NUR242 Exam 2 V1 | NUR 242 Med-Surg Exam
Q&A | Galen College of Nursing
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This exam preparation resource focuses on gastrointestinal disorders, renal conditions, and
endocrine nursing care in adult patients. The material is designed to strengthen understanding
of pathophysiology, nursing interventions, and evidence-based management strategies used in
medical-surgical nursing.
The questions included in this version closely mirror the style and complexity of actual nursing
exams. Detailed expert explanations are included to improve clinical reasoning and patient
management skills.
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The Exam Covers:
• Gastrointestinal disorders
• Renal and urinary system disorders
• Diabetes mellitus management
• Endocrine nursing care
• Nutritional support in adults
• Fluid replacement therapy
• Nursing assessment findings
• Adult elimination disorders
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1. A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is
receiving oxygen therapy. Which of the following findings should the nurse report
immediately?
A. Oxygen saturation of 91% on 2L nasal cannula
B. Respiratory rate of 24 breaths per minute
,C. Increasing lethargy and confusion
D. Expectoration of clear mucus
Correct Answer: C
Expert Explanation: In patients with COPD, a significant increase in lethargy and
confusion may indicate CO2 narcosis due to excessive oxygen administration. This occurs
because the patient’s drive to breathe is shifted to a low oxygen level rather than high CO2
levels. Immediate assessment of arterial blood gases is necessary to evaluate for
respiratory acidosis.
2. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Crackles in the lung bases
B. Jugular venous distention
C. Productive cough with frothy sputum
D. Orthopnea
Correct Answer: B
Expert Explanation: Right-sided heart failure results in systemic venous congestion
because the right ventricle is unable to pump blood effectively to the lungs. Jugular venous
distention (JVD) is a classic sign of this backup into the superior vena cava. Other signs
include peripheral edema, hepatomegaly, and ascites.
, 3. A nurse is preparing to administer Lisinopril to a patient with hypertension. Which
assessment finding would require the nurse to hold the medication?
A. Swelling of the lips and tongue
B. Heart rate of 62 beats per minute
C. Blood pressure of 138/88 mmHg
D. A dry, hacking cough
Correct Answer: A
Expert Explanation: Swelling of the lips and tongue indicates angioedema, which is a life-
threatening adverse effect of ACE inhibitors like Lisinopril. This condition requires
immediate intervention to maintain airway patency and the medication must be
discontinued permanently. While a dry cough is a common side effect, angioedema is a
priority emergency.
4. The nurse is educating a patient on how to use an incentive spirometer. Which instruction
is correct?
A. Blow as hard and fast as possible into the mouthpiece.
B. Use the device once every 4 hours while awake.
C. Inhale slowly and deeply through the mouthpiece.
D. Exhale into the device until the piston reaches the top.
Correct Answer: C
Q&A | Galen College of Nursing
────────────────────────────────────
This exam preparation resource focuses on gastrointestinal disorders, renal conditions, and
endocrine nursing care in adult patients. The material is designed to strengthen understanding
of pathophysiology, nursing interventions, and evidence-based management strategies used in
medical-surgical nursing.
The questions included in this version closely mirror the style and complexity of actual nursing
exams. Detailed expert explanations are included to improve clinical reasoning and patient
management skills.
════════════════════════════════════
The Exam Covers:
• Gastrointestinal disorders
• Renal and urinary system disorders
• Diabetes mellitus management
• Endocrine nursing care
• Nutritional support in adults
• Fluid replacement therapy
• Nursing assessment findings
• Adult elimination disorders
════════════════════════════════════
1. A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is
receiving oxygen therapy. Which of the following findings should the nurse report
immediately?
A. Oxygen saturation of 91% on 2L nasal cannula
B. Respiratory rate of 24 breaths per minute
,C. Increasing lethargy and confusion
D. Expectoration of clear mucus
Correct Answer: C
Expert Explanation: In patients with COPD, a significant increase in lethargy and
confusion may indicate CO2 narcosis due to excessive oxygen administration. This occurs
because the patient’s drive to breathe is shifted to a low oxygen level rather than high CO2
levels. Immediate assessment of arterial blood gases is necessary to evaluate for
respiratory acidosis.
2. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Crackles in the lung bases
B. Jugular venous distention
C. Productive cough with frothy sputum
D. Orthopnea
Correct Answer: B
Expert Explanation: Right-sided heart failure results in systemic venous congestion
because the right ventricle is unable to pump blood effectively to the lungs. Jugular venous
distention (JVD) is a classic sign of this backup into the superior vena cava. Other signs
include peripheral edema, hepatomegaly, and ascites.
, 3. A nurse is preparing to administer Lisinopril to a patient with hypertension. Which
assessment finding would require the nurse to hold the medication?
A. Swelling of the lips and tongue
B. Heart rate of 62 beats per minute
C. Blood pressure of 138/88 mmHg
D. A dry, hacking cough
Correct Answer: A
Expert Explanation: Swelling of the lips and tongue indicates angioedema, which is a life-
threatening adverse effect of ACE inhibitors like Lisinopril. This condition requires
immediate intervention to maintain airway patency and the medication must be
discontinued permanently. While a dry cough is a common side effect, angioedema is a
priority emergency.
4. The nurse is educating a patient on how to use an incentive spirometer. Which instruction
is correct?
A. Blow as hard and fast as possible into the mouthpiece.
B. Use the device once every 4 hours while awake.
C. Inhale slowly and deeply through the mouthpiece.
D. Exhale into the device until the piston reaches the top.
Correct Answer: C
