NUR 242 – FINAL EXAM – MEDICAL-SURGICAL NURSING CONCEPTS – GALEN COLLEGE OF NURSING]
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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Core Domains
Fluid and Electrolyte Balance
Perioperative Nursing Care
Cardiovascular Disorders
Respiratory Disorders
Endocrine and Metabolic Disorders
Renal and Urinary Disorders
Gastrointestinal Disorders
Neurological Disorders
Pain Management and Palliative Care
Infectious Diseases and Immunity
Introduction
*This comprehensive final examination is designed to assess essential medical-surgical nursing concepts for
NUR 242. It evaluates foundational theory, applied clinical knowledge, regulatory compliance, ethical practice,
and critical decision-making in real-world scenarios. The exam consists of 200 multiple-choice questions
organized into two sections. Each question is followed by the correct answer and a detailed rationale to
reinforce learning. Emphasis is placed on prioritization, delegation, patient safety, and evidence-based
,interventions. This assessment mirrors the complexity of nursing practice and prepares students for licensure
and professional clinical judgment.*
SECTION ONE: QUESTIONS 1 – 100
Question 1
A nurse is assessing a patient with chronic heart failure. Which finding is most indicative of worsening fluid
overload?
A. Weight loss of 1 kg in 24 hours
B. Crackles in the lung bases
C. Thready peripheral pulses
D. Decreased jugular venous pressure
🟢B
🔴 RATIONALE: Crackles in the lung bases indicate pulmonary congestion from left ventricular failure and fluid
overload. Weight loss would suggest improvement; thready pulses occur in shock or hypovolemia; decreased
jugular venous pressure suggests hypovolemia.
Question 2
A postoperative patient reports sudden chest pain and dyspnea. The nurse notes tachycardia and hypotension.
What is the priority action?
,A. Administer prescribed PRN morphine
B. Apply supplemental oxygen
C. Reassure the patient and monitor vital signs
D. Encourage deep breathing and coughing
🟢B
🔴 RATIONALE: Oxygenation is the priority to prevent further hypoxia from a potential pulmonary embolism.
Morphine may be given later; reassurance and monitoring delay intervention; deep breathing does not address
acute embolism.
Question 3
A nurse is providing discharge teaching to a patient prescribed warfarin for atrial fibrillation. Which statement
by the patient indicates correct understanding?
A. "I will take ibuprofen if I get a headache."
B. "I can eat as many green leafy vegetables as I want."
C. "I will report any unusual bruising or bleeding to my provider."
D. "I will stop warfarin if I see blood in my urine."
🟢C
🔴 RATIONALE: Unusual bruising or bleeding may indicate excessive anticoagulation and requires provider
notification. Ibuprofen increases bleeding risk; green leafy vegetables contain vitamin K and affect INR; stopping
warfarin abruptly increases stroke risk.
Question 4
, A patient with type 1 diabetes mellitus is found unconscious. The nurse assesses a blood glucose level of 42
mg/dL. Which intervention is most appropriate while the patient is unconscious?
A. Administer glucagon intramuscularly
B. Give oral orange juice
C. Start an insulin drip
D. Provide a glass of milk
🟢A
🔴 RATIONALE: Glucagon raises blood glucose rapidly and can be given IM when the patient is unconscious.
Oral glucose is unsafe due to aspiration risk. Insulin would worsen hypoglycemia. Milk contains insufficient fast-
acting carbohydrate.
Question 5
A nurse is caring for a patient with acute kidney injury in the oliguric phase. Which laboratory finding is
expected?
A. Hypokalemia
B. Decreased serum creatinine
C. Hypernatremia
D. Hyperkalemia
🟢D
🔴 RATIONALE: In oliguria, decreased urine output leads to potassium retention and hyperkalemia.
Hypokalemia occurs in diuretic phase; creatinine rises, not decreases; hyponatremia from fluid retention is more
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains
Fluid and Electrolyte Balance
Perioperative Nursing Care
Cardiovascular Disorders
Respiratory Disorders
Endocrine and Metabolic Disorders
Renal and Urinary Disorders
Gastrointestinal Disorders
Neurological Disorders
Pain Management and Palliative Care
Infectious Diseases and Immunity
Introduction
*This comprehensive final examination is designed to assess essential medical-surgical nursing concepts for
NUR 242. It evaluates foundational theory, applied clinical knowledge, regulatory compliance, ethical practice,
and critical decision-making in real-world scenarios. The exam consists of 200 multiple-choice questions
organized into two sections. Each question is followed by the correct answer and a detailed rationale to
reinforce learning. Emphasis is placed on prioritization, delegation, patient safety, and evidence-based
,interventions. This assessment mirrors the complexity of nursing practice and prepares students for licensure
and professional clinical judgment.*
SECTION ONE: QUESTIONS 1 – 100
Question 1
A nurse is assessing a patient with chronic heart failure. Which finding is most indicative of worsening fluid
overload?
A. Weight loss of 1 kg in 24 hours
B. Crackles in the lung bases
C. Thready peripheral pulses
D. Decreased jugular venous pressure
🟢B
🔴 RATIONALE: Crackles in the lung bases indicate pulmonary congestion from left ventricular failure and fluid
overload. Weight loss would suggest improvement; thready pulses occur in shock or hypovolemia; decreased
jugular venous pressure suggests hypovolemia.
Question 2
A postoperative patient reports sudden chest pain and dyspnea. The nurse notes tachycardia and hypotension.
What is the priority action?
,A. Administer prescribed PRN morphine
B. Apply supplemental oxygen
C. Reassure the patient and monitor vital signs
D. Encourage deep breathing and coughing
🟢B
🔴 RATIONALE: Oxygenation is the priority to prevent further hypoxia from a potential pulmonary embolism.
Morphine may be given later; reassurance and monitoring delay intervention; deep breathing does not address
acute embolism.
Question 3
A nurse is providing discharge teaching to a patient prescribed warfarin for atrial fibrillation. Which statement
by the patient indicates correct understanding?
A. "I will take ibuprofen if I get a headache."
B. "I can eat as many green leafy vegetables as I want."
C. "I will report any unusual bruising or bleeding to my provider."
D. "I will stop warfarin if I see blood in my urine."
🟢C
🔴 RATIONALE: Unusual bruising or bleeding may indicate excessive anticoagulation and requires provider
notification. Ibuprofen increases bleeding risk; green leafy vegetables contain vitamin K and affect INR; stopping
warfarin abruptly increases stroke risk.
Question 4
, A patient with type 1 diabetes mellitus is found unconscious. The nurse assesses a blood glucose level of 42
mg/dL. Which intervention is most appropriate while the patient is unconscious?
A. Administer glucagon intramuscularly
B. Give oral orange juice
C. Start an insulin drip
D. Provide a glass of milk
🟢A
🔴 RATIONALE: Glucagon raises blood glucose rapidly and can be given IM when the patient is unconscious.
Oral glucose is unsafe due to aspiration risk. Insulin would worsen hypoglycemia. Milk contains insufficient fast-
acting carbohydrate.
Question 5
A nurse is caring for a patient with acute kidney injury in the oliguric phase. Which laboratory finding is
expected?
A. Hypokalemia
B. Decreased serum creatinine
C. Hypernatremia
D. Hyperkalemia
🟢D
🔴 RATIONALE: In oliguria, decreased urine output leads to potassium retention and hyperkalemia.
Hypokalemia occurs in diuretic phase; creatinine rises, not decreases; hyponatremia from fluid retention is more
