GALEN NUR 242 EXAM 4 MED-SURG COMPREHENSIVE
TEST WITH VERIFIED ANSWERS & RATIONALES
This comprehensive medical-surgical nursing exam bank
delivers high-yield practice questions complete with detailed,
italicized answer keys and bolded rationales. Perfectly
structured for Stuvia and Docsity sales, it targets critical test
concepts across cardiovascular, neurological, endocrine, and
musculoskeletal systems to guarantee a passing score. Elevate
your study routine or marketplace store with this premium,
verified, and classroom-ready nursing resource.
Question 1
A nurse is assessing a client with a history of heart failure who
takes digoxin and furosemide. Which lab value demands
immediate intervention?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Magnesium 2.0 mEq/L
D) Digoxin level 1.0 ng/mL
Answer: B) Potassium 3.1 mEq/L
Rationale: Furosemide is a potassium-wasting loop
diuretic. Hypokalemia (potassium < 3.5 mEq/L) strongly
,predisposes a client to digoxin toxicity, which can induce
fatal cardiac arrhythmias.
Question 2
A client presents to the emergency department with symptoms
of an acute ischemic stroke. Which diagnostic test must be
completed first?
A) Magnetic Resonance Imaging (MRI) of the head
B) Lumbar puncture
C) Non-contrast Computed Tomography (CT) scan of the
head
D) Cerebral angiography
Answer: C) Non-contrast Computed Tomography (CT) scan of
the head
Rationale: A non-contrast head CT scan must be performed
immediately to differentiate an ischemic stroke from a
hemorrhagic stroke. Fibrinolytic therapy (rtPA) is
contraindicated and fatal in hemorrhagic stroke.
Question 3
The nurse cares for a client in acute atrial fibrillation. Which
clinical manifestation is the highest priority to report?
, A) Palpitations
B) Fatigue
C) Sudden slurred speech
D) Irregular pulse of 110 bpm
Answer: C) Sudden slurred speech
Rationale: Atrial fibrillation causes ineffective atrial
contraction, leading to blood stasis and mural thrombi. A
sudden neurological deficit like slurred speech indicates a
thromboembolic stroke, requiring immediate stroke
protocol activation.
Question 4
A client is actively having a generalized tonic-clonic seizure.
Which nursing action is the absolute priority?
A) Place a padded tongue blade in the mouth
B) Turn the client to a side-lying position
C) Restrain the client's arms and legs
D) Administer oral glucose paste
Answer: B) Turn the client to a side-lying position
Rationale: Airway and safety are the top priorities during a
seizure. A side-lying position allows secretions to drain,
preventing aspiration, and protects the airway. Objects
, should never be inserted into the mouth, and the client
should never be restrained.
Question 5
A client with peripheral arterial disease (PAD) reports cramping
leg pain when walking. What instruction should the nurse
include in discharge teaching?
A) Apply a commercial heating pad to the legs when
resting
B) Elevate the legs above heart level when sitting
C) Walk until pain occurs, rest until it subsides, then
resume walking
D) Cross legs at the knees to compress superficial veins
Answer: C) Walk until pain occurs, rest until it subsides, then
resume walking
Rationale: Intermittent claudication is managed with
structured exercise. Walking to the point of pain, resting,
and resuming helps stimulate collateral circulation. Legs
should not be elevated above heart level in PAD because
gravity assists arterial flow, and direct heat sources are
contraindicated due to reduced sensation.
Question 6
TEST WITH VERIFIED ANSWERS & RATIONALES
This comprehensive medical-surgical nursing exam bank
delivers high-yield practice questions complete with detailed,
italicized answer keys and bolded rationales. Perfectly
structured for Stuvia and Docsity sales, it targets critical test
concepts across cardiovascular, neurological, endocrine, and
musculoskeletal systems to guarantee a passing score. Elevate
your study routine or marketplace store with this premium,
verified, and classroom-ready nursing resource.
Question 1
A nurse is assessing a client with a history of heart failure who
takes digoxin and furosemide. Which lab value demands
immediate intervention?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Magnesium 2.0 mEq/L
D) Digoxin level 1.0 ng/mL
Answer: B) Potassium 3.1 mEq/L
Rationale: Furosemide is a potassium-wasting loop
diuretic. Hypokalemia (potassium < 3.5 mEq/L) strongly
,predisposes a client to digoxin toxicity, which can induce
fatal cardiac arrhythmias.
Question 2
A client presents to the emergency department with symptoms
of an acute ischemic stroke. Which diagnostic test must be
completed first?
A) Magnetic Resonance Imaging (MRI) of the head
B) Lumbar puncture
C) Non-contrast Computed Tomography (CT) scan of the
head
D) Cerebral angiography
Answer: C) Non-contrast Computed Tomography (CT) scan of
the head
Rationale: A non-contrast head CT scan must be performed
immediately to differentiate an ischemic stroke from a
hemorrhagic stroke. Fibrinolytic therapy (rtPA) is
contraindicated and fatal in hemorrhagic stroke.
Question 3
The nurse cares for a client in acute atrial fibrillation. Which
clinical manifestation is the highest priority to report?
, A) Palpitations
B) Fatigue
C) Sudden slurred speech
D) Irregular pulse of 110 bpm
Answer: C) Sudden slurred speech
Rationale: Atrial fibrillation causes ineffective atrial
contraction, leading to blood stasis and mural thrombi. A
sudden neurological deficit like slurred speech indicates a
thromboembolic stroke, requiring immediate stroke
protocol activation.
Question 4
A client is actively having a generalized tonic-clonic seizure.
Which nursing action is the absolute priority?
A) Place a padded tongue blade in the mouth
B) Turn the client to a side-lying position
C) Restrain the client's arms and legs
D) Administer oral glucose paste
Answer: B) Turn the client to a side-lying position
Rationale: Airway and safety are the top priorities during a
seizure. A side-lying position allows secretions to drain,
preventing aspiration, and protects the airway. Objects
, should never be inserted into the mouth, and the client
should never be restrained.
Question 5
A client with peripheral arterial disease (PAD) reports cramping
leg pain when walking. What instruction should the nurse
include in discharge teaching?
A) Apply a commercial heating pad to the legs when
resting
B) Elevate the legs above heart level when sitting
C) Walk until pain occurs, rest until it subsides, then
resume walking
D) Cross legs at the knees to compress superficial veins
Answer: C) Walk until pain occurs, rest until it subsides, then
resume walking
Rationale: Intermittent claudication is managed with
structured exercise. Walking to the point of pain, resting,
and resuming helps stimulate collateral circulation. Legs
should not be elevated above heart level in PAD because
gravity assists arterial flow, and direct heat sources are
contraindicated due to reduced sensation.
Question 6
