NUR 242 MED-SURG NURSING EXAM 2
COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A patient is admitted with an acute exacerbation of heart failure. Which clinical finding
should the nurse prioritize as the most indicative of left-sided heart failure?
A. Jugular venous distension and peripheral edema
B. Hepatomegaly and abdominal ascites
C. Splenomegaly and anorexia
D. Crackles in the lungs and dyspnea on exertion
Answer: D
Conceptual Explanation: Left-sided heart failure causes pulmonary congestion due to the
heart’s inability to pump blood effectively into the systemic circulation, leading to crackles
and dyspnea. Other options describe right-sided failure.
2. When interpreting an arterial blood gas (ABG) for a patient with COPD, the nurse notes pH
7.31, PaCO2 58 mmHg, and HCO3 28 mEq/L. How should the nurse interpret these results?
A. Compensated Metabolic Alkalosis
,B. Uncompensated Respiratory Alkalosis
C. Partially Compensated Respiratory Acidosis
D. Fully Compensated Respiratory Acidosis
Answer: C
Conceptual Explanation: The pH is acidic (<7.35), the PaCO2 is high (acidic), and the
HCO3 is high (basic/compensatory). Since the pH is not within normal range but the
bicarbonate has moved to compensate, it is partially compensated respiratory acidosis.
3. A patient with a history of atrial fibrillation is prescribed Warfarin. Which lab value should
the nurse monitor to ensure the medication is within the therapeutic range?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Conceptual Explanation: INR is the standard monitoring parameter for Warfarin therapy.
aPTT is used for Heparin monitoring.
4. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which nursing intervention is most appropriate?
A. Restricting fluid intake to 800-1000 mL per day
, B. Administering IV 0.45% normal saline
C. Encouraging increased oral water intake
D. Monitoring for signs of hypernatremia
Answer: A
Conceptual Explanation: SIADH involves excessive water retention and dilutional
hyponatremia. Fluid restriction is the primary treatment to prevent further dilution of
serum sodium.
5. A patient presents with sudden, sharp chest pain that worsens with deep inspiration and is
relieved by leaning forward. The nurse suspects which condition?
A. Myocardial Infarction
B. Pericarditis
C. Pneumonia
D. Pulmonary Embolism
Answer: B
Conceptual Explanation: Pleuritic chest pain that improves when sitting up and leaning
forward is a hallmark sign of pericarditis, often accompanied by a pericardial friction rub.
6. The nurse is caring for a patient post-thyroidectomy. Which assessment finding requires
immediate notification of the healthcare provider?
A. Slight hoarseness when speaking
COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A patient is admitted with an acute exacerbation of heart failure. Which clinical finding
should the nurse prioritize as the most indicative of left-sided heart failure?
A. Jugular venous distension and peripheral edema
B. Hepatomegaly and abdominal ascites
C. Splenomegaly and anorexia
D. Crackles in the lungs and dyspnea on exertion
Answer: D
Conceptual Explanation: Left-sided heart failure causes pulmonary congestion due to the
heart’s inability to pump blood effectively into the systemic circulation, leading to crackles
and dyspnea. Other options describe right-sided failure.
2. When interpreting an arterial blood gas (ABG) for a patient with COPD, the nurse notes pH
7.31, PaCO2 58 mmHg, and HCO3 28 mEq/L. How should the nurse interpret these results?
A. Compensated Metabolic Alkalosis
,B. Uncompensated Respiratory Alkalosis
C. Partially Compensated Respiratory Acidosis
D. Fully Compensated Respiratory Acidosis
Answer: C
Conceptual Explanation: The pH is acidic (<7.35), the PaCO2 is high (acidic), and the
HCO3 is high (basic/compensatory). Since the pH is not within normal range but the
bicarbonate has moved to compensate, it is partially compensated respiratory acidosis.
3. A patient with a history of atrial fibrillation is prescribed Warfarin. Which lab value should
the nurse monitor to ensure the medication is within the therapeutic range?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Conceptual Explanation: INR is the standard monitoring parameter for Warfarin therapy.
aPTT is used for Heparin monitoring.
4. A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Which nursing intervention is most appropriate?
A. Restricting fluid intake to 800-1000 mL per day
, B. Administering IV 0.45% normal saline
C. Encouraging increased oral water intake
D. Monitoring for signs of hypernatremia
Answer: A
Conceptual Explanation: SIADH involves excessive water retention and dilutional
hyponatremia. Fluid restriction is the primary treatment to prevent further dilution of
serum sodium.
5. A patient presents with sudden, sharp chest pain that worsens with deep inspiration and is
relieved by leaning forward. The nurse suspects which condition?
A. Myocardial Infarction
B. Pericarditis
C. Pneumonia
D. Pulmonary Embolism
Answer: B
Conceptual Explanation: Pleuritic chest pain that improves when sitting up and leaning
forward is a hallmark sign of pericarditis, often accompanied by a pericardial friction rub.
6. The nurse is caring for a patient post-thyroidectomy. Which assessment finding requires
immediate notification of the healthcare provider?
A. Slight hoarseness when speaking
