NUR242 Exam 4 V2 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This study guide is intended to help students strengthen their understanding of critical illness
management, advanced adult nursing care, and complex psychosocial issues affecting adult
patients and families. The content reflects practical nursing concepts frequently tested in
medical-surgical nursing examinations.
The questions are designed to simulate actual exam conditions while reinforcing nursing
prioritization, therapeutic communication, and emergency nursing management skills. Detailed
expert explanations are included to support concept mastery and exam preparedness.
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The Exam Covers:
• Respiratory failure management
• Emergency cardiovascular care
• Intensive care nursing assessment
• Adult trauma care
• Palliative and hospice nursing
• Family coping and support systems
• Ethical and legal nursing issues
• Crisis intervention nursing care
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1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
mechanical ventilator setting is specifically designed to prevent the collapse of alveoli at the
end of expiration?
A. Tidal Volume (VT)
B. Fraction of Inspired Oxygen (FiO2)
,C. Inspiratory Flow Rate
D. Positive End-Expiratory Pressure (PEEP)
Correct Answer: D
Expert Explanation: PEEP provides pressure at the end of expiration to maintain alveolar
patency and improve gas exchange. It is a hallmark treatment for ARDS. Proper titration is
necessary to prevent barotrauma or decreased cardiac output.
2. When performing a primary survey on a trauma patient, which assessment should the
nurse prioritize immediately after ensuring the airway is patent?
A. Circulation and hemorrhage control
B. Disability and neurological status
C. Breathing and ventilation
D. Exposure and environmental control
Correct Answer: C
Expert Explanation: The ABCDE mnemonic guides trauma care. Once the airway (A) is
secured, the nurse must assess breathing (B) to ensure adequate oxygenation. Following
this, circulation (C) is addressed to manage shock or bleeding.
3. A patient with end-stage heart failure is being transitioned to hospice care. Which
statement by the nurse best describes the primary goal of hospice?
A. Hospice provides aggressive treatment to prolong life in the home setting.
, B. Hospice focuses on curative measures while managing pain.
C. Hospice is only for patients who have less than 48 hours to live.
D. Hospice focuses on quality of life and comfort rather than curative treatment.
Correct Answer: D
Expert Explanation: Hospice care is centered on palliative goals and comfort for patients
with a terminal diagnosis. It aims to improve the quality of remaining life. It is typically
initiated when life expectancy is six months or less.
4. The nurse is monitoring a patient with a chest tube following a motor vehicle accident. The
nurse notes continuous bubbling in the water-seal chamber. What is the nurse’s first action?
A. Document this as a normal finding for a chest tube.
B. Increase the suction pressure on the regulator.
C. Clamp the chest tube immediately near the insertion site.
D. Check for a system leak or air leak in the patient’s pleural space.
Correct Answer: D
Expert Explanation: Continuous bubbling in the water-seal chamber indicates an air leak.
The nurse must check the tubing connections and the patient’s status. Intermittent
bubbling is normal during coughing or expiration, but continuous bubbling is not.
Q&A | Galen College of Nursing
────────────────────────────────────
This study guide is intended to help students strengthen their understanding of critical illness
management, advanced adult nursing care, and complex psychosocial issues affecting adult
patients and families. The content reflects practical nursing concepts frequently tested in
medical-surgical nursing examinations.
The questions are designed to simulate actual exam conditions while reinforcing nursing
prioritization, therapeutic communication, and emergency nursing management skills. Detailed
expert explanations are included to support concept mastery and exam preparedness.
════════════════════════════════════
The Exam Covers:
• Respiratory failure management
• Emergency cardiovascular care
• Intensive care nursing assessment
• Adult trauma care
• Palliative and hospice nursing
• Family coping and support systems
• Ethical and legal nursing issues
• Crisis intervention nursing care
════════════════════════════════════
1. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
mechanical ventilator setting is specifically designed to prevent the collapse of alveoli at the
end of expiration?
A. Tidal Volume (VT)
B. Fraction of Inspired Oxygen (FiO2)
,C. Inspiratory Flow Rate
D. Positive End-Expiratory Pressure (PEEP)
Correct Answer: D
Expert Explanation: PEEP provides pressure at the end of expiration to maintain alveolar
patency and improve gas exchange. It is a hallmark treatment for ARDS. Proper titration is
necessary to prevent barotrauma or decreased cardiac output.
2. When performing a primary survey on a trauma patient, which assessment should the
nurse prioritize immediately after ensuring the airway is patent?
A. Circulation and hemorrhage control
B. Disability and neurological status
C. Breathing and ventilation
D. Exposure and environmental control
Correct Answer: C
Expert Explanation: The ABCDE mnemonic guides trauma care. Once the airway (A) is
secured, the nurse must assess breathing (B) to ensure adequate oxygenation. Following
this, circulation (C) is addressed to manage shock or bleeding.
3. A patient with end-stage heart failure is being transitioned to hospice care. Which
statement by the nurse best describes the primary goal of hospice?
A. Hospice provides aggressive treatment to prolong life in the home setting.
, B. Hospice focuses on curative measures while managing pain.
C. Hospice is only for patients who have less than 48 hours to live.
D. Hospice focuses on quality of life and comfort rather than curative treatment.
Correct Answer: D
Expert Explanation: Hospice care is centered on palliative goals and comfort for patients
with a terminal diagnosis. It aims to improve the quality of remaining life. It is typically
initiated when life expectancy is six months or less.
4. The nurse is monitoring a patient with a chest tube following a motor vehicle accident. The
nurse notes continuous bubbling in the water-seal chamber. What is the nurse’s first action?
A. Document this as a normal finding for a chest tube.
B. Increase the suction pressure on the regulator.
C. Clamp the chest tube immediately near the insertion site.
D. Check for a system leak or air leak in the patient’s pleural space.
Correct Answer: D
Expert Explanation: Continuous bubbling in the water-seal chamber indicates an air leak.
The nurse must check the tubing connections and the patient’s status. Intermittent
bubbling is normal during coughing or expiration, but continuous bubbling is not.
