NUR 242 Exam 2: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 2: Advanced Medical-Surgical Nursing
Concepts 2026/2027 UPDATE Galen
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 242 Exam 2: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is being mechanically
ventilated with high levels of Positive End-Expiratory Pressure (PEEP). The nurse notes a
sudden drop in blood pressure and decreased breath sounds on the right side. What is the
priority nursing action?
A. Increase the PEEP setting to improve oxygenation.
B. Prepare for needle decompression or chest tube insertion.
C. Administer a bolus of IV fluids to treat hypotension.
D. Suction the patient to clear a potential mucus plug.
Answer: B
Rationale: High levels of PEEP increase the risk of barotrauma, specifically a tension pneumothorax.
A sudden drop in BP and unilateral decreased breath sounds are hallmark signs. Immediate
intervention is required via needle decompression or chest tube insertion. Understanding this helps the
nurse notice early warning signs and act before the problem gets worse. Early action often prevents
bigger complications for the client. This is important because the nurse must choose the action that
keeps the client safest while still meeting their basic needs. Always think about safety first when
answering these questions.
2. The nurse is caring for a patient in the ICU with the following ABG results: pH 7.28, PaCO2
55 mmHg, PaO2 70 mmHg, and HCO3 26 mEq/L. Which interpretation and intervention are
most appropriate?
A. Respiratory Acidosis; increase the respiratory rate on the ventilator.
B. Respiratory Alkalosis; encourage the patient to breathe into a paper bag.
C. Metabolic Acidosis; administer sodium bicarbonate.
D. Metabolic Alkalosis; provide supplemental oxygen.
Answer: A
Rationale: The pH is low (<7.35), the PaCO2 is high (>45), and the HCO3 is normal, indicating
uncompensated respiratory acidosis. The goal is to ‘blow off’ CO2 by increasing ventilation. Knowing
the reason behind the correct answer makes it easier to rule out the wrong options quickly. Look for
the choice that protects the client and matches the priority need. Understanding this helps the nurse
notice early warning signs and act before the problem gets worse. Early action often prevents bigger
complications for the client.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 2: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
3. A patient arrives in the Emergency Department with burns to the entire left arm, the
anterior trunk, and the entire left leg. Using the Rule of Nines, what is the estimated Total
Body Surface Area (TBSA) burned?
A. burned?
B. 45%
C. 54%
D. 27%
Answer: B
Rationale: Left arm (9%) + Anterior trunk (18%) + Left leg (18%) = 45%. Knowing the reason behind
the correct answer makes it easier to rule out the wrong options quickly. Look for the choice that
protects the client and matches the priority need. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
4. During the emergent phase of a major burn injury, which electrolyte imbalance should the
nurse expect to find?
A. Hypokalemia and Hypernatremia
B. Hypocalcemia and Hypomagnesemia
C. Hyperkalemia and Hyponatremia
D. Hypermagnesemia and Hypophosphatemia
Answer: C
Rationale: Cellular destruction releases potassium into the extracellular space (hyperkalemia), while
sodium leaks into the interstitium during the massive fluid shift (hyponatremia). Knowing the reason
behind the correct answer makes it easier to rule out the wrong options quickly. Look for the choice
that protects the client and matches the priority need. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 2: Advanced Medical-Surgical Nursing
Concepts 2026/2027 UPDATE Galen
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 242 Exam 2: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is being mechanically
ventilated with high levels of Positive End-Expiratory Pressure (PEEP). The nurse notes a
sudden drop in blood pressure and decreased breath sounds on the right side. What is the
priority nursing action?
A. Increase the PEEP setting to improve oxygenation.
B. Prepare for needle decompression or chest tube insertion.
C. Administer a bolus of IV fluids to treat hypotension.
D. Suction the patient to clear a potential mucus plug.
Answer: B
Rationale: High levels of PEEP increase the risk of barotrauma, specifically a tension pneumothorax.
A sudden drop in BP and unilateral decreased breath sounds are hallmark signs. Immediate
intervention is required via needle decompression or chest tube insertion. Understanding this helps the
nurse notice early warning signs and act before the problem gets worse. Early action often prevents
bigger complications for the client. This is important because the nurse must choose the action that
keeps the client safest while still meeting their basic needs. Always think about safety first when
answering these questions.
2. The nurse is caring for a patient in the ICU with the following ABG results: pH 7.28, PaCO2
55 mmHg, PaO2 70 mmHg, and HCO3 26 mEq/L. Which interpretation and intervention are
most appropriate?
A. Respiratory Acidosis; increase the respiratory rate on the ventilator.
B. Respiratory Alkalosis; encourage the patient to breathe into a paper bag.
C. Metabolic Acidosis; administer sodium bicarbonate.
D. Metabolic Alkalosis; provide supplemental oxygen.
Answer: A
Rationale: The pH is low (<7.35), the PaCO2 is high (>45), and the HCO3 is normal, indicating
uncompensated respiratory acidosis. The goal is to ‘blow off’ CO2 by increasing ventilation. Knowing
the reason behind the correct answer makes it easier to rule out the wrong options quickly. Look for
the choice that protects the client and matches the priority need. Understanding this helps the nurse
notice early warning signs and act before the problem gets worse. Early action often prevents bigger
complications for the client.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 2: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
3. A patient arrives in the Emergency Department with burns to the entire left arm, the
anterior trunk, and the entire left leg. Using the Rule of Nines, what is the estimated Total
Body Surface Area (TBSA) burned?
A. burned?
B. 45%
C. 54%
D. 27%
Answer: B
Rationale: Left arm (9%) + Anterior trunk (18%) + Left leg (18%) = 45%. Knowing the reason behind
the correct answer makes it easier to rule out the wrong options quickly. Look for the choice that
protects the client and matches the priority need. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
4. During the emergent phase of a major burn injury, which electrolyte imbalance should the
nurse expect to find?
A. Hypokalemia and Hypernatremia
B. Hypocalcemia and Hypomagnesemia
C. Hyperkalemia and Hyponatremia
D. Hypermagnesemia and Hypophosphatemia
Answer: C
Rationale: Cellular destruction releases potassium into the extracellular space (hyperkalemia), while
sodium leaks into the interstitium during the massive fluid shift (hyponatremia). Knowing the reason
behind the correct answer makes it easier to rule out the wrong options quickly. Look for the choice
that protects the client and matches the priority need. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
Exam (Elaborations) • Detailed Rationales Page 3
