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NUR 242 Medical-Surgical Nursing Exam 2 – 500+ Questions & Answers on Fluid Balance, Electrolytes, Acid-Base Disorders & Nursing Interventions – Galen College of Nursing

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This document provides a comprehensive and in-depth collection of over 500 exam-style questions and verified answers with rationales for NUR 242: Medical-Surgical Nursing Exam 2 at Galen College of Nursing. It focuses on core nursing concepts including fluid balance, electrolyte imbalances, and acid-base disorders, emphasizing clinical assessment and intervention strategies. Based on the full 27-page document , the material is structured in a detailed Q&A format with rationales to enhance clinical reasoning. Early sections (pages 1–4) focus on fluid imbalances, including fluid overload (e.g., caused by heart failure or kidney disease) and dehydration, with detailed signs such as JVD, crackles, hypotension, and lab findings like serum osmolality changes. Mid-sections (pages 7–15) provide extensive coverage of electrolyte disorders including calcium, potassium, magnesium, and sodium imbalances, along with hallmark symptoms (e.g., tetany in hypocalcemia, peaked T waves in hyperkalemia) and ECG changes. The document also outlines targeted nursing interventions such as IV fluid replacement, electrolyte correction, cardiac monitoring, and medication administration (e.g., furosemide, calcium gluconate). Later sections (pages 18–27) expand into acid-base imbalances, including metabolic and respiratory acidosis/alkalosis, with clear breakdowns of causes (e.g., DKA, COPD, vomiting), ABG interpretations (pH, PaCO₂, HCO₃), and nursing management strategies. The guide emphasizes high-yield clinical priorities such as airway management, seizure precautions, and monitoring for life-threatening complications like dysrhythmias and coma. Rationales throughout the document reinforce understanding of “why” behind interventions, making it especially valuable for exam success and real-world patient care. This resource aligns with standard textbooks such as Lewis’s Medical-Surgical Nursing and NCLEX-RN preparation materials. It is particularly valuable for mastering both theoretical knowledge and clinical application required in medical-surgical nursing. This document is highly relevant for courses and programs such as: NUR 242 Medical-Surgical Nursing Nursing (ADN, BSN) Pathophysiology for Nurses Pharmacology for Nursing Clinical Nursing Practice It is especially suitable for: Nursing students preparing for Exam 2 NCLEX-RN candidates Medical-surgical nursing students Healthcare trainees needing electrolyte and fluid balance mastery Keywords: fluid overload nursing, dehydration assessment nursing, electrolyte imbalance calcium potassium sodium magnesium, hyperkalemia ECG peaked T waves, hypokalemia symptoms nursing, hypernatremia hyponatremia causes, ABG interpretation nursing, metabolic acidosis alkalosis, respiratory acidosis alkalosis, serum osmolality nursing, IV fluid replacement nursing, furosemide calcium gluconate nursing, cardiac dysrhythmias electrolyte imbalance, nursing interventions fluid balance

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NUR 242 – MEDICAL-SURGICAL
NURSING EXAM 2 GALEN
COLLEGE OF NURSING
QUESTIONS AND VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST

Causes of fluid overload - 🧠 ANSWER ✔✔•Excessive fluid replacement


•Kidney failure (late phase)

•Heart failure

,•Long term corticosteroid therapy

•Syndrome of inappropriate antidiuretic hormone (SIADH)

•Psychiatric disorders with polydipsia

•Water intoxication


s/s fluid overload - 🧠 ANSWER ✔✔•CV: tachycardia, bounding pulse, HTN,

decrease pulse pressure, JVD, weight gain

•Resp: increase and shallow resp; SOB, crackles lung sounds

•Skin: pitting edema, skin pale and cool to touch

•Neuromuscular: LOC, HA, visual disturbance, muscle weakness,

paresthesia

•GI: increase motility, enlarge liver


Assessment for fluid overload - 🧠 ANSWER ✔✔•Assess risk r/t age and

diagnosis, history (overhydration, CHF, kidney disease)

•Assess vital signs why: watch for bounding tachycardia, HTN,

dysrhythmias, tachypnea

•Assess lung sounds (crackles) , weight, LOC, Observe JVD

•Assess lab values: electrolytes imbalance and signs and symptoms

, • Focus Assessment: skin/extremities/ abdomen and sacrum area for

edema

•Assess perfusion: edema may impair perfusion to extremities, assess

peripheral and central pulses, capillary refill, skin color, temp, sensory and

motor function

•Observe for urine output


Lab values fluid overload - 🧠 ANSWER ✔✔•Serum osmolality (275-295

mOsm/kg)

•Decrease found in overhydration <275; and < 265 is critical finding

•CBC

•Decrease hemoglobin and hematocrit

•BUN

•decreased BUN

•Electrolytes

•Decreased sodium (shifts due to dilution)

•Urine specific gravity Decrease < 1.005




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