JERSEY COLLEGE MEDSURG 1 RN FINAL EXAM 2026/2027 LATEST
UPDATE |VERIFIED QUESTIONS AND ANSWERS
Question 1
A patient with congestive heart failure is admitted to the medical-surgical unit
with complaints of shortness of breath, edema, and fatigue. Discuss the nursing
assessment, priority interventions, medications, and patient teaching required
for this patient.
Answer
The nurse should first assess the patient’s respiratory status, oxygen saturation,
lung sounds, heart sounds, level of edema, and activity tolerance. Patients with
congestive heart failure commonly present with crackles in the lungs, jugular vein
distention, weight gain, and fluid retention. Vital signs should be monitored
closely because heart failure can lead to decreased cardiac output and
hypotension.
Priority nursing interventions include placing the patient in a semi-Fowler’s or
high-Fowler’s position to improve breathing, administering oxygen therapy as
prescribed, monitoring intake and output, and obtaining daily weights. The nurse
should assess for worsening symptoms such as increasing edema or respiratory
distress.
Common medications include diuretics to reduce fluid overload, ACE inhibitors to
lower blood pressure and improve cardiac function, beta blockers to decrease
cardiac workload, and vasodilators to improve circulation. The nurse should
monitor for medication side effects such as electrolyte imbalance and
hypotension.
Patient teaching should include sodium restriction, fluid restriction if ordered,
medication adherence, smoking cessation, daily weight monitoring, exercise
,recommendations, and recognizing early signs of worsening heart failure such as
rapid weight gain and increased shortness of breath.
Question 2
A patient is admitted with chronic obstructive pulmonary disease (COPD)
exacerbation. Explain the pathophysiology, symptoms, nursing management,
and discharge teaching for this patient.
Answer
COPD is a progressive respiratory disorder characterized by airflow limitation
caused by chronic bronchitis or emphysema. Damage to the airways and alveoli
reduces oxygen exchange and causes difficulty breathing.
Common symptoms include dyspnea, chronic cough, wheezing, chest tightness,
and excessive mucus production. Patients may also develop cyanosis and fatigue
due to poor oxygenation.
Nursing management includes assessing respiratory status, monitoring oxygen
saturation, auscultating lung sounds, encouraging coughing and deep breathing
exercises, and positioning the patient upright to promote lung expansion. Oxygen
therapy should be carefully administered because excessive oxygen may suppress
respiratory drive in some COPD patients.
Medications commonly prescribed include bronchodilators, corticosteroids,
antibiotics, and mucolytics. The nurse should monitor the patient’s response to
treatment and observe for complications such as respiratory failure.
Discharge teaching should focus on smoking cessation, avoiding respiratory
irritants, proper inhaler use, vaccination recommendations, hydration, nutrition,
breathing exercises, and recognizing signs of exacerbation requiring medical
attention.
,Question 3
Discuss the nursing care of a patient experiencing diabetic ketoacidosis (DKA).
Answer
Diabetic ketoacidosis is a serious complication of diabetes mellitus caused by
insulin deficiency, leading to hyperglycemia, dehydration, and ketone production.
Symptoms include excessive thirst, polyuria, fruity breath odor, nausea, vomiting,
abdominal pain, and altered mental status.
The nurse should assess blood glucose levels, electrolyte balance, hydration
status, vital signs, and neurological status. Continuous cardiac monitoring may be
required because electrolyte imbalances can affect cardiac function.
Priority interventions include administering intravenous fluids to correct
dehydration, insulin therapy to reduce blood glucose, and electrolyte
replacement, especially potassium. Intake and output should be monitored
carefully.
The nurse should also monitor laboratory results including arterial blood gases,
serum ketones, and electrolyte levels. Frequent reassessment is necessary to
evaluate response to treatment.
Patient education should include medication compliance, proper insulin
administration, sick-day management, blood glucose monitoring, dietary
management, and recognizing early symptoms of hyperglycemia.
Question 4
A patient is diagnosed with pneumonia. Explain the nursing assessment and
management of this condition.
Answer
Pneumonia is an infection of the lungs that causes inflammation and
accumulation of fluid or pus in the alveoli. Patients commonly present with fever,
productive cough, dyspnea, chest pain, and fatigue.
, The nurse should assess respiratory status, lung sounds, oxygen saturation,
temperature, sputum characteristics, and breathing pattern. Crackles or
diminished breath sounds may be present during auscultation.
Nursing interventions include administering prescribed antibiotics, oxygen
therapy, antipyretics, and bronchodilators if ordered. Encouraging coughing, deep
breathing, and incentive spirometry helps improve lung expansion and secretion
clearance.
Adequate hydration is important to thin respiratory secretions. The nurse should
monitor for complications such as respiratory failure or sepsis.
Patient teaching should include completing the full course of antibiotics, smoking
cessation, adequate rest, hydration, and vaccination against influenza and
pneumococcal infections.
Question 5
Explain the nursing management of a patient recovering from a cerebrovascular
accident (stroke).
Answer
A stroke occurs when blood flow to the brain is interrupted, causing neurological
damage. Symptoms may include weakness, paralysis, speech difficulties, facial
drooping, and altered consciousness.
The nurse should assess neurological status frequently, including pupil response,
level of consciousness, motor function, and speech ability. Airway management is
a priority because stroke patients are at risk for aspiration.
Nursing interventions include maintaining proper positioning, assisting with
mobility, implementing fall precautions, monitoring vital signs, and supporting
rehabilitation therapies. Swallowing ability should be evaluated before oral
intake.
UPDATE |VERIFIED QUESTIONS AND ANSWERS
Question 1
A patient with congestive heart failure is admitted to the medical-surgical unit
with complaints of shortness of breath, edema, and fatigue. Discuss the nursing
assessment, priority interventions, medications, and patient teaching required
for this patient.
Answer
The nurse should first assess the patient’s respiratory status, oxygen saturation,
lung sounds, heart sounds, level of edema, and activity tolerance. Patients with
congestive heart failure commonly present with crackles in the lungs, jugular vein
distention, weight gain, and fluid retention. Vital signs should be monitored
closely because heart failure can lead to decreased cardiac output and
hypotension.
Priority nursing interventions include placing the patient in a semi-Fowler’s or
high-Fowler’s position to improve breathing, administering oxygen therapy as
prescribed, monitoring intake and output, and obtaining daily weights. The nurse
should assess for worsening symptoms such as increasing edema or respiratory
distress.
Common medications include diuretics to reduce fluid overload, ACE inhibitors to
lower blood pressure and improve cardiac function, beta blockers to decrease
cardiac workload, and vasodilators to improve circulation. The nurse should
monitor for medication side effects such as electrolyte imbalance and
hypotension.
Patient teaching should include sodium restriction, fluid restriction if ordered,
medication adherence, smoking cessation, daily weight monitoring, exercise
,recommendations, and recognizing early signs of worsening heart failure such as
rapid weight gain and increased shortness of breath.
Question 2
A patient is admitted with chronic obstructive pulmonary disease (COPD)
exacerbation. Explain the pathophysiology, symptoms, nursing management,
and discharge teaching for this patient.
Answer
COPD is a progressive respiratory disorder characterized by airflow limitation
caused by chronic bronchitis or emphysema. Damage to the airways and alveoli
reduces oxygen exchange and causes difficulty breathing.
Common symptoms include dyspnea, chronic cough, wheezing, chest tightness,
and excessive mucus production. Patients may also develop cyanosis and fatigue
due to poor oxygenation.
Nursing management includes assessing respiratory status, monitoring oxygen
saturation, auscultating lung sounds, encouraging coughing and deep breathing
exercises, and positioning the patient upright to promote lung expansion. Oxygen
therapy should be carefully administered because excessive oxygen may suppress
respiratory drive in some COPD patients.
Medications commonly prescribed include bronchodilators, corticosteroids,
antibiotics, and mucolytics. The nurse should monitor the patient’s response to
treatment and observe for complications such as respiratory failure.
Discharge teaching should focus on smoking cessation, avoiding respiratory
irritants, proper inhaler use, vaccination recommendations, hydration, nutrition,
breathing exercises, and recognizing signs of exacerbation requiring medical
attention.
,Question 3
Discuss the nursing care of a patient experiencing diabetic ketoacidosis (DKA).
Answer
Diabetic ketoacidosis is a serious complication of diabetes mellitus caused by
insulin deficiency, leading to hyperglycemia, dehydration, and ketone production.
Symptoms include excessive thirst, polyuria, fruity breath odor, nausea, vomiting,
abdominal pain, and altered mental status.
The nurse should assess blood glucose levels, electrolyte balance, hydration
status, vital signs, and neurological status. Continuous cardiac monitoring may be
required because electrolyte imbalances can affect cardiac function.
Priority interventions include administering intravenous fluids to correct
dehydration, insulin therapy to reduce blood glucose, and electrolyte
replacement, especially potassium. Intake and output should be monitored
carefully.
The nurse should also monitor laboratory results including arterial blood gases,
serum ketones, and electrolyte levels. Frequent reassessment is necessary to
evaluate response to treatment.
Patient education should include medication compliance, proper insulin
administration, sick-day management, blood glucose monitoring, dietary
management, and recognizing early symptoms of hyperglycemia.
Question 4
A patient is diagnosed with pneumonia. Explain the nursing assessment and
management of this condition.
Answer
Pneumonia is an infection of the lungs that causes inflammation and
accumulation of fluid or pus in the alveoli. Patients commonly present with fever,
productive cough, dyspnea, chest pain, and fatigue.
, The nurse should assess respiratory status, lung sounds, oxygen saturation,
temperature, sputum characteristics, and breathing pattern. Crackles or
diminished breath sounds may be present during auscultation.
Nursing interventions include administering prescribed antibiotics, oxygen
therapy, antipyretics, and bronchodilators if ordered. Encouraging coughing, deep
breathing, and incentive spirometry helps improve lung expansion and secretion
clearance.
Adequate hydration is important to thin respiratory secretions. The nurse should
monitor for complications such as respiratory failure or sepsis.
Patient teaching should include completing the full course of antibiotics, smoking
cessation, adequate rest, hydration, and vaccination against influenza and
pneumococcal infections.
Question 5
Explain the nursing management of a patient recovering from a cerebrovascular
accident (stroke).
Answer
A stroke occurs when blood flow to the brain is interrupted, causing neurological
damage. Symptoms may include weakness, paralysis, speech difficulties, facial
drooping, and altered consciousness.
The nurse should assess neurological status frequently, including pupil response,
level of consciousness, motor function, and speech ability. Airway management is
a priority because stroke patients are at risk for aspiration.
Nursing interventions include maintaining proper positioning, assisting with
mobility, implementing fall precautions, monitoring vital signs, and supporting
rehabilitation therapies. Swallowing ability should be evaluated before oral
intake.
