NUR 242 FINAL EXAM: ADVANCED
MEDICAL-SURGICAL NURSING
QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a pH of 7.30,
PaCO2 of 58 mmHg, and HCO3 of 30 mEq/L. How should the nurse interpret these arterial
blood gas (ABG) results?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated metabolic alkalosis
D. Uncompensated metabolic acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated, indicating the kidneys are attempting to compensate but have
not yet returned the pH to normal range, thus it is partially compensated.
,2. A client is admitted with suspected Pheochromocytoma. Which nursing intervention is the
highest priority?
A. Monitoring intake and output hourly
B. Encouraging a high-protein diet
C. Avoiding abdominal palpation
D. Administering prophylactic antibiotics
Answer: C
Conceptual Explanation: Palpating the abdomen can cause a sudden release of
catecholamines, leading to severe hypertension and potential hypertensive crisis.
3. A nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). Which
electrolyte abnormality is the most life-threatening?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: A
Conceptual Explanation: Hyperkalemia can lead to lethal cardiac dysrhythmias and is the
most immediate threat to life in AKI.
, 4. A patient exhibits a Glasgow Coma Scale (GCS) score of 7. Which action should the nurse
prepare for immediately?
A. Administering intravenous mannitol
B. Initiating a continuous morphine drip
C. Preparing the patient for a lumbar puncture
D. Assisting with endotracheal intubation
Answer: D
Conceptual Explanation: A GCS score of 8 or less typically indicates that the patient
cannot maintain a patent airway, necessitating intubation.
5. During the assessment of a patient with a chest tube, the nurse notes continuous bubbling
in the water-seal chamber. What does this finding indicate?
A. There is an air leak in the drainage system
B. The lung has fully re-expanded
C. A normal finding during the early postoperative period
D. The suction pressure is set too high
Answer: A
Conceptual Explanation: Intermittent bubbling is normal with expiration or coughing, but
continuous bubbling in the water-seal chamber indicates a leak in the system or from the
patient’s pleural space.
MEDICAL-SURGICAL NURSING
QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a pH of 7.30,
PaCO2 of 58 mmHg, and HCO3 of 30 mEq/L. How should the nurse interpret these arterial
blood gas (ABG) results?
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated metabolic alkalosis
D. Uncompensated metabolic acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated, indicating the kidneys are attempting to compensate but have
not yet returned the pH to normal range, thus it is partially compensated.
,2. A client is admitted with suspected Pheochromocytoma. Which nursing intervention is the
highest priority?
A. Monitoring intake and output hourly
B. Encouraging a high-protein diet
C. Avoiding abdominal palpation
D. Administering prophylactic antibiotics
Answer: C
Conceptual Explanation: Palpating the abdomen can cause a sudden release of
catecholamines, leading to severe hypertension and potential hypertensive crisis.
3. A nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). Which
electrolyte abnormality is the most life-threatening?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: A
Conceptual Explanation: Hyperkalemia can lead to lethal cardiac dysrhythmias and is the
most immediate threat to life in AKI.
, 4. A patient exhibits a Glasgow Coma Scale (GCS) score of 7. Which action should the nurse
prepare for immediately?
A. Administering intravenous mannitol
B. Initiating a continuous morphine drip
C. Preparing the patient for a lumbar puncture
D. Assisting with endotracheal intubation
Answer: D
Conceptual Explanation: A GCS score of 8 or less typically indicates that the patient
cannot maintain a patent airway, necessitating intubation.
5. During the assessment of a patient with a chest tube, the nurse notes continuous bubbling
in the water-seal chamber. What does this finding indicate?
A. There is an air leak in the drainage system
B. The lung has fully re-expanded
C. A normal finding during the early postoperative period
D. The suction pressure is set too high
Answer: A
Conceptual Explanation: Intermittent bubbling is normal with expiration or coughing, but
continuous bubbling in the water-seal chamber indicates a leak in the system or from the
patient’s pleural space.
