NUR 242 / NUR242 Medical-Surgical Nursing: (Latest
2026/2027 Update) 50 Verified Questions & Answers with
Detailed Rationales | Grade A Galen
SUBTITLE:
50 Exam Questions with Answers & Detailed Rationales
PREPARED FOR:
NUR242 Medical-Surgical Nursing - Galen College
DOCUMENT INCLUDES:
- Exam-style questions
- Correct answers
- Detailed rationales
- Key topics covered
TOPICS COVERED:
- Cardiovascular Disorders
- Respiratory Conditions
- GI/Hepatic Diseases
- Endocrine/Metabolic Disorders
- Neurological Conditions
- Renal/Urological Issues
- Perioperative Nursing
- Fluid & Electrolyte Balance
- Pain Management
- Oncology
PURPOSE:
This comprehensive resource is designed to help NUR242 students master essential
Medical-Surgical nursing concepts, reinforce clinical reasoning, and confidently prepare for the latest
2026/2027 course exams.
================================================================================
END OF COVER PAGE
================================================================================
SECTION 1: CARDIOVASCULAR DISORDERS
,Question 1
A client with heart failure is prescribed furosemide (Lasix) 40 mg PO daily. The nurse understands
that the primary therapeutic effect of this medication is to:
A. Increase myocardial contractility
B. Reduce preload by promoting diuresis
C. Decrease afterload through vasodilation
D. Slow the heart rate and reduce oxygen demand
Correct Answer: B
Rationale: Furosemide is a loop diuretic that acts on the ascending loop of Henle to promote the
excretion of sodium and water. In heart failure, fluid volume overload increases venous return
(preload), which strains the failing heart. By promoting diuresis, furosemide reduces preload,
decreasing the workload on the heart and relieving symptoms of pulmonary congestion and
peripheral edema. Option A is incorrect because furosemide does not increase contractility (positive
inotropy is achieved by digoxin or dobutamine). Option C is incorrect because furosemide does not
significantly decrease afterload through vasodilation (ACE inhibitors or hydralazine serve this
purpose). Option D is incorrect because furosemide does not affect heart rate (beta-blockers like
metoprolol reduce heart rate).
Question 2
The nurse is caring for a client who had a myocardial infarction (MI) 24 hours ago. Which
assessment finding requires immediate intervention?
A. Blood pressure 138/88 mmHg
B. Heart rate of 96 beats per minute
C. New onset of ventricular tachycardia
D. Mild chest discomfort rated 2/10
Correct Answer: C
Rationale: New onset ventricular tachycardia in a post-MI client is a life-threatening arrhythmia that
can rapidly deteriorate into ventricular fibrillation and cardiac arrest. The nurse must immediately
notify the provider and prepare for emergency interventions such as antiarrhythmic medications
(amiodarone) or defibrillation if the client becomes unstable. Option A is a normal blood pressure
reading. Option B is a slightly elevated but acceptable heart rate post-MI. Option D indicates mild
discomfort that should be monitored but does not require immediate intervention compared to a
lethal arrhythmia.
, Question 3
A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should instruct the client
to avoid which food because it can decrease the effectiveness of the medication?
A. Bananas
B. Spinach and kale
C. Oranges
D. Red meat
Correct Answer: B
Rationale: Warfarin acts by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Green leafy
vegetables such as spinach, kale, broccoli, and Brussels sprouts are high in vitamin K. Consuming
large amounts of these foods can antagonize the anticoagulant effect of warfarin, making it less
effective and increasing the risk of thromboembolic events. Option A (bananas) are high in
potassium and do not affect warfarin. Option C (oranges) contain vitamin C and do not interfere with
warfarin. Option D (red meat) does not contain significant vitamin K and does not affect warfarin
metabolism.
Question 4
The nurse is assessing a client with chronic peripheral arterial disease (PAD). Which finding is most
consistent with this condition?
A. Warm, erythematous skin with bounding pulses
B. Cool, pale skin with diminished or absent pulses
C. Pitting edema in the lower extremities
D. Bilateral varicose veins with brownish discoloration
Correct Answer: B
Rationale: Peripheral arterial disease results from atherosclerotic narrowing of the arteries, leading
to reduced blood flow to the extremities. The classic presentation includes the "6 P's": pain, pallor,
pulselessness, paresthesia, paralysis, and poikilothermia (coolness). Diminished or absent pulses
and cool, pale skin are hallmark signs of arterial insufficiency. Option A describes signs of
inflammation or infection, not PAD. Option C describes venous insufficiency or heart failure, not
arterial disease. Option D describes chronic venous insufficiency with hemosiderin deposition.
Question 5
2026/2027 Update) 50 Verified Questions & Answers with
Detailed Rationales | Grade A Galen
SUBTITLE:
50 Exam Questions with Answers & Detailed Rationales
PREPARED FOR:
NUR242 Medical-Surgical Nursing - Galen College
DOCUMENT INCLUDES:
- Exam-style questions
- Correct answers
- Detailed rationales
- Key topics covered
TOPICS COVERED:
- Cardiovascular Disorders
- Respiratory Conditions
- GI/Hepatic Diseases
- Endocrine/Metabolic Disorders
- Neurological Conditions
- Renal/Urological Issues
- Perioperative Nursing
- Fluid & Electrolyte Balance
- Pain Management
- Oncology
PURPOSE:
This comprehensive resource is designed to help NUR242 students master essential
Medical-Surgical nursing concepts, reinforce clinical reasoning, and confidently prepare for the latest
2026/2027 course exams.
================================================================================
END OF COVER PAGE
================================================================================
SECTION 1: CARDIOVASCULAR DISORDERS
,Question 1
A client with heart failure is prescribed furosemide (Lasix) 40 mg PO daily. The nurse understands
that the primary therapeutic effect of this medication is to:
A. Increase myocardial contractility
B. Reduce preload by promoting diuresis
C. Decrease afterload through vasodilation
D. Slow the heart rate and reduce oxygen demand
Correct Answer: B
Rationale: Furosemide is a loop diuretic that acts on the ascending loop of Henle to promote the
excretion of sodium and water. In heart failure, fluid volume overload increases venous return
(preload), which strains the failing heart. By promoting diuresis, furosemide reduces preload,
decreasing the workload on the heart and relieving symptoms of pulmonary congestion and
peripheral edema. Option A is incorrect because furosemide does not increase contractility (positive
inotropy is achieved by digoxin or dobutamine). Option C is incorrect because furosemide does not
significantly decrease afterload through vasodilation (ACE inhibitors or hydralazine serve this
purpose). Option D is incorrect because furosemide does not affect heart rate (beta-blockers like
metoprolol reduce heart rate).
Question 2
The nurse is caring for a client who had a myocardial infarction (MI) 24 hours ago. Which
assessment finding requires immediate intervention?
A. Blood pressure 138/88 mmHg
B. Heart rate of 96 beats per minute
C. New onset of ventricular tachycardia
D. Mild chest discomfort rated 2/10
Correct Answer: C
Rationale: New onset ventricular tachycardia in a post-MI client is a life-threatening arrhythmia that
can rapidly deteriorate into ventricular fibrillation and cardiac arrest. The nurse must immediately
notify the provider and prepare for emergency interventions such as antiarrhythmic medications
(amiodarone) or defibrillation if the client becomes unstable. Option A is a normal blood pressure
reading. Option B is a slightly elevated but acceptable heart rate post-MI. Option D indicates mild
discomfort that should be monitored but does not require immediate intervention compared to a
lethal arrhythmia.
, Question 3
A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse should instruct the client
to avoid which food because it can decrease the effectiveness of the medication?
A. Bananas
B. Spinach and kale
C. Oranges
D. Red meat
Correct Answer: B
Rationale: Warfarin acts by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Green leafy
vegetables such as spinach, kale, broccoli, and Brussels sprouts are high in vitamin K. Consuming
large amounts of these foods can antagonize the anticoagulant effect of warfarin, making it less
effective and increasing the risk of thromboembolic events. Option A (bananas) are high in
potassium and do not affect warfarin. Option C (oranges) contain vitamin C and do not interfere with
warfarin. Option D (red meat) does not contain significant vitamin K and does not affect warfarin
metabolism.
Question 4
The nurse is assessing a client with chronic peripheral arterial disease (PAD). Which finding is most
consistent with this condition?
A. Warm, erythematous skin with bounding pulses
B. Cool, pale skin with diminished or absent pulses
C. Pitting edema in the lower extremities
D. Bilateral varicose veins with brownish discoloration
Correct Answer: B
Rationale: Peripheral arterial disease results from atherosclerotic narrowing of the arteries, leading
to reduced blood flow to the extremities. The classic presentation includes the "6 P's": pain, pallor,
pulselessness, paresthesia, paralysis, and poikilothermia (coolness). Diminished or absent pulses
and cool, pale skin are hallmark signs of arterial insufficiency. Option A describes signs of
inflammation or infection, not PAD. Option C describes venous insufficiency or heart failure, not
arterial disease. Option D describes chronic venous insufficiency with hemosiderin deposition.
Question 5
