NUR 242 – Medical-Surgical Nursing: Recommended Practice
Questions with Verified Answers & Detailed Rationales | 2026/2027
Complete Exam Study Guide
Question 1
A patient with heart failure reports shortness of breath and edema. Which
nursing intervention is priority?
A. Encourage high-sodium diet
B. Administer prescribed diuretics
C. Restrict oxygen therapy
D. Promote bed rest only
Correct Answer: Administer prescribed diuretics
Rationale: Diuretics help reduce fluid overload, relieve pulmonary congestion,
and manage edema in heart failure patients.
Question 2
A patient with chronic kidney disease presents with hyperkalemia. Which ECG
change is most likely?
A. Peaked T waves
B. ST depression
C. Prolonged QT interval
D. Inverted P wave
Correct Answer: Peaked T waves
Rationale: Hyperkalemia affects cardiac conduction, often presenting as
peaked T waves, widening QRS, and potentially life-threatening arrhythmias.
Question 3
Which sign is most indicative of hypovolemic shock?
, A. Bradycardia and hypertension
B. Tachycardia and hypotension
C. Normal vital signs
D. Bounding pulses and edema
Correct Answer: Tachycardia and hypotension
Rationale: Hypovolemia reduces circulating volume, triggering compensatory
tachycardia and hypotension to maintain perfusion.
Question 4
A patient with pneumonia has a high fever, productive cough, and shortness of
breath. Which lab value should the nurse monitor closely?
A. Serum glucose
B. White blood cell count
C. Serum calcium
D. Hematocrit
Correct Answer: White blood cell count
Rationale: WBC count helps assess the body’s inflammatory and infectious
response; elevated levels indicate ongoing infection.
Question 5
Which complication is most common after a total hip replacement?
A. Deep vein thrombosis
B. Pulmonary embolism
C. Hip dislocation
D. All of the above
Correct Answer: All of the above
Rationale: Patients are at risk for DVT, pulmonary embolism, and joint
dislocation postoperatively. Nursing interventions include early ambulation,
anticoagulation, and hip precautions.
,Question 6
A patient with chronic obstructive pulmonary disease (COPD) has a PaO₂ of 55
mmHg. Which intervention is most appropriate?
A. Administer high-flow oxygen at 10 L/min
B. Administer low-flow oxygen at 1–2 L/min
C. Encourage vigorous exercise
D. Restrict fluids
Correct Answer: Administer low-flow oxygen at 1–2 L/min
Rationale: COPD patients are often hypoxemia-driven for respiration. High-
flow oxygen can reduce their respiratory drive, leading to CO₂ retention. Low-flow
oxygen corrects hypoxia safely.
Question 7
A patient is admitted with diabetic ketoacidosis (DKA). Which lab finding is
expected?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: Hyperkalemia
Rationale: Insulin deficiency and acidosis cause potassium to shift out of cells
into the bloodstream, leading to hyperkalemia despite total body potassium
depletion.
Question 8
Which nursing action is priority for a patient with neutropenia?
A. Encourage visitors
B. Strict hand hygiene and infection precautions
C. Provide high-fiber diet
, D. Encourage vigorous exercise
Correct Answer: Strict hand hygiene and infection precautions
Rationale: Neutropenic patients are highly susceptible to infections;
preventing pathogen exposure is critical.
Question 9
A patient post-splenectomy is at highest risk for:
A. Infection
B. Thrombocytopenia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: Infection
Rationale: The spleen plays a key role in filtering bacteria and mounting
immune responses. Post-splenectomy patients are at increased risk for severe
infections.
Question 10
A patient with cirrhosis develops ascites and edema. Which nursing intervention
is essential?
A. Fluid and sodium restriction
B. High-protein diet only
C. Encourage heavy exercise
D. Administer calcium supplements
Correct Answer: Fluid and sodium restriction
Rationale: Sodium and water restriction help prevent fluid accumulation and
reduce ascites. Diuretics may also be prescribed.
Questions with Verified Answers & Detailed Rationales | 2026/2027
Complete Exam Study Guide
Question 1
A patient with heart failure reports shortness of breath and edema. Which
nursing intervention is priority?
A. Encourage high-sodium diet
B. Administer prescribed diuretics
C. Restrict oxygen therapy
D. Promote bed rest only
Correct Answer: Administer prescribed diuretics
Rationale: Diuretics help reduce fluid overload, relieve pulmonary congestion,
and manage edema in heart failure patients.
Question 2
A patient with chronic kidney disease presents with hyperkalemia. Which ECG
change is most likely?
A. Peaked T waves
B. ST depression
C. Prolonged QT interval
D. Inverted P wave
Correct Answer: Peaked T waves
Rationale: Hyperkalemia affects cardiac conduction, often presenting as
peaked T waves, widening QRS, and potentially life-threatening arrhythmias.
Question 3
Which sign is most indicative of hypovolemic shock?
, A. Bradycardia and hypertension
B. Tachycardia and hypotension
C. Normal vital signs
D. Bounding pulses and edema
Correct Answer: Tachycardia and hypotension
Rationale: Hypovolemia reduces circulating volume, triggering compensatory
tachycardia and hypotension to maintain perfusion.
Question 4
A patient with pneumonia has a high fever, productive cough, and shortness of
breath. Which lab value should the nurse monitor closely?
A. Serum glucose
B. White blood cell count
C. Serum calcium
D. Hematocrit
Correct Answer: White blood cell count
Rationale: WBC count helps assess the body’s inflammatory and infectious
response; elevated levels indicate ongoing infection.
Question 5
Which complication is most common after a total hip replacement?
A. Deep vein thrombosis
B. Pulmonary embolism
C. Hip dislocation
D. All of the above
Correct Answer: All of the above
Rationale: Patients are at risk for DVT, pulmonary embolism, and joint
dislocation postoperatively. Nursing interventions include early ambulation,
anticoagulation, and hip precautions.
,Question 6
A patient with chronic obstructive pulmonary disease (COPD) has a PaO₂ of 55
mmHg. Which intervention is most appropriate?
A. Administer high-flow oxygen at 10 L/min
B. Administer low-flow oxygen at 1–2 L/min
C. Encourage vigorous exercise
D. Restrict fluids
Correct Answer: Administer low-flow oxygen at 1–2 L/min
Rationale: COPD patients are often hypoxemia-driven for respiration. High-
flow oxygen can reduce their respiratory drive, leading to CO₂ retention. Low-flow
oxygen corrects hypoxia safely.
Question 7
A patient is admitted with diabetic ketoacidosis (DKA). Which lab finding is
expected?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: Hyperkalemia
Rationale: Insulin deficiency and acidosis cause potassium to shift out of cells
into the bloodstream, leading to hyperkalemia despite total body potassium
depletion.
Question 8
Which nursing action is priority for a patient with neutropenia?
A. Encourage visitors
B. Strict hand hygiene and infection precautions
C. Provide high-fiber diet
, D. Encourage vigorous exercise
Correct Answer: Strict hand hygiene and infection precautions
Rationale: Neutropenic patients are highly susceptible to infections;
preventing pathogen exposure is critical.
Question 9
A patient post-splenectomy is at highest risk for:
A. Infection
B. Thrombocytopenia
C. Hypokalemia
D. Hypercalcemia
Correct Answer: Infection
Rationale: The spleen plays a key role in filtering bacteria and mounting
immune responses. Post-splenectomy patients are at increased risk for severe
infections.
Question 10
A patient with cirrhosis develops ascites and edema. Which nursing intervention
is essential?
A. Fluid and sodium restriction
B. High-protein diet only
C. Encourage heavy exercise
D. Administer calcium supplements
Correct Answer: Fluid and sodium restriction
Rationale: Sodium and water restriction help prevent fluid accumulation and
reduce ascites. Diuretics may also be prescribed.
