Galen NUR 242 / NUR 242 Exam 4 Med-
Surg (Latest ): Most
Comprehensive Qs & Ans - to Pass
the Exam, 100% Verified
QUESTION 1
A patient with heart failure has crackles in all lung fields, jugular venous
distention, and 3+ pitting edema. Which medication should the nurse expect
to administer first?
A) Digoxin
B) Furosemide
C) Enalapril
D) Carvedilol
Correct ,,,,answer,,,,: B) Furosemide
Rationale: Furosemide is a loop diuretic that reduces preload by promoting
diuresis, relieving pulmonary congestion and edema. It is first-line for acute
decompensated heart failure with fluid overload symptoms .
QUESTION 2
Which of the following is the most common early sign of increased
intracranial pressure (ICP)?
,A) Cushing's triad
B) Decerebrate posturing
C) A change in level of consciousness (LOC)
D) Fixed and dilated pupils
Correct ,,,,answer,,,,: C) A change in level of consciousness (LOC)
Rationale: A change in LOC, such as restlessness, confusion, or drowsiness, is the
earliest and most sensitive indicator of rising ICP. Pupillary changes, motor
abnormalities, and Cushing's triad are late findings indicating brainstem
compression .
QUESTION 3
What is the priority nursing intervention for an adult patient with a Glasgow
Coma Scale (GCS) score of 8?
A) Continue routine neurological assessments every 4 hours
B) Prepare for endotracheal intubation and mechanical ventilation
C) Administer prescribed pain medication
D) Elevate the head of the bed to 90 degrees
Correct ,,,,answer,,,,: B) Prepare for endotracheal intubation and mechanical
ventilation
Rationale: A GCS score of 8 or less indicates severe brain injury with inability to
protect the airway. Intubation is required to secure the airway and control
ventilation, particularly to manage PaCO₂ levels which affect cerebral blood flow
and ICP .
,QUESTION 4
A patient with chronic kidney disease (CKD) has a serum potassium level of
6.2 mEq/L. Which ECG change should the nurse expect?
A) U waves
B) Peaked T waves
C) ST segment depression
D) Prolonged PR interval
Correct ,,,,answer,,,,: B) Peaked T waves
Rationale: Hyperkalemia (K+ >5.5 mEq/L) causes tall, peaked T waves on ECG.
U waves are seen in hypokalemia. Peaked T waves are the classic early sign of
hyperkalemia .
QUESTION 5
A patient with chronic kidney disease (CKD) has a serum potassium level of
6.2 mEq/L. What is the priority nursing action?
A) Administer potassium supplements
B) Encourage high-potassium foods
C) Place the patient on a cardiac monitor
D) Restrict fluids only
Correct ,,,,answer,,,,: C) Place the patient on a cardiac monitor
, Rationale: A serum potassium of 6.2 mEq/L indicates hyperkalemia, which can
lead to life-threatening cardiac arrhythmias including peaked T waves, widened
QRS, and asystole. Continuous cardiac monitoring is the priority to detect
dangerous rhythms immediately .
QUESTION 6
A client with atrial fibrillation is prescribed warfarin. Which laboratory test
should the nurse monitor to evaluate therapeutic effect?
A) aPTT (activated partial thromboplastin time)
B) INR (International Normalized Ratio)
C) Platelet count
D) Bleeding time
Correct ,,,,answer,,,,: B) INR (International Normalized Ratio)
Rationale: Warfarin is an anticoagulant affecting vitamin K-dependent clotting
factors. Anticoagulation therapy with warfarin is monitored by INR. For atrial
fibrillation, the therapeutic INR goal is 2.0 to 3.0 .
QUESTION 7
A patient on a cardiac monitor shows ST-segment elevation in leads V1-V4.
Which coronary artery is most likely occluded?
A) Left circumflex artery
B) Right coronary artery (RCA)
Surg (Latest ): Most
Comprehensive Qs & Ans - to Pass
the Exam, 100% Verified
QUESTION 1
A patient with heart failure has crackles in all lung fields, jugular venous
distention, and 3+ pitting edema. Which medication should the nurse expect
to administer first?
A) Digoxin
B) Furosemide
C) Enalapril
D) Carvedilol
Correct ,,,,answer,,,,: B) Furosemide
Rationale: Furosemide is a loop diuretic that reduces preload by promoting
diuresis, relieving pulmonary congestion and edema. It is first-line for acute
decompensated heart failure with fluid overload symptoms .
QUESTION 2
Which of the following is the most common early sign of increased
intracranial pressure (ICP)?
,A) Cushing's triad
B) Decerebrate posturing
C) A change in level of consciousness (LOC)
D) Fixed and dilated pupils
Correct ,,,,answer,,,,: C) A change in level of consciousness (LOC)
Rationale: A change in LOC, such as restlessness, confusion, or drowsiness, is the
earliest and most sensitive indicator of rising ICP. Pupillary changes, motor
abnormalities, and Cushing's triad are late findings indicating brainstem
compression .
QUESTION 3
What is the priority nursing intervention for an adult patient with a Glasgow
Coma Scale (GCS) score of 8?
A) Continue routine neurological assessments every 4 hours
B) Prepare for endotracheal intubation and mechanical ventilation
C) Administer prescribed pain medication
D) Elevate the head of the bed to 90 degrees
Correct ,,,,answer,,,,: B) Prepare for endotracheal intubation and mechanical
ventilation
Rationale: A GCS score of 8 or less indicates severe brain injury with inability to
protect the airway. Intubation is required to secure the airway and control
ventilation, particularly to manage PaCO₂ levels which affect cerebral blood flow
and ICP .
,QUESTION 4
A patient with chronic kidney disease (CKD) has a serum potassium level of
6.2 mEq/L. Which ECG change should the nurse expect?
A) U waves
B) Peaked T waves
C) ST segment depression
D) Prolonged PR interval
Correct ,,,,answer,,,,: B) Peaked T waves
Rationale: Hyperkalemia (K+ >5.5 mEq/L) causes tall, peaked T waves on ECG.
U waves are seen in hypokalemia. Peaked T waves are the classic early sign of
hyperkalemia .
QUESTION 5
A patient with chronic kidney disease (CKD) has a serum potassium level of
6.2 mEq/L. What is the priority nursing action?
A) Administer potassium supplements
B) Encourage high-potassium foods
C) Place the patient on a cardiac monitor
D) Restrict fluids only
Correct ,,,,answer,,,,: C) Place the patient on a cardiac monitor
, Rationale: A serum potassium of 6.2 mEq/L indicates hyperkalemia, which can
lead to life-threatening cardiac arrhythmias including peaked T waves, widened
QRS, and asystole. Continuous cardiac monitoring is the priority to detect
dangerous rhythms immediately .
QUESTION 6
A client with atrial fibrillation is prescribed warfarin. Which laboratory test
should the nurse monitor to evaluate therapeutic effect?
A) aPTT (activated partial thromboplastin time)
B) INR (International Normalized Ratio)
C) Platelet count
D) Bleeding time
Correct ,,,,answer,,,,: B) INR (International Normalized Ratio)
Rationale: Warfarin is an anticoagulant affecting vitamin K-dependent clotting
factors. Anticoagulation therapy with warfarin is monitored by INR. For atrial
fibrillation, the therapeutic INR goal is 2.0 to 3.0 .
QUESTION 7
A patient on a cardiac monitor shows ST-segment elevation in leads V1-V4.
Which coronary artery is most likely occluded?
A) Left circumflex artery
B) Right coronary artery (RCA)
