NUR242 Exam 2 V3 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This comprehensive exam-style resource is designed to prepare students for medical-surgical
nursing assessments related to complex gastrointestinal conditions, renal management, and
adult endocrine disorders. The material emphasizes evidence-based nursing interventions and
safe patient care practices.
The questions are structured to closely mirror actual course exams while reinforcing
prioritization, clinical reasoning, and nursing management strategies. Detailed expert
explanations support understanding and successful exam performance.
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The Exam Covers:
• Acute kidney injury
• Chronic kidney disease
• Peptic ulcer disease
• Diabetes complications
• Enteral and parenteral nutrition
• Electrolyte imbalances
• Adult endocrine disorders
• Nursing care planning
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1. A patient with Acute Kidney Injury (AKI) has a urine output of 350 mL/day. Which phase of
AKI is the patient currently experiencing?
A. Prerenal phase
B. Diuretic phase
C. Oliguric phase
,D. Recovery phase
Correct Answer: C
Expert Explanation: The oliguric phase is characterized by a urine output of less than 400
mL per day. During this stage, the kidneys are unable to effectively excrete metabolic
wastes, leading to azotemia. Monitoring fluid intake and electrolyte balance is the priority
nursing intervention during this time.
2. Which clinical manifestation is most indicative of a perforated peptic ulcer?
A. A rigid, board-like abdomen
B. Hyperactive bowel sounds
C. Increased appetite and weight gain
D. Lower left quadrant pain
Correct Answer: A
Expert Explanation: Perforation of a peptic ulcer is a medical emergency that results in
chemical peritonitis. The classic presentation includes sudden, severe upper abdominal
pain that radiates to the back and a rigid, board-like abdomen. The nurse must immediately
notify the provider and prepare for surgical intervention.
3. A patient receiving Total Parenteral Nutrition (TPN) suddenly develops a fever of 101.5°F.
What is the priority nursing action?
A. Slow the infusion rate to half
, B. Administer acetaminophen as ordered
C. Prepare for a blood culture and catheter tip culture
D. Change the TPN bag to 10% Dextrose
Correct Answer: C
Expert Explanation: TPN carries a high risk of infection due to the high glucose content,
which provides a medium for bacterial growth. Fever is often the first sign of a catheter-
related bloodstream infection (CRBSI). The nurse should prepare to draw blood cultures
and may need to assist in removing the catheter for culture.
4. A nurse is caring for a patient with Chronic Kidney Disease (CKD) who has a serum
potassium level of 6.8 mEq/L. Which EKG change should the nurse expect?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Shortened PR interval
Correct Answer: C
Expert Explanation: Hyperkalemia is a life-threatening complication of CKD and is most
dangerous because of its effects on cardiac rhythm. Tall, peaked T waves are one of the
earliest signs seen on an EKG as potassium levels rise above 6.0 mEq/L. If left untreated, it
can progress to QRS widening and cardiac arrest.
Q&A | Galen College of Nursing
────────────────────────────────────
This comprehensive exam-style resource is designed to prepare students for medical-surgical
nursing assessments related to complex gastrointestinal conditions, renal management, and
adult endocrine disorders. The material emphasizes evidence-based nursing interventions and
safe patient care practices.
The questions are structured to closely mirror actual course exams while reinforcing
prioritization, clinical reasoning, and nursing management strategies. Detailed expert
explanations support understanding and successful exam performance.
════════════════════════════════════
The Exam Covers:
• Acute kidney injury
• Chronic kidney disease
• Peptic ulcer disease
• Diabetes complications
• Enteral and parenteral nutrition
• Electrolyte imbalances
• Adult endocrine disorders
• Nursing care planning
════════════════════════════════════
1. A patient with Acute Kidney Injury (AKI) has a urine output of 350 mL/day. Which phase of
AKI is the patient currently experiencing?
A. Prerenal phase
B. Diuretic phase
C. Oliguric phase
,D. Recovery phase
Correct Answer: C
Expert Explanation: The oliguric phase is characterized by a urine output of less than 400
mL per day. During this stage, the kidneys are unable to effectively excrete metabolic
wastes, leading to azotemia. Monitoring fluid intake and electrolyte balance is the priority
nursing intervention during this time.
2. Which clinical manifestation is most indicative of a perforated peptic ulcer?
A. A rigid, board-like abdomen
B. Hyperactive bowel sounds
C. Increased appetite and weight gain
D. Lower left quadrant pain
Correct Answer: A
Expert Explanation: Perforation of a peptic ulcer is a medical emergency that results in
chemical peritonitis. The classic presentation includes sudden, severe upper abdominal
pain that radiates to the back and a rigid, board-like abdomen. The nurse must immediately
notify the provider and prepare for surgical intervention.
3. A patient receiving Total Parenteral Nutrition (TPN) suddenly develops a fever of 101.5°F.
What is the priority nursing action?
A. Slow the infusion rate to half
, B. Administer acetaminophen as ordered
C. Prepare for a blood culture and catheter tip culture
D. Change the TPN bag to 10% Dextrose
Correct Answer: C
Expert Explanation: TPN carries a high risk of infection due to the high glucose content,
which provides a medium for bacterial growth. Fever is often the first sign of a catheter-
related bloodstream infection (CRBSI). The nurse should prepare to draw blood cultures
and may need to assist in removing the catheter for culture.
4. A nurse is caring for a patient with Chronic Kidney Disease (CKD) who has a serum
potassium level of 6.8 mEq/L. Which EKG change should the nurse expect?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Shortened PR interval
Correct Answer: C
Expert Explanation: Hyperkalemia is a life-threatening complication of CKD and is most
dangerous because of its effects on cardiac rhythm. Tall, peaked T waves are one of the
earliest signs seen on an EKG as potassium levels rise above 6.0 mEq/L. If left untreated, it
can progress to QRS widening and cardiac arrest.
