NUR 242
OBJECTIVE ASSESSMENT - EXAM
NUR 242 Exam 3
(2026/2027) | Med-Surg
Nursing | Galen College
(A+ Guarantee) | PDF
2026/2027
Med-Surg Nursing | Galen College | A+ Guarantee
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiogenic Shock Management
Diabetes Mellitus & Diabetic Emergencies
COPD, Asthma & Acute Respiratory Failure
Osteoarthritis, Fractures & Joint Replacement
Peptic Ulcer Disease, GI Bleeding & Liver Disorders
Pressure Injuries, Burns & Wound Care
COVER PAGE - 1
,N 1 | Cardiovascular Disorders | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 20
Q1 Question 1 of 75
Q1. A 68-year-old male is admitted with acute decompensated heart failure. His vital signs are
BP 92/58 mmHg, HR 118 bpm, RR 28/min, and SpO2 88% on room air. He is dyspneic and has
bilateral crackles on auscultation. Which intervention should the nurse prioritize first?
A. Administer IV furosemide 40 mg as ordered
B. Apply supplemental oxygen via non-rebreather mask
C. Insert a Foley catheter for strict intake and output monitoring
D. Begin dobutamine infusion per protocol
Correct Answer: B
Rationale:
The patient is hypoxemic with SpO2 88%, which is life-threatening. Supplemental oxygen is the immediate
priority to improve tissue oxygenation before addressing fluid overload or initiating inotropic support.
Furosemide and dobutamine are important but secondary to correcting hypoxemia.
Q2 Question 2 of 75
Q2. A 54-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg daily. Her
INR today is 3.8, and she reports dark, tarry stools. Which action by the nurse is most
appropriate?
A. Hold the next dose of warfarin and notify the provider immediately
B. Administer vitamin K 10 mg subcutaneously without contacting the provider
C. Continue the warfarin and schedule a repeat INR in one week
D. Increase the warfarin dose to achieve a therapeutic INR of 4.0
Correct Answer: A
Rationale:
An INR of 3.8 is supratherapeutic, and dark tarry stools suggest GI bleeding. The nurse should hold the next
warfarin dose and notify the provider promptly. Administering vitamin K without orders is outside nursing
scope, and continuing or increasing warfarin would worsen bleeding risk.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 2 of 45
,N 1 | Cardiovascular Disorders | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 20
Q3 Question 3 of 75
Q3. A 72-year-old patient recovering from an acute myocardial infarction develops sudden onset
of severe dyspnea, tachypnea, and anxiety. Crackles are heard bilaterally, and the patient is
coughing pink, frothy sputum. Which condition is the patient most likely experiencing?
A. Pulmonary embolism
B. Acute cardiogenic pulmonary edema
C. Acute respiratory distress syndrome
D. Pneumothorax
Correct Answer: B
Rationale:
Pink, frothy sputum with sudden severe dyspnea and bilateral crackles in a post-MI patient is the classic
presentation of acute cardiogenic pulmonary edema due to left ventricular failure. Pulmonary embolism
typically presents with pleuritic chest pain and hemoptysis, not pink frothy sputum.
Q4 Question 4 of 75
Q4. A nurse is caring for a patient with infective endocarditis who is receiving IV antibiotic
therapy. Which assessment finding would most concern the nurse regarding potential embolic
complications?
A. Temperature of 100.4°F (38°C)
B. Sudden onset of left-sided hemiparesis and aphasia
C. Mild fatigue after ambulating 50 feet
D. A new systolic murmur at the apex
Correct Answer: B
Rationale:
Infective endocarditis carries a high risk of embolization. Sudden hemiparesis and aphasia strongly suggest a
cerebral embolus, a life-threatening complication requiring immediate intervention. Fever and fatigue are
expected findings, and a new murmur may indicate valvular damage but is less immediately dangerous than a
stroke.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 3 of 45
,N 1 | Cardiovascular Disorders | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 20
Q5 Question 5 of 75
Q5. A 45-year-old patient with hypertension is started on lisinopril 10 mg daily. Two weeks later,
the patient calls the clinic complaining of a persistent dry cough. Which explanation by the nurse
is most accurate?
A. The cough indicates an allergic reaction and the medication must be stopped immediately
B. Dry cough is a common side effect of ACE inhibitors due to bradykinin accumulation
C. The cough suggests the lisinopril dose is too low and needs to be increased
D. This is a sign of worsening heart failure and requires emergency evaluation
Correct Answer: B
Rationale:
A dry, nonproductive cough is a well-known side effect of ACE inhibitors like lisinopril, caused by bradykinin
accumulation in the lungs. It is not an allergic reaction, nor does it indicate inadequate dosing or heart failure.
The provider may consider switching to an ARB if the cough is bothersome.
Q6 Question 6 of 75
Q6. A patient with chronic heart failure is being discharged home on digoxin 0.25 mg daily. The
nurse is teaching the patient about signs of digoxin toxicity. Which symptom should the patient
report immediately?
A. Occasional mild ankle swelling by evening
B. Visual disturbances such as seeing yellow-green halos around lights
C. Feeling slightly tired after climbing two flights of stairs
D. A weight gain of 1 pound over the past week
Correct Answer: B
Rationale:
Visual disturbances, especially yellow-green halos, are a classic and specific sign of digoxin toxicity. Mild
ankle swelling, post-exertional fatigue, and minimal weight gain are expected in chronic heart failure and do
not indicate toxicity.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 4 of 45
OBJECTIVE ASSESSMENT - EXAM
NUR 242 Exam 3
(2026/2027) | Med-Surg
Nursing | Galen College
(A+ Guarantee) | PDF
2026/2027
Med-Surg Nursing | Galen College | A+ Guarantee
75 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Heart Failure & Cardiogenic Shock Management
Diabetes Mellitus & Diabetic Emergencies
COPD, Asthma & Acute Respiratory Failure
Osteoarthritis, Fractures & Joint Replacement
Peptic Ulcer Disease, GI Bleeding & Liver Disorders
Pressure Injuries, Burns & Wound Care
COVER PAGE - 1
,N 1 | Cardiovascular Disorders | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 20
Q1 Question 1 of 75
Q1. A 68-year-old male is admitted with acute decompensated heart failure. His vital signs are
BP 92/58 mmHg, HR 118 bpm, RR 28/min, and SpO2 88% on room air. He is dyspneic and has
bilateral crackles on auscultation. Which intervention should the nurse prioritize first?
A. Administer IV furosemide 40 mg as ordered
B. Apply supplemental oxygen via non-rebreather mask
C. Insert a Foley catheter for strict intake and output monitoring
D. Begin dobutamine infusion per protocol
Correct Answer: B
Rationale:
The patient is hypoxemic with SpO2 88%, which is life-threatening. Supplemental oxygen is the immediate
priority to improve tissue oxygenation before addressing fluid overload or initiating inotropic support.
Furosemide and dobutamine are important but secondary to correcting hypoxemia.
Q2 Question 2 of 75
Q2. A 54-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg daily. Her
INR today is 3.8, and she reports dark, tarry stools. Which action by the nurse is most
appropriate?
A. Hold the next dose of warfarin and notify the provider immediately
B. Administer vitamin K 10 mg subcutaneously without contacting the provider
C. Continue the warfarin and schedule a repeat INR in one week
D. Increase the warfarin dose to achieve a therapeutic INR of 4.0
Correct Answer: A
Rationale:
An INR of 3.8 is supratherapeutic, and dark tarry stools suggest GI bleeding. The nurse should hold the next
warfarin dose and notify the provider promptly. Administering vitamin K without orders is outside nursing
scope, and continuing or increasing warfarin would worsen bleeding risk.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 2 of 45
,N 1 | Cardiovascular Disorders | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 20
Q3 Question 3 of 75
Q3. A 72-year-old patient recovering from an acute myocardial infarction develops sudden onset
of severe dyspnea, tachypnea, and anxiety. Crackles are heard bilaterally, and the patient is
coughing pink, frothy sputum. Which condition is the patient most likely experiencing?
A. Pulmonary embolism
B. Acute cardiogenic pulmonary edema
C. Acute respiratory distress syndrome
D. Pneumothorax
Correct Answer: B
Rationale:
Pink, frothy sputum with sudden severe dyspnea and bilateral crackles in a post-MI patient is the classic
presentation of acute cardiogenic pulmonary edema due to left ventricular failure. Pulmonary embolism
typically presents with pleuritic chest pain and hemoptysis, not pink frothy sputum.
Q4 Question 4 of 75
Q4. A nurse is caring for a patient with infective endocarditis who is receiving IV antibiotic
therapy. Which assessment finding would most concern the nurse regarding potential embolic
complications?
A. Temperature of 100.4°F (38°C)
B. Sudden onset of left-sided hemiparesis and aphasia
C. Mild fatigue after ambulating 50 feet
D. A new systolic murmur at the apex
Correct Answer: B
Rationale:
Infective endocarditis carries a high risk of embolization. Sudden hemiparesis and aphasia strongly suggest a
cerebral embolus, a life-threatening complication requiring immediate intervention. Fever and fatigue are
expected findings, and a new murmur may indicate valvular damage but is less immediately dangerous than a
stroke.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 3 of 45
,N 1 | Cardiovascular Disorders | Q1-Q15 | NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 20
Q5 Question 5 of 75
Q5. A 45-year-old patient with hypertension is started on lisinopril 10 mg daily. Two weeks later,
the patient calls the clinic complaining of a persistent dry cough. Which explanation by the nurse
is most accurate?
A. The cough indicates an allergic reaction and the medication must be stopped immediately
B. Dry cough is a common side effect of ACE inhibitors due to bradykinin accumulation
C. The cough suggests the lisinopril dose is too low and needs to be increased
D. This is a sign of worsening heart failure and requires emergency evaluation
Correct Answer: B
Rationale:
A dry, nonproductive cough is a well-known side effect of ACE inhibitors like lisinopril, caused by bradykinin
accumulation in the lungs. It is not an allergic reaction, nor does it indicate inadequate dosing or heart failure.
The provider may consider switching to an ARB if the cough is bothersome.
Q6 Question 6 of 75
Q6. A patient with chronic heart failure is being discharged home on digoxin 0.25 mg daily. The
nurse is teaching the patient about signs of digoxin toxicity. Which symptom should the patient
report immediately?
A. Occasional mild ankle swelling by evening
B. Visual disturbances such as seeing yellow-green halos around lights
C. Feeling slightly tired after climbing two flights of stairs
D. A weight gain of 1 pound over the past week
Correct Answer: B
Rationale:
Visual disturbances, especially yellow-green halos, are a classic and specific sign of digoxin toxicity. Mild
ankle swelling, post-exertional fatigue, and minimal weight gain are expected in chronic heart failure and do
not indicate toxicity.
NUR 242 Exam 3 (2026/2027) | Med-Surg Nursing | Galen College (A+ Guarantee) | PDF 2026/2027 | Passing Score: 80% | Page 4 of 45
