NUR242 Medical-Surgical Nursing Exam 4 Question Bank – Version 2 | 150 New Practice Questions with Answers & Detailed Rationales | Latest 2026/2027 Edition

NUR 242 Medical-Surgical Nursing Exam 4 Question
Bank

Latest 2026/2027 Edition | Full Exam with Questions,
Answers, and Italicized Rationales

This NUR 242 Med-Surg Exam 4 Question Bank features 150 questions with answers and

italicized rationales covering cardiac, hematologic, renal, endocrine, neurologic, and

musculoskeletal disorders for NCLEX preparation and advanced medical-surgical nursing

practice.




Question 1
A client with heart failure reports shortness of breath that worsens when lying flat and
improves when sitting up. The nurse documents this finding as:

 A) Dyspnea on exertion
 B) Orthopnea
 C) Paroxysmal nocturnal dyspnea
 D) Tachypnea

Correct Answer: B

, Question 2
A client with left-sided heart failure is expected to exhibit which finding?

 A) Jugular vein distention
 B) Peripheral edema
 C) Crackles in the lung bases
 D) Hepatomegaly

Correct Answer: C




Question 3
A nurse is caring for a patient with heart failure who has gained 2 kg (4.4 lbs) in 24
hours. Which action should the nurse take first?

 A) Restrict fluid intake to 1 L/day
 B) Administer furosemide as prescribed
 C) Assess lung sounds and oxygen saturation
 D) Elevate the head of the bed

Correct Answer: C




Question 4
A client with chronic heart failure is taking digoxin and furosemide. Which finding
suggests digoxin toxicity?

, A) Heart rate 62 bpm
 B) Anorexia and nausea
 C) Pedal edema 1+
 D) Dry cough

Correct Answer: B




Question 5
A client with heart failure has an ejection fraction of 35%. Which medication class
improves survival in HFrEF?

 A) Calcium channel blockers
 B) Beta-blockers (carvedilol, metoprolol succinate)
 C) Non-dihydropyridine CCBs
 D) Direct vasodilators only

Correct Answer: B




Question 6
The nurse is assessing a client with heart failure. Which finding indicates that the client is
experiencing worsening fluid overload?

 A) Weight loss of 2 pounds in one week
 B) Weight gain of 3 pounds in 24 hours

,  C) Blood pressure 110/70 mmHg
 D) Heart rate 72 bpm

Correct Answer: B

*Weight gain of 2-3 pounds in 24 hours or 5 pounds in one week indicates significant
fluid retention and worsening heart failure. Daily weights are the most reliable indicator
of fluid status. Clients with heart failure should weigh themselves daily at the same time
and report sudden weight gain .*




Question 7
The nurse is monitoring a client with heart failure receiving furosemide (Lasix). Which
electrolyte imbalance should the nurse monitor for?

 A) Hyperkalemia
 B) Hypokalemia
 C) Hypernatremia
 D) Hypocalcemia

Correct Answer: B




Question 8
The nurse is caring for a client with acute decompensated heart failure who develops
severe dyspnea, crackles throughout the lung fields, and pink frothy sputum. The nurse
suspects:

 A) Pneumonia
 B) Pulmonary embolism
 C) Pulmonary edema
 D) Cardiac tamponade