NUR 242 ADVANCED MEDICAL-
SURGICAL NURSING FINAL EXAM
PREP QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with a traumatic brain injury has a blood pressure of 160/60 mmHg, a heart rate
of 48 bpm, and irregular respirations. Which physiological phenomenon is occurring?
A. Neurogenic shock
B. Autonomic dysreflexia
C. Cushing’s triad
D. Brain herniation syndrome
Answer: C
Conceptual Explanation: Cushing’s triad consists of hypertension with a widening pulse
pressure, bradycardia, and irregular respirations, indicating increased intracranial
pressure.
,2. A patient with acute respiratory distress syndrome (ARDS) is being mechanically ventilated.
The high-pressure alarm sounds. Which action should the nurse take first?
A. Check for kinks in the ventilator tubing
B. Assess the patient’s respiratory status and breath sounds
C. Suction the patient’s airway
D. Silence the alarm and increase the oxygen concentration
Answer: B
Conceptual Explanation: The first action is always to assess the patient to determine if the
alarm is due to a clinical change (like a pneumothorax) or a mechanical issue.
3. Which arterial blood gas (ABG) result is most indicative of partially compensated
respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.36, PaCO2 48, HCO3 28
C. pH 7.46, PaCO2 30, HCO3 18
D. pH 7.31, PaCO2 52, HCO3 30
Answer: D
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is still
acidic (<7.35), the PaCO2 is high, and the HCO3 is high as the kidneys attempt to
compensate.
, 4. A patient in the ICU is being treated for septic shock. Despite fluid resuscitation, the mean
arterial pressure (MAP) remains at 50 mmHg. Which medication is the first-line vasopressor
of choice?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Answer: C
Conceptual Explanation: Norepinephrine is the first-line vasopressor recommended for
septic shock to maintain a MAP of at least 65 mmHg.
5. A patient with chronic kidney disease (CKD) presents with a potassium level of 7.2 mEq/L
and peaked T-waves on the EKG. Which order should the nurse prioritize?
A. Sodium polystyrene sulfonate (Kayexalate) orally
B. Intravenous Calcium Gluconate
C. Intravenous Regular Insulin and Dextrose
D. Emergency Hemodialysis
Answer: B
Conceptual Explanation: Calcium gluconate does not lower potassium but stabilizes the
myocardial membrane to prevent lethal dysrhythmias.
SURGICAL NURSING FINAL EXAM
PREP QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with a traumatic brain injury has a blood pressure of 160/60 mmHg, a heart rate
of 48 bpm, and irregular respirations. Which physiological phenomenon is occurring?
A. Neurogenic shock
B. Autonomic dysreflexia
C. Cushing’s triad
D. Brain herniation syndrome
Answer: C
Conceptual Explanation: Cushing’s triad consists of hypertension with a widening pulse
pressure, bradycardia, and irregular respirations, indicating increased intracranial
pressure.
,2. A patient with acute respiratory distress syndrome (ARDS) is being mechanically ventilated.
The high-pressure alarm sounds. Which action should the nurse take first?
A. Check for kinks in the ventilator tubing
B. Assess the patient’s respiratory status and breath sounds
C. Suction the patient’s airway
D. Silence the alarm and increase the oxygen concentration
Answer: B
Conceptual Explanation: The first action is always to assess the patient to determine if the
alarm is due to a clinical change (like a pneumothorax) or a mechanical issue.
3. Which arterial blood gas (ABG) result is most indicative of partially compensated
respiratory acidosis?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.36, PaCO2 48, HCO3 28
C. pH 7.46, PaCO2 30, HCO3 18
D. pH 7.31, PaCO2 52, HCO3 30
Answer: D
Conceptual Explanation: In partially compensated respiratory acidosis, the pH is still
acidic (<7.35), the PaCO2 is high, and the HCO3 is high as the kidneys attempt to
compensate.
, 4. A patient in the ICU is being treated for septic shock. Despite fluid resuscitation, the mean
arterial pressure (MAP) remains at 50 mmHg. Which medication is the first-line vasopressor
of choice?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Vasopressin
Answer: C
Conceptual Explanation: Norepinephrine is the first-line vasopressor recommended for
septic shock to maintain a MAP of at least 65 mmHg.
5. A patient with chronic kidney disease (CKD) presents with a potassium level of 7.2 mEq/L
and peaked T-waves on the EKG. Which order should the nurse prioritize?
A. Sodium polystyrene sulfonate (Kayexalate) orally
B. Intravenous Calcium Gluconate
C. Intravenous Regular Insulin and Dextrose
D. Emergency Hemodialysis
Answer: B
Conceptual Explanation: Calcium gluconate does not lower potassium but stabilizes the
myocardial membrane to prevent lethal dysrhythmias.
