NUR242 Exam 3 V1 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This exam preparation resource is designed to help students strengthen their understanding of
neurological disorders, musculoskeletal conditions, and hematologic nursing care in adult
patients. The material emphasizes clinical nursing management, patient safety, and evidence-
based interventions.
The questions included in this version are structured to closely mirror the actual course exam
format and level of difficulty. Detailed expert explanations are included to improve clinical
judgment, prioritization skills, and nursing knowledge.
════════════════════════════════════
The Exam Covers:
• Neurological assessment
• Stroke nursing management
• Seizure disorders
• Musculoskeletal disorders
• Orthopedic nursing care
• Hematologic disorders
• Rehabilitation nursing concepts
• Pain management strategies
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1. A patient is admitted with a suspected stroke and the nurse notes the patient is
experiencing expressive aphasia. Which area of the brain is most likely affected?
A. Broca’s area
B. Wernicke’s area
C. Occipital lobe
,D. Cerebellum
Correct Answer: A
Expert Explanation: Broca’s area is located in the frontal lobe and is responsible for motor
speech production. Expressive aphasia occurs when the patient understands what is being
said but cannot produce the words to respond. In contrast, Wernicke’s area is responsible
for language comprehension and results in receptive aphasia when damaged.
2. The nurse is caring for a patient who has just returned from a femoral-popliteal bypass
graft. Which assessment finding requires immediate intervention?
A. Capillary refill of 2 seconds in the affected foot
B. Pitting edema (+1) at the ankle
C. Absent pedal pulses in the affected extremity
D. Pain level of 4 on a 1-10 scale
Correct Answer: C
Expert Explanation: Absent pedal pulses in a post-operative bypass patient indicate a
potential graft occlusion or arterial compromise. This is a surgical emergency that requires
immediate notification of the healthcare provider to restore perfusion. While mild edema
and moderate pain are expected, the loss of pulses is a critical finding.
3. A client with a history of seizures is experiencing a tonic-clonic seizure. Which action should
the nurse take first?
A. Insert a padded tongue blade into the client’s mouth
,B. Turn the client to a side-lying position
C. Restrain the client’s arms and legs to prevent injury
D. Administer oral phenytoin immediately
Correct Answer: B
Expert Explanation: Turning the client to a side-lying position is the priority to maintain a
patent airway and prevent aspiration of secretions. Restraints should never be used as they
can cause fractures or soft tissue injury during a seizure. Nothing should ever be placed in
the client’s mouth, including tongue blades, as this can cause dental damage or airway
obstruction.
4. A nurse is assessing a patient with a head injury and notes a Glasglow Coma Scale (GCS)
score of 7. How should the nurse interpret this finding?
A. The patient is alert and oriented
B. The patient is in a coma and requires airway protection
C. The patient has a mild brain injury
D. The patient is experiencing normal post-concussion symptoms
Correct Answer: B
Expert Explanation: A GCS score of 8 or less is generally used as the clinical definition for
a coma and typically indicates the need for intubation to protect the airway. The scale
, ranges from 3 to 15, with 15 being the highest level of neurological functioning. Nurses
must monitor these scores closely to detect early signs of neurological deterioration.
5. Which of the following is an early clinical manifestation of increased intracranial pressure
(ICP)?
A. Cushing’s Triad
B. Level of consciousness changes
C. Fixed and dilated pupils
D. Decerebrate posturing
Correct Answer: B
Expert Explanation: A change in the level of consciousness (LOC) is the most sensitive and
earliest indicator of increased ICP. Later signs include pupillary changes, motor
dysfunction, and posturing. Cushing’s Triad, which consists of bradycardia, hypertension
with a widening pulse pressure, and irregular respirations, is a very late sign indicating
brainstem herniation.
6. A patient with a T6 spinal cord injury reports a sudden, severe headache and has a blood
pressure of 190/100 mmHg. What is the priority nursing action?
A. Assess the patient for bladder distension or fecal impaction
B. Administer PRN pain medication for the headache
C. Lower the head of the bed to the flat position
Q&A | Galen College of Nursing
────────────────────────────────────
This exam preparation resource is designed to help students strengthen their understanding of
neurological disorders, musculoskeletal conditions, and hematologic nursing care in adult
patients. The material emphasizes clinical nursing management, patient safety, and evidence-
based interventions.
The questions included in this version are structured to closely mirror the actual course exam
format and level of difficulty. Detailed expert explanations are included to improve clinical
judgment, prioritization skills, and nursing knowledge.
════════════════════════════════════
The Exam Covers:
• Neurological assessment
• Stroke nursing management
• Seizure disorders
• Musculoskeletal disorders
• Orthopedic nursing care
• Hematologic disorders
• Rehabilitation nursing concepts
• Pain management strategies
════════════════════════════════════
1. A patient is admitted with a suspected stroke and the nurse notes the patient is
experiencing expressive aphasia. Which area of the brain is most likely affected?
A. Broca’s area
B. Wernicke’s area
C. Occipital lobe
,D. Cerebellum
Correct Answer: A
Expert Explanation: Broca’s area is located in the frontal lobe and is responsible for motor
speech production. Expressive aphasia occurs when the patient understands what is being
said but cannot produce the words to respond. In contrast, Wernicke’s area is responsible
for language comprehension and results in receptive aphasia when damaged.
2. The nurse is caring for a patient who has just returned from a femoral-popliteal bypass
graft. Which assessment finding requires immediate intervention?
A. Capillary refill of 2 seconds in the affected foot
B. Pitting edema (+1) at the ankle
C. Absent pedal pulses in the affected extremity
D. Pain level of 4 on a 1-10 scale
Correct Answer: C
Expert Explanation: Absent pedal pulses in a post-operative bypass patient indicate a
potential graft occlusion or arterial compromise. This is a surgical emergency that requires
immediate notification of the healthcare provider to restore perfusion. While mild edema
and moderate pain are expected, the loss of pulses is a critical finding.
3. A client with a history of seizures is experiencing a tonic-clonic seizure. Which action should
the nurse take first?
A. Insert a padded tongue blade into the client’s mouth
,B. Turn the client to a side-lying position
C. Restrain the client’s arms and legs to prevent injury
D. Administer oral phenytoin immediately
Correct Answer: B
Expert Explanation: Turning the client to a side-lying position is the priority to maintain a
patent airway and prevent aspiration of secretions. Restraints should never be used as they
can cause fractures or soft tissue injury during a seizure. Nothing should ever be placed in
the client’s mouth, including tongue blades, as this can cause dental damage or airway
obstruction.
4. A nurse is assessing a patient with a head injury and notes a Glasglow Coma Scale (GCS)
score of 7. How should the nurse interpret this finding?
A. The patient is alert and oriented
B. The patient is in a coma and requires airway protection
C. The patient has a mild brain injury
D. The patient is experiencing normal post-concussion symptoms
Correct Answer: B
Expert Explanation: A GCS score of 8 or less is generally used as the clinical definition for
a coma and typically indicates the need for intubation to protect the airway. The scale
, ranges from 3 to 15, with 15 being the highest level of neurological functioning. Nurses
must monitor these scores closely to detect early signs of neurological deterioration.
5. Which of the following is an early clinical manifestation of increased intracranial pressure
(ICP)?
A. Cushing’s Triad
B. Level of consciousness changes
C. Fixed and dilated pupils
D. Decerebrate posturing
Correct Answer: B
Expert Explanation: A change in the level of consciousness (LOC) is the most sensitive and
earliest indicator of increased ICP. Later signs include pupillary changes, motor
dysfunction, and posturing. Cushing’s Triad, which consists of bradycardia, hypertension
with a widening pulse pressure, and irregular respirations, is a very late sign indicating
brainstem herniation.
6. A patient with a T6 spinal cord injury reports a sudden, severe headache and has a blood
pressure of 190/100 mmHg. What is the priority nursing action?
A. Assess the patient for bladder distension or fecal impaction
B. Administer PRN pain medication for the headache
C. Lower the head of the bed to the flat position
