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NUR 242 Exam 3 () | Med-Surg
Nursing | Galen College
NUR 242 EXAM 3 () | MED-SURG
NURSING | GALEN COLLEGE – COMPREHENSIVE
QUESTIONS AND ANSWERS | VERIFIED AND
WELL-DETAILED ANSWERS | DETAILED
EXPLANATIONS AND RATIONALES | COMPLETE
EXAM PREPARATION STUDY GUIDE | PRACTICE
QUESTIONS | LATEST EXAM UPDATE
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CORE DOMAINS
1. Respiratory assessment and disorders
2. Oxygen therapy and respiratory interventions
3. Tracheostomy and airway management
4. Chest tubes and pleural disorders
5. Gastrointestinal assessment and disorders
6. Nutrition and nutritional support
7. Diabetes mellitus and glucose management
8. Insulin therapy and blood-glucose monitoring
9. Diabetic emergencies: hypoglycemia, DKA, and HHS
10. Clinical judgment, prioritization, safety, and patient educati
SECTION ONE: QUESTIONS 1–50
Question 1. Which assessment finding is most directly associated with hypoxemia?
A. Oxygen saturation of 88%
B. Temperature of 37°C (98.6°F)
,C. Blood pressure of 118/72 mm Hg
D. Heart rate of 72/min
Correct Answer: A. Oxygen saturation of 88%
Explanation: An oxygen saturation of 88% indicates inadequate arterial oxygenation and
requires assessment and intervention. Hypoxemia may also produce restlessness, confusion,
tachycardia, and cyanosis. The other findings are not independently indicative of impaired
oxygenation.
Question 2. A nurse assessing a client with respiratory disease hears a high-pitched
musical sound primarily during expiration. Which finding is this?
A. Crackles
B. Wheezing
C. Pleural friction rub
D. Stridor
Correct Answer: B. Wheezing
Explanation: Wheezing is a musical, high-pitched sound caused by narrowed lower airways
and is commonly associated with asthma or bronchospasm. Stridor is generally louder
during inspiration and suggests upper-airway obstruction.
Question 3. Which respiratory assessment should the nurse perform first?
A. Ask about the client's usual exercise tolerance
B. Inspect the client's fingernails
C. Assess airway patency and breathing effort
D. Review the client's smoking history
Correct Answer: C. Assess airway patency and breathing effort
Explanation: Airway and breathing are immediate priorities under the ABC framework. A
compromised airway or severe respiratory distress can rapidly become life-threatening,
making immediate assessment more important than historical information.
Question 4. Which position generally promotes maximum lung expansion in a client
experiencing dyspnea?
A. Supine
B. Trendelenburg
C. High Fowler's
D. Sims'
Correct Answer: C. High Fowler's
,Explanation: High Fowler's positioning promotes diaphragmatic expansion and reduces
abdominal pressure against the diaphragm. Supine and Trendelenburg positions can worsen
ventilation in a dyspneic client.
Question 5. Which oxygen-delivery device provides a relatively precise concentration of
oxygen?
A. Venturi mask
B. Nasal cannula
C. Simple face mask
D. Nonrebreather mask
Correct Answer: A. Venturi mask
Explanation: A Venturi mask delivers a controlled and predictable oxygen concentration by
entraining room air in a specific ratio. It is especially useful when precise oxygen
concentration is required.
Question 6. A client receiving oxygen through a nasal cannula reports nasal dryness. Which
intervention is appropriate?
A. Apply petroleum jelly inside the nares
B. Discontinue oxygen therapy
C. Increase the oxygen flow rate
D. Use a prescribed humidification system when indicated
Correct Answer: D. Use a prescribed humidification system when indicated
Explanation: Humidification can reduce mucosal dryness associated with oxygen therapy
when clinically indicated. Petroleum-based products should be avoided around oxygen
because they can increase fire risk.
Question 7. Which finding most strongly suggests increased work of breathing?
A. Respiratory rate of 16/min
B. Use of accessory muscles
C. Relaxed abdominal breathing
D. Symmetrical chest expansion
Correct Answer: B. Use of accessory muscles
Explanation: Accessory-muscle use indicates that the client is working harder to ventilate. It
can be an important sign of respiratory distress and should prompt further assessment.
Question 8. Which oxygen-safety instruction is most important?
A. Keep oxygen away from open flames
B. Store oxygen cylinders beside radiators
, C. Apply petroleum products to dry skin
D. Permit smoking near the oxygen equipment
Correct Answer: A. Keep oxygen away from open flames
Explanation: Oxygen supports combustion and greatly increases fire risk. Smoking, candles,
flames, and heat sources must be kept away from oxygen equipment.
Question 9. Which finding is most characteristic of a productive cough?
A. Cough without secretions
B. Cough that produces sputum
C. Cough occurring only during sleep
D. Cough associated exclusively with anxiety
Correct Answer: B. Cough that produces sputum
Explanation: A productive cough brings mucus or other respiratory secretions into the
mouth. It can assist with airway clearance and should be assessed for amount, color, odor,
and consistency.
Question 10. What is the primary purpose of incentive spirometry?
A. Reduce blood glucose
B. Prevent atelectasis
C. Treat hypoglycemia
D. Remove pleural fluid
Correct Answer: B. Prevent atelectasis
Explanation: Incentive spirometry encourages sustained deep inspiration, helping expand
alveoli and prevent postoperative or immobility-related atelectasis.
Question 11. Which instruction is appropriate when teaching a client to use an incentive
spirometer?
A. Exhale forcefully into the device
B. Breathe rapidly through the mouthpiece
C. Inhale slowly and deeply through the mouthpiece
D. Use the device only when experiencing severe dyspnea
Correct Answer: C. Inhale slowly and deeply through the mouthpiece
Explanation: Slow, sustained inhalation maximizes alveolar expansion. The client should seal
the lips around the mouthpiece and inhale steadily rather than rapidly.
Question 12. A client with COPD becomes increasingly dyspneic. Which intervention
should the nurse implement first?
NUR 242 Exam 3 () | Med-Surg
Nursing | Galen College
NUR 242 EXAM 3 () | MED-SURG
NURSING | GALEN COLLEGE – COMPREHENSIVE
QUESTIONS AND ANSWERS | VERIFIED AND
WELL-DETAILED ANSWERS | DETAILED
EXPLANATIONS AND RATIONALES | COMPLETE
EXAM PREPARATION STUDY GUIDE | PRACTICE
QUESTIONS | LATEST EXAM UPDATE
*
*
CORE DOMAINS
1. Respiratory assessment and disorders
2. Oxygen therapy and respiratory interventions
3. Tracheostomy and airway management
4. Chest tubes and pleural disorders
5. Gastrointestinal assessment and disorders
6. Nutrition and nutritional support
7. Diabetes mellitus and glucose management
8. Insulin therapy and blood-glucose monitoring
9. Diabetic emergencies: hypoglycemia, DKA, and HHS
10. Clinical judgment, prioritization, safety, and patient educati
SECTION ONE: QUESTIONS 1–50
Question 1. Which assessment finding is most directly associated with hypoxemia?
A. Oxygen saturation of 88%
B. Temperature of 37°C (98.6°F)
,C. Blood pressure of 118/72 mm Hg
D. Heart rate of 72/min
Correct Answer: A. Oxygen saturation of 88%
Explanation: An oxygen saturation of 88% indicates inadequate arterial oxygenation and
requires assessment and intervention. Hypoxemia may also produce restlessness, confusion,
tachycardia, and cyanosis. The other findings are not independently indicative of impaired
oxygenation.
Question 2. A nurse assessing a client with respiratory disease hears a high-pitched
musical sound primarily during expiration. Which finding is this?
A. Crackles
B. Wheezing
C. Pleural friction rub
D. Stridor
Correct Answer: B. Wheezing
Explanation: Wheezing is a musical, high-pitched sound caused by narrowed lower airways
and is commonly associated with asthma or bronchospasm. Stridor is generally louder
during inspiration and suggests upper-airway obstruction.
Question 3. Which respiratory assessment should the nurse perform first?
A. Ask about the client's usual exercise tolerance
B. Inspect the client's fingernails
C. Assess airway patency and breathing effort
D. Review the client's smoking history
Correct Answer: C. Assess airway patency and breathing effort
Explanation: Airway and breathing are immediate priorities under the ABC framework. A
compromised airway or severe respiratory distress can rapidly become life-threatening,
making immediate assessment more important than historical information.
Question 4. Which position generally promotes maximum lung expansion in a client
experiencing dyspnea?
A. Supine
B. Trendelenburg
C. High Fowler's
D. Sims'
Correct Answer: C. High Fowler's
,Explanation: High Fowler's positioning promotes diaphragmatic expansion and reduces
abdominal pressure against the diaphragm. Supine and Trendelenburg positions can worsen
ventilation in a dyspneic client.
Question 5. Which oxygen-delivery device provides a relatively precise concentration of
oxygen?
A. Venturi mask
B. Nasal cannula
C. Simple face mask
D. Nonrebreather mask
Correct Answer: A. Venturi mask
Explanation: A Venturi mask delivers a controlled and predictable oxygen concentration by
entraining room air in a specific ratio. It is especially useful when precise oxygen
concentration is required.
Question 6. A client receiving oxygen through a nasal cannula reports nasal dryness. Which
intervention is appropriate?
A. Apply petroleum jelly inside the nares
B. Discontinue oxygen therapy
C. Increase the oxygen flow rate
D. Use a prescribed humidification system when indicated
Correct Answer: D. Use a prescribed humidification system when indicated
Explanation: Humidification can reduce mucosal dryness associated with oxygen therapy
when clinically indicated. Petroleum-based products should be avoided around oxygen
because they can increase fire risk.
Question 7. Which finding most strongly suggests increased work of breathing?
A. Respiratory rate of 16/min
B. Use of accessory muscles
C. Relaxed abdominal breathing
D. Symmetrical chest expansion
Correct Answer: B. Use of accessory muscles
Explanation: Accessory-muscle use indicates that the client is working harder to ventilate. It
can be an important sign of respiratory distress and should prompt further assessment.
Question 8. Which oxygen-safety instruction is most important?
A. Keep oxygen away from open flames
B. Store oxygen cylinders beside radiators
, C. Apply petroleum products to dry skin
D. Permit smoking near the oxygen equipment
Correct Answer: A. Keep oxygen away from open flames
Explanation: Oxygen supports combustion and greatly increases fire risk. Smoking, candles,
flames, and heat sources must be kept away from oxygen equipment.
Question 9. Which finding is most characteristic of a productive cough?
A. Cough without secretions
B. Cough that produces sputum
C. Cough occurring only during sleep
D. Cough associated exclusively with anxiety
Correct Answer: B. Cough that produces sputum
Explanation: A productive cough brings mucus or other respiratory secretions into the
mouth. It can assist with airway clearance and should be assessed for amount, color, odor,
and consistency.
Question 10. What is the primary purpose of incentive spirometry?
A. Reduce blood glucose
B. Prevent atelectasis
C. Treat hypoglycemia
D. Remove pleural fluid
Correct Answer: B. Prevent atelectasis
Explanation: Incentive spirometry encourages sustained deep inspiration, helping expand
alveoli and prevent postoperative or immobility-related atelectasis.
Question 11. Which instruction is appropriate when teaching a client to use an incentive
spirometer?
A. Exhale forcefully into the device
B. Breathe rapidly through the mouthpiece
C. Inhale slowly and deeply through the mouthpiece
D. Use the device only when experiencing severe dyspnea
Correct Answer: C. Inhale slowly and deeply through the mouthpiece
Explanation: Slow, sustained inhalation maximizes alveolar expansion. The client should seal
the lips around the mouthpiece and inhale steadily rather than rapidly.
Question 12. A client with COPD becomes increasingly dyspneic. Which intervention
should the nurse implement first?
