NUR 242 | Exam 3
OBJECTIVE ASSESSMENT - EXAM
NUR 242 Exam 3
(2026/2027) | Med-Surg
Nursing | Galen College
(A+ Guarantee) | PDF
2026/2027
Medical-Surgical Nursing Concepts | Galen College of Nursing
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiogenic ShockGI
Management
Bleeding, Liver Failure & Pancreatitis
COPD, Asthma & Mechanical Ventilation
Acute Kidney Injury & Chronic Kidney Disease
Diabetes Mellitus & DKA/HHS Stroke, Seizures & Increased Intracranial Pressure
COVER PAGE - 1
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 1 of TBD
, 1 SECTION 1 | Cardiovascular System | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guaran
Q1 Question 1 of 75
A 68-year-old male with a history of myocardial infarction presents with sudden onset
dyspnea, frothy pink sputum, and a blood pressure of 92/58 mmHg. Crackles are
audible bilaterally. The nurse recognizes these findings as consistent with acute
cardiogenic shock. Which intervention should the nurse prioritize first?
A. Administer intravenous furosemide 40 mg push.
B. Initiate a dobutamine infusion per protocol.
C. Apply supplemental oxygen via non-rebreather mask at 15 L/min.
D. Insert a Foley catheter to monitor hourly urine output.
Correct Answer: C
Rationale:
In acute cardiogenic shock with pulmonary edema, ensuring adequate oxygenation is the first priority to
prevent hypoxic organ damage. Dobutamine (B) and diuretics (A) are important but come after airway and
oxygenation are secured. Urine output monitoring (D) is a secondary assessment.
Q2 Question 2 of 75
A nurse is caring for a client with heart failure who is prescribed digoxin 0.25 mg daily.
The morning laboratory results reveal a serum potassium level of 2.8 mEq/L. What is
the nurse's most appropriate action before administering the dose?
A. Hold the digoxin and notify the provider about the hypokalemia.
B. Administer the digoxin as prescribed since the level is only mildly low.
C. Give the digoxin and administer a potassium supplement simultaneously.
D. Recheck the potassium level in one hour before making a decision.
Correct Answer: A
Rationale:
Hypokalemia significantly increases the risk of digoxin toxicity because low potassium levels enhance
digoxin binding to the Na+/K+ ATPase pump. The nurse must hold the dose and notify the provider.
Administering digoxin with low potassium (A, C) is unsafe, and delaying notification (D) is inappropriate.
,Q3 Question 3 of 75
A 72-year-old female with chronic heart failure is being discharged home on lisinopril,
metoprolol, and furosemide. Which statement by the client indicates a need for further
teaching?
A. I will weigh myself every morning before breakfast and keep a log.
B. I can eat a banana every day to help replace the potassium I lose.
C. I should call my doctor if I gain more than two pounds in one day.
D. I will take my furosemide at bedtime so I do not have to get up at night.
Correct Answer: D
Rationale:
Furosemide is a loop diuretic that causes frequent urination; taking it at bedtime disrupts sleep and
increases fall risk from nocturia. It should be taken in the morning. Daily weights (A), potassium-rich foods
(B), and weight gain alerts (C) are all correct self-management strategies.
Q4 Question 4 of 75
A client with atrial fibrillation is started on warfarin therapy. The nurse is reviewing
dietary instructions. Which food choice should the nurse counsel the client to keep
intake consistent?
A. Spinach and kale salads.
B. Oranges and orange juice.
C. Chicken breast and turkey.
D. White rice and pasta.
Correct Answer: A
Rationale:
Leafy green vegetables like spinach and kale are high in vitamin K, which antagonizes warfarin's
anticoagulant effect. Consistent intake is essential to maintain a stable INR. Oranges (A), chicken (C), and
rice (D) do not significantly affect warfarin metabolism.
, Q5 Question 5 of 75
A 55-year-old male is admitted with chest pain radiating to the left arm, diaphoresis,
and nausea. His troponin I is elevated at 4.2 ng/mL. The ECG shows ST-segment
elevation in leads V1-V4. Which medication should the nurse anticipate administering
first?
A. Oral metoprolol 25 mg.
B. Sublingual nitroglycerin 0.4 mg.
C. Chewable aspirin 325 mg.
D. Intravenous morphine sulfate 2 mg.
Correct Answer: C
Rationale:
For an ST-elevation myocardial infarction (STEMI), aspirin is given first to inhibit platelet aggregation and
reduce mortality. Nitroglycerin (B) may be given for pain but does not address the clot. Morphine (D) is for
refractory pain, and beta-blockers (A) are given after initial stabilization.
Q6 Question 6 of 75
A client with severe aortic stenosis reports exertional dyspnea, angina, and occasional
syncope. The nurse is preparing the client for a scheduled valve replacement. Which
assessment finding would most concern the nurse in the preoperative period?
A. Blood pressure of 138/84 mmHg.
B. Heart rate of 58 beats per minute.
C. New-onset atrial fibrillation with a rapid ventricular response.
D. Oxygen saturation of 94% on room air.
Correct Answer: C
Rationale:
New-onset atrial fibrillation with rapid ventricular response in aortic stenosis is dangerous because the stiff,
noncompliant left ventricle cannot tolerate sudden changes in preload or rate, potentially causing acute
heart failure or hemodynamic collapse. The other findings are less immediately threatening.
OBJECTIVE ASSESSMENT - EXAM
NUR 242 Exam 3
(2026/2027) | Med-Surg
Nursing | Galen College
(A+ Guarantee) | PDF
2026/2027
Medical-Surgical Nursing Concepts | Galen College of Nursing
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiogenic ShockGI
Management
Bleeding, Liver Failure & Pancreatitis
COPD, Asthma & Mechanical Ventilation
Acute Kidney Injury & Chronic Kidney Disease
Diabetes Mellitus & DKA/HHS Stroke, Seizures & Increased Intracranial Pressure
COVER PAGE - 1
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 1 of TBD
, 1 SECTION 1 | Cardiovascular System | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guaran
Q1 Question 1 of 75
A 68-year-old male with a history of myocardial infarction presents with sudden onset
dyspnea, frothy pink sputum, and a blood pressure of 92/58 mmHg. Crackles are
audible bilaterally. The nurse recognizes these findings as consistent with acute
cardiogenic shock. Which intervention should the nurse prioritize first?
A. Administer intravenous furosemide 40 mg push.
B. Initiate a dobutamine infusion per protocol.
C. Apply supplemental oxygen via non-rebreather mask at 15 L/min.
D. Insert a Foley catheter to monitor hourly urine output.
Correct Answer: C
Rationale:
In acute cardiogenic shock with pulmonary edema, ensuring adequate oxygenation is the first priority to
prevent hypoxic organ damage. Dobutamine (B) and diuretics (A) are important but come after airway and
oxygenation are secured. Urine output monitoring (D) is a secondary assessment.
Q2 Question 2 of 75
A nurse is caring for a client with heart failure who is prescribed digoxin 0.25 mg daily.
The morning laboratory results reveal a serum potassium level of 2.8 mEq/L. What is
the nurse's most appropriate action before administering the dose?
A. Hold the digoxin and notify the provider about the hypokalemia.
B. Administer the digoxin as prescribed since the level is only mildly low.
C. Give the digoxin and administer a potassium supplement simultaneously.
D. Recheck the potassium level in one hour before making a decision.
Correct Answer: A
Rationale:
Hypokalemia significantly increases the risk of digoxin toxicity because low potassium levels enhance
digoxin binding to the Na+/K+ ATPase pump. The nurse must hold the dose and notify the provider.
Administering digoxin with low potassium (A, C) is unsafe, and delaying notification (D) is inappropriate.
,Q3 Question 3 of 75
A 72-year-old female with chronic heart failure is being discharged home on lisinopril,
metoprolol, and furosemide. Which statement by the client indicates a need for further
teaching?
A. I will weigh myself every morning before breakfast and keep a log.
B. I can eat a banana every day to help replace the potassium I lose.
C. I should call my doctor if I gain more than two pounds in one day.
D. I will take my furosemide at bedtime so I do not have to get up at night.
Correct Answer: D
Rationale:
Furosemide is a loop diuretic that causes frequent urination; taking it at bedtime disrupts sleep and
increases fall risk from nocturia. It should be taken in the morning. Daily weights (A), potassium-rich foods
(B), and weight gain alerts (C) are all correct self-management strategies.
Q4 Question 4 of 75
A client with atrial fibrillation is started on warfarin therapy. The nurse is reviewing
dietary instructions. Which food choice should the nurse counsel the client to keep
intake consistent?
A. Spinach and kale salads.
B. Oranges and orange juice.
C. Chicken breast and turkey.
D. White rice and pasta.
Correct Answer: A
Rationale:
Leafy green vegetables like spinach and kale are high in vitamin K, which antagonizes warfarin's
anticoagulant effect. Consistent intake is essential to maintain a stable INR. Oranges (A), chicken (C), and
rice (D) do not significantly affect warfarin metabolism.
, Q5 Question 5 of 75
A 55-year-old male is admitted with chest pain radiating to the left arm, diaphoresis,
and nausea. His troponin I is elevated at 4.2 ng/mL. The ECG shows ST-segment
elevation in leads V1-V4. Which medication should the nurse anticipate administering
first?
A. Oral metoprolol 25 mg.
B. Sublingual nitroglycerin 0.4 mg.
C. Chewable aspirin 325 mg.
D. Intravenous morphine sulfate 2 mg.
Correct Answer: C
Rationale:
For an ST-elevation myocardial infarction (STEMI), aspirin is given first to inhibit platelet aggregation and
reduce mortality. Nitroglycerin (B) may be given for pain but does not address the clot. Morphine (D) is for
refractory pain, and beta-blockers (A) are given after initial stabilization.
Q6 Question 6 of 75
A client with severe aortic stenosis reports exertional dyspnea, angina, and occasional
syncope. The nurse is preparing the client for a scheduled valve replacement. Which
assessment finding would most concern the nurse in the preoperative period?
A. Blood pressure of 138/84 mmHg.
B. Heart rate of 58 beats per minute.
C. New-onset atrial fibrillation with a rapid ventricular response.
D. Oxygen saturation of 94% on room air.
Correct Answer: C
Rationale:
New-onset atrial fibrillation with rapid ventricular response in aortic stenosis is dangerous because the stiff,
noncompliant left ventricle cannot tolerate sudden changes in preload or rate, potentially causing acute
heart failure or hemodynamic collapse. The other findings are less immediately threatening.
