NUR 242 MEDICAL-SURGICAL NURSING
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. A patient with Type 1 Diabetes presents with deep, rapid respirations and a fruity breath
odor. Which acid-base imbalance does the nurse anticipate?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The symptoms describe Kussmaul’s respirations associated with
Diabetic Ketoacidosis (DKA), which results in metabolic acidosis due to the accumulation of
ketones.
2. Which clinical manifestation should a nurse expect in a patient diagnosed with Left-Sided
Heart Failure?
A. Jugular Venous Distention
,B. Peripheral Edema
C. Splenomegaly
D. Crackles in the lungs
Answer: D
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary system, leading to pulmonary congestion and crackles; the other options are
signs of right-sided failure.
3. A nurse is caring for a patient post-thyroidectomy. The patient reports numbness and
tingling in their fingers. Which assessment should the nurse perform?
A. Babinski reflex
B. Homan’s sign
C. Chvostek’s sign
D. Kernig’s sign
Answer: C
Conceptual Explanation: Numbness and tingling are signs of hypocalcemia, often caused
by accidental parathyroid damage during thyroidectomy. Chvostek’s sign is a clinical
indicator of hypocalcemia.
4. Which medication is the priority for a patient experiencing an acute asthma attack?
A. Salmeterol
, B. Fluticasone
C. Albuterol
D. Montelukast
Answer: C
Conceptual Explanation: Albuterol is a short-acting beta-agonist (SABA) used as a rescue
medication for rapid bronchodilation during an acute attack.
5. A patient with a history of cirrhosis presents with increased confusion and asterixis. Which
lab value is most likely elevated?
A. Serum Creatinine
B. Serum Troponin
C. Serum Amylase
D. Serum Ammonia
Answer: D
Conceptual Explanation: Asterixis (liver flap) and confusion are hallmarks of hepatic
encephalopathy, caused by elevated serum ammonia levels that cross the blood-brain
barrier.
6. What is the gold standard diagnostic test for confirming a Pulmonary Embolism (PE)?
A. Chest X-ray
B. Electrocardiogram (ECG)
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. A patient with Type 1 Diabetes presents with deep, rapid respirations and a fruity breath
odor. Which acid-base imbalance does the nurse anticipate?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The symptoms describe Kussmaul’s respirations associated with
Diabetic Ketoacidosis (DKA), which results in metabolic acidosis due to the accumulation of
ketones.
2. Which clinical manifestation should a nurse expect in a patient diagnosed with Left-Sided
Heart Failure?
A. Jugular Venous Distention
,B. Peripheral Edema
C. Splenomegaly
D. Crackles in the lungs
Answer: D
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary system, leading to pulmonary congestion and crackles; the other options are
signs of right-sided failure.
3. A nurse is caring for a patient post-thyroidectomy. The patient reports numbness and
tingling in their fingers. Which assessment should the nurse perform?
A. Babinski reflex
B. Homan’s sign
C. Chvostek’s sign
D. Kernig’s sign
Answer: C
Conceptual Explanation: Numbness and tingling are signs of hypocalcemia, often caused
by accidental parathyroid damage during thyroidectomy. Chvostek’s sign is a clinical
indicator of hypocalcemia.
4. Which medication is the priority for a patient experiencing an acute asthma attack?
A. Salmeterol
, B. Fluticasone
C. Albuterol
D. Montelukast
Answer: C
Conceptual Explanation: Albuterol is a short-acting beta-agonist (SABA) used as a rescue
medication for rapid bronchodilation during an acute attack.
5. A patient with a history of cirrhosis presents with increased confusion and asterixis. Which
lab value is most likely elevated?
A. Serum Creatinine
B. Serum Troponin
C. Serum Amylase
D. Serum Ammonia
Answer: D
Conceptual Explanation: Asterixis (liver flap) and confusion are hallmarks of hepatic
encephalopathy, caused by elevated serum ammonia levels that cross the blood-brain
barrier.
6. What is the gold standard diagnostic test for confirming a Pulmonary Embolism (PE)?
A. Chest X-ray
B. Electrocardiogram (ECG)
