NUR 242 MED SURG EXAM 3 LATEST ACTUAL
EXAM 180 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES|
ALREADY GRADED A+||CHAMBERLAIN
COLLEGE OF NURSING
Course
NUR 242 MED SURG
1. Question: A patient presents with a distended abdomen and reports the inability to pass gas or
have a bowel movement for the past two days. Which condition is most likely?
Answer: Intestinal obstruction.
Rationale: Intestinal obstruction involves a partial or complete blockage of the bowel,
preventing the passage of contents. Symptoms include abdominal distention, pain, and the
absence of flatus or bowel movements.
2. Question: Which of the following is a common cause of mechanical bowel obstruction?
Answer: Adhesions from previous surgeries.
Rationale: Mechanical obstructions can result from physical barriers like adhesions, hernias, or
tumors. Adhesions, or scar tissues from prior surgeries, are a frequent cause.
3. Question: A patient with a small bowel obstruction is vomiting fecal-like material. What does
this indicate?
Answer: Severe obstruction with potential for reverse peristalsis.
Rationale: In complete small bowel obstruction, intense peristaltic activity can reverse, leading
to the vomiting of intestinal contents, which may appear fecal.
4. Question: What is the priority nursing intervention for a patient with suspected appendicitis?
Answer: Prepare the patient for possible surgery.
Rationale: Appendicitis requires prompt surgical intervention to prevent rupture. Preparing the
patient includes ensuring NPO status and initiating preoperative protocols.
5. Question: Which symptom is most indicative of peritonitis?
Answer: Rebound tenderness.
,Rationale: Peritonitis, inflammation of the peritoneum, often presents with rebound tenderness,
where pain intensifies upon release of pressure on the abdomen.
6. Question: A patient with a history of asthma has a peak expiratory flow (PEF) reading in the
red zone. What is the immediate nursing action?
Answer: Administer rescue inhaler and seek emergency assistance.
Rationale: A red zone PEF indicates severe airway narrowing. Immediate administration of a
bronchodilator and activation of emergency services are crucial.
7. Question: In older adults, which symptom is commonly the first indication of pneumonia?
Answer: Confusion.
Rationale: Elderly patients may not exhibit typical pneumonia symptoms like fever or cough.
Instead, acute confusion or delirium is often the initial sign due to hypoxia.
8. Question: What is the primary purpose of a chest tube following a pneumonectomy?
Answer: To drain air and fluid from the pleural space.
Rationale: Post-pneumonectomy, chest tubes help remove air and fluid, preventing
complications like tension pneumothorax and promoting lung re-expansion.
9. Question: Which laboratory finding is most concerning in a patient with suspected sepsis?
Answer: Elevated lactate levels.
Rationale: Increased lactate indicates tissue hypoperfusion and anaerobic metabolism, common
in sepsis, and necessitates urgent intervention.
10. Question: A patient reports severe, sharp pain in the lower right abdomen that worsens with
movement. Which condition is most likely?
Answer: Appendicitis.
Rationale: Acute appendicitis typically presents with sharp pain in the right lower quadrant,
exacerbated by movement, coughing, or palpation.
11. Question: What is the most common cause of small bowel obstruction?
Answer: Postoperative adhesions.
Rationale: Adhesions from previous abdominal surgeries are the leading cause of small bowel
obstructions, creating bands that constrict the intestines.
,12. Question: Which diagnostic test is most useful for confirming a bowel obstruction?
Answer: Abdominal X-ray.
Rationale: An abdominal X-ray can reveal dilated loops of bowel and air-fluid levels, indicative
of an obstruction.
13. Question: A patient with a large bowel obstruction is at risk for which serious complication?
Answer: Bowel perforation.
Rationale: If untreated, increased pressure from a large bowel obstruction can lead to bowel
wall ischemia and perforation, causing peritonitis.
14. Question: Which electrolyte imbalance is commonly associated with prolonged nasogastric
suctioning?
Answer: Hypokalemia.
Rationale: Prolonged NG suctioning can lead to loss of potassium-rich gastric contents,
resulting in hypokalemia.
15. Question: What is the initial treatment approach for a patient with a partial small bowel
obstruction?
Answer: NPO status and nasogastric decompression.
Rationale: Allowing the bowel to rest (NPO) and decompressing with an NG tube can relieve
symptoms and may resolve a partial obstruction without surgery.
16. Question: Which assessment finding suggests a complication in a patient with a chest tube?
Answer: Continuous bubbling in the water seal chamber.
Rationale: Continuous bubbling indicates an air leak in the system, which requires prompt
evaluation and correction.
17. Question:
A patient with peritonitis is at high risk for which life-threatening condition?
Answer:
Septic shock.
Rationale:
Peritonitis involves inflammation and infection of the peritoneum, which can rapidly progress to
, sepsis. If the body’s response to infection becomes dysregulated, it may lead to septic shock—a
state of systemic hypotension and organ dysfunction that requires immediate intervention.
18. Question:
What is the priority nursing intervention for a patient suspected of developing septic shock?
Answer:
Initiate aggressive IV fluid resuscitation and notify the healthcare provider immediately.
Rationale:
Early fluid resuscitation is critical to restore perfusion and maintain blood pressure in septic
shock. Prompt recognition and notification help ensure that additional interventions (e.g.,
vasopressors and antibiotics) are started as soon as possible.
19. Question:
Which assessment finding most strongly indicates deteriorating respiratory status in a patient
with pneumonia?
Answer:
Increased respiratory rate with use of accessory muscles.
Rationale:
An elevated respiratory rate and the use of accessory muscles signal that the patient is working
harder to breathe, which may indicate respiratory fatigue or impending failure. These are key
indicators that the patient may require supplemental oxygen or advanced airway support.
20. Question:
A patient on mechanical ventilation experiences a sudden drop in oxygen saturation. What is
the nurse’s first action?
Answer:
Assess the airway for patency and check for displacement or obstruction of the endotracheal
tube.
Rationale:
A sudden drop in oxygen saturation can result from tube displacement, kinking, or blockage.
Immediate assessment is essential to restore proper ventilation and prevent further hypoxia.
EXAM 180 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES|
ALREADY GRADED A+||CHAMBERLAIN
COLLEGE OF NURSING
Course
NUR 242 MED SURG
1. Question: A patient presents with a distended abdomen and reports the inability to pass gas or
have a bowel movement for the past two days. Which condition is most likely?
Answer: Intestinal obstruction.
Rationale: Intestinal obstruction involves a partial or complete blockage of the bowel,
preventing the passage of contents. Symptoms include abdominal distention, pain, and the
absence of flatus or bowel movements.
2. Question: Which of the following is a common cause of mechanical bowel obstruction?
Answer: Adhesions from previous surgeries.
Rationale: Mechanical obstructions can result from physical barriers like adhesions, hernias, or
tumors. Adhesions, or scar tissues from prior surgeries, are a frequent cause.
3. Question: A patient with a small bowel obstruction is vomiting fecal-like material. What does
this indicate?
Answer: Severe obstruction with potential for reverse peristalsis.
Rationale: In complete small bowel obstruction, intense peristaltic activity can reverse, leading
to the vomiting of intestinal contents, which may appear fecal.
4. Question: What is the priority nursing intervention for a patient with suspected appendicitis?
Answer: Prepare the patient for possible surgery.
Rationale: Appendicitis requires prompt surgical intervention to prevent rupture. Preparing the
patient includes ensuring NPO status and initiating preoperative protocols.
5. Question: Which symptom is most indicative of peritonitis?
Answer: Rebound tenderness.
,Rationale: Peritonitis, inflammation of the peritoneum, often presents with rebound tenderness,
where pain intensifies upon release of pressure on the abdomen.
6. Question: A patient with a history of asthma has a peak expiratory flow (PEF) reading in the
red zone. What is the immediate nursing action?
Answer: Administer rescue inhaler and seek emergency assistance.
Rationale: A red zone PEF indicates severe airway narrowing. Immediate administration of a
bronchodilator and activation of emergency services are crucial.
7. Question: In older adults, which symptom is commonly the first indication of pneumonia?
Answer: Confusion.
Rationale: Elderly patients may not exhibit typical pneumonia symptoms like fever or cough.
Instead, acute confusion or delirium is often the initial sign due to hypoxia.
8. Question: What is the primary purpose of a chest tube following a pneumonectomy?
Answer: To drain air and fluid from the pleural space.
Rationale: Post-pneumonectomy, chest tubes help remove air and fluid, preventing
complications like tension pneumothorax and promoting lung re-expansion.
9. Question: Which laboratory finding is most concerning in a patient with suspected sepsis?
Answer: Elevated lactate levels.
Rationale: Increased lactate indicates tissue hypoperfusion and anaerobic metabolism, common
in sepsis, and necessitates urgent intervention.
10. Question: A patient reports severe, sharp pain in the lower right abdomen that worsens with
movement. Which condition is most likely?
Answer: Appendicitis.
Rationale: Acute appendicitis typically presents with sharp pain in the right lower quadrant,
exacerbated by movement, coughing, or palpation.
11. Question: What is the most common cause of small bowel obstruction?
Answer: Postoperative adhesions.
Rationale: Adhesions from previous abdominal surgeries are the leading cause of small bowel
obstructions, creating bands that constrict the intestines.
,12. Question: Which diagnostic test is most useful for confirming a bowel obstruction?
Answer: Abdominal X-ray.
Rationale: An abdominal X-ray can reveal dilated loops of bowel and air-fluid levels, indicative
of an obstruction.
13. Question: A patient with a large bowel obstruction is at risk for which serious complication?
Answer: Bowel perforation.
Rationale: If untreated, increased pressure from a large bowel obstruction can lead to bowel
wall ischemia and perforation, causing peritonitis.
14. Question: Which electrolyte imbalance is commonly associated with prolonged nasogastric
suctioning?
Answer: Hypokalemia.
Rationale: Prolonged NG suctioning can lead to loss of potassium-rich gastric contents,
resulting in hypokalemia.
15. Question: What is the initial treatment approach for a patient with a partial small bowel
obstruction?
Answer: NPO status and nasogastric decompression.
Rationale: Allowing the bowel to rest (NPO) and decompressing with an NG tube can relieve
symptoms and may resolve a partial obstruction without surgery.
16. Question: Which assessment finding suggests a complication in a patient with a chest tube?
Answer: Continuous bubbling in the water seal chamber.
Rationale: Continuous bubbling indicates an air leak in the system, which requires prompt
evaluation and correction.
17. Question:
A patient with peritonitis is at high risk for which life-threatening condition?
Answer:
Septic shock.
Rationale:
Peritonitis involves inflammation and infection of the peritoneum, which can rapidly progress to
, sepsis. If the body’s response to infection becomes dysregulated, it may lead to septic shock—a
state of systemic hypotension and organ dysfunction that requires immediate intervention.
18. Question:
What is the priority nursing intervention for a patient suspected of developing septic shock?
Answer:
Initiate aggressive IV fluid resuscitation and notify the healthcare provider immediately.
Rationale:
Early fluid resuscitation is critical to restore perfusion and maintain blood pressure in septic
shock. Prompt recognition and notification help ensure that additional interventions (e.g.,
vasopressors and antibiotics) are started as soon as possible.
19. Question:
Which assessment finding most strongly indicates deteriorating respiratory status in a patient
with pneumonia?
Answer:
Increased respiratory rate with use of accessory muscles.
Rationale:
An elevated respiratory rate and the use of accessory muscles signal that the patient is working
harder to breathe, which may indicate respiratory fatigue or impending failure. These are key
indicators that the patient may require supplemental oxygen or advanced airway support.
20. Question:
A patient on mechanical ventilation experiences a sudden drop in oxygen saturation. What is
the nurse’s first action?
Answer:
Assess the airway for patency and check for displacement or obstruction of the endotracheal
tube.
Rationale:
A sudden drop in oxygen saturation can result from tube displacement, kinking, or blockage.
Immediate assessment is essential to restore proper ventilation and prevent further hypoxia.
