions like Trendelenburg or excessive
