NUR 242 COMPREHENSIVE MED-SURG
NURSING EXAM (2026/2027) NUR 242
COMPREHENSIVE MED-SURG
NURSING EXAM (2026/2027)
1. A patient is admitted with a serum potassium level of 6.8 mEq/L. Which clinical
manifestation should the nurse prioritize for immediate assessment?
A. Muscle weakness in the lower extremities
B. Cardiac dysrhythmias and tall peaked T waves
C. Hyperactive bowel sounds
D. Increased urinary output
Answer: B
Conceptual Explanation: Hyperkalemia (K > 5.0) significantly affects cardiac conduction.
Levels above 6.5 are critical and can lead to ventricular fibrillation or standstill; tall peaked
T waves are a classic early sign.
,2. Which arterial blood gas (ABG) result is most indicative of a patient in uncompensated
respiratory acidosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
C. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and a
high PaCO2 (>45). If the HCO3 is normal, it is uncompensated.
3. A patient with Right-Sided Heart Failure is most likely to exhibit which of the following
physical assessment findings?
A. Crackles and wheezes in lung bases
B. Jugular Venous Distention (JVD) and peripheral edema
C. Orthopnea and paroxysmal nocturnal dyspnea
D. Pink frothy sputum
Answer: B
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
resulting in JVD, hepatomegaly, splenomegaly, and peripheral edema. Pulmonary
symptoms (crackles, dyspnea) are associated with Left-sided failure.
, 4. When caring for a patient in the oliguric phase of Acute Kidney Injury (AKI), the nurse
should monitor for which electrolyte imbalance?
A. Hypokalemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: In the oliguric phase of AKI, the kidneys cannot excrete
potassium, leading to hyperkalemia, which is life-threatening.
5. A patient is diagnosed with Pheochromocytoma. Which vital sign abnormality is the nurse
most likely to observe?
A. Profound hypertension
B. Bradycardia
C. Severe hypotension
D. Hypothermia
Answer: A
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla, leading to episodic or sustained severe hypertension, tachycardia, and
diaphoresis.
NURSING EXAM (2026/2027) NUR 242
COMPREHENSIVE MED-SURG
NURSING EXAM (2026/2027)
1. A patient is admitted with a serum potassium level of 6.8 mEq/L. Which clinical
manifestation should the nurse prioritize for immediate assessment?
A. Muscle weakness in the lower extremities
B. Cardiac dysrhythmias and tall peaked T waves
C. Hyperactive bowel sounds
D. Increased urinary output
Answer: B
Conceptual Explanation: Hyperkalemia (K > 5.0) significantly affects cardiac conduction.
Levels above 6.5 are critical and can lead to ventricular fibrillation or standstill; tall peaked
T waves are a classic early sign.
,2. Which arterial blood gas (ABG) result is most indicative of a patient in uncompensated
respiratory acidosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L
B. pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
C. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Answer: B
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and a
high PaCO2 (>45). If the HCO3 is normal, it is uncompensated.
3. A patient with Right-Sided Heart Failure is most likely to exhibit which of the following
physical assessment findings?
A. Crackles and wheezes in lung bases
B. Jugular Venous Distention (JVD) and peripheral edema
C. Orthopnea and paroxysmal nocturnal dyspnea
D. Pink frothy sputum
Answer: B
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
resulting in JVD, hepatomegaly, splenomegaly, and peripheral edema. Pulmonary
symptoms (crackles, dyspnea) are associated with Left-sided failure.
, 4. When caring for a patient in the oliguric phase of Acute Kidney Injury (AKI), the nurse
should monitor for which electrolyte imbalance?
A. Hypokalemia
B. Hypercalcemia
C. Hypophosphatemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: In the oliguric phase of AKI, the kidneys cannot excrete
potassium, leading to hyperkalemia, which is life-threatening.
5. A patient is diagnosed with Pheochromocytoma. Which vital sign abnormality is the nurse
most likely to observe?
A. Profound hypertension
B. Bradycardia
C. Severe hypotension
D. Hypothermia
Answer: A
Conceptual Explanation: Pheochromocytoma is a catecholamine-secreting tumor of the
adrenal medulla, leading to episodic or sustained severe hypertension, tachycardia, and
diaphoresis.
