NUR 242 – EXAM 3 – MEDICAL-SURGICAL NURSING CONCEPTS – GWaluation College of
Nursing QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Respiratory System Assessment and Management*
*- Cardiovascular System Disorders and Nursing Care*
*- Renal and Urinary System Conditions*
*- Gastrointestinal System Disorders*
*- Endocrine System and Diabetes Management*
*- Fluid, Electrolyte, and Acid-Base Balance*
*- Pain Management and Pharmacology*
*- Preoperative and Postoperative Care*
*- Infection Control and Sepsis Management*
*- Critical Thinking and Clinical Decision-Making*
This comprehensive exam assesses essential knowledge and skills for medical-surgical nursing practice at the
intermediate level. The purpose is to evaluate student competency in caring for adults experiencing acute
health problems across multiple body systems. The assessment includes 200 multiple-choice questions
designed to test both foundational theory and applied professional knowledge.
Questions cover regulatory and legal compliance, ethics and professional standards, with emphasis on real-
world clinical scenarios that require critical thinking and decision-making abilities. The exam structure
includes scenario-based questions that simulate actual nursing practice situations, requiring students to
prioritize care, recognize complications, and implement appropriate interventions.
,This assessment prepares nursing students for NCLEX-RN examination success while building confidence for
clinical practice. Students will demonstrate mastery of the nursing process, interprofessional collaborative
care, and evidence-based practice guidelines essential for safe, quality, patient-centered nursing care.
SECTION ONE: QUESTIONS 1–100
Question 1
The nurse is assessing a patient with COPD who presents with increased dyspnea, productive cough with yellow
sputum, and oxygen saturation of 88% on room air. Which intervention should the nurse prioritize?
A. Administer bronchodilator via nebulizer
B. Obtain sputum culture before antibiotics
C. Apply oxygen via nasal cannula at 2 L/min
D. Encourage deep breathing and coughing exercises
🟢 Correct answer: C
🔴 RATIONALE: In COPD patients, oxygen should be administered cautiously at low flow rates (1-2 L/min) to
maintain target saturation of 88-92% and prevent CO2 retention. This is the priority intervention for
hypoxemia. Bronchodilators and antibiotics are important but addressing hypoxemia comes first.
Question 2
A patient with heart failure presents with 3+ pitting edema, jugular vein distention, and crackles in both lung
fields. Which laboratory value should the nurse monitor most closely?
,A. Serum sodium
B. Serum potassium
C. BUN and creatinine
D. Troponin level
🟢 Correct answer: B
🔴 RATIONALE: Heart failure patients often take diuretics (especially loop diuretics like furosemide) which
cause potassium loss. Hypokalemia can precipitate dangerous cardiac arrhythmias, particularly in patients with
underlying heart disease. Monitoring potassium is critical for patient safety.
Question 3
Which assessment finding in a patient with acute kidney injury requires immediate notification of the
healthcare provider?
A. Urine output of 25 mL/hr
B. Serum potassium of 6.2 mEq/L
C. BUN of 45 mg/dL
D. Serum creatinine of 2.1 mg/dL
🟢 Correct answer: B
🔴 RATIONALE: Hyperkalemia (K+ > 5.0 mEq/L) is a life-threatening complication of AKI that can cause fatal
cardiac arrhythmias. A potassium level of 6.2 mEq/L requires immediate intervention including cardiac
monitoring, calcium gluconate, insulin with glucose, and possibly dialysis.
, Question 4
A patient with suspected pulmonary embolism presents with sudden onset dyspnea, chest pain, and
tachycardia. What is the priority nursing action?
A. Administer anticoagulant therapy
B. Apply oxygen and monitor vital signs
C. Prepare for CT pulmonary angiography
D. Obtain D-dimer laboratory test
🟢 Correct answer: B
🔴 RATIONALE: Oxygen therapy and continuous monitoring are the immediate priorities for a patient with
suspected PE to maintain oxygenation and detect hemodynamic changes. Diagnostic testing and
anticoagulation follow after stabilizing the patient.
Question 5
The nurse is caring for a patient with diabetic ketoacidosis (DKA). Which assessment finding indicates
improvement in the patient's condition?
A. Blood glucose of 250 mg/dL
B. Serum bicarbonate of 18 mEq/L
C. pH of 7.28
D. Positive ketones in urine
🟢 Correct answer: A
Nursing QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*- Respiratory System Assessment and Management*
*- Cardiovascular System Disorders and Nursing Care*
*- Renal and Urinary System Conditions*
*- Gastrointestinal System Disorders*
*- Endocrine System and Diabetes Management*
*- Fluid, Electrolyte, and Acid-Base Balance*
*- Pain Management and Pharmacology*
*- Preoperative and Postoperative Care*
*- Infection Control and Sepsis Management*
*- Critical Thinking and Clinical Decision-Making*
This comprehensive exam assesses essential knowledge and skills for medical-surgical nursing practice at the
intermediate level. The purpose is to evaluate student competency in caring for adults experiencing acute
health problems across multiple body systems. The assessment includes 200 multiple-choice questions
designed to test both foundational theory and applied professional knowledge.
Questions cover regulatory and legal compliance, ethics and professional standards, with emphasis on real-
world clinical scenarios that require critical thinking and decision-making abilities. The exam structure
includes scenario-based questions that simulate actual nursing practice situations, requiring students to
prioritize care, recognize complications, and implement appropriate interventions.
,This assessment prepares nursing students for NCLEX-RN examination success while building confidence for
clinical practice. Students will demonstrate mastery of the nursing process, interprofessional collaborative
care, and evidence-based practice guidelines essential for safe, quality, patient-centered nursing care.
SECTION ONE: QUESTIONS 1–100
Question 1
The nurse is assessing a patient with COPD who presents with increased dyspnea, productive cough with yellow
sputum, and oxygen saturation of 88% on room air. Which intervention should the nurse prioritize?
A. Administer bronchodilator via nebulizer
B. Obtain sputum culture before antibiotics
C. Apply oxygen via nasal cannula at 2 L/min
D. Encourage deep breathing and coughing exercises
🟢 Correct answer: C
🔴 RATIONALE: In COPD patients, oxygen should be administered cautiously at low flow rates (1-2 L/min) to
maintain target saturation of 88-92% and prevent CO2 retention. This is the priority intervention for
hypoxemia. Bronchodilators and antibiotics are important but addressing hypoxemia comes first.
Question 2
A patient with heart failure presents with 3+ pitting edema, jugular vein distention, and crackles in both lung
fields. Which laboratory value should the nurse monitor most closely?
,A. Serum sodium
B. Serum potassium
C. BUN and creatinine
D. Troponin level
🟢 Correct answer: B
🔴 RATIONALE: Heart failure patients often take diuretics (especially loop diuretics like furosemide) which
cause potassium loss. Hypokalemia can precipitate dangerous cardiac arrhythmias, particularly in patients with
underlying heart disease. Monitoring potassium is critical for patient safety.
Question 3
Which assessment finding in a patient with acute kidney injury requires immediate notification of the
healthcare provider?
A. Urine output of 25 mL/hr
B. Serum potassium of 6.2 mEq/L
C. BUN of 45 mg/dL
D. Serum creatinine of 2.1 mg/dL
🟢 Correct answer: B
🔴 RATIONALE: Hyperkalemia (K+ > 5.0 mEq/L) is a life-threatening complication of AKI that can cause fatal
cardiac arrhythmias. A potassium level of 6.2 mEq/L requires immediate intervention including cardiac
monitoring, calcium gluconate, insulin with glucose, and possibly dialysis.
, Question 4
A patient with suspected pulmonary embolism presents with sudden onset dyspnea, chest pain, and
tachycardia. What is the priority nursing action?
A. Administer anticoagulant therapy
B. Apply oxygen and monitor vital signs
C. Prepare for CT pulmonary angiography
D. Obtain D-dimer laboratory test
🟢 Correct answer: B
🔴 RATIONALE: Oxygen therapy and continuous monitoring are the immediate priorities for a patient with
suspected PE to maintain oxygenation and detect hemodynamic changes. Diagnostic testing and
anticoagulation follow after stabilizing the patient.
Question 5
The nurse is caring for a patient with diabetic ketoacidosis (DKA). Which assessment finding indicates
improvement in the patient's condition?
A. Blood glucose of 250 mg/dL
B. Serum bicarbonate of 18 mEq/L
C. pH of 7.28
D. Positive ketones in urine
🟢 Correct answer: A
