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.
════════════════════════════════════
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 who is 4 hours postoperative following a total hip
arthroplasty. Which of the following tasks is most appropriate to delegate to an unlicensed
assistive personnel (UAP)?
A. Assessing the surgical site for drainage or signs of infection.
B. Reviewing the patient’s postoperative physical therapy goals.
,C. Teaching the patient how to use the incentive spirometer correctly.
D. Assisting the patient to change positions while maintaining hip precautions.
Correct Answer: D
Expert Explanation: Assisting a stable patient with positioning is a routine task that falls
within the scope of a UAP, provided they are trained in hip precautions. Assessments,
teaching, and clinical evaluation are responsibilities that must remain with the registered
nurse. The RN must always ensure that the UAP understands the specific movement
restrictions associated with the surgery before delegating.
2. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.2 mEq/L.
Which of the following medical orders should the nurse prioritize?
A. Administering a dose of oral calcium carbonate.
B. Starting a low-protein diet for the next meal.
C. Obtaining a 12-lead electrocardiogram (ECG).
D. Encouraging increased fluid intake to flush the kidneys.
Correct Answer: C
Expert Explanation: Hyperkalemia (potassium > 5.0 mEq/L) can lead to life-threatening
cardiac dysrhythmias and cardiac arrest. Obtaining an ECG is the priority to assess for
peaked T waves or widened QRS complexes that indicate cardiac instability. Once the
cardiac status is assessed, further treatments like insulin/dextrose or Kayexalate can be
administered safely.
,3. A nurse is triaging patients in the emergency department. Which patient should the nurse
see first?
A. A 10-year-old with a temperature of 101.5°F and a productive cough.
B. A 60-year-old with chronic back pain requesting a refill of medication.
C. A 25-year-old with a 2-cm laceration on the forearm that is not bleeding.
D. A 45-year-old reporting sudden onset of ‘the worst headache of my life.’
Correct Answer: D
Expert Explanation: The report of the ‘worst headache of my life’ is a classic symptom of a
subarachnoid hemorrhage, which is a neurological emergency. This patient is at high risk
for rapid deterioration and requires immediate imaging and intervention. Other patients,
while needing care, do not present with immediately life-threatening symptoms.
4. A patient diagnosed with heart failure is prescribed Digoxin 0.125 mg daily. Which
assessment finding should lead the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg.
B. A heart rate of 52 beats per minute.
C. A potassium level of 4.5 mEq/L.
D. Respiratory rate of 18 breaths per minute.
Correct Answer: B
, Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate and increases
the force of contraction. It is standard practice to withhold digoxin if the apical pulse is less
than 60 beats per minute to prevent bradycardia. The nurse should notify the healthcare
provider and monitor for signs of digoxin toxicity.
5. Which arterial blood gas (ABG) result would the nurse expect to find in a patient
experiencing severe diabetic ketoacidosis (DKA)?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.50, PaCO2 32, HCO3 24
C. pH 7.32, PaCO2 48, HCO3 26
D. pH 7.30, PaCO2 30, HCO3 16
Correct Answer: D
Expert Explanation: Diabetic ketoacidosis results in metabolic acidosis due to the
accumulation of ketones, which are acidic. Option A represents metabolic acidosis (low pH
and low HCO3) with partial respiratory compensation (low PaCO2). Correcting the
underlying hyperglycemia and fluid deficit is essential for restoring acid-base balance.
6. A nurse is assessing a patient with a suspected tension pneumothorax. Which clinical
manifestation is a hallmark sign of this condition?
A. Tracheal deviation toward the unaffected side.
B. Tracheal deviation toward the affected side.
C. Increased breath sounds on the affected side.
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 who is 4 hours postoperative following a total hip
arthroplasty. Which of the following tasks is most appropriate to delegate to an unlicensed
assistive personnel (UAP)?
A. Assessing the surgical site for drainage or signs of infection.
B. Reviewing the patient’s postoperative physical therapy goals.
,C. Teaching the patient how to use the incentive spirometer correctly.
D. Assisting the patient to change positions while maintaining hip precautions.
Correct Answer: D
Expert Explanation: Assisting a stable patient with positioning is a routine task that falls
within the scope of a UAP, provided they are trained in hip precautions. Assessments,
teaching, and clinical evaluation are responsibilities that must remain with the registered
nurse. The RN must always ensure that the UAP understands the specific movement
restrictions associated with the surgery before delegating.
2. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.2 mEq/L.
Which of the following medical orders should the nurse prioritize?
A. Administering a dose of oral calcium carbonate.
B. Starting a low-protein diet for the next meal.
C. Obtaining a 12-lead electrocardiogram (ECG).
D. Encouraging increased fluid intake to flush the kidneys.
Correct Answer: C
Expert Explanation: Hyperkalemia (potassium > 5.0 mEq/L) can lead to life-threatening
cardiac dysrhythmias and cardiac arrest. Obtaining an ECG is the priority to assess for
peaked T waves or widened QRS complexes that indicate cardiac instability. Once the
cardiac status is assessed, further treatments like insulin/dextrose or Kayexalate can be
administered safely.
,3. A nurse is triaging patients in the emergency department. Which patient should the nurse
see first?
A. A 10-year-old with a temperature of 101.5°F and a productive cough.
B. A 60-year-old with chronic back pain requesting a refill of medication.
C. A 25-year-old with a 2-cm laceration on the forearm that is not bleeding.
D. A 45-year-old reporting sudden onset of ‘the worst headache of my life.’
Correct Answer: D
Expert Explanation: The report of the ‘worst headache of my life’ is a classic symptom of a
subarachnoid hemorrhage, which is a neurological emergency. This patient is at high risk
for rapid deterioration and requires immediate imaging and intervention. Other patients,
while needing care, do not present with immediately life-threatening symptoms.
4. A patient diagnosed with heart failure is prescribed Digoxin 0.125 mg daily. Which
assessment finding should lead the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg.
B. A heart rate of 52 beats per minute.
C. A potassium level of 4.5 mEq/L.
D. Respiratory rate of 18 breaths per minute.
Correct Answer: B
, Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate and increases
the force of contraction. It is standard practice to withhold digoxin if the apical pulse is less
than 60 beats per minute to prevent bradycardia. The nurse should notify the healthcare
provider and monitor for signs of digoxin toxicity.
5. Which arterial blood gas (ABG) result would the nurse expect to find in a patient
experiencing severe diabetic ketoacidosis (DKA)?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.50, PaCO2 32, HCO3 24
C. pH 7.32, PaCO2 48, HCO3 26
D. pH 7.30, PaCO2 30, HCO3 16
Correct Answer: D
Expert Explanation: Diabetic ketoacidosis results in metabolic acidosis due to the
accumulation of ketones, which are acidic. Option A represents metabolic acidosis (low pH
and low HCO3) with partial respiratory compensation (low PaCO2). Correcting the
underlying hyperglycemia and fluid deficit is essential for restoring acid-base balance.
6. A nurse is assessing a patient with a suspected tension pneumothorax. Which clinical
manifestation is a hallmark sign of this condition?
A. Tracheal deviation toward the unaffected side.
B. Tracheal deviation toward the affected side.
C. Increased breath sounds on the affected side.
