1 of 26
NUR 242 MED SURG EXAM LATEST ACTUAL EXAM 100 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+ 2025/2026
PICC line - ......ANSWER........placed by a PICC certified nurse
used when long-term therapy is needed (up to one year)
always flush with a 10 ml syringe
RNs can remove a PICC line. Have the patient perform the Valsalva maneuver, make sure
the tip is intact. If discontinuing due to infection, send the tip of the PICC line to the lab for
C&S
Implantable ports - ......ANSWER........surgically implanted in the right or left chest
canoe used for individuals receiving chemotherapy
hubber needle is used to access the port at a 90-degree angle
Complications of central Line Access
Central line associated blood stream infection (CLABI) - ......ANSWER........s/s: localized
erythema, tenderness, fever, drainage
can lead to a systemic infection and sepsis
d/c the central line and culture the tip
Tx: ABT and antifungals
prevention: meticulous hand washing
Complications of Central Access Device
,2 of 26
Air Embolism - ......ANSWER........Bolus of air enters circulation
potentially fatal
s/s: tachycardia, chest pain, dyspnea, and cyanosis
interventions: trapping the air into the R atrium, turn the client to the left side in
Trendelenburg position
all lines should be primed prior to use and connections secure when not in use
Complications of central line access
Clotted access - ......ANSWER........The catheter becomes clogged from either the solution
being infused or from insufficient flushing
a thrombolytic can be ordered from the physician to dwell and dissolve the clot
needs to be treated promptly to prevent having to remove the central line
prevention: routine flushing
Complications of central line access
Pneumothorax - ......ANSWER........Occurs following insertion of the central line
fatal if not treated
s/s: tachypnea, absent breath sounds on the affected side, decreased oxygen saturation,
and restlessness
ALWAYS verify placement of a central line with a chest x-ray
TPN Total Parenteral Nutrition - ......ANSWER........Nutritional status is monitored by
checking protein levels, such as albumin and pre-albumin levels
, 3 of 26
TPN care and maintenance of - ......ANSWER........check each bag of TPN for accuracy by
comparing it with the physician's order (2 nurses to check to prevent errors)
if the TPN solution is unavailable, give 10% dextrose/water (or 20% D/W) until the TPN
solution can be obtained
if the TPN administration is not on time, do not increase the rate
Change IV tubing every 24 hours when new bag is hung
dressing change around the IV site should be changed every 48-72 hours
Sickle cell Disease - ......ANSWER........RBCs are sickle shaped, rigid and clump together.
the clumps form assesses of sickled RBC's that block blood flow, leads to tissue hypoxia.
Repeated episodes of ischemia lead to progressive organ damage
Pain is the most common problem
Sickle cell crisis - ......ANSWER........pain due to tissue injury caused by poor oxygenation
from obstructed blood flow. Pain is severe enough to require hospitalization and large
doses of opioid analgesic. concerns about substance abuse can lead to inadequate pain
treatment
Care of Patient in Sickle Call Crisis - ......ANSWER........Give prescribed pain medication
hydrate with normal saline IV, encourage oral intake of fluids without caffeine
administer oxygen
remove restrictive clothing, no blood pressure with external cuff
NUR 242 MED SURG EXAM LATEST ACTUAL EXAM 100 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+ 2025/2026
PICC line - ......ANSWER........placed by a PICC certified nurse
used when long-term therapy is needed (up to one year)
always flush with a 10 ml syringe
RNs can remove a PICC line. Have the patient perform the Valsalva maneuver, make sure
the tip is intact. If discontinuing due to infection, send the tip of the PICC line to the lab for
C&S
Implantable ports - ......ANSWER........surgically implanted in the right or left chest
canoe used for individuals receiving chemotherapy
hubber needle is used to access the port at a 90-degree angle
Complications of central Line Access
Central line associated blood stream infection (CLABI) - ......ANSWER........s/s: localized
erythema, tenderness, fever, drainage
can lead to a systemic infection and sepsis
d/c the central line and culture the tip
Tx: ABT and antifungals
prevention: meticulous hand washing
Complications of Central Access Device
,2 of 26
Air Embolism - ......ANSWER........Bolus of air enters circulation
potentially fatal
s/s: tachycardia, chest pain, dyspnea, and cyanosis
interventions: trapping the air into the R atrium, turn the client to the left side in
Trendelenburg position
all lines should be primed prior to use and connections secure when not in use
Complications of central line access
Clotted access - ......ANSWER........The catheter becomes clogged from either the solution
being infused or from insufficient flushing
a thrombolytic can be ordered from the physician to dwell and dissolve the clot
needs to be treated promptly to prevent having to remove the central line
prevention: routine flushing
Complications of central line access
Pneumothorax - ......ANSWER........Occurs following insertion of the central line
fatal if not treated
s/s: tachypnea, absent breath sounds on the affected side, decreased oxygen saturation,
and restlessness
ALWAYS verify placement of a central line with a chest x-ray
TPN Total Parenteral Nutrition - ......ANSWER........Nutritional status is monitored by
checking protein levels, such as albumin and pre-albumin levels
, 3 of 26
TPN care and maintenance of - ......ANSWER........check each bag of TPN for accuracy by
comparing it with the physician's order (2 nurses to check to prevent errors)
if the TPN solution is unavailable, give 10% dextrose/water (or 20% D/W) until the TPN
solution can be obtained
if the TPN administration is not on time, do not increase the rate
Change IV tubing every 24 hours when new bag is hung
dressing change around the IV site should be changed every 48-72 hours
Sickle cell Disease - ......ANSWER........RBCs are sickle shaped, rigid and clump together.
the clumps form assesses of sickled RBC's that block blood flow, leads to tissue hypoxia.
Repeated episodes of ischemia lead to progressive organ damage
Pain is the most common problem
Sickle cell crisis - ......ANSWER........pain due to tissue injury caused by poor oxygenation
from obstructed blood flow. Pain is severe enough to require hospitalization and large
doses of opioid analgesic. concerns about substance abuse can lead to inadequate pain
treatment
Care of Patient in Sickle Call Crisis - ......ANSWER........Give prescribed pain medication
hydrate with normal saline IV, encourage oral intake of fluids without caffeine
administer oxygen
remove restrictive clothing, no blood pressure with external cuff
