NUR242 Exam 2 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 adult chronic
illnesses, complex medical conditions, and evidence-based nursing interventions. The content
reflects practical nursing concepts commonly tested in medical-surgical nursing examinations.
The questions are designed to simulate actual exam conditions while reinforcing clinical
judgment, assessment skills, and therapeutic nursing interventions. Detailed expert explanations
are included to support concept mastery and exam preparedness.
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The Exam Covers:
• Renal failure nursing care
• Dialysis concepts
• Gastrointestinal bleeding
• Endocrine emergencies
• Adult nutritional disorders
• Laboratory value interpretation
• Medication administration safety
• Chronic illness nursing interventions
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1. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.2 mEq/L. Which
medical intervention should the nurse anticipate first?
A. Administering oral phosphate binders
B. Starting a low-sodium diet
C. Administration of intravenous calcium gluconate
D. Scheduling the patient for an immediate MRI
,Correct Answer: C
Expert Explanation: Hyperkalemia (K+ > 6.0) is a medical emergency; calcium gluconate
is used to stabilize the cardiac membrane and prevent life-threatening arrhythmias.
2. Which assessment finding is most characteristic of a patient experiencing a lower
gastrointestinal (GI) bleed?
A. Coffee-ground emesis
B. Black, tarry stools (melena)
C. Hyperactive bowel sounds in the upper quadrants
D. Bright red blood in the stool (hematochezia)
Correct Answer: D
Expert Explanation: Hematochezia, or bright red blood per rectum, usually indicates a
lower GI source, whereas melena indicates an upper GI source where blood has been
digested.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which breathing pattern does the
nurse expect to observe?
A. Cheyne-Stokes respirations
B. Bradypnea
C. Apneustic breathing
D. Kussmaul respirations
, Correct Answer: D
Expert Explanation: Kussmaul respirations are deep, rapid breaths that occur as the body
attempts to blow off excess CO2 to compensate for metabolic acidosis in DKA.
4. When caring for a patient with an Arteriovenous (AV) fistula, which action is a priority for
the nurse?
A. Perform blood pressures on the arm with the fistula
B. Palpate for a thrill and auscultate for a bruit
C. Apply a tight dressing to the site daily
D. Use the fistula for routine intravenous fluid administration
Correct Answer: B
Expert Explanation: The presence of a thrill (vibration) and bruit (whooshing sound)
indicates that the fistula is patent and functioning correctly.
5. A patient with Diabetes Insipidus (DI) is receiving desmopressin. Which lab result indicates
the medication is effective?
A. Increased serum osmolality
B. Decreased serum sodium
C. Increased urine specific gravity
D. Decreased blood glucose
Correct Answer: C
Q&A | Galen College of Nursing
────────────────────────────────────
This study guide is intended to help students strengthen their understanding of adult chronic
illnesses, complex medical conditions, and evidence-based nursing interventions. The content
reflects practical nursing concepts commonly tested in medical-surgical nursing examinations.
The questions are designed to simulate actual exam conditions while reinforcing clinical
judgment, assessment skills, and therapeutic nursing interventions. Detailed expert explanations
are included to support concept mastery and exam preparedness.
════════════════════════════════════
The Exam Covers:
• Renal failure nursing care
• Dialysis concepts
• Gastrointestinal bleeding
• Endocrine emergencies
• Adult nutritional disorders
• Laboratory value interpretation
• Medication administration safety
• Chronic illness nursing interventions
════════════════════════════════════
1. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.2 mEq/L. Which
medical intervention should the nurse anticipate first?
A. Administering oral phosphate binders
B. Starting a low-sodium diet
C. Administration of intravenous calcium gluconate
D. Scheduling the patient for an immediate MRI
,Correct Answer: C
Expert Explanation: Hyperkalemia (K+ > 6.0) is a medical emergency; calcium gluconate
is used to stabilize the cardiac membrane and prevent life-threatening arrhythmias.
2. Which assessment finding is most characteristic of a patient experiencing a lower
gastrointestinal (GI) bleed?
A. Coffee-ground emesis
B. Black, tarry stools (melena)
C. Hyperactive bowel sounds in the upper quadrants
D. Bright red blood in the stool (hematochezia)
Correct Answer: D
Expert Explanation: Hematochezia, or bright red blood per rectum, usually indicates a
lower GI source, whereas melena indicates an upper GI source where blood has been
digested.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which breathing pattern does the
nurse expect to observe?
A. Cheyne-Stokes respirations
B. Bradypnea
C. Apneustic breathing
D. Kussmaul respirations
, Correct Answer: D
Expert Explanation: Kussmaul respirations are deep, rapid breaths that occur as the body
attempts to blow off excess CO2 to compensate for metabolic acidosis in DKA.
4. When caring for a patient with an Arteriovenous (AV) fistula, which action is a priority for
the nurse?
A. Perform blood pressures on the arm with the fistula
B. Palpate for a thrill and auscultate for a bruit
C. Apply a tight dressing to the site daily
D. Use the fistula for routine intravenous fluid administration
Correct Answer: B
Expert Explanation: The presence of a thrill (vibration) and bruit (whooshing sound)
indicates that the fistula is patent and functioning correctly.
5. A patient with Diabetes Insipidus (DI) is receiving desmopressin. Which lab result indicates
the medication is effective?
A. Increased serum osmolality
B. Decreased serum sodium
C. Increased urine specific gravity
D. Decreased blood glucose
Correct Answer: C
