NUR242 Exam 4 V1 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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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.
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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
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1. A nurse is caring for a patient in the compensatory stage of shock. Which clinical
manifestation should the nurse expect to find?
A. Hypotension with a systolic BP below 90 mmHg
B. Anuria and peripheral edema
C. Metabolic acidosis on arterial blood gas
,D. Heart rate greater than 100 beats per minute
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body activates the
sympathetic nervous system to maintain cardiac output. Tachycardia occurs as a
compensatory mechanism to keep blood pressure within normal limits. If the nurse
identifies this early, interventions can prevent the progression to the progressive stage
where blood pressure falls.
2. Which priority intervention should the nurse implement first for a patient experiencing
anaphylactic shock?
A. Administer diphenhydramine intravenously
B. Initiate a high-flow oxygen mask
C. Start a large-bore IV for fluid resuscitation
D. Administer epinephrine intramuscularly
Correct Answer: D
Expert Explanation: Epinephrine is the first-line treatment for anaphylaxis because it
causes peripheral vasoconstriction and bronchodilation. It rapidly reverses the life-
threatening hypotension and airway obstruction associated with the allergic reaction.
Other treatments like antihistamines and fluids are secondary to the administration of
epinephrine.
, 3. The nurse is monitoring a patient with septic shock. Which laboratory value is most
indicative of the transition from sepsis to septic shock?
A. White blood cell count of 15,000/mm3
B. Serum lactate level of 4.2 mmol/L
C. Blood glucose level of 180 mg/dL
D. C-reactive protein of 10 mg/L
Correct Answer: B
Expert Explanation: Elevated serum lactate levels indicate cellular hypoxia and anaerobic
metabolism, which are hallmarks of septic shock. A lactate level above 2 mmol/L despite
adequate fluid resuscitation suggests profound circulatory and cellular abnormalities. This
finding requires immediate clinical attention to improve tissue perfusion and oxygenation.
4. A patient with hypovolemic shock is receiving rapid fluid resuscitation. Which assessment
finding indicates that the treatment is effective?
A. Heart rate increases from 110 to 130 bpm
B. Mean arterial pressure (MAP) is 55 mmHg
C. Skin remains cool and clammy
D. Urine output is 40 mL per hour
Correct Answer: D
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 find?
A. Hypotension with a systolic BP below 90 mmHg
B. Anuria and peripheral edema
C. Metabolic acidosis on arterial blood gas
,D. Heart rate greater than 100 beats per minute
Correct Answer: D
Expert Explanation: In the compensatory stage of shock, the body activates the
sympathetic nervous system to maintain cardiac output. Tachycardia occurs as a
compensatory mechanism to keep blood pressure within normal limits. If the nurse
identifies this early, interventions can prevent the progression to the progressive stage
where blood pressure falls.
2. Which priority intervention should the nurse implement first for a patient experiencing
anaphylactic shock?
A. Administer diphenhydramine intravenously
B. Initiate a high-flow oxygen mask
C. Start a large-bore IV for fluid resuscitation
D. Administer epinephrine intramuscularly
Correct Answer: D
Expert Explanation: Epinephrine is the first-line treatment for anaphylaxis because it
causes peripheral vasoconstriction and bronchodilation. It rapidly reverses the life-
threatening hypotension and airway obstruction associated with the allergic reaction.
Other treatments like antihistamines and fluids are secondary to the administration of
epinephrine.
, 3. The nurse is monitoring a patient with septic shock. Which laboratory value is most
indicative of the transition from sepsis to septic shock?
A. White blood cell count of 15,000/mm3
B. Serum lactate level of 4.2 mmol/L
C. Blood glucose level of 180 mg/dL
D. C-reactive protein of 10 mg/L
Correct Answer: B
Expert Explanation: Elevated serum lactate levels indicate cellular hypoxia and anaerobic
metabolism, which are hallmarks of septic shock. A lactate level above 2 mmol/L despite
adequate fluid resuscitation suggests profound circulatory and cellular abnormalities. This
finding requires immediate clinical attention to improve tissue perfusion and oxygenation.
4. A patient with hypovolemic shock is receiving rapid fluid resuscitation. Which assessment
finding indicates that the treatment is effective?
A. Heart rate increases from 110 to 130 bpm
B. Mean arterial pressure (MAP) is 55 mmHg
C. Skin remains cool and clammy
D. Urine output is 40 mL per hour
Correct Answer: D
