NUR242 MED SURG EXAM 3 | QUESTIONS AND VERIFIED
ANSWERS GRADED A+ | 100% CORRECT | 2026/2027
Medical-Surgical Nursing III | Key Domains: Neurological Disorders, Sensory Disorders (Eye/Ear),
Endocrine Disorders, Musculoskeletal Disorders, Integumentary Disorders (Burns, Wounds), and
Multisystem Disorders (Shock, Sepsis) | Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured NUR242 Medical-Surgical Exam 3 for 2026/2027 provides a focused set of
high-quality exam-style questions with correct answers and rationales. It emphasizes the nursing
management of complex neurological, endocrine, musculoskeletal, and integumentary conditions,
as well as the recognition and intervention for life-threatening multisystem failures, integrating
advanced assessment and critical thinking skills.
Exam Structure:
• Exam 3: (70 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the specific neurological assessment finding, the pathophysiological basis for an
endocrine imbalance, the priority nursing intervention for a burn or shock patient, and why
alternative options are incorrect, contraindicated, or represent a lower priority in patient care.
Domain 1: Neurological Disorders
1. A client who had a stroke 2 days ago has right-sided hemiparesis and difficulty swallowing.
What is the priority nursing action?
A. Elevate the head of the bed during meals
B. Request a speech-language pathology evaluation
C. Initiate range-of-motion exercises
D. Monitor blood pressure every 4 hours
,B. Request a speech-language pathology evaluation
Dysphagia is common after stroke and increases the risk of aspiration pneumonia. The priority is to
assess swallowing safety before any oral intake. While elevating the HOB (A) is supportive, it should
not be done until after a formal swallow evaluation. ROM (C) and BP monitoring (D) are important but
not the immediate priority.
2. A client with increased intracranial pressure (ICP) has a blood pressure of 170/60 mm Hg
and a heart rate of 50 bpm. What is this called?
A. Beck’s triad
B. Cushing’s triad
C. Virchow’s triad
D. Charcot’s triad
B. Cushing’s triad
Cushing’s triad—hypertension with widened pulse pressure, bradycardia, and irregular
respirations—is a late sign of increased ICP indicating brainstem herniation. Beck’s triad (A) is for
cardiac tamponade. Virchow’s triad (C) relates to DVT. Charcot’s triad (D) is for cholangitis.
3. A client with myasthenia gravis develops sudden respiratory distress, weak cough, and
falling vital capacity. What is the priority action?
A. Administer pyridostigmine
B. Prepare for intubation and mechanical ventilation
C. Give IV immunoglobulin
D. Perform plasmapheresis
B. Prepare for intubation and mechanical ventilation
,These signs indicate myasthenic crisis with impending respiratory failure. Airway protection and
ventilation are immediate priorities. Pyridostigmine (A) may worsen secretions and is not sufficient in
crisis. IVIG (C) and plasmapheresis (D) are long-term treatments, not acute airway interventions.
Domain 2: Sensory Disorders (Eye/Ear)
4. A client with acute angle-closure glaucoma reports severe eye pain, blurred vision, and
nausea. What is the priority intervention?
A. Administer a mydriatic eye drop
B. Provide a dark, quiet room
C. Administer acetazolamide IV
D. Encourage fluid intake
C. Administer acetazolamide IV
Acute angle-closure glaucoma is an emergency caused by blocked aqueous humor drainage, leading to
rapid intraocular pressure (IOP) rise. Acetazolamide (a carbonic anhydrase inhibitor) reduces IOP
quickly. Mydriatics (A) worsen it by dilating the pupil. A dark room (B) may help comfort but doesn’t
lower IOP. Fluids (D) can increase IOP.
5. After cataract surgery, the nurse should instruct the client to avoid:
A. Wearing an eye shield at night
B. Bending over to tie shoes
C. Using prescribed eye drops
D. Sleeping on the unaffected side
B. Bending over to tie shoes
Bending increases intraocular pressure and risk of hemorrhage or lens dislocation. The eye shield (A)
protects from accidental rubbing. Eye drops (C) prevent infection and inflammation. Sleeping on the
unaffected side (D) avoids pressure on the surgical eye.
, 6. A client with Ménière’s disease is experiencing vertigo. What is the best nursing
intervention?
A. Encourage ambulation to improve balance
B. Provide a low-sodium diet
C. Assist with slow head movements and ensure bed rest
D. Administer meclizine only during severe attacks
C. Assist with slow head movements and ensure bed rest
During acute vertigo, bed rest and minimizing head movement reduce symptom severity and fall risk.
Ambulation (A) is unsafe during vertigo. Low-sodium diet (B) is long-term management to reduce
endolymphatic pressure. Meclizine (D) is often used prophylactically, not just during attacks.
Domain 3: Endocrine Disorders
7. A client with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious but shaky.
What is the priority nursing action?
A. Administer glucagon IM
B. Give 15 grams of fast-acting carbohydrate
C. Check urine for ketones
D. Infuse D50W IV
B. Give 15 grams of fast-acting carbohydrate
For a conscious hypoglycemic patient, the priority is oral fast-acting carbs (e.g., 4 oz juice, glucose
tablets). Glucagon (A) and D50W (D) are for unconscious patients. Ketones (C) are checked in
hyperglycemia, not hypoglycemia.
8. A client with Graves’ disease is started on methimazole. What is the most important
teaching point?
ANSWERS GRADED A+ | 100% CORRECT | 2026/2027
Medical-Surgical Nursing III | Key Domains: Neurological Disorders, Sensory Disorders (Eye/Ear),
Endocrine Disorders, Musculoskeletal Disorders, Integumentary Disorders (Burns, Wounds), and
Multisystem Disorders (Shock, Sepsis) | Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured NUR242 Medical-Surgical Exam 3 for 2026/2027 provides a focused set of
high-quality exam-style questions with correct answers and rationales. It emphasizes the nursing
management of complex neurological, endocrine, musculoskeletal, and integumentary conditions,
as well as the recognition and intervention for life-threatening multisystem failures, integrating
advanced assessment and critical thinking skills.
Exam Structure:
• Exam 3: (70 QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the specific neurological assessment finding, the pathophysiological basis for an
endocrine imbalance, the priority nursing intervention for a burn or shock patient, and why
alternative options are incorrect, contraindicated, or represent a lower priority in patient care.
Domain 1: Neurological Disorders
1. A client who had a stroke 2 days ago has right-sided hemiparesis and difficulty swallowing.
What is the priority nursing action?
A. Elevate the head of the bed during meals
B. Request a speech-language pathology evaluation
C. Initiate range-of-motion exercises
D. Monitor blood pressure every 4 hours
,B. Request a speech-language pathology evaluation
Dysphagia is common after stroke and increases the risk of aspiration pneumonia. The priority is to
assess swallowing safety before any oral intake. While elevating the HOB (A) is supportive, it should
not be done until after a formal swallow evaluation. ROM (C) and BP monitoring (D) are important but
not the immediate priority.
2. A client with increased intracranial pressure (ICP) has a blood pressure of 170/60 mm Hg
and a heart rate of 50 bpm. What is this called?
A. Beck’s triad
B. Cushing’s triad
C. Virchow’s triad
D. Charcot’s triad
B. Cushing’s triad
Cushing’s triad—hypertension with widened pulse pressure, bradycardia, and irregular
respirations—is a late sign of increased ICP indicating brainstem herniation. Beck’s triad (A) is for
cardiac tamponade. Virchow’s triad (C) relates to DVT. Charcot’s triad (D) is for cholangitis.
3. A client with myasthenia gravis develops sudden respiratory distress, weak cough, and
falling vital capacity. What is the priority action?
A. Administer pyridostigmine
B. Prepare for intubation and mechanical ventilation
C. Give IV immunoglobulin
D. Perform plasmapheresis
B. Prepare for intubation and mechanical ventilation
,These signs indicate myasthenic crisis with impending respiratory failure. Airway protection and
ventilation are immediate priorities. Pyridostigmine (A) may worsen secretions and is not sufficient in
crisis. IVIG (C) and plasmapheresis (D) are long-term treatments, not acute airway interventions.
Domain 2: Sensory Disorders (Eye/Ear)
4. A client with acute angle-closure glaucoma reports severe eye pain, blurred vision, and
nausea. What is the priority intervention?
A. Administer a mydriatic eye drop
B. Provide a dark, quiet room
C. Administer acetazolamide IV
D. Encourage fluid intake
C. Administer acetazolamide IV
Acute angle-closure glaucoma is an emergency caused by blocked aqueous humor drainage, leading to
rapid intraocular pressure (IOP) rise. Acetazolamide (a carbonic anhydrase inhibitor) reduces IOP
quickly. Mydriatics (A) worsen it by dilating the pupil. A dark room (B) may help comfort but doesn’t
lower IOP. Fluids (D) can increase IOP.
5. After cataract surgery, the nurse should instruct the client to avoid:
A. Wearing an eye shield at night
B. Bending over to tie shoes
C. Using prescribed eye drops
D. Sleeping on the unaffected side
B. Bending over to tie shoes
Bending increases intraocular pressure and risk of hemorrhage or lens dislocation. The eye shield (A)
protects from accidental rubbing. Eye drops (C) prevent infection and inflammation. Sleeping on the
unaffected side (D) avoids pressure on the surgical eye.
, 6. A client with Ménière’s disease is experiencing vertigo. What is the best nursing
intervention?
A. Encourage ambulation to improve balance
B. Provide a low-sodium diet
C. Assist with slow head movements and ensure bed rest
D. Administer meclizine only during severe attacks
C. Assist with slow head movements and ensure bed rest
During acute vertigo, bed rest and minimizing head movement reduce symptom severity and fall risk.
Ambulation (A) is unsafe during vertigo. Low-sodium diet (B) is long-term management to reduce
endolymphatic pressure. Meclizine (D) is often used prophylactically, not just during attacks.
Domain 3: Endocrine Disorders
7. A client with type 1 diabetes has a blood glucose of 52 mg/dL and is conscious but shaky.
What is the priority nursing action?
A. Administer glucagon IM
B. Give 15 grams of fast-acting carbohydrate
C. Check urine for ketones
D. Infuse D50W IV
B. Give 15 grams of fast-acting carbohydrate
For a conscious hypoglycemic patient, the priority is oral fast-acting carbs (e.g., 4 oz juice, glucose
tablets). Glucagon (A) and D50W (D) are for unconscious patients. Ketones (C) are checked in
hyperglycemia, not hypoglycemia.
8. A client with Graves’ disease is started on methimazole. What is the most important
teaching point?
