NUR 242 Medical-Surgical Nursing Concepts Exam 4 … 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Medical-Surgical Nursing Concepts Exam 4 Study
Guide 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 Medical-Surgical Nursing Concepts Exam 4 … 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with liver cirrhosis presents with significant ascites and a serum albumin level of
2.2 g/dL. Which pathophysiological mechanism primarily explains this finding?
A. Increased hydrostatic pressure in the portal vein
B. Decreased oncotic pressure leading to fluid shift into the peritoneal cavity
C. Activation of the renin-angiotensin-aldosterone system (RAAS)
D. Impaired synthesis of clotting factors by the hepatocytes
Answer: B
Rationale: Low albumin levels (hypoalbuminemia) result in decreased colloidal osmotic (oncotic)
pressure, which allows fluid to leak from the intravascular space into the interstitial/peritoneal space.
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. This
knowledge supports safe care and helps the nurse teach the client and family clearly and simply. Clear
teaching improves cooperation and reduces anxiety.
2. Which of the following clinical manifestations is most indicative of a patient entering a
state of thyroid storm?
A. Bradycardia and hypothermia
B. Severe tachycardia, hyperpyrexia, and agitation
C. Hypotension and lethargy
D. Constipation and weight gain
Answer: B
Rationale: Thyroid storm is a life-threatening emergency characterized by extreme hypermetabolism,
leading to high fever (hyperpyrexia), tachycardia, and central nervous system disturbances. 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. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Medical-Surgical Nursing Concepts Exam 4 … 2026/2027 • Verified • Assured Grade A+
3. A patient is diagnosed with Addisonian Crisis. Which set of laboratory results should the
nurse anticipate?
A. Hypernatremia and hypokalemia
B. Hyperglycemia and hypernatremia
C. Hyponatremia, hyperkalemia, and hypoglycemia
D. Hypocalcemia and metabolic alkalosis
Answer: C
Rationale: Adrenal insufficiency (Addisonian Crisis) leads to a deficiency in cortisol and aldosterone,
causing the body to lose sodium and water while retaining potassium, and failing to maintain blood
glucose levels. This knowledge supports safe care and helps the nurse teach the client and family
clearly and simply. Clear teaching improves cooperation and reduces anxiety. Clear understanding of
this concept improves both test performance and everyday clinical judgment. Practice applying it to
short case scenarios to lock the idea in place.
4. When caring for a patient with acute pancreatitis, which intervention is the highest priority
during the first 24 hours?
A. Providing high-protein, low-fat oral supplements
B. Aggressive fluid resuscitation and pain management
C. Administering oral pancreatic enzymes with meals
D. Encouraging early ambulation to prevent DVT
Answer: B
Rationale: The initial management of acute pancreatitis focuses on treating hypovolemia (due to fluid
sequestration) and controlling severe pain. The patient is typically NPO to rest the pancreas.
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.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Medical-Surgical Nursing Concepts Exam 4 Study
Guide 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 Medical-Surgical Nursing Concepts Exam 4 … 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with liver cirrhosis presents with significant ascites and a serum albumin level of
2.2 g/dL. Which pathophysiological mechanism primarily explains this finding?
A. Increased hydrostatic pressure in the portal vein
B. Decreased oncotic pressure leading to fluid shift into the peritoneal cavity
C. Activation of the renin-angiotensin-aldosterone system (RAAS)
D. Impaired synthesis of clotting factors by the hepatocytes
Answer: B
Rationale: Low albumin levels (hypoalbuminemia) result in decreased colloidal osmotic (oncotic)
pressure, which allows fluid to leak from the intravascular space into the interstitial/peritoneal space.
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. This
knowledge supports safe care and helps the nurse teach the client and family clearly and simply. Clear
teaching improves cooperation and reduces anxiety.
2. Which of the following clinical manifestations is most indicative of a patient entering a
state of thyroid storm?
A. Bradycardia and hypothermia
B. Severe tachycardia, hyperpyrexia, and agitation
C. Hypotension and lethargy
D. Constipation and weight gain
Answer: B
Rationale: Thyroid storm is a life-threatening emergency characterized by extreme hypermetabolism,
leading to high fever (hyperpyrexia), tachycardia, and central nervous system disturbances. 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. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Medical-Surgical Nursing Concepts Exam 4 … 2026/2027 • Verified • Assured Grade A+
3. A patient is diagnosed with Addisonian Crisis. Which set of laboratory results should the
nurse anticipate?
A. Hypernatremia and hypokalemia
B. Hyperglycemia and hypernatremia
C. Hyponatremia, hyperkalemia, and hypoglycemia
D. Hypocalcemia and metabolic alkalosis
Answer: C
Rationale: Adrenal insufficiency (Addisonian Crisis) leads to a deficiency in cortisol and aldosterone,
causing the body to lose sodium and water while retaining potassium, and failing to maintain blood
glucose levels. This knowledge supports safe care and helps the nurse teach the client and family
clearly and simply. Clear teaching improves cooperation and reduces anxiety. Clear understanding of
this concept improves both test performance and everyday clinical judgment. Practice applying it to
short case scenarios to lock the idea in place.
4. When caring for a patient with acute pancreatitis, which intervention is the highest priority
during the first 24 hours?
A. Providing high-protein, low-fat oral supplements
B. Aggressive fluid resuscitation and pain management
C. Administering oral pancreatic enzymes with meals
D. Encouraging early ambulation to prevent DVT
Answer: B
Rationale: The initial management of acute pancreatitis focuses on treating hypovolemia (due to fluid
sequestration) and controlling severe pain. The patient is typically NPO to rest the pancreas.
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.
Exam (Elaborations) • Detailed Rationales Page 3
