NUR 242
OBJECTIVE ASSESSMENT - EXAM
Galen NUR 242 Exam 4 (2026/2027) |
Med-Surg Nursing | (A+ Guarantee) | PDF
2026/2027
NUR 242 | Med-Surg Nursing | Objective Assessment
75 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiomyopathy Management COPD, Asthma & ARDS Interventions
Liver Cirrhosis, Hepatitis & Pancreatitis Care Diabetes Mellitus & Thyroid Disorders
Burns, Wounds & Pressure Injury Management Osteoarthritis, Fractures & Joint Replacement
COVER PAGE - 1
,SECTION 1 | Cardiovascular Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
2026/2027
Q1 Question 1 of 75
A 68-year-old client with a history of chronic heart failure is admitted with increasing
dyspnea, orthopnea, and 3+ pitting edema in both lower extremities. The nurse notes
a weight gain of 4.5 lb over the past 3 days. Which intervention should the nurse
prioritize first?
A. Administer furosemide 40 mg IV as prescribed
B. Apply supplemental oxygen via nasal cannula at 2 L/min
C. Place the client in high-Fowler's position
D. Insert an indwelling urinary catheter for strict intake and output
Correct Answer: C
Rationale:
High-Fowler's position reduces venous return to the heart, decreases preload, and maximizes lung
expansion, which is the immediate priority for a client in acute decompensated heart failure. While
furosemide and oxygen are important, positioning is the fastest intervention to relieve acute respiratory
distress.
Q2 Question 2 of 75
A 72-year-old client with dilated cardiomyopathy is receiving digoxin 0.25 mg daily.
The nurse checks the apical pulse and finds it to be 52 beats per minute. Which action
should the nurse take next?
A. Administer the digoxin and notify the provider of the low pulse
B. Hold the digoxin and immediately notify the healthcare provider
C. Recheck the pulse in 15 minutes and then administer the medication
D. Administer half the dose and document the low pulse
Correct Answer: B
Rationale:
Digoxin should be held when the apical pulse is below 60 bpm due to the risk of bradycardia and heart
block. The nurse must notify the provider immediately because the client may need a dosage adjustment
or further cardiac evaluation.
, Q3 Question 3 of 75
A 55-year-old client is 2 hours post-percutaneous coronary intervention (PCI) with
stent placement. The nurse notes that the client's right groin site is oozing blood and
a 3-cm hematoma is forming. Which is the nurse's priority action?
A. Apply manual pressure proximal to the insertion site
B. Notify the interventional cardiologist immediately
C. Apply an ice pack to the groin area
D. Check the client's distal pulses and compare bilaterally
Correct Answer: A
Rationale:
Manual pressure proximal to the insertion site is the immediate priority to control active bleeding and
prevent hematoma expansion. Distal pulse assessment and provider notification follow once hemostasis is
achieved.
Q4 Question 4 of 75
A 64-year-old client with atrial fibrillation is prescribed warfarin 5 mg daily. The nurse
reviews the client's INR result of 4.2. Which dietary instruction should the nurse
reinforce?
A. Increase intake of green leafy vegetables to stabilize INR
B. Avoid all vitamin K-containing foods until INR normalizes
C. Maintain consistent intake of vitamin K foods and report any dietary changes
D. Stop eating all vegetables until the next INR check
Correct Answer: C
Rationale:
The key to warfarin management is consistency in vitamin K intake, not elimination. Fluctuating vitamin K
intake causes INR instability. The client should maintain a consistent diet and report changes so the
warfarin dose can be adjusted accordingly.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 2 of 40
, Q5 Question 5 of 75
A 58-year-old client with hypertension is started on lisinopril 10 mg daily. Two weeks
later, the client reports a persistent dry cough. The nurse recognizes this as which
type of adverse effect?
A. An allergic reaction requiring immediate discontinuation
B. A common ACE inhibitor side effect from bradykinin accumulation
C. A sign of worsening heart failure
D. An indication that the dose is too high and needs reduction
Correct Answer: B
Rationale:
A dry, nonproductive cough is a well-known side effect of ACE inhibitors caused by bradykinin
accumulation. It is not an allergy but may require switching to an ARB if the cough is intolerable.
Q6 Question 6 of 75
A 70-year-old client with severe aortic stenosis reports chest pain with exertion,
syncope on climbing stairs, and worsening dyspnea. The nurse understands that
these symptoms represent which pathophysiologic progression?
A. Left ventricular dilation leading to mitral regurgitation
B. Progressive obstruction of left ventricular outflow causing decreased cardiac output
C. Pulmonary hypertension causing right-sided heart failure
D. Coronary artery spasm triggered by valvular disease
Correct Answer: B
Rationale:
The classic triad of angina, syncope, and dyspnea in aortic stenosis results from progressive narrowing of
the aortic valve, which obstructs left ventricular outflow and reduces cardiac output to the coronary arteries
and systemic circulation.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 3 of 40
OBJECTIVE ASSESSMENT - EXAM
Galen NUR 242 Exam 4 (2026/2027) |
Med-Surg Nursing | (A+ Guarantee) | PDF
2026/2027
NUR 242 | Med-Surg Nursing | Objective Assessment
75 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiomyopathy Management COPD, Asthma & ARDS Interventions
Liver Cirrhosis, Hepatitis & Pancreatitis Care Diabetes Mellitus & Thyroid Disorders
Burns, Wounds & Pressure Injury Management Osteoarthritis, Fractures & Joint Replacement
COVER PAGE - 1
,SECTION 1 | Cardiovascular Disorders | Q1-Q15 | Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027
2026/2027
Q1 Question 1 of 75
A 68-year-old client with a history of chronic heart failure is admitted with increasing
dyspnea, orthopnea, and 3+ pitting edema in both lower extremities. The nurse notes
a weight gain of 4.5 lb over the past 3 days. Which intervention should the nurse
prioritize first?
A. Administer furosemide 40 mg IV as prescribed
B. Apply supplemental oxygen via nasal cannula at 2 L/min
C. Place the client in high-Fowler's position
D. Insert an indwelling urinary catheter for strict intake and output
Correct Answer: C
Rationale:
High-Fowler's position reduces venous return to the heart, decreases preload, and maximizes lung
expansion, which is the immediate priority for a client in acute decompensated heart failure. While
furosemide and oxygen are important, positioning is the fastest intervention to relieve acute respiratory
distress.
Q2 Question 2 of 75
A 72-year-old client with dilated cardiomyopathy is receiving digoxin 0.25 mg daily.
The nurse checks the apical pulse and finds it to be 52 beats per minute. Which action
should the nurse take next?
A. Administer the digoxin and notify the provider of the low pulse
B. Hold the digoxin and immediately notify the healthcare provider
C. Recheck the pulse in 15 minutes and then administer the medication
D. Administer half the dose and document the low pulse
Correct Answer: B
Rationale:
Digoxin should be held when the apical pulse is below 60 bpm due to the risk of bradycardia and heart
block. The nurse must notify the provider immediately because the client may need a dosage adjustment
or further cardiac evaluation.
, Q3 Question 3 of 75
A 55-year-old client is 2 hours post-percutaneous coronary intervention (PCI) with
stent placement. The nurse notes that the client's right groin site is oozing blood and
a 3-cm hematoma is forming. Which is the nurse's priority action?
A. Apply manual pressure proximal to the insertion site
B. Notify the interventional cardiologist immediately
C. Apply an ice pack to the groin area
D. Check the client's distal pulses and compare bilaterally
Correct Answer: A
Rationale:
Manual pressure proximal to the insertion site is the immediate priority to control active bleeding and
prevent hematoma expansion. Distal pulse assessment and provider notification follow once hemostasis is
achieved.
Q4 Question 4 of 75
A 64-year-old client with atrial fibrillation is prescribed warfarin 5 mg daily. The nurse
reviews the client's INR result of 4.2. Which dietary instruction should the nurse
reinforce?
A. Increase intake of green leafy vegetables to stabilize INR
B. Avoid all vitamin K-containing foods until INR normalizes
C. Maintain consistent intake of vitamin K foods and report any dietary changes
D. Stop eating all vegetables until the next INR check
Correct Answer: C
Rationale:
The key to warfarin management is consistency in vitamin K intake, not elimination. Fluctuating vitamin K
intake causes INR instability. The client should maintain a consistent diet and report changes so the
warfarin dose can be adjusted accordingly.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 2 of 40
, Q5 Question 5 of 75
A 58-year-old client with hypertension is started on lisinopril 10 mg daily. Two weeks
later, the client reports a persistent dry cough. The nurse recognizes this as which
type of adverse effect?
A. An allergic reaction requiring immediate discontinuation
B. A common ACE inhibitor side effect from bradykinin accumulation
C. A sign of worsening heart failure
D. An indication that the dose is too high and needs reduction
Correct Answer: B
Rationale:
A dry, nonproductive cough is a well-known side effect of ACE inhibitors caused by bradykinin
accumulation. It is not an allergy but may require switching to an ARB if the cough is intolerable.
Q6 Question 6 of 75
A 70-year-old client with severe aortic stenosis reports chest pain with exertion,
syncope on climbing stairs, and worsening dyspnea. The nurse understands that
these symptoms represent which pathophysiologic progression?
A. Left ventricular dilation leading to mitral regurgitation
B. Progressive obstruction of left ventricular outflow causing decreased cardiac output
C. Pulmonary hypertension causing right-sided heart failure
D. Coronary artery spasm triggered by valvular disease
Correct Answer: B
Rationale:
The classic triad of angina, syncope, and dyspnea in aortic stenosis results from progressive narrowing of
the aortic valve, which obstructs left ventricular outflow and reduces cardiac output to the coronary arteries
and systemic circulation.
Galen NUR 242 Exam 4 (2026/2027) | Med-Surg Nursing | (A+ Guarantee) | PDF 2026/2027 -- 2026/2027 | Passing Score: 80% | Page 3 of 40
