Galen NUR 242 Exams 2 – Med-Surg Concepts (2026) Actual Questions and
Answers (PDF).
Table of Contents
Exam Overview & Study Tips
Section 1: Fluid & Electrolyte Imbalances (1-40)
Section 2: Cardiovascular Disorders – Hypertension & Heart Failure (41-80)
Section 3: Cardiovascular Disorders – Dysrhythmias & MI (81-120)
Section 4: Endocrine Disorders – Diabetes (121-150)
Section 5: Priority & Emergency Nursing (151-170)
Answer Key
,Exam Overview & Study Tips
NUR 242 Exam 2 typically covers Fluid and Electrolyte Imbalances, ABG
Interpretation, Cardiovascular Disorders (Hypertension, Heart Failure,
Dysrhythmias, MI), and Endocrine Disorders (primarily Diabetes Mellitus).
Students often struggle with differentiating types of heart failure, recognizing
digoxin toxicity, and interpreting lab values .
High-Yield Focus Areas:
Digoxin Toxicity: Know the symptoms (nausea, yellow/green halos, bradycardia)
and that hypokalemia increases toxicity risk .
Heart Failure: Distinguish Left-sided (crackles, dyspnea) vs. Right-sided (JVD,
edema) .
Fluids: Daily weight is the best indicator of fluid status .
Section 1: Fluid & Electrolyte Imbalances (1-40)
1. A patient with heart failure is admitted for fluid volume excess. Which finding
requires the nurse’s immediate intervention?
A. 2+ pitting edema in both ankles
,B. Hematocrit decreased from baseline
C. Crackles and dyspnea when lying flat
D. Weight gain of 1 lb over 3 days
Rationale: Crackles and dyspnea (orthopnea) indicate pulmonary congestion,
which is a life-threatening complication of fluid volume excess requiring
immediate intervention (C). Edema (A) and weight gain (D) are expected but not
immediately life-threatening .
2. The nurse evaluates lab results for a client with dehydration. Which pattern is
most consistent with fluid volume deficit?
A. Decreased Hct, decreased BUN, decreased specific gravity
B. Increased Hct, increased BUN, increased specific gravity
C. Normal Hct with decreased BUN and increased specific gravity
D. Increased Hct with normal BUN and decreased specific gravity
Rationale: Fluid volume deficit causes hemoconcentration (increased Hct),
prerenal azotemia (increased BUN), and concentrated urine (increased specific
gravity) .
3. Which client is at highest risk for developing fluid volume deficit?
, A. Client with SIADH receiving fluid restriction
B. Client with continuous NG suction and diarrhea
C. Client with heart failure on long-term corticosteroid therapy
D. Client receiving rapid infusion of isotonic IV fluids
Rationale: GI losses (vomiting, NG suction, diarrhea) remove sodium-containing
fluids from the body, making this the highest risk for true volume deficit .
4. A client with fluid volume deficit has flat neck veins, tachycardia, and dry
mucous membranes. Which nursing intervention is most appropriate?
A. Place the client in high-Fowler’s position
B. Restrict oral fluids to prevent overload
C. Start ordered isotonic IV fluids and monitor vital signs
D. Administer IV furosemide as prescribed
Rationale: Isotonic fluids (0.9% NS, LR) are used for volume resuscitation in
hypovolemia .
5. Which is the most reliable indicator of fluid volume status?
A. Monitoring blood pressure every 4 hours
Answers (PDF).
Table of Contents
Exam Overview & Study Tips
Section 1: Fluid & Electrolyte Imbalances (1-40)
Section 2: Cardiovascular Disorders – Hypertension & Heart Failure (41-80)
Section 3: Cardiovascular Disorders – Dysrhythmias & MI (81-120)
Section 4: Endocrine Disorders – Diabetes (121-150)
Section 5: Priority & Emergency Nursing (151-170)
Answer Key
,Exam Overview & Study Tips
NUR 242 Exam 2 typically covers Fluid and Electrolyte Imbalances, ABG
Interpretation, Cardiovascular Disorders (Hypertension, Heart Failure,
Dysrhythmias, MI), and Endocrine Disorders (primarily Diabetes Mellitus).
Students often struggle with differentiating types of heart failure, recognizing
digoxin toxicity, and interpreting lab values .
High-Yield Focus Areas:
Digoxin Toxicity: Know the symptoms (nausea, yellow/green halos, bradycardia)
and that hypokalemia increases toxicity risk .
Heart Failure: Distinguish Left-sided (crackles, dyspnea) vs. Right-sided (JVD,
edema) .
Fluids: Daily weight is the best indicator of fluid status .
Section 1: Fluid & Electrolyte Imbalances (1-40)
1. A patient with heart failure is admitted for fluid volume excess. Which finding
requires the nurse’s immediate intervention?
A. 2+ pitting edema in both ankles
,B. Hematocrit decreased from baseline
C. Crackles and dyspnea when lying flat
D. Weight gain of 1 lb over 3 days
Rationale: Crackles and dyspnea (orthopnea) indicate pulmonary congestion,
which is a life-threatening complication of fluid volume excess requiring
immediate intervention (C). Edema (A) and weight gain (D) are expected but not
immediately life-threatening .
2. The nurse evaluates lab results for a client with dehydration. Which pattern is
most consistent with fluid volume deficit?
A. Decreased Hct, decreased BUN, decreased specific gravity
B. Increased Hct, increased BUN, increased specific gravity
C. Normal Hct with decreased BUN and increased specific gravity
D. Increased Hct with normal BUN and decreased specific gravity
Rationale: Fluid volume deficit causes hemoconcentration (increased Hct),
prerenal azotemia (increased BUN), and concentrated urine (increased specific
gravity) .
3. Which client is at highest risk for developing fluid volume deficit?
, A. Client with SIADH receiving fluid restriction
B. Client with continuous NG suction and diarrhea
C. Client with heart failure on long-term corticosteroid therapy
D. Client receiving rapid infusion of isotonic IV fluids
Rationale: GI losses (vomiting, NG suction, diarrhea) remove sodium-containing
fluids from the body, making this the highest risk for true volume deficit .
4. A client with fluid volume deficit has flat neck veins, tachycardia, and dry
mucous membranes. Which nursing intervention is most appropriate?
A. Place the client in high-Fowler’s position
B. Restrict oral fluids to prevent overload
C. Start ordered isotonic IV fluids and monitor vital signs
D. Administer IV furosemide as prescribed
Rationale: Isotonic fluids (0.9% NS, LR) are used for volume resuscitation in
hypovolemia .
5. Which is the most reliable indicator of fluid volume status?
A. Monitoring blood pressure every 4 hours
