,Galen College NUR 242 Exam 2 (pdf) | 2026/2027 | Med-Surg Q&A |
Medical-Surgical Nursing
**1. What are the two most common causes of fluid overload in hospitalized
patients?**
A) Excessive fluid replacement and kidney failure
B) Heart failure and cirrhosis
C) SIADH and psychogenic polydipsia
D) Long-term corticosteroid use and water intoxication
**Correct Answer:** Excessive fluid replacement and kidney failure
**Rationale:** In the hospital setting, fluid overload most often results from
overaggressive IV fluid replacement and the inability of failing kidneys to
excrete excess fluid. While heart failure, SIADH, and medications can
contribute, the most frequently cited causes in exam materials are excessive
fluid replacement and kidney failure.
---
**2. A nurse assesses a patient with fluid overload. Which lung sound is
expected?**
A) Stridor
B) Wheezes
C) Crackles (rales)
D) Rhonchi
**Correct Answer:** Crackles (rales)
,**Rationale:** Crackles are characteristic of pulmonary congestion caused by
fluid accumulation in the interstitial and alveolar spaces. This finding is
frequently tested as a key sign of fluid overload. Other lung sounds are
associated with different pathologies.
---
**3. Which cardiovascular finding is consistent with fluid overload?**
A) Thready, weak pulse
B) Narrowed pulse pressure
C) Bounding pulse and jugular vein distension (JVD)
D) Hypotension
**Correct Answer:** Bounding pulse and jugular vein distension (JVD)
**Rationale:** Fluid overload increases venous pressure, causing JVD, and
increases stroke volume, leading to a bounding pulse. These are hallmark
cardiovascular signs that distinguish fluid overload from dehydration. Other
findings such as narrowed pulse pressure and hypotension are not
consistent.
---
**4. A patient has a serum sodium level of 128 mEq/L. Which assessment
finding is most consistent with this laboratory value?**
A) Thirst and dry mucous membranes
B) Hyperactive bowel sounds
C) Confusion and headache
D) Oliguria
, **Correct Answer:** Confusion and headache
**Rationale:** Hyponatremia causes cerebral edema as water shifts into
brain cells, leading to neurological symptoms such as confusion, headache,
and, if severe, seizures. Thirst is associated with hypernatremia, while
gastrointestinal changes are non-specific.
---
**5. A patient is diagnosed with hypokalemia. Which ECG change should the
nurse anticipate?**
A) Peaked T waves
B) Prolonged PR interval
C) Presence of a U wave
D) Widened QRS complex
**Correct Answer:** Presence of a U wave
**Rationale:** A prominent U wave is a classic ECG finding in hypokalemia.
Other hypokalemic changes include ST depression and flattened T waves.
Peaked T waves and widened QRS are seen in hyperkalemia.
---
**6. Which condition is most likely to cause metabolic acidosis?**
A) Severe diarrhea
B) Gastric suctioning
C) Chronic vomiting
Medical-Surgical Nursing
**1. What are the two most common causes of fluid overload in hospitalized
patients?**
A) Excessive fluid replacement and kidney failure
B) Heart failure and cirrhosis
C) SIADH and psychogenic polydipsia
D) Long-term corticosteroid use and water intoxication
**Correct Answer:** Excessive fluid replacement and kidney failure
**Rationale:** In the hospital setting, fluid overload most often results from
overaggressive IV fluid replacement and the inability of failing kidneys to
excrete excess fluid. While heart failure, SIADH, and medications can
contribute, the most frequently cited causes in exam materials are excessive
fluid replacement and kidney failure.
---
**2. A nurse assesses a patient with fluid overload. Which lung sound is
expected?**
A) Stridor
B) Wheezes
C) Crackles (rales)
D) Rhonchi
**Correct Answer:** Crackles (rales)
,**Rationale:** Crackles are characteristic of pulmonary congestion caused by
fluid accumulation in the interstitial and alveolar spaces. This finding is
frequently tested as a key sign of fluid overload. Other lung sounds are
associated with different pathologies.
---
**3. Which cardiovascular finding is consistent with fluid overload?**
A) Thready, weak pulse
B) Narrowed pulse pressure
C) Bounding pulse and jugular vein distension (JVD)
D) Hypotension
**Correct Answer:** Bounding pulse and jugular vein distension (JVD)
**Rationale:** Fluid overload increases venous pressure, causing JVD, and
increases stroke volume, leading to a bounding pulse. These are hallmark
cardiovascular signs that distinguish fluid overload from dehydration. Other
findings such as narrowed pulse pressure and hypotension are not
consistent.
---
**4. A patient has a serum sodium level of 128 mEq/L. Which assessment
finding is most consistent with this laboratory value?**
A) Thirst and dry mucous membranes
B) Hyperactive bowel sounds
C) Confusion and headache
D) Oliguria
, **Correct Answer:** Confusion and headache
**Rationale:** Hyponatremia causes cerebral edema as water shifts into
brain cells, leading to neurological symptoms such as confusion, headache,
and, if severe, seizures. Thirst is associated with hypernatremia, while
gastrointestinal changes are non-specific.
---
**5. A patient is diagnosed with hypokalemia. Which ECG change should the
nurse anticipate?**
A) Peaked T waves
B) Prolonged PR interval
C) Presence of a U wave
D) Widened QRS complex
**Correct Answer:** Presence of a U wave
**Rationale:** A prominent U wave is a classic ECG finding in hypokalemia.
Other hypokalemic changes include ST depression and flattened T waves.
Peaked T waves and widened QRS are seen in hyperkalemia.
---
**6. Which condition is most likely to cause metabolic acidosis?**
A) Severe diarrhea
B) Gastric suctioning
C) Chronic vomiting
