NUR 242 FINAL EXAM: MEDICAL-
SURGICAL NURSING QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient with a history of heart failure presents with a sudden onset of shortness of
breath, restlessness, and the expectoration of pink, frothy sputum. Which condition should
the nurse prioritize?
A. Acute Myocardial Infarction
B. Acute Pulmonary Edema
C. Pulmonary Embolism
D. Exacerbation of COPD
Answer: B
Conceptual Explanation: Pink, frothy sputum is a classic, late-stage sign of acute
pulmonary edema, which results from left-sided heart failure causing fluid to back up into
the lungs.
2. Which arterial blood gas (ABG) result would the nurse expect in a patient who has been
experiencing prolonged nasogastric suctioning?
A. pH 7.50, PaCO2 30, HCO3 22
,B. pH 7.32, PaCO2 50, HCO3 24
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 42, HCO3 30
Answer: D
Conceptual Explanation: Prolonged NG suctioning causes metabolic alkalosis due to the
loss of gastric acids. ABGs for metabolic alkalosis show a pH > 7.45 and HCO3 > 26.
3. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). Which finding is
most characteristic of the early stages of this condition?
A. Refractory hypoxemia
B. Hypercapnia and acidosis
C. Large pleural effusions on X-ray
D. Increased pulmonary compliance
Answer: A
Conceptual Explanation: Refractory hypoxemia, where oxygen levels do not improve
despite high levels of supplemental oxygen, is the hallmark of ARDS due to shunting and
alveolar collapse.
4. A patient with Type 1 Diabetes is admitted with a blood glucose of 650 mg/dL, Kussmaul
respirations, and a fruity breath odor. What is the priority nursing intervention?
A. Administer IV potassium immediately
, B. Start a bolus of IV regular insulin
C. Initiate fluid resuscitation with 0.9% Normal Saline
D. Administer subcutaneous glargine
Answer: C
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), the priority is fluid resuscitation
to correct dehydration and restore perfusion before addressing hyperglycemia and
electrolyte imbalances.
5. A patient is experiencing Cushing’s triad after a head injury. Which set of vital signs aligns
with this diagnosis?
A. BP 120/80, HR 70, regular respirations
B. BP 90/60, HR 120, rapid respirations
C. BP 180/60, HR 50, irregular respirations
D. BP 140/90, HR 110, Cheyne-Stokes respirations
Answer: C
Conceptual Explanation: Cushing’s triad is a sign of increased intracranial pressure
consisting of systolic hypertension with a widening pulse pressure, bradycardia, and
irregular respirations.
SURGICAL NURSING QUESTIONS &
VERIFIED ANSWERS | GALEN
COLLEGE (A+ GUARANTEE)
1. A patient with a history of heart failure presents with a sudden onset of shortness of
breath, restlessness, and the expectoration of pink, frothy sputum. Which condition should
the nurse prioritize?
A. Acute Myocardial Infarction
B. Acute Pulmonary Edema
C. Pulmonary Embolism
D. Exacerbation of COPD
Answer: B
Conceptual Explanation: Pink, frothy sputum is a classic, late-stage sign of acute
pulmonary edema, which results from left-sided heart failure causing fluid to back up into
the lungs.
2. Which arterial blood gas (ABG) result would the nurse expect in a patient who has been
experiencing prolonged nasogastric suctioning?
A. pH 7.50, PaCO2 30, HCO3 22
,B. pH 7.32, PaCO2 50, HCO3 24
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 42, HCO3 30
Answer: D
Conceptual Explanation: Prolonged NG suctioning causes metabolic alkalosis due to the
loss of gastric acids. ABGs for metabolic alkalosis show a pH > 7.45 and HCO3 > 26.
3. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). Which finding is
most characteristic of the early stages of this condition?
A. Refractory hypoxemia
B. Hypercapnia and acidosis
C. Large pleural effusions on X-ray
D. Increased pulmonary compliance
Answer: A
Conceptual Explanation: Refractory hypoxemia, where oxygen levels do not improve
despite high levels of supplemental oxygen, is the hallmark of ARDS due to shunting and
alveolar collapse.
4. A patient with Type 1 Diabetes is admitted with a blood glucose of 650 mg/dL, Kussmaul
respirations, and a fruity breath odor. What is the priority nursing intervention?
A. Administer IV potassium immediately
, B. Start a bolus of IV regular insulin
C. Initiate fluid resuscitation with 0.9% Normal Saline
D. Administer subcutaneous glargine
Answer: C
Conceptual Explanation: In Diabetic Ketoacidosis (DKA), the priority is fluid resuscitation
to correct dehydration and restore perfusion before addressing hyperglycemia and
electrolyte imbalances.
5. A patient is experiencing Cushing’s triad after a head injury. Which set of vital signs aligns
with this diagnosis?
A. BP 120/80, HR 70, regular respirations
B. BP 90/60, HR 120, rapid respirations
C. BP 180/60, HR 50, irregular respirations
D. BP 140/90, HR 110, Cheyne-Stokes respirations
Answer: C
Conceptual Explanation: Cushing’s triad is a sign of increased intracranial pressure
consisting of systolic hypertension with a widening pulse pressure, bradycardia, and
irregular respirations.
