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 glomerular filtration rate (GFR) of 14
mL/min. Which stage of CKD is the patient experiencing?
A. Stage 2
B. Stage 3
C. Stage 4
D. Stage 5
,Correct Answer: D
Expert Explanation: Stage 5 CKD, also known as end-stage renal disease (ESRD), is
characterized by a GFR less than 15 mL/min, indicating the need for dialysis or transplant.
2. A nurse is assessing a patient undergoing peritoneal dialysis. The nurse notes that the
returning dialysate is cloudy. Which is the priority intervention?
A. Notify the healthcare provider and prepare for a sample culture
B. Reposition the patient to improve drainage
C. Warm the next bag of dialysate
D. Slow the infusion rate
Correct Answer: A
Expert Explanation: Cloudy dialysate is an early sign of peritonitis, a serious complication
of peritoneal dialysis that requires immediate culture and antibiotic therapy.
3. Which electrolyte imbalance is most commonly associated with the oliguric phase of acute
kidney injury (AKI)?
A. Hypokalemia
B. Hypomagnesemia
C. Hypernatremia
D. Hyperkalemia
Correct Answer: D
, Expert Explanation: During the oliguric phase, the kidneys fail to excrete potassium,
leading to hyperkalemia, which can cause life-threatening cardiac arrhythmias.
4. A patient with an arteriovenous (AV) fistula for hemodialysis is being assessed. Which
finding indicates a patent and functioning fistula?
A. Presence of a radial pulse distal to the site
B. Absence of a bruit on auscultation
C. Palpation of a thrill over the site
D. Numbness in the fingers of the affected arm
Correct Answer: C
Expert Explanation: A palpable thrill and an audible bruit are normal findings that
indicate the fistula is patent and functioning properly.
5. A patient is admitted with an upper GI bleed and is vomiting bright red blood. Which
nursing action is the highest priority?
A. Assessing the patient’s blood pressure and heart rate
B. Inserting a nasogastric (NG) tube
C. Administering an antacid
D. Preparing the patient for an endoscopy
Correct Answer: A
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 glomerular filtration rate (GFR) of 14
mL/min. Which stage of CKD is the patient experiencing?
A. Stage 2
B. Stage 3
C. Stage 4
D. Stage 5
,Correct Answer: D
Expert Explanation: Stage 5 CKD, also known as end-stage renal disease (ESRD), is
characterized by a GFR less than 15 mL/min, indicating the need for dialysis or transplant.
2. A nurse is assessing a patient undergoing peritoneal dialysis. The nurse notes that the
returning dialysate is cloudy. Which is the priority intervention?
A. Notify the healthcare provider and prepare for a sample culture
B. Reposition the patient to improve drainage
C. Warm the next bag of dialysate
D. Slow the infusion rate
Correct Answer: A
Expert Explanation: Cloudy dialysate is an early sign of peritonitis, a serious complication
of peritoneal dialysis that requires immediate culture and antibiotic therapy.
3. Which electrolyte imbalance is most commonly associated with the oliguric phase of acute
kidney injury (AKI)?
A. Hypokalemia
B. Hypomagnesemia
C. Hypernatremia
D. Hyperkalemia
Correct Answer: D
, Expert Explanation: During the oliguric phase, the kidneys fail to excrete potassium,
leading to hyperkalemia, which can cause life-threatening cardiac arrhythmias.
4. A patient with an arteriovenous (AV) fistula for hemodialysis is being assessed. Which
finding indicates a patent and functioning fistula?
A. Presence of a radial pulse distal to the site
B. Absence of a bruit on auscultation
C. Palpation of a thrill over the site
D. Numbness in the fingers of the affected arm
Correct Answer: C
Expert Explanation: A palpable thrill and an audible bruit are normal findings that
indicate the fistula is patent and functioning properly.
5. A patient is admitted with an upper GI bleed and is vomiting bright red blood. Which
nursing action is the highest priority?
A. Assessing the patient’s blood pressure and heart rate
B. Inserting a nasogastric (NG) tube
C. Administering an antacid
D. Preparing the patient for an endoscopy
Correct Answer: A
