NUR 242 Med-Surg Nursing Exam 4 – Practice
Questions & Rationales
Based on the available search results, I have compiled a representative set of practice
questions for the NUR 242 Exam 4 (Medical-Surgical Nursing Concepts) at Galen College
of Nursing. These questions are derived from unofficial student-shared resources and
are designed to help you prepare for the exam format .
SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A client with heart failure has crackles in all lung fields, jugular venous distention, and 3+
pitting edema. Which medication should the nurse expect to administer first?
A) Digoxin
B) Furosemide
C) Enalapril
D) Carvedilol
Correct Resolution Result Verified Answers : B
Rationale: Furosemide is a loop diuretic that reduces preload by promoting diuresis,
relieving pulmonary congestion and edema. It is first-line for acute decompensated heart
failure with fluid overload .
Question 2
A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the
nurse monitor to evaluate therapeutic effect?
A) aPTT
, B) INR
C) Platelet count
D) Bleeding time
Correct Resolution Result Verified Answers : B
Rationale: Warfarin anticoagulation is monitored by INR. The therapeutic target INR for
atrial fibrillation is 2-3 (2.5-3.5 for mechanical valves). aPTT is used to monitor heparin
therapy .
Question 3
A nurse is caring for a patient with heart failure who has gained 2 kg (4.4 lbs) in 24
hours. Which action should the nurse take first?
A) Restrict fluid intake to 1 L/day
B) Administer furosemide as prescribed
C) Assess lung sounds and oxygen saturation
D) Elevate the head of the bed
Correct Resolution Result Verified Answers : C
Rationale: The nurse must first assess the patient's respiratory status (lung sounds, SpO2)
to detect pulmonary edema. Assessment always precedes intervention. Elevating HOB
helps breathing but assessment comes first .
Question 4
A client with chronic heart failure is taking digoxin and furosemide. Which finding
suggests digoxin toxicity?
A) Heart rate 62 bpm
Questions & Rationales
Based on the available search results, I have compiled a representative set of practice
questions for the NUR 242 Exam 4 (Medical-Surgical Nursing Concepts) at Galen College
of Nursing. These questions are derived from unofficial student-shared resources and
are designed to help you prepare for the exam format .
SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A client with heart failure has crackles in all lung fields, jugular venous distention, and 3+
pitting edema. Which medication should the nurse expect to administer first?
A) Digoxin
B) Furosemide
C) Enalapril
D) Carvedilol
Correct Resolution Result Verified Answers : B
Rationale: Furosemide is a loop diuretic that reduces preload by promoting diuresis,
relieving pulmonary congestion and edema. It is first-line for acute decompensated heart
failure with fluid overload .
Question 2
A client with atrial fibrillation is prescribed warfarin. Which laboratory test should the
nurse monitor to evaluate therapeutic effect?
A) aPTT
, B) INR
C) Platelet count
D) Bleeding time
Correct Resolution Result Verified Answers : B
Rationale: Warfarin anticoagulation is monitored by INR. The therapeutic target INR for
atrial fibrillation is 2-3 (2.5-3.5 for mechanical valves). aPTT is used to monitor heparin
therapy .
Question 3
A nurse is caring for a patient with heart failure who has gained 2 kg (4.4 lbs) in 24
hours. Which action should the nurse take first?
A) Restrict fluid intake to 1 L/day
B) Administer furosemide as prescribed
C) Assess lung sounds and oxygen saturation
D) Elevate the head of the bed
Correct Resolution Result Verified Answers : C
Rationale: The nurse must first assess the patient's respiratory status (lung sounds, SpO2)
to detect pulmonary edema. Assessment always precedes intervention. Elevating HOB
helps breathing but assessment comes first .
Question 4
A client with chronic heart failure is taking digoxin and furosemide. Which finding
suggests digoxin toxicity?
A) Heart rate 62 bpm
