3 LATEST ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 2026/2027 |
GALEN COLLEGE OF NURSING
NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM WITH
COMPLETE 180 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN
COLLEGE OF NURSING 2026/2027
MEDICAL SURGICAL NURSING - Official Exam 2026/2027
180 80% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-Q36
Section 2 Respiratory Disorders Q37-Q72
Section 3 Hematologic & Immune Disorders Q73-Q108
Section 4 Neurological Disorders Q109-Q144
Section 5 Musculoskeletal & Connective Tissue Disorders Q145-Q180
Instructions: Select the single best answer for each question. This exam is designed for Galen College of Nursing Medical
Surgical Nursing preparation. Passing score: 80% (144 questions correct).
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
,2 MED SURG EXAM 3 LATEST ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED
Q1 Question 1 of 180
A 68-year-old male presents to the emergency department with crushing chest pain radiating to
his left arm, diaphoresis, and nausea that began 45 minutes ago. The 12-lead ECG shows
ST-segment elevation in leads V2 through V4. The nurse anticipates which immediate
intervention?
A. Administer thrombolytic therapy and prepare for percutaneous coronary intervention
B. Obtain a chest X-ray and serial cardiac enzymes before initiating treatment
C. Start beta-blocker therapy and schedule a stress test for the next day
D. Administer sublingual nitroglycerin and monitor for pain relief over 30 minutes
Correct Answer: A
Rationale:
ST-segment elevation in V2-V4 indicates an anterior STEMI requiring immediate reperfusion therapy. Thrombolytics
and PCI are the standard of care to restore coronary blood flow. Waiting for cardiac enzymes delays critical
reperfusion and increases myocardial damage.
Q2 Question 2 of 180
A 72-year-old female with a history of hypertension and heart failure is admitted with worsening
dyspnea, bilateral crackles in the lung bases, and 3+ pitting edema in both lower extremities. Her
brain natriuretic peptide level is 850 pg/mL. The nurse understands this patient is experiencing
which type of heart failure?
A. Right-sided heart failure with systemic venous congestion
B. Left-sided heart failure with pulmonary congestion
C. High-output heart failure with decreased systemic vascular resistance
D. Diastolic heart failure with preserved ejection fraction
Correct Answer: B
Rationale:
Bilateral crackles and dyspnea indicate pulmonary congestion characteristic of left-sided heart failure. Elevated BNP
confirms heart failure as the cause. Right-sided heart failure would present with jugular venous distension and
hepatomegaly rather than pulmonary symptoms.
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
, Q3 Question 3 of 180
A 55-year-old male is admitted with a diagnosis of unstable angina. He reports chest pain at rest
that has been increasing in frequency over the past 48 hours. The nurse should prioritize which
nursing intervention?
A. Administer oxygen, aspirin, and nitroglycerin as prescribed and monitor for rhythm changes
B. Prepare the patient for discharge with a prescription for nitroglycerin PRN
C. Obtain a 24-hour Holter monitor and schedule an outpatient stress test
D. Encourage ambulation to promote circulation and prevent DVT formation
Correct Answer: C
Rationale:
Unstable angina is a medical emergency requiring immediate intervention with oxygen, antiplatelet therapy, and
nitrates to reduce myocardial oxygen demand. The patient is at high risk for progression to MI and requires
continuous monitoring for dysrhythmias.
Q4 Question 4 of 180
A 60-year-old male with a permanent pacemaker is admitted for a routine evaluation. The nurse
notes a spike on the ECG before each QRS complex, and the heart rate is set at 70 bpm. The
nurse recognizes this pacemaker is functioning in which mode?
A. Atrial synchronous pacing mode with sensing of P waves
B. Ventricular demand pacing with sensing of intrinsic QRS complexes
C. Dual-chamber pacing with sequential atrioventricular pacing
D. Fixed-rate ventricular pacing without sensing intrinsic activity
Correct Answer: D
Rationale:
A spike before each QRS complex at a consistent rate without variation suggests fixed-rate ventricular pacing,
where the pacemaker fires regardless of intrinsic activity. Demand pacemakers would only fire when no intrinsic beat
is detected, causing variable spike patterns.
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
, Q5 Question 5 of 180
A 48-year-old female is recovering from a cardiac catheterization via the right femoral approach.
Two hours post-procedure, she reports numbness and tingling in her right foot. On assessment,
the right pedal pulse is absent and the limb is cool to touch. The nurse should take which action
first?
A. Document the findings and continue routine post-procedure monitoring
B. Apply a warm compress to the right foot and reassess in 30 minutes
C. Notify the provider immediately of potential arterial occlusion
D. Elevate the right leg above heart level to promote venous return
Correct Answer: A
Rationale:
Absent pedal pulse with coolness and numbness indicates possible arterial occlusion at the catheterization site,
which is a medical emergency requiring immediate provider notification. Delayed intervention can result in limb
ischemia and potential loss of the extremity.
Q6 Question 6 of 180
A 65-year-old male with chronic heart failure is prescribed lisinopril 10 mg daily. At his follow-up
visit, his potassium level is 5.8 mEq/L and he reports a persistent dry cough. The nurse
anticipates the provider will make which change to his medication regimen?
A. Increase the lisinopril dose to 20 mg daily for better blood pressure control
B. Switch from lisinopril to losartan to address the cough while maintaining RAAS blockade
C. Discontinue the ACE inhibitor and start a calcium channel blocker instead
D. Add a potassium supplement to correct the hyperkalemia
Correct Answer: B
Rationale:
ACE inhibitors like lisinopril can cause a dry cough due to bradykinin accumulation and hyperkalemia due to
decreased aldosterone. ARBs like losartan provide similar RAAS blockade without the cough side effect and may
have less effect on potassium levels.
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
GALEN COLLEGE OF NURSING
NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM WITH
COMPLETE 180 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN
COLLEGE OF NURSING 2026/2027
MEDICAL SURGICAL NURSING - Official Exam 2026/2027
180 80% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiovascular Disorders Q1-Q36
Section 2 Respiratory Disorders Q37-Q72
Section 3 Hematologic & Immune Disorders Q73-Q108
Section 4 Neurological Disorders Q109-Q144
Section 5 Musculoskeletal & Connective Tissue Disorders Q145-Q180
Instructions: Select the single best answer for each question. This exam is designed for Galen College of Nursing Medical
Surgical Nursing preparation. Passing score: 80% (144 questions correct).
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
,2 MED SURG EXAM 3 LATEST ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED
Q1 Question 1 of 180
A 68-year-old male presents to the emergency department with crushing chest pain radiating to
his left arm, diaphoresis, and nausea that began 45 minutes ago. The 12-lead ECG shows
ST-segment elevation in leads V2 through V4. The nurse anticipates which immediate
intervention?
A. Administer thrombolytic therapy and prepare for percutaneous coronary intervention
B. Obtain a chest X-ray and serial cardiac enzymes before initiating treatment
C. Start beta-blocker therapy and schedule a stress test for the next day
D. Administer sublingual nitroglycerin and monitor for pain relief over 30 minutes
Correct Answer: A
Rationale:
ST-segment elevation in V2-V4 indicates an anterior STEMI requiring immediate reperfusion therapy. Thrombolytics
and PCI are the standard of care to restore coronary blood flow. Waiting for cardiac enzymes delays critical
reperfusion and increases myocardial damage.
Q2 Question 2 of 180
A 72-year-old female with a history of hypertension and heart failure is admitted with worsening
dyspnea, bilateral crackles in the lung bases, and 3+ pitting edema in both lower extremities. Her
brain natriuretic peptide level is 850 pg/mL. The nurse understands this patient is experiencing
which type of heart failure?
A. Right-sided heart failure with systemic venous congestion
B. Left-sided heart failure with pulmonary congestion
C. High-output heart failure with decreased systemic vascular resistance
D. Diastolic heart failure with preserved ejection fraction
Correct Answer: B
Rationale:
Bilateral crackles and dyspnea indicate pulmonary congestion characteristic of left-sided heart failure. Elevated BNP
confirms heart failure as the cause. Right-sided heart failure would present with jugular venous distension and
hepatomegaly rather than pulmonary symptoms.
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
, Q3 Question 3 of 180
A 55-year-old male is admitted with a diagnosis of unstable angina. He reports chest pain at rest
that has been increasing in frequency over the past 48 hours. The nurse should prioritize which
nursing intervention?
A. Administer oxygen, aspirin, and nitroglycerin as prescribed and monitor for rhythm changes
B. Prepare the patient for discharge with a prescription for nitroglycerin PRN
C. Obtain a 24-hour Holter monitor and schedule an outpatient stress test
D. Encourage ambulation to promote circulation and prevent DVT formation
Correct Answer: C
Rationale:
Unstable angina is a medical emergency requiring immediate intervention with oxygen, antiplatelet therapy, and
nitrates to reduce myocardial oxygen demand. The patient is at high risk for progression to MI and requires
continuous monitoring for dysrhythmias.
Q4 Question 4 of 180
A 60-year-old male with a permanent pacemaker is admitted for a routine evaluation. The nurse
notes a spike on the ECG before each QRS complex, and the heart rate is set at 70 bpm. The
nurse recognizes this pacemaker is functioning in which mode?
A. Atrial synchronous pacing mode with sensing of P waves
B. Ventricular demand pacing with sensing of intrinsic QRS complexes
C. Dual-chamber pacing with sequential atrioventricular pacing
D. Fixed-rate ventricular pacing without sensing intrinsic activity
Correct Answer: D
Rationale:
A spike before each QRS complex at a consistent rate without variation suggests fixed-rate ventricular pacing,
where the pacemaker fires regardless of intrinsic activity. Demand pacemakers would only fire when no intrinsic beat
is detected, causing variable spike patterns.
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
, Q5 Question 5 of 180
A 48-year-old female is recovering from a cardiac catheterization via the right femoral approach.
Two hours post-procedure, she reports numbness and tingling in her right foot. On assessment,
the right pedal pulse is absent and the limb is cool to touch. The nurse should take which action
first?
A. Document the findings and continue routine post-procedure monitoring
B. Apply a warm compress to the right foot and reassess in 30 minutes
C. Notify the provider immediately of potential arterial occlusion
D. Elevate the right leg above heart level to promote venous return
Correct Answer: A
Rationale:
Absent pedal pulse with coolness and numbness indicates possible arterial occlusion at the catheterization site,
which is a medical emergency requiring immediate provider notification. Delayed intervention can result in limb
ischemia and potential loss of the extremity.
Q6 Question 6 of 180
A 65-year-old male with chronic heart failure is prescribed lisinopril 10 mg daily. At his follow-up
visit, his potassium level is 5.8 mEq/L and he reports a persistent dry cough. The nurse
anticipates the provider will make which change to his medication regimen?
A. Increase the lisinopril dose to 20 mg daily for better blood pressure control
B. Switch from lisinopril to losartan to address the cough while maintaining RAAS blockade
C. Discontinue the ACE inhibitor and start a calcium channel blocker instead
D. Add a potassium supplement to correct the hyperkalemia
Correct Answer: B
Rationale:
ACE inhibitors like lisinopril can cause a dry cough due to bradykinin accumulation and hyperkalemia due to
decreased aldosterone. ARBs like losartan provide similar RAAS blockade without the cough side effect and may
have less effect on potassium levels.
ACTUAL EXAM WITH COMPLETE 180 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY GRADED A+ | GALEN COLLEGE OF NURSING 2026/2027 - 2026/2
