NUR242 Final Exam V2 | NUR 242 Med-Surg
Exam Q&A | Galen College of Nursing
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This study guide is intended to help students consolidate foundational and advanced concepts
related to adult healthcare, acute care nursing, and evidence-based medical-surgical
interventions. The material reflects the style and complexity commonly encountered in nursing
final examinations.
This version contains realistic final exam-style questions covering adult disorders, nursing
assessments, and therapeutic interventions. Detailed expert explanations are included to support
deeper understanding and comprehensive exam preparation.
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The Exam Covers:
• Acute and chronic adult illnesses
• Adult emergency nursing care
• Complex nursing interventions
• Adult fluid and electrolyte management
• Critical care prioritization
• Adult rehabilitation concepts
• Ethical and legal nursing care
• Nursing leadership and delegation
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1. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which of the following
is the priority intervention?
A. Initiating continuous cardiac monitoring
B. Administering a dose of spironolactone
C. Encouraging the intake of bananas and orange juice
,D. Checking the patient’s blood pressure every 4 hours
Correct Answer: A
Expert Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia, which poses
a significant risk for life-threatening cardiac dysrhythmias. Continuous cardiac monitoring
is essential to detect changes like peaked T waves or widened QRS complexes immediately.
The nurse must prioritize safety and assessment before administering further treatments
or medications that might affect potassium levels.
2. Which assessment finding is most indicative of left-sided heart failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Crackles heard upon lung auscultation
D. Hepatosplenomegaly
Correct Answer: C
Expert Explanation: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion and crackles. In contrast, right-sided heart
failure typically manifests as systemic venous congestion, such as peripheral edema and
jugular venous distention. The nurse must distinguish between systemic and pulmonary
symptoms to identify the affected side of the heart.
, 3. A patient in the emergency department reports sudden chest pain and shortness of breath.
Which action should the nurse take first?
A. Obtain a 12-lead electrocardiogram (ECG)
B. Administer 2 mg of morphine IV push
C. Draw blood for cardiac enzyme markers
D. Auscultate the patient’s heart sounds
Correct Answer: A
Expert Explanation: An immediate 12-lead ECG is the priority for a patient with chest pain
to determine if a myocardial infarction is occurring. Rapid diagnosis allows for timely
reperfusion therapy and prevents further myocardial damage. The nurse should also assess
the patient’s oxygenation while the ECG is being performed.
4. Which arterial blood gas (ABG) result reflects uncompensated respiratory acidosis?
A. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 40 mmHg, HCO3 18 mEq/L
D. pH 7.35, PaCO2 48 mmHg, HCO3 28 mEq/L
Correct Answer: A
Expert Explanation: Respiratory acidosis is characterized by a low pH and a high PaCO2
level. In this case, the pH is 7.30 (acidotic) and the PaCO2 is 50 (high), while the HCO3
Exam Q&A | Galen College of Nursing
────────────────────────────────────
This study guide is intended to help students consolidate foundational and advanced concepts
related to adult healthcare, acute care nursing, and evidence-based medical-surgical
interventions. The material reflects the style and complexity commonly encountered in nursing
final examinations.
This version contains realistic final exam-style questions covering adult disorders, nursing
assessments, and therapeutic interventions. Detailed expert explanations are included to support
deeper understanding and comprehensive exam preparation.
════════════════════════════════════
The Exam Covers:
• Acute and chronic adult illnesses
• Adult emergency nursing care
• Complex nursing interventions
• Adult fluid and electrolyte management
• Critical care prioritization
• Adult rehabilitation concepts
• Ethical and legal nursing care
• Nursing leadership and delegation
════════════════════════════════════
1. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which of the following
is the priority intervention?
A. Initiating continuous cardiac monitoring
B. Administering a dose of spironolactone
C. Encouraging the intake of bananas and orange juice
,D. Checking the patient’s blood pressure every 4 hours
Correct Answer: A
Expert Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia, which poses
a significant risk for life-threatening cardiac dysrhythmias. Continuous cardiac monitoring
is essential to detect changes like peaked T waves or widened QRS complexes immediately.
The nurse must prioritize safety and assessment before administering further treatments
or medications that might affect potassium levels.
2. Which assessment finding is most indicative of left-sided heart failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Crackles heard upon lung auscultation
D. Hepatosplenomegaly
Correct Answer: C
Expert Explanation: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion and crackles. In contrast, right-sided heart
failure typically manifests as systemic venous congestion, such as peripheral edema and
jugular venous distention. The nurse must distinguish between systemic and pulmonary
symptoms to identify the affected side of the heart.
, 3. A patient in the emergency department reports sudden chest pain and shortness of breath.
Which action should the nurse take first?
A. Obtain a 12-lead electrocardiogram (ECG)
B. Administer 2 mg of morphine IV push
C. Draw blood for cardiac enzyme markers
D. Auscultate the patient’s heart sounds
Correct Answer: A
Expert Explanation: An immediate 12-lead ECG is the priority for a patient with chest pain
to determine if a myocardial infarction is occurring. Rapid diagnosis allows for timely
reperfusion therapy and prevents further myocardial damage. The nurse should also assess
the patient’s oxygenation while the ECG is being performed.
4. Which arterial blood gas (ABG) result reflects uncompensated respiratory acidosis?
A. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
C. pH 7.32, PaCO2 40 mmHg, HCO3 18 mEq/L
D. pH 7.35, PaCO2 48 mmHg, HCO3 28 mEq/L
Correct Answer: A
Expert Explanation: Respiratory acidosis is characterized by a low pH and a high PaCO2
level. In this case, the pH is 7.30 (acidotic) and the PaCO2 is 50 (high), while the HCO3
