NUR 242 – EXAM 1 – MEDICAL-SURGICAL NURSING CONCEPTS QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Fluid and Electrolyte Balance
- Acid-Base Imbalances
- Perioperative Nursing Care
- Pain Management
- Infection Control and Immunity
- Wound Healing and Pressure Injuries
- Medication Administration and Safety
- Legal and Ethical Nursing Practice
- Clinical Judgment and Prioritization
- Patient Education and Health Promotion
Introduction
This comprehensive examination is designed to assess foundational medical-surgical nursing concepts essential for
safe, competent practice. It evaluates the student’s ability to apply theoretical knowledge to clinical scenarios,
prioritize patient care, recognize subtle changes in patient status, and implement evidence-based interventions.
The exam includes multiple-choice questions that test recall, comprehension, application, and analysis. Each
question is followed by a verified correct answer and a detailed rationale to reinforce learning and clinical
reasoning. Emphasis is placed on real-world decision-making, regulatory compliance, ethical standards, and
critical thinking. This assessment serves as a reliable study tool for exam preparation and clinical readiness.
,SECTION ONE: QUESTIONS 1 – 100
Question 1
A nurse is caring for a patient with hyponatremia. Which assessment finding requires immediate intervention?
A. Serum sodium 132 mEq/L
B. Mild headache
C. Muscle twitching and altered mental status
D. Nausea with vomiting
🟢C
🔴 RATIONALE: Muscle twitching and altered mental status indicate worsening hyponatremia and risk of
cerebral edema, seizures, or coma. This is a neurological emergency requiring rapid correction. Mild symptoms
(headache, nausea) do not require immediate intervention compared to neurological decline.
Question 2
A postoperative patient reports pain of 8 on a 0–10 scale. The nurse administers morphine 4 mg IV. Thirty
minutes later, the patient’s respiratory rate is 8 breaths per minute. What is the nurse’s priority action?
A. Administer naloxone per protocol
B. Reassess pain level
C. Apply supplemental oxygen at 2 L/min
D. Continue to monitor every 15 minutes
🟢A
🔴 RATIONALE: Respiratory rate of 8 indicates opioid-induced respiratory depression. Naloxone is the specific
antagonist that reverses this life-threatening complication. Oxygen and monitoring are supportive but not the
priority without reversal.
,Question 3
Which electrolyte imbalance is most commonly associated with digoxin toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
🟢B
🔴 RATIONALE: Hypokalemia increases cardiac cell sensitivity to digoxin, raising the risk of toxicity and
dysrhythmias. Low potassium impairs sodium-potassium pump function, potentiating digoxin’s effects.
Question 4
A nurse is preparing a patient for surgery. Which statement by the patient indicates a need for further teaching
about informed consent?
A. “I can change my mind even after signing the form.”
B. “My surgeon has explained the risks and benefits.”
C. “The nurse will answer all my questions about the procedure.”
D. “I understand I will be under general anesthesia.”
🟢C
🔴 RATIONALE: The nurse may witness the consent but cannot answer medical questions about the procedure
or act as the primary explainer of risks/benefits. That responsibility belongs to the surgeon or proceduralist.
Question 5
A patient with heart failure has arterial blood gas results: pH 7.31, PaCO2 50 mm Hg, HCO3 24 mEq/L. How
should the nurse interpret these values?
A. Metabolic alkalosis, uncompensated
, B. Respiratory acidosis, uncompensated
C. Metabolic acidosis, partially compensated
D. Respiratory alkalosis, fully compensated
🟢B
🔴 RATIONALE: Low pH (acidosis) with elevated PaCO2 (normal 35–45) indicates respiratory acidosis. HCO3 is
normal, showing no renal compensation yet. Thus, it is acute uncompensated respiratory acidosis.
Question 6
A nurse is changing a pressure injury dressing. Which finding suggests healing?
A. Thick, adherent eschar
B. Pale, dry wound bed
C. Red granulation tissue
D. Foul-smelling yellow exudate
🟢C
🔴 RATIONALE: Red granulation tissue indicates new capillary growth and healthy healing. Eschar, pallor, and
foul exudate suggest necrosis, poor perfusion, or infection.
Question 7
Which patient is at highest risk for developing a healthcare-associated infection (HAI)?
A. A 30-year-old with a fractured tibia
B. A 65-year-old with an indwelling urinary catheter
C. A 45-year-old with hypertension
D. A 22-year-old with migraine headaches
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Fluid and Electrolyte Balance
- Acid-Base Imbalances
- Perioperative Nursing Care
- Pain Management
- Infection Control and Immunity
- Wound Healing and Pressure Injuries
- Medication Administration and Safety
- Legal and Ethical Nursing Practice
- Clinical Judgment and Prioritization
- Patient Education and Health Promotion
Introduction
This comprehensive examination is designed to assess foundational medical-surgical nursing concepts essential for
safe, competent practice. It evaluates the student’s ability to apply theoretical knowledge to clinical scenarios,
prioritize patient care, recognize subtle changes in patient status, and implement evidence-based interventions.
The exam includes multiple-choice questions that test recall, comprehension, application, and analysis. Each
question is followed by a verified correct answer and a detailed rationale to reinforce learning and clinical
reasoning. Emphasis is placed on real-world decision-making, regulatory compliance, ethical standards, and
critical thinking. This assessment serves as a reliable study tool for exam preparation and clinical readiness.
,SECTION ONE: QUESTIONS 1 – 100
Question 1
A nurse is caring for a patient with hyponatremia. Which assessment finding requires immediate intervention?
A. Serum sodium 132 mEq/L
B. Mild headache
C. Muscle twitching and altered mental status
D. Nausea with vomiting
🟢C
🔴 RATIONALE: Muscle twitching and altered mental status indicate worsening hyponatremia and risk of
cerebral edema, seizures, or coma. This is a neurological emergency requiring rapid correction. Mild symptoms
(headache, nausea) do not require immediate intervention compared to neurological decline.
Question 2
A postoperative patient reports pain of 8 on a 0–10 scale. The nurse administers morphine 4 mg IV. Thirty
minutes later, the patient’s respiratory rate is 8 breaths per minute. What is the nurse’s priority action?
A. Administer naloxone per protocol
B. Reassess pain level
C. Apply supplemental oxygen at 2 L/min
D. Continue to monitor every 15 minutes
🟢A
🔴 RATIONALE: Respiratory rate of 8 indicates opioid-induced respiratory depression. Naloxone is the specific
antagonist that reverses this life-threatening complication. Oxygen and monitoring are supportive but not the
priority without reversal.
,Question 3
Which electrolyte imbalance is most commonly associated with digoxin toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
🟢B
🔴 RATIONALE: Hypokalemia increases cardiac cell sensitivity to digoxin, raising the risk of toxicity and
dysrhythmias. Low potassium impairs sodium-potassium pump function, potentiating digoxin’s effects.
Question 4
A nurse is preparing a patient for surgery. Which statement by the patient indicates a need for further teaching
about informed consent?
A. “I can change my mind even after signing the form.”
B. “My surgeon has explained the risks and benefits.”
C. “The nurse will answer all my questions about the procedure.”
D. “I understand I will be under general anesthesia.”
🟢C
🔴 RATIONALE: The nurse may witness the consent but cannot answer medical questions about the procedure
or act as the primary explainer of risks/benefits. That responsibility belongs to the surgeon or proceduralist.
Question 5
A patient with heart failure has arterial blood gas results: pH 7.31, PaCO2 50 mm Hg, HCO3 24 mEq/L. How
should the nurse interpret these values?
A. Metabolic alkalosis, uncompensated
, B. Respiratory acidosis, uncompensated
C. Metabolic acidosis, partially compensated
D. Respiratory alkalosis, fully compensated
🟢B
🔴 RATIONALE: Low pH (acidosis) with elevated PaCO2 (normal 35–45) indicates respiratory acidosis. HCO3 is
normal, showing no renal compensation yet. Thus, it is acute uncompensated respiratory acidosis.
Question 6
A nurse is changing a pressure injury dressing. Which finding suggests healing?
A. Thick, adherent eschar
B. Pale, dry wound bed
C. Red granulation tissue
D. Foul-smelling yellow exudate
🟢C
🔴 RATIONALE: Red granulation tissue indicates new capillary growth and healthy healing. Eschar, pallor, and
foul exudate suggest necrosis, poor perfusion, or infection.
Question 7
Which patient is at highest risk for developing a healthcare-associated infection (HAI)?
A. A 30-year-old with a fractured tibia
B. A 65-year-old with an indwelling urinary catheter
C. A 45-year-old with hypertension
D. A 22-year-old with migraine headaches
