NUR242 Exam 4 V3 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This comprehensive exam-style preparation material is designed to support students preparing
for advanced medical-surgical nursing assessments involving critical care, complex
multisystem disorders, and specialized nursing interventions. The content focuses on
integrating nursing knowledge into high-level clinical decision-making scenarios.
The questions are structured to closely mirror actual course assessments while reinforcing
analytical reasoning, prioritization, and safe nursing interventions. Detailed expert explanations
are included to improve comprehension and academic performance.
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The Exam Covers:
• Advanced adult assessment
• Disaster preparedness nursing
• Pharmacological management in critical care
• Specialized adult nursing procedures
• Leadership in nursing practice
• Cultural considerations in adult care
• Complex patient prioritization
• Comprehensive medical-surgical review
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1. During a mass casualty incident, which color tag is assigned to a victim with a sucking chest
wound and stable vital signs?
A. Red
B. Green
C. Yellow
,D. Black
Correct Answer: A
Expert Explanation: Red tags are assigned to patients with life-threatening injuries who
have a high probability of survival if treated immediately. A sucking chest wound indicates
an immediate threat to the airway and breathing, requiring rapid intervention. Yellow is for
delayed, Green for minor, and Black for expectant or deceased.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the LPN?
A. Performing an admission physical assessment on a new patient
B. Providing wound care and dressing changes for a stable post-operative patient
C. Administering an intravenous bolus of a critical care medication
D. Developing the initial plan of care for a patient with septic shock
Correct Answer: B
Expert Explanation: LPNs can perform routine procedures like wound care on stable
patients. Admission assessments and planning of care are the responsibility of the RN.
Critical care IV bolus medications are typically reserved for RNs or advanced practice
providers in high-acuity settings.
3. A patient in the ICU is being treated for septic shock. Which of the following is the priority
intervention in the first hour of treatment?
A. Administering a 30 mL/kg isotonic crystalloid bolus
, B. Starting a vasopressor infusion to maintain MAP > 65 mmHg
C. Obtaining a sputum culture for diagnostic testing
D. Providing a dose of broad-spectrum antibiotics
Correct Answer: A
Expert Explanation: The Surviving Sepsis Campaign guidelines emphasize rapid fluid
resuscitation (30 mL/kg) as a primary intervention for hypotension or lactate levels above
4 mmol/L. While antibiotics are crucial, fluid resuscitation addresses the immediate
circulatory collapse. Vasopressors are typically added if fluid resuscitation is insufficient.
4. Which clinical finding is most indicative of the ‘Compensatory’ stage of shock?
A. Lethargy and decreased responsiveness
B. Narrowing pulse pressure and tachycardia
C. Anuria and profound metabolic acidosis
D. Mottled skin and cold extremities
Correct Answer: B
Expert Explanation: In the compensatory stage, the body attempts to maintain
homeostasis through the sympathetic nervous system, leading to tachycardia and
vasoconstriction, which narrows pulse pressure. Lethargy and mottling occur in the
progressive stage. Anuria and profound acidosis signify the refractory stage.
Q&A | Galen College of Nursing
────────────────────────────────────
This comprehensive exam-style preparation material is designed to support students preparing
for advanced medical-surgical nursing assessments involving critical care, complex
multisystem disorders, and specialized nursing interventions. The content focuses on
integrating nursing knowledge into high-level clinical decision-making scenarios.
The questions are structured to closely mirror actual course assessments while reinforcing
analytical reasoning, prioritization, and safe nursing interventions. Detailed expert explanations
are included to improve comprehension and academic performance.
════════════════════════════════════
The Exam Covers:
• Advanced adult assessment
• Disaster preparedness nursing
• Pharmacological management in critical care
• Specialized adult nursing procedures
• Leadership in nursing practice
• Cultural considerations in adult care
• Complex patient prioritization
• Comprehensive medical-surgical review
════════════════════════════════════
1. During a mass casualty incident, which color tag is assigned to a victim with a sucking chest
wound and stable vital signs?
A. Red
B. Green
C. Yellow
,D. Black
Correct Answer: A
Expert Explanation: Red tags are assigned to patients with life-threatening injuries who
have a high probability of survival if treated immediately. A sucking chest wound indicates
an immediate threat to the airway and breathing, requiring rapid intervention. Yellow is for
delayed, Green for minor, and Black for expectant or deceased.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the LPN?
A. Performing an admission physical assessment on a new patient
B. Providing wound care and dressing changes for a stable post-operative patient
C. Administering an intravenous bolus of a critical care medication
D. Developing the initial plan of care for a patient with septic shock
Correct Answer: B
Expert Explanation: LPNs can perform routine procedures like wound care on stable
patients. Admission assessments and planning of care are the responsibility of the RN.
Critical care IV bolus medications are typically reserved for RNs or advanced practice
providers in high-acuity settings.
3. A patient in the ICU is being treated for septic shock. Which of the following is the priority
intervention in the first hour of treatment?
A. Administering a 30 mL/kg isotonic crystalloid bolus
, B. Starting a vasopressor infusion to maintain MAP > 65 mmHg
C. Obtaining a sputum culture for diagnostic testing
D. Providing a dose of broad-spectrum antibiotics
Correct Answer: A
Expert Explanation: The Surviving Sepsis Campaign guidelines emphasize rapid fluid
resuscitation (30 mL/kg) as a primary intervention for hypotension or lactate levels above
4 mmol/L. While antibiotics are crucial, fluid resuscitation addresses the immediate
circulatory collapse. Vasopressors are typically added if fluid resuscitation is insufficient.
4. Which clinical finding is most indicative of the ‘Compensatory’ stage of shock?
A. Lethargy and decreased responsiveness
B. Narrowing pulse pressure and tachycardia
C. Anuria and profound metabolic acidosis
D. Mottled skin and cold extremities
Correct Answer: B
Expert Explanation: In the compensatory stage, the body attempts to maintain
homeostasis through the sympathetic nervous system, leading to tachycardia and
vasoconstriction, which narrows pulse pressure. Lethargy and mottling occur in the
progressive stage. Anuria and profound acidosis signify the refractory stage.
