GALEN NUR 242 EXAM 3 - ADVANCED
MED-SURG MASTERY QUESTIONS AND
ANSWERS
1. A patient with a history of heart failure is admitted with acute pulmonary edema. Which
medication should the nurse expect to administer first to decrease preload?
A. Metoprolol
B. Spironolactone
C. Digoxin
D. Furosemide
Answer: D
Conceptual Explanation: Loop diuretics like Furosemide are the first-line treatment in
acute pulmonary edema to rapidly decrease preload by increasing venous capacitance and
inducing diuresis.
2. A patient’s EKG shows a saw-tooth pattern with a ventricular rate of 80 bpm. Which
rhythm is most likely present?
A. Atrial Fibrillation
,B. Ventricular Tachycardia
C. Atrial Flutter
D. First-degree Heart Block
Answer: C
Conceptual Explanation: Atrial Flutter is characterized by a ‘saw-tooth’ P-wave pattern
(F-waves).
3. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which ventilator
setting is specifically used to prevent alveolar collapse at the end of expiration?
A. FiO2 100%
B. PEEP (Positive End-Expiratory Pressure)
C. Tidal Volume 800 mL
D. Pressure Support
Answer: B
Conceptual Explanation: PEEP provides positive pressure at the end of expiration to keep
alveoli open, improving oxygenation in ARDS.
4. In a patient with Acute Kidney Injury (AKI), which phase is characterized by a daily urine
output of less than 400 mL?
A. Oliguric phase
B. Diuretic phase
, C. Recovery phase
D. Initiation phase
Answer: A
Conceptual Explanation: The oliguric phase is defined as urine output less than 400
mL/day, leading to fluid volume excess and electrolyte imbalances.
5. A patient with Type 1 Diabetes is found unresponsive with Kussmaul respirations and a
fruity breath odor. The nurse suspects Diabetic Ketoacidosis (DKA). What is the priority
intervention?
A. Administering subcutaneous Glucagon
B. IV bolus of Dextrose 50%
C. IV infusion of 0.9% Normal Saline
D. Immediate administration of IV Potassium
Answer: C
Conceptual Explanation: The priority in DKA is fluid resuscitation to address dehydration
and restore perfusion before insulin therapy.
6. Which assessment finding is most indicative of Cardiac Tamponade?
A. Widened pulse pressure
B. Beck’s Triad (Muffled heart sounds, JVD, Hypotension)
C. Hyperactive bowel sounds
MED-SURG MASTERY QUESTIONS AND
ANSWERS
1. A patient with a history of heart failure is admitted with acute pulmonary edema. Which
medication should the nurse expect to administer first to decrease preload?
A. Metoprolol
B. Spironolactone
C. Digoxin
D. Furosemide
Answer: D
Conceptual Explanation: Loop diuretics like Furosemide are the first-line treatment in
acute pulmonary edema to rapidly decrease preload by increasing venous capacitance and
inducing diuresis.
2. A patient’s EKG shows a saw-tooth pattern with a ventricular rate of 80 bpm. Which
rhythm is most likely present?
A. Atrial Fibrillation
,B. Ventricular Tachycardia
C. Atrial Flutter
D. First-degree Heart Block
Answer: C
Conceptual Explanation: Atrial Flutter is characterized by a ‘saw-tooth’ P-wave pattern
(F-waves).
3. A patient is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which ventilator
setting is specifically used to prevent alveolar collapse at the end of expiration?
A. FiO2 100%
B. PEEP (Positive End-Expiratory Pressure)
C. Tidal Volume 800 mL
D. Pressure Support
Answer: B
Conceptual Explanation: PEEP provides positive pressure at the end of expiration to keep
alveoli open, improving oxygenation in ARDS.
4. In a patient with Acute Kidney Injury (AKI), which phase is characterized by a daily urine
output of less than 400 mL?
A. Oliguric phase
B. Diuretic phase
, C. Recovery phase
D. Initiation phase
Answer: A
Conceptual Explanation: The oliguric phase is defined as urine output less than 400
mL/day, leading to fluid volume excess and electrolyte imbalances.
5. A patient with Type 1 Diabetes is found unresponsive with Kussmaul respirations and a
fruity breath odor. The nurse suspects Diabetic Ketoacidosis (DKA). What is the priority
intervention?
A. Administering subcutaneous Glucagon
B. IV bolus of Dextrose 50%
C. IV infusion of 0.9% Normal Saline
D. Immediate administration of IV Potassium
Answer: C
Conceptual Explanation: The priority in DKA is fluid resuscitation to address dehydration
and restore perfusion before insulin therapy.
6. Which assessment finding is most indicative of Cardiac Tamponade?
A. Widened pulse pressure
B. Beck’s Triad (Muffled heart sounds, JVD, Hypotension)
C. Hyperactive bowel sounds
