NUR 242 Exam 3: Advanced Med-Surg Concepts 2026/2… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 3: Advanced Med-Surg Concepts 2026/2027
UPDATE Galen College
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 3: Advanced Med-Surg Concepts 2026/2… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with ARDS is receiving mechanical ventilation with high PEEP. Which
assessment finding should the nurse prioritize as a potential complication of this setting?
A. Increased cardiac output
B. Decreased intracranial pressure
C. Respiratory alkalosis
D. Pneumothorax due to barotrauma
Answer: D
Rationale: High levels of Positive End-Expiratory Pressure (PEEP) can lead to barotrauma, resulting
in a pneumothorax or subcutaneous emphysema. It also typically decreases cardiac output due to
increased intrathoracic pressure. This knowledge supports safe care and helps the nurse teach the
client and family clearly and simply. Clear teaching improves cooperation and reduces anxiety.
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.
2. Which clinical manifestation is most characteristic of a patient experiencing the early
stage of septic shock?
A. Warm, flushed skin with high cardiac output
B. Bradycardia and hypertension
C. Cool, clammy skin
D. Decreased respiratory rate
Answer: A
Rationale: Early (hyperdynamic) septic shock is characterized by vasodilation, leading to warm,
flushed skin and a compensatory increase in cardiac output. Remembering this point will help you
decide the best nursing action when similar questions appear on the exam. Link the answer to the
client’s current condition and risk level. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 3: Advanced Med-Surg Concepts 2026/2… 2026/2027 • Verified • Assured Grade A+
3. A patient’s ABG results are: pH 7.28, PaCO2 55, HCO3 25. How should the nurse interpret
these findings?
A. Compensated metabolic acidosis
B. Uncompensated metabolic alkalosis
C. Partially compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates a respiratory cause.
Since the HCO3 is within the normal range (22-26), it is uncompensated. Exam questions often test
whether you can pick the most practical and safe choice for the client in real situations. Focus on what
the nurse can actually do right now. Exam questions often test whether you can pick the most practical
and safe choice for the client in real situations. Focus on what the nurse can actually do right now.
4. In a patient with Acute Renal Failure (AKI), which phase is marked by a sudden increase in
urine output but a continued inability of the kidneys to concentrate urine?
A. Oliguric phase
B. Diuretic phase
C. Recovery phase
D. Onset phase
Answer: B
Rationale: During the diuretic phase, urine volume increases significantly (up to 5L/day), but the
nephrons are not yet fully functional, leading to potential dehydration and electrolyte imbalances. Exam
questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now. 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.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 3: Advanced Med-Surg Concepts 2026/2027
UPDATE Galen College
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 3: Advanced Med-Surg Concepts 2026/2… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with ARDS is receiving mechanical ventilation with high PEEP. Which
assessment finding should the nurse prioritize as a potential complication of this setting?
A. Increased cardiac output
B. Decreased intracranial pressure
C. Respiratory alkalosis
D. Pneumothorax due to barotrauma
Answer: D
Rationale: High levels of Positive End-Expiratory Pressure (PEEP) can lead to barotrauma, resulting
in a pneumothorax or subcutaneous emphysema. It also typically decreases cardiac output due to
increased intrathoracic pressure. This knowledge supports safe care and helps the nurse teach the
client and family clearly and simply. Clear teaching improves cooperation and reduces anxiety.
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.
2. Which clinical manifestation is most characteristic of a patient experiencing the early
stage of septic shock?
A. Warm, flushed skin with high cardiac output
B. Bradycardia and hypertension
C. Cool, clammy skin
D. Decreased respiratory rate
Answer: A
Rationale: Early (hyperdynamic) septic shock is characterized by vasodilation, leading to warm,
flushed skin and a compensatory increase in cardiac output. Remembering this point will help you
decide the best nursing action when similar questions appear on the exam. Link the answer to the
client’s current condition and risk level. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 3: Advanced Med-Surg Concepts 2026/2… 2026/2027 • Verified • Assured Grade A+
3. A patient’s ABG results are: pH 7.28, PaCO2 55, HCO3 25. How should the nurse interpret
these findings?
A. Compensated metabolic acidosis
B. Uncompensated metabolic alkalosis
C. Partially compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates a respiratory cause.
Since the HCO3 is within the normal range (22-26), it is uncompensated. Exam questions often test
whether you can pick the most practical and safe choice for the client in real situations. Focus on what
the nurse can actually do right now. Exam questions often test whether you can pick the most practical
and safe choice for the client in real situations. Focus on what the nurse can actually do right now.
4. In a patient with Acute Renal Failure (AKI), which phase is marked by a sudden increase in
urine output but a continued inability of the kidneys to concentrate urine?
A. Oliguric phase
B. Diuretic phase
C. Recovery phase
D. Onset phase
Answer: B
Rationale: During the diuretic phase, urine volume increases significantly (up to 5L/day), but the
nephrons are not yet fully functional, leading to potential dehydration and electrolyte imbalances. Exam
questions often test whether you can pick the most practical and safe choice for the client in real
situations. Focus on what the nurse can actually do right now. 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.
Exam (Elaborations) • Detailed Rationales Page 3
