Galen | NUR 242
OBJECTIVE ASSESSMENT - EXAM
Galen NUR 242 Exam 4 (2026/2027) |
Med-Surg Nursing | (A+ Guarantee) |
PDF 2026/2027
Med-Surg Nursing | Board Exam
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure and Dysrhythmias Management Chronic Obstructive Pulmonary Disease and Asthma
Gastrointestinal Bleeding and Liver Disorders Diabetes Mellitus Complications and Management
Oncologic Emergencies and Immunotherapy Shock, Sepsis, and Multi-Organ Dysfunction
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 1 of COVER
45 PAGE - 1
,| Cardiovascular and Hematologic Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
Q1 Question 1 of 75
A 68-year-old male with a history of chronic heart failure presents to the emergency department
with worsening dyspnea, orthopnea, and a 5-pound weight gain over the past 3 days. His vital
signs reveal BP 162/94 mmHg, HR 112 bpm, RR 28/min, and SpO2 88% on room air. Which
intervention should the nurse prioritize first?
A. Administer furosemide 40 mg IV push
B. Apply supplemental oxygen at 2 L/min via nasal cannula
C. Obtain a 12-lead electrocardiogram immediately
D. Insert a Foley catheter to monitor hourly urine output
Correct Answer: B
Rationale:
The patient is experiencing acute decompensated heart failure with significant hypoxemia (SpO2 88%). Addressing the
airway and breathing is the priority according to the ABCs of emergency care. While furosemide and other interventions
are important, oxygenation must be addressed first to prevent tissue hypoxia and further cardiac strain.
Q2 Question 2 of 75
A 54-year-old female with atrial fibrillation is started on warfarin therapy. The nurse is educating
her about dietary considerations. Which statement by the patient indicates a correct
understanding of the teaching?
A. I should avoid all green vegetables completely while taking warfarin
B. I need to keep my vitamin K intake consistent from day to day
C. I can eat as much broccoli as I want because it does not affect warfarin
D. I should double my vitamin K intake to counteract the warfarin
Correct Answer: B
Rationale:
Warfarin works by inhibiting vitamin K-dependent clotting factors. The key dietary principle is consistency in vitamin K
intake rather than avoidance. Fluctuating vitamin K levels can cause unpredictable INR values. Patients should maintain
a consistent diet and have regular INR monitoring rather than eliminating vitamin K foods entirely.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 2 of 45
,| Cardiovascular and Hematologic Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
Q3 Question 3 of 75
A 72-year-old male is admitted with acute coronary syndrome and is scheduled for cardiac
catheterization. The nurse reviews his medication list and notes he takes metformin 1000 mg
twice daily. What is the most appropriate nursing action regarding this medication?
A. Continue metformin as scheduled through the procedure
B. Hold metformin 48 hours before and after the procedure due to contrast dye risk
C. Switch metformin to insulin temporarily for the procedure only
D. Administer metformin with a full glass of water immediately before the procedure
Correct Answer: B
Rationale:
Metformin should be held 48 hours before and after procedures involving iodinated contrast media because of the risk of
metformin-associated lactic acidosis if renal function is compromised by the contrast dye. This is a standard safety
protocol for diabetic patients undergoing cardiac catheterization.
Q4 Question 4 of 75
A 45-year-old female with a history of deep vein thrombosis is receiving heparin via continuous
IV infusion. The nurse notes that the patient's activated partial thromboplastin time (aPTT) is 95
seconds. Which action should the nurse take?
A. Continue the heparin infusion at the current rate
B. Increase the heparin infusion rate by 2 units/kg/hr
C. Stop the heparin infusion immediately and notify the provider
D. Administer protamine sulfate and restart heparin at a lower dose
Correct Answer: C
Rationale:
A therapeutic aPTT for heparin therapy is typically 1.5 to 2.5 times the control value (approximately 60-80 seconds). An
aPTT of 95 seconds indicates supratherapeutic anticoagulation with a high bleeding risk. The nurse should stop the
infusion and notify the provider immediately. Protamine sulfate is the antidote but should only be given with a provider
order.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 3 of 45
,| Cardiovascular and Hematologic Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
Q5 Question 5 of 75
A 60-year-old male with dilated cardiomyopathy is being evaluated for a left ventricular assist
device (LVAD). The nurse is providing preoperative education. Which statement by the patient
demonstrates a need for further teaching?
A. I will need to take anticoagulants for the rest of my life with this device
B. I can shower normally without any special precautions for the driveline
C. I need to carry backup batteries with me at all times when I leave home
D. I should report any fever or redness around the driveline site immediately
Correct Answer: B
Rationale:
The driveline exit site is a major infection risk for LVAD patients. Patients must use specialized shower bags or covers to
protect the driveline and controller from water exposure. Normal showering without precautions could lead to serious
driveline infections, which are a leading cause of morbidity in LVAD patients.
Q6 Question 6 of 75
A 58-year-old female is admitted with unstable angina. Her troponin I level is elevated at 0.8
ng/mL. The nurse is monitoring for complications. Which assessment finding would be most
concerning for acute myocardial infarction progression?
A. Occasional premature ventricular contractions on telemetry
B. New onset of crackles in bilateral lung bases and SpO2 dropping to 91%
C. Mild anxiety and restlessness requiring reassurance
D. Blood pressure of 138/82 mmHg with a regular heart rate of 88 bpm
Correct Answer: B
Rationale:
New crackles and dropping oxygen saturation in a patient with elevated troponins suggest acute left ventricular
dysfunction and pulmonary edema, indicating progression to acute myocardial infarction with heart failure. This
represents a life-threatening complication requiring immediate intervention. Occasional PVCs, mild anxiety, and stable
vital signs are less immediately concerning.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 4 of 45
OBJECTIVE ASSESSMENT - EXAM
Galen NUR 242 Exam 4 (2026/2027) |
Med-Surg Nursing | (A+ Guarantee) |
PDF 2026/2027
Med-Surg Nursing | Board Exam
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure and Dysrhythmias Management Chronic Obstructive Pulmonary Disease and Asthma
Gastrointestinal Bleeding and Liver Disorders Diabetes Mellitus Complications and Management
Oncologic Emergencies and Immunotherapy Shock, Sepsis, and Multi-Organ Dysfunction
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 1 of COVER
45 PAGE - 1
,| Cardiovascular and Hematologic Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
Q1 Question 1 of 75
A 68-year-old male with a history of chronic heart failure presents to the emergency department
with worsening dyspnea, orthopnea, and a 5-pound weight gain over the past 3 days. His vital
signs reveal BP 162/94 mmHg, HR 112 bpm, RR 28/min, and SpO2 88% on room air. Which
intervention should the nurse prioritize first?
A. Administer furosemide 40 mg IV push
B. Apply supplemental oxygen at 2 L/min via nasal cannula
C. Obtain a 12-lead electrocardiogram immediately
D. Insert a Foley catheter to monitor hourly urine output
Correct Answer: B
Rationale:
The patient is experiencing acute decompensated heart failure with significant hypoxemia (SpO2 88%). Addressing the
airway and breathing is the priority according to the ABCs of emergency care. While furosemide and other interventions
are important, oxygenation must be addressed first to prevent tissue hypoxia and further cardiac strain.
Q2 Question 2 of 75
A 54-year-old female with atrial fibrillation is started on warfarin therapy. The nurse is educating
her about dietary considerations. Which statement by the patient indicates a correct
understanding of the teaching?
A. I should avoid all green vegetables completely while taking warfarin
B. I need to keep my vitamin K intake consistent from day to day
C. I can eat as much broccoli as I want because it does not affect warfarin
D. I should double my vitamin K intake to counteract the warfarin
Correct Answer: B
Rationale:
Warfarin works by inhibiting vitamin K-dependent clotting factors. The key dietary principle is consistency in vitamin K
intake rather than avoidance. Fluctuating vitamin K levels can cause unpredictable INR values. Patients should maintain
a consistent diet and have regular INR monitoring rather than eliminating vitamin K foods entirely.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 2 of 45
,| Cardiovascular and Hematologic Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
Q3 Question 3 of 75
A 72-year-old male is admitted with acute coronary syndrome and is scheduled for cardiac
catheterization. The nurse reviews his medication list and notes he takes metformin 1000 mg
twice daily. What is the most appropriate nursing action regarding this medication?
A. Continue metformin as scheduled through the procedure
B. Hold metformin 48 hours before and after the procedure due to contrast dye risk
C. Switch metformin to insulin temporarily for the procedure only
D. Administer metformin with a full glass of water immediately before the procedure
Correct Answer: B
Rationale:
Metformin should be held 48 hours before and after procedures involving iodinated contrast media because of the risk of
metformin-associated lactic acidosis if renal function is compromised by the contrast dye. This is a standard safety
protocol for diabetic patients undergoing cardiac catheterization.
Q4 Question 4 of 75
A 45-year-old female with a history of deep vein thrombosis is receiving heparin via continuous
IV infusion. The nurse notes that the patient's activated partial thromboplastin time (aPTT) is 95
seconds. Which action should the nurse take?
A. Continue the heparin infusion at the current rate
B. Increase the heparin infusion rate by 2 units/kg/hr
C. Stop the heparin infusion immediately and notify the provider
D. Administer protamine sulfate and restart heparin at a lower dose
Correct Answer: C
Rationale:
A therapeutic aPTT for heparin therapy is typically 1.5 to 2.5 times the control value (approximately 60-80 seconds). An
aPTT of 95 seconds indicates supratherapeutic anticoagulation with a high bleeding risk. The nurse should stop the
infusion and notify the provider immediately. Protamine sulfate is the antidote but should only be given with a provider
order.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 3 of 45
,| Cardiovascular and Hematologic Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
Q5 Question 5 of 75
A 60-year-old male with dilated cardiomyopathy is being evaluated for a left ventricular assist
device (LVAD). The nurse is providing preoperative education. Which statement by the patient
demonstrates a need for further teaching?
A. I will need to take anticoagulants for the rest of my life with this device
B. I can shower normally without any special precautions for the driveline
C. I need to carry backup batteries with me at all times when I leave home
D. I should report any fever or redness around the driveline site immediately
Correct Answer: B
Rationale:
The driveline exit site is a major infection risk for LVAD patients. Patients must use specialized shower bags or covers to
protect the driveline and controller from water exposure. Normal showering without precautions could lead to serious
driveline infections, which are a leading cause of morbidity in LVAD patients.
Q6 Question 6 of 75
A 58-year-old female is admitted with unstable angina. Her troponin I level is elevated at 0.8
ng/mL. The nurse is monitoring for complications. Which assessment finding would be most
concerning for acute myocardial infarction progression?
A. Occasional premature ventricular contractions on telemetry
B. New onset of crackles in bilateral lung bases and SpO2 dropping to 91%
C. Mild anxiety and restlessness requiring reassurance
D. Blood pressure of 138/82 mmHg with a regular heart rate of 88 bpm
Correct Answer: B
Rationale:
New crackles and dropping oxygen saturation in a patient with elevated troponins suggest acute left ventricular
dysfunction and pulmonary edema, indicating progression to acute myocardial infarction with heart failure. This
represents a life-threatening complication requiring immediate intervention. Occasional PVCs, mild anxiety, and stable
vital signs are less immediately concerning.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 4 of 45
