NUR242 Exam 1 V2 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This study guide is intended to provide comprehensive preparation for medical-surgical nursing
examinations by focusing on adult disease processes, acute care interventions, and safe
nursing practices. The content reflects practical nursing concepts frequently tested in nursing
school assessments.
This version contains realistic exam-style questions designed to strengthen understanding of
adult disorders, therapeutic nursing interventions, and clinical prioritization strategies. Detailed
expert explanations support deeper understanding and practical nursing application.
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The Exam Covers:
• Pulmonary nursing management
• Cardiac monitoring concepts
• Hypertension and heart failure
• Oxygenation and perfusion
• Pain management strategies
• Adult patient education
• Nursing documentation standards
• Prioritization and delegation
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1. A nurse is assessing a patient with suspected left-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Peripheral edema in the lower extremities
B. Jugular venous distention
C. Hepatomegaly and abdominal girth increase
,D. Crackles heard upon lung auscultation
Correct Answer: D
Expert Explanation: Left-sided heart failure primarily affects the pulmonary system
because the left ventricle cannot pump blood efficiently to the body, causing backflow into
the lungs. This leads to symptoms such as crackles, dyspnea, and orthopnea. The other
options describe right-sided heart failure, which involves systemic venous congestion.
2. When teaching a patient about the newly prescribed ACE inhibitor Lisinopril, which side
effect should the nurse emphasize as a reason to contact the provider?
A. Increased appetite
B. A persistent dry cough
C. Yellow-tinged vision
D. Decreased urinary frequency
Correct Answer: B
Expert Explanation: A dry, hacking cough is a common and often intolerable side effect of
ACE inhibitors due to the accumulation of bradykinin in the lungs. Patients should be
taught to report this as it may require a medication change to an Angiotensin II Receptor
Blocker (ARB). This symptom is specific to the drug class and does not indicate an allergy
but rather a biochemical reaction.
, 3. A patient with COPD is receiving oxygen via nasal cannula at 2L/min. The nurse notes the
patient’s oxygen saturation is 89%. What is the most appropriate nursing action?
A. Increase the oxygen flow to 6L/min immediately
B. Switch the patient to a non-rebreather mask
C. Document the finding as normal for this patient
D. Prepare for emergency endotracheal intubation
Correct Answer: C
Expert Explanation: For patients with chronic obstructive pulmonary disease (COPD), an
oxygen saturation between 88% and 92% is often considered an acceptable and expected
range. Providing too much supplemental oxygen can suppress the hypoxic drive, which is
the stimulus for breathing in these patients. The nurse should monitor the patient’s
respiratory effort and clinical status rather than increasing oxygen excessively.
4. Which of the following patients should the nurse assess first after receiving the change-of-
shift report?
A. A patient with heart failure who gained 1 pound in 24 hours
B. A patient with pneumonia who is requesting a PRN cough suppressant
C. A patient with a history of hypertension complaining of a sudden ‘tearing’ chest pain
D. A patient post-op day 2 after a tracheostomy who requires dressing change
Correct Answer: C
Q&A | Galen College of Nursing
────────────────────────────────────
This study guide is intended to provide comprehensive preparation for medical-surgical nursing
examinations by focusing on adult disease processes, acute care interventions, and safe
nursing practices. The content reflects practical nursing concepts frequently tested in nursing
school assessments.
This version contains realistic exam-style questions designed to strengthen understanding of
adult disorders, therapeutic nursing interventions, and clinical prioritization strategies. Detailed
expert explanations support deeper understanding and practical nursing application.
════════════════════════════════════
The Exam Covers:
• Pulmonary nursing management
• Cardiac monitoring concepts
• Hypertension and heart failure
• Oxygenation and perfusion
• Pain management strategies
• Adult patient education
• Nursing documentation standards
• Prioritization and delegation
════════════════════════════════════
1. A nurse is assessing a patient with suspected left-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Peripheral edema in the lower extremities
B. Jugular venous distention
C. Hepatomegaly and abdominal girth increase
,D. Crackles heard upon lung auscultation
Correct Answer: D
Expert Explanation: Left-sided heart failure primarily affects the pulmonary system
because the left ventricle cannot pump blood efficiently to the body, causing backflow into
the lungs. This leads to symptoms such as crackles, dyspnea, and orthopnea. The other
options describe right-sided heart failure, which involves systemic venous congestion.
2. When teaching a patient about the newly prescribed ACE inhibitor Lisinopril, which side
effect should the nurse emphasize as a reason to contact the provider?
A. Increased appetite
B. A persistent dry cough
C. Yellow-tinged vision
D. Decreased urinary frequency
Correct Answer: B
Expert Explanation: A dry, hacking cough is a common and often intolerable side effect of
ACE inhibitors due to the accumulation of bradykinin in the lungs. Patients should be
taught to report this as it may require a medication change to an Angiotensin II Receptor
Blocker (ARB). This symptom is specific to the drug class and does not indicate an allergy
but rather a biochemical reaction.
, 3. A patient with COPD is receiving oxygen via nasal cannula at 2L/min. The nurse notes the
patient’s oxygen saturation is 89%. What is the most appropriate nursing action?
A. Increase the oxygen flow to 6L/min immediately
B. Switch the patient to a non-rebreather mask
C. Document the finding as normal for this patient
D. Prepare for emergency endotracheal intubation
Correct Answer: C
Expert Explanation: For patients with chronic obstructive pulmonary disease (COPD), an
oxygen saturation between 88% and 92% is often considered an acceptable and expected
range. Providing too much supplemental oxygen can suppress the hypoxic drive, which is
the stimulus for breathing in these patients. The nurse should monitor the patient’s
respiratory effort and clinical status rather than increasing oxygen excessively.
4. Which of the following patients should the nurse assess first after receiving the change-of-
shift report?
A. A patient with heart failure who gained 1 pound in 24 hours
B. A patient with pneumonia who is requesting a PRN cough suppressant
C. A patient with a history of hypertension complaining of a sudden ‘tearing’ chest pain
D. A patient post-op day 2 after a tracheostomy who requires dressing change
Correct Answer: C
