NUR242 Exam 3 V2 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This study guide is intended to provide comprehensive preparation for medical-surgical nursing
assessments related to neurological care, orthopedic nursing, and complex adult medical
conditions. The content reflects practical nursing concepts commonly tested in nursing
examinations.
This version contains realistic exam-style questions designed to strengthen understanding of
adult disease management, nursing assessment findings, and therapeutic interventions. Detailed
expert explanations support concept mastery and practical nursing application.
════════════════════════════════════
The Exam Covers:
• Increased intracranial pressure
• Spinal cord injury nursing care
• Arthritis and joint disorders
• Osteoporosis management
• Blood transfusion nursing care
• Hematologic laboratory interpretation
• Mobility and safety interventions
• Postoperative orthopedic nursing care
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1. A nurse is monitoring a patient with a head injury. Which assessment finding is the earliest
sign of increased intracranial pressure (ICP)?
A. Change in level of consciousness
B. Decerebrate posturing
C. Cushing’s triad
,D. Fixed and dilated pupils
Correct Answer: A
Expert Explanation: A change in the level of consciousness is the most sensitive and
earliest indicator of increased ICP. This occurs because the cerebral cortex is highly
sensitive to changes in oxygen and pressure levels. Late signs include Cushing’s triad and
motor posturing which indicate brainstem compression.
2. A patient with a T4 spinal cord injury reports a severe, throbbing headache and has a blood
pressure of 190/110 mmHg. What is the nurse’s priority action?
A. Administer an antihypertensive medication
B. Check the patient for bladder distention
C. Place the patient in a supine position
D. Notify the healthcare provider immediately
Correct Answer: B
Expert Explanation: The patient is exhibiting signs of autonomic dysreflexia, a medical
emergency triggered by noxious stimuli like a full bladder. The nurse should immediately
sit the patient up to lower blood pressure and then identify and remove the stimulus.
Checking for bladder distention is a critical step in resolving the underlying cause.
3. Which clinical manifestation is a hallmark sign of Rheumatoid Arthritis (RA) that
distinguishes it from Osteoarthritis (OA)?
A. Asymmetrical joint involvement
,B. Morning stiffness lasting less than 30 minutes
C. Crepitus with joint movement
D. Systemic symptoms like fatigue and fever
Correct Answer: D
Expert Explanation: Rheumatoid Arthritis is a systemic autoimmune disease
characterized by symmetrical joint involvement and systemic symptoms such as fever and
fatigue. Osteoarthritis is a localized degenerative disease and typically does not cause
systemic inflammation. RA patients also experience morning stiffness lasting more than an
hour, whereas OA stiffness is shorter.
4. A nurse is educating a postmenopausal client about osteoporosis prevention. Which
weight-bearing exercise should the nurse recommend?
A. Swimming in a heated pool
B. Bicycling on a stationary bike
C. Yoga for flexibility
D. Brisk walking for 30 minutes
Correct Answer: D
Expert Explanation: Weight-bearing exercises, such as walking, are essential for
stimulating bone formation and maintaining bone density in patients at risk for
osteoporosis. Swimming and bicycling are low-impact and do not put enough stress on the
, bones to prevent bone loss. Walking is an accessible and effective way to strengthen the
skeletal system.
5. A nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which action
must the nurse take first?
A. Obtain informed consent from the patient
B. Verify the blood type with another RN
C. Prime the tubing with Normal Saline
D. Check the patient’s temperature
Correct Answer: A
Expert Explanation: Obtaining informed consent is a prerequisite for any blood
transfusion and must be verified before the procedure begins. Once consent is confirmed,
the nurse can proceed with baseline vitals and dual verification at the bedside. Verification
of the patient and the blood product is a critical safety step to prevent hemolytic reactions.
6. A patient has a platelet count of 40,000/mm3. Which nursing intervention is most
appropriate?
A. Apply pressure to venipuncture sites for 10 minutes
B. Encourage the use of a firm toothbrush
C. Monitor for signs of infection and fever
D. Limit oral fluid intake to 1000 mL daily
Q&A | Galen College of Nursing
────────────────────────────────────
This study guide is intended to provide comprehensive preparation for medical-surgical nursing
assessments related to neurological care, orthopedic nursing, and complex adult medical
conditions. The content reflects practical nursing concepts commonly tested in nursing
examinations.
This version contains realistic exam-style questions designed to strengthen understanding of
adult disease management, nursing assessment findings, and therapeutic interventions. Detailed
expert explanations support concept mastery and practical nursing application.
════════════════════════════════════
The Exam Covers:
• Increased intracranial pressure
• Spinal cord injury nursing care
• Arthritis and joint disorders
• Osteoporosis management
• Blood transfusion nursing care
• Hematologic laboratory interpretation
• Mobility and safety interventions
• Postoperative orthopedic nursing care
════════════════════════════════════
1. A nurse is monitoring a patient with a head injury. Which assessment finding is the earliest
sign of increased intracranial pressure (ICP)?
A. Change in level of consciousness
B. Decerebrate posturing
C. Cushing’s triad
,D. Fixed and dilated pupils
Correct Answer: A
Expert Explanation: A change in the level of consciousness is the most sensitive and
earliest indicator of increased ICP. This occurs because the cerebral cortex is highly
sensitive to changes in oxygen and pressure levels. Late signs include Cushing’s triad and
motor posturing which indicate brainstem compression.
2. A patient with a T4 spinal cord injury reports a severe, throbbing headache and has a blood
pressure of 190/110 mmHg. What is the nurse’s priority action?
A. Administer an antihypertensive medication
B. Check the patient for bladder distention
C. Place the patient in a supine position
D. Notify the healthcare provider immediately
Correct Answer: B
Expert Explanation: The patient is exhibiting signs of autonomic dysreflexia, a medical
emergency triggered by noxious stimuli like a full bladder. The nurse should immediately
sit the patient up to lower blood pressure and then identify and remove the stimulus.
Checking for bladder distention is a critical step in resolving the underlying cause.
3. Which clinical manifestation is a hallmark sign of Rheumatoid Arthritis (RA) that
distinguishes it from Osteoarthritis (OA)?
A. Asymmetrical joint involvement
,B. Morning stiffness lasting less than 30 minutes
C. Crepitus with joint movement
D. Systemic symptoms like fatigue and fever
Correct Answer: D
Expert Explanation: Rheumatoid Arthritis is a systemic autoimmune disease
characterized by symmetrical joint involvement and systemic symptoms such as fever and
fatigue. Osteoarthritis is a localized degenerative disease and typically does not cause
systemic inflammation. RA patients also experience morning stiffness lasting more than an
hour, whereas OA stiffness is shorter.
4. A nurse is educating a postmenopausal client about osteoporosis prevention. Which
weight-bearing exercise should the nurse recommend?
A. Swimming in a heated pool
B. Bicycling on a stationary bike
C. Yoga for flexibility
D. Brisk walking for 30 minutes
Correct Answer: D
Expert Explanation: Weight-bearing exercises, such as walking, are essential for
stimulating bone formation and maintaining bone density in patients at risk for
osteoporosis. Swimming and bicycling are low-impact and do not put enough stress on the
, bones to prevent bone loss. Walking is an accessible and effective way to strengthen the
skeletal system.
5. A nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which action
must the nurse take first?
A. Obtain informed consent from the patient
B. Verify the blood type with another RN
C. Prime the tubing with Normal Saline
D. Check the patient’s temperature
Correct Answer: A
Expert Explanation: Obtaining informed consent is a prerequisite for any blood
transfusion and must be verified before the procedure begins. Once consent is confirmed,
the nurse can proceed with baseline vitals and dual verification at the bedside. Verification
of the patient and the blood product is a critical safety step to prevent hemolytic reactions.
6. A patient has a platelet count of 40,000/mm3. Which nursing intervention is most
appropriate?
A. Apply pressure to venipuncture sites for 10 minutes
B. Encourage the use of a firm toothbrush
C. Monitor for signs of infection and fever
D. Limit oral fluid intake to 1000 mL daily
