NUR 242 MED-SURG NURSING EXAM 4
PRACTICE (2026/2027) QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient is admitted with a suspected Thyroid Storm. Which of the following clinical
manifestations should the nurse prioritize for immediate intervention?
A. Severe tachycardia and hyperthermia
B. Exophthalmos and weight loss
C. Constipation and bradycardia
D. Generalized edema and lethargy
Answer: A
Conceptual Explanation: Thyroid storm is a life-threatening crisis characterized by
extreme hypermetabolism, resulting in high fever (hyperthermia), severe tachycardia, and
potential heart failure.
2. A patient with Diabetes Insipidus (DI) is being monitored. Which laboratory finding most
accurately reflects this condition?
A. Urine specific gravity of 1.035
B. Serum sodium of 125 mEq/L
,C. Urine specific gravity of 1.002
D. Serum glucose of 250 mg/dL
Answer: C
Conceptual Explanation: Diabetes Insipidus involves a deficiency of ADH, leading to the
excretion of large amounts of very dilute urine, reflected by a low specific gravity (typically
<1.005).
3. When assessing a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH),
which neurological sign is the most concerning result of hyponatremia?
A. Increased appetite and euphoria
B. Hyporeflexia and numbness
C. Restlessness and seizures
D. Tinnitus and blurred vision
Answer: C
Conceptual Explanation: Low sodium levels in SIADH cause cerebral edema, leading to
altered mental status, restlessness, and eventually seizures or coma.
4. A nurse is caring for a patient post-adrenalectomy. The patient’s blood pressure drops to
80/50 mmHg and they report severe abdominal pain. Which condition should be suspected?
A. Addisonian crisis
B. Thyroid storm
, C. Pheochromocytoma
D. Myxedema coma
Answer: A
Conceptual Explanation: Sudden withdrawal of adrenal hormones or stress post-surgery
can trigger an Addisonian crisis, characterized by hypotension, shock, and acute abdominal
pain.
5. A patient is diagnosed with Pheochromocytoma. Which of the following should the nurse
avoid during physical assessment?
A. Auscultating heart sounds
B. Assessing pupillary response
C. Deep palpation of the abdomen
D. Checking pedal pulses
Answer: C
Conceptual Explanation: Palpating the abdomen can stimulate the tumor to release a
massive amount of catecholamines, causing a hypertensive crisis.
6. Using the Parkland Formula, calculate the total fluid resuscitation required for the first 24
hours for a 70kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 2,800 mL
PRACTICE (2026/2027) QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient is admitted with a suspected Thyroid Storm. Which of the following clinical
manifestations should the nurse prioritize for immediate intervention?
A. Severe tachycardia and hyperthermia
B. Exophthalmos and weight loss
C. Constipation and bradycardia
D. Generalized edema and lethargy
Answer: A
Conceptual Explanation: Thyroid storm is a life-threatening crisis characterized by
extreme hypermetabolism, resulting in high fever (hyperthermia), severe tachycardia, and
potential heart failure.
2. A patient with Diabetes Insipidus (DI) is being monitored. Which laboratory finding most
accurately reflects this condition?
A. Urine specific gravity of 1.035
B. Serum sodium of 125 mEq/L
,C. Urine specific gravity of 1.002
D. Serum glucose of 250 mg/dL
Answer: C
Conceptual Explanation: Diabetes Insipidus involves a deficiency of ADH, leading to the
excretion of large amounts of very dilute urine, reflected by a low specific gravity (typically
<1.005).
3. When assessing a patient with Syndrome of Inappropriate Antidiuretic Hormone (SIADH),
which neurological sign is the most concerning result of hyponatremia?
A. Increased appetite and euphoria
B. Hyporeflexia and numbness
C. Restlessness and seizures
D. Tinnitus and blurred vision
Answer: C
Conceptual Explanation: Low sodium levels in SIADH cause cerebral edema, leading to
altered mental status, restlessness, and eventually seizures or coma.
4. A nurse is caring for a patient post-adrenalectomy. The patient’s blood pressure drops to
80/50 mmHg and they report severe abdominal pain. Which condition should be suspected?
A. Addisonian crisis
B. Thyroid storm
, C. Pheochromocytoma
D. Myxedema coma
Answer: A
Conceptual Explanation: Sudden withdrawal of adrenal hormones or stress post-surgery
can trigger an Addisonian crisis, characterized by hypotension, shock, and acute abdominal
pain.
5. A patient is diagnosed with Pheochromocytoma. Which of the following should the nurse
avoid during physical assessment?
A. Auscultating heart sounds
B. Assessing pupillary response
C. Deep palpation of the abdomen
D. Checking pedal pulses
Answer: C
Conceptual Explanation: Palpating the abdomen can stimulate the tumor to release a
massive amount of catecholamines, causing a hypertensive crisis.
6. Using the Parkland Formula, calculate the total fluid resuscitation required for the first 24
hours for a 70kg patient with 40% Total Body Surface Area (TBSA) burns.
A. 5,600 mL
B. 2,800 mL