NUR242 Exam 4 V1 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
────────────────────────────────────
This exam preparation resource focuses on advanced concepts related to critical care nursing,
multisystem disorders, and complex adult patient management. The material is designed to
strengthen understanding of high-risk adult conditions and interdisciplinary healthcare
interventions.
The questions included in this version closely mirror the style and complexity of actual medical-
surgical nursing exams. Detailed expert explanations are included to improve analytical
reasoning, clinical judgment, and evidence-based nursing practice.
════════════════════════════════════
The Exam Covers:
• Critical care nursing concepts
• Shock and sepsis management
• Emergency nursing interventions
• Multisystem organ dysfunction
• Adult trauma nursing
• Mechanical ventilation concepts
• Ethical issues in nursing care
• End-of-life nursing management
════════════════════════════════════
1. A nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect to observe?
A. Cold, clammy skin and metabolic acidosis
B. Anuria and respiratory failure
C. Decreased consciousness and hypotension
,D. Heart rate >100 bpm and narrowed pulse pressure
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body attempts to maintain
homeostasis through the activation of the sympathetic nervous system, leading to
tachycardia and narrowed pulse pressure. This exam preparation material emphasizes
critical care concepts such as the physiological response to shock. Understanding these
early indicators is crucial for preventing progression to organ failure and multi-system
dysfunction.
2. A patient is admitted with suspected septic shock. Which laboratory value is most
indicative of tissue hypoperfusion?
A. Elevated White Blood Cell count
B. Hemoglobin level of 12 g/dL
C. Blood Urea Nitrogen (BUN) of 20 mg/dL
D. Serum Lactate level of 5.2 mmol/L
Correct Answer: D
Expert Explanation: A serum lactate level greater than 2 mmol/L is a hallmark indicator
of anaerobic metabolism and tissue hypoperfusion in sepsis.
3. During mechanical ventilation, the high-pressure alarm sounds. Which action should the
nurse take first?
A. Assess the patient’s airway for secretions or biting the tube
, B. Increase the oxygen concentration to 100%
C. Silence the alarm and check the settings
D. Call the respiratory therapist to change the circuit
Correct Answer: A
Expert Explanation: High-pressure alarms are triggered by resistance; common causes
include secretions, biting the endotracheal tube, or coughing.
4. A patient with Multiple Organ Dysfunction Syndrome (MODS) is showing signs of liver
failure. Which lab result supports this?
A. Decreased Serum Creatinine
B. Elevated Serum Bilirubin and ALT/AST levels
C. Increased Albumin levels
D. Decreased Prothrombin Time (PT)
Correct Answer: B
Expert Explanation: Liver dysfunction in MODS typically presents as elevated bilirubin
and liver enzymes (ALT/AST) due to hepatocellular damage.
5. When performing a primary survey on a trauma patient, what is the priority assessment
after ensuring a patent airway?
A. Circulation and hemorrhage control
B. Exposure and environmental control
Q&A | Galen College of Nursing
────────────────────────────────────
This exam preparation resource focuses on advanced concepts related to critical care nursing,
multisystem disorders, and complex adult patient management. The material is designed to
strengthen understanding of high-risk adult conditions and interdisciplinary healthcare
interventions.
The questions included in this version closely mirror the style and complexity of actual medical-
surgical nursing exams. Detailed expert explanations are included to improve analytical
reasoning, clinical judgment, and evidence-based nursing practice.
════════════════════════════════════
The Exam Covers:
• Critical care nursing concepts
• Shock and sepsis management
• Emergency nursing interventions
• Multisystem organ dysfunction
• Adult trauma nursing
• Mechanical ventilation concepts
• Ethical issues in nursing care
• End-of-life nursing management
════════════════════════════════════
1. A nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect to observe?
A. Cold, clammy skin and metabolic acidosis
B. Anuria and respiratory failure
C. Decreased consciousness and hypotension
,D. Heart rate >100 bpm and narrowed pulse pressure
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body attempts to maintain
homeostasis through the activation of the sympathetic nervous system, leading to
tachycardia and narrowed pulse pressure. This exam preparation material emphasizes
critical care concepts such as the physiological response to shock. Understanding these
early indicators is crucial for preventing progression to organ failure and multi-system
dysfunction.
2. A patient is admitted with suspected septic shock. Which laboratory value is most
indicative of tissue hypoperfusion?
A. Elevated White Blood Cell count
B. Hemoglobin level of 12 g/dL
C. Blood Urea Nitrogen (BUN) of 20 mg/dL
D. Serum Lactate level of 5.2 mmol/L
Correct Answer: D
Expert Explanation: A serum lactate level greater than 2 mmol/L is a hallmark indicator
of anaerobic metabolism and tissue hypoperfusion in sepsis.
3. During mechanical ventilation, the high-pressure alarm sounds. Which action should the
nurse take first?
A. Assess the patient’s airway for secretions or biting the tube
, B. Increase the oxygen concentration to 100%
C. Silence the alarm and check the settings
D. Call the respiratory therapist to change the circuit
Correct Answer: A
Expert Explanation: High-pressure alarms are triggered by resistance; common causes
include secretions, biting the endotracheal tube, or coughing.
4. A patient with Multiple Organ Dysfunction Syndrome (MODS) is showing signs of liver
failure. Which lab result supports this?
A. Decreased Serum Creatinine
B. Elevated Serum Bilirubin and ALT/AST levels
C. Increased Albumin levels
D. Decreased Prothrombin Time (PT)
Correct Answer: B
Expert Explanation: Liver dysfunction in MODS typically presents as elevated bilirubin
and liver enzymes (ALT/AST) due to hepatocellular damage.
5. When performing a primary survey on a trauma patient, what is the priority assessment
after ensuring a patent airway?
A. Circulation and hemorrhage control
B. Exposure and environmental control
