NUR242 / NUR 242 Exam 3 (Latest 2026)
Medical-Surgical Nursing Concepts | 100+
Questions with Verified Answers & Rationales
| A+ Guaranteed - Galen
Section 1: Cardiovascular Disorders
Q1: The nurse's physical assessment of a client with heart failure reveals tachypnea and
bilateral crackles. Which is the priority nursing intervention?
A) Administer digoxin as prescribed
B) Place client in a high-Fowler position
C) Notify the provider immediately
D) Apply oxygen at 2 L/min via nasal cannula
A: B) Place client in a high-Fowler position.
Rationale: Placing the client in high-Fowler's position uses gravity to reduce venous return
(preload) and promote lung expansion. This is the immediate priority action to improve
breathing.
Q2: When caring for a client with a diagnosis of right ventricular heart failure, the nurse
expects which assessment findings? (Select all that apply.)
A) Dependent edema
B) Crackles in lung bases
C) Swollen hands and fingers
D) Right upper quadrant discomfort
E) Paroxysmal nocturnal dyspnea
,A: A, C, D
Rationale: Right-sided heart failure causes systemic congestion leading to dependent
edema, swollen extremities, and hepatomegaly (right upper quadrant discomfort). Crackles
and PND are signs of left-sided failure.
Q3: A client with left ventricular heart failure and supraventricular tachycardia is prescribed
digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is
therapeutically effective? (Select all that apply.)
A) Decreased heart rate
B) Increased cardiac output
C) Decreased dyspnea
D) Increased urine output
E) Widened pulse pressure
A: A, B, C, D
Rationale: Digoxin has positive inotropic effects (increases cardiac output) and negative
chronotropic effects (decreases heart rate). Effective treatment leads to improved perfusion,
decreased dyspnea, and increased urine output.
Q4: An older client with a history of congestive heart failure expresses concern about
potential exposure to tuberculosis from a roommate who coughs and sometimes spits up
blood. Which is the primary reason the nurse pursues more information about the
roommate?
A) The client is immunocompromised
B) TB adversely affects older adults with chronic illness
,C) The roommate is exhibiting signs of active TB
D) The client's heart failure increases TB risk
A: B) TB adversely affects older adults with chronic illness
Rationale: Older adults with chronic illnesses are particularly vulnerable to TB and have
higher morbidity.
Q5: Which action would the nurse take first when a client with heart failure has an episode
of paroxysmal nocturnal dyspnea (PND)?
A) Administer oxygen
B) Notify the provider
C) Assist the client to sit on the edge of the bed
D) Check vital signs
A: C) Assist the client to sit on the edge of the bed
Rationale: PND is caused by fluid redistribution when lying flat. Sitting the patient up uses
gravity to reduce venous return and pulmonary congestion as the first priority.
Q6: An infant with a diagnosis of heart failure is being given furosemide twice daily. Which
laboratory value would the nurse report to the health care provider?
A) Sodium 140 mEq/L
B) Potassium 3.0 mEq/L
C) Calcium 9.5 mg/dL
D) Glucose 110 mg/dL
, A: B) Potassium 3.0 mEq/L
Rationale: Potassium of 3.0 mEq/L indicates hypokalemia, a common side effect of
furosemide. This is especially concerning in infants and requires provider notification.
Section 2: Respiratory Disorders
Q7: A patient with a history of COPD is admitted with shortness of breath. Which nursing
intervention is most appropriate?
A) Do not administer oxygen
B) Administer oxygen via Venturi mask
C) Use nasal cannula to administer high flow oxygen
D) Administer oxygen at 6L per simple face mask
A: B) Administer oxygen via Venturi mask.
Rationale: Oxygen therapy is prescribed at the lowest liter flow needed to manage
hypoxemia. A Venturi mask delivers precise oxygen levels. Use caution when giving oxygen
to patients with COPD and CO₂ retention.
Q8: While suctioning a patient, vagal stimulation occurs. What is the appropriate nursing
action?
A) Instruct the patient to cough
B) Place the patient in a high Fowler's position
C) Oxygenate the patient with 100% oxygen
D) Instruct the patient to breathe slowly and deeply
A: C) Oxygenate the patient with 100% oxygen.
Rationale: Vagal stimulation may occur during suctioning and result in severe bradycardia,
Medical-Surgical Nursing Concepts | 100+
Questions with Verified Answers & Rationales
| A+ Guaranteed - Galen
Section 1: Cardiovascular Disorders
Q1: The nurse's physical assessment of a client with heart failure reveals tachypnea and
bilateral crackles. Which is the priority nursing intervention?
A) Administer digoxin as prescribed
B) Place client in a high-Fowler position
C) Notify the provider immediately
D) Apply oxygen at 2 L/min via nasal cannula
A: B) Place client in a high-Fowler position.
Rationale: Placing the client in high-Fowler's position uses gravity to reduce venous return
(preload) and promote lung expansion. This is the immediate priority action to improve
breathing.
Q2: When caring for a client with a diagnosis of right ventricular heart failure, the nurse
expects which assessment findings? (Select all that apply.)
A) Dependent edema
B) Crackles in lung bases
C) Swollen hands and fingers
D) Right upper quadrant discomfort
E) Paroxysmal nocturnal dyspnea
,A: A, C, D
Rationale: Right-sided heart failure causes systemic congestion leading to dependent
edema, swollen extremities, and hepatomegaly (right upper quadrant discomfort). Crackles
and PND are signs of left-sided failure.
Q3: A client with left ventricular heart failure and supraventricular tachycardia is prescribed
digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is
therapeutically effective? (Select all that apply.)
A) Decreased heart rate
B) Increased cardiac output
C) Decreased dyspnea
D) Increased urine output
E) Widened pulse pressure
A: A, B, C, D
Rationale: Digoxin has positive inotropic effects (increases cardiac output) and negative
chronotropic effects (decreases heart rate). Effective treatment leads to improved perfusion,
decreased dyspnea, and increased urine output.
Q4: An older client with a history of congestive heart failure expresses concern about
potential exposure to tuberculosis from a roommate who coughs and sometimes spits up
blood. Which is the primary reason the nurse pursues more information about the
roommate?
A) The client is immunocompromised
B) TB adversely affects older adults with chronic illness
,C) The roommate is exhibiting signs of active TB
D) The client's heart failure increases TB risk
A: B) TB adversely affects older adults with chronic illness
Rationale: Older adults with chronic illnesses are particularly vulnerable to TB and have
higher morbidity.
Q5: Which action would the nurse take first when a client with heart failure has an episode
of paroxysmal nocturnal dyspnea (PND)?
A) Administer oxygen
B) Notify the provider
C) Assist the client to sit on the edge of the bed
D) Check vital signs
A: C) Assist the client to sit on the edge of the bed
Rationale: PND is caused by fluid redistribution when lying flat. Sitting the patient up uses
gravity to reduce venous return and pulmonary congestion as the first priority.
Q6: An infant with a diagnosis of heart failure is being given furosemide twice daily. Which
laboratory value would the nurse report to the health care provider?
A) Sodium 140 mEq/L
B) Potassium 3.0 mEq/L
C) Calcium 9.5 mg/dL
D) Glucose 110 mg/dL
, A: B) Potassium 3.0 mEq/L
Rationale: Potassium of 3.0 mEq/L indicates hypokalemia, a common side effect of
furosemide. This is especially concerning in infants and requires provider notification.
Section 2: Respiratory Disorders
Q7: A patient with a history of COPD is admitted with shortness of breath. Which nursing
intervention is most appropriate?
A) Do not administer oxygen
B) Administer oxygen via Venturi mask
C) Use nasal cannula to administer high flow oxygen
D) Administer oxygen at 6L per simple face mask
A: B) Administer oxygen via Venturi mask.
Rationale: Oxygen therapy is prescribed at the lowest liter flow needed to manage
hypoxemia. A Venturi mask delivers precise oxygen levels. Use caution when giving oxygen
to patients with COPD and CO₂ retention.
Q8: While suctioning a patient, vagal stimulation occurs. What is the appropriate nursing
action?
A) Instruct the patient to cough
B) Place the patient in a high Fowler's position
C) Oxygenate the patient with 100% oxygen
D) Instruct the patient to breathe slowly and deeply
A: C) Oxygenate the patient with 100% oxygen.
Rationale: Vagal stimulation may occur during suctioning and result in severe bradycardia,
