NUR 242 MEDICAL-SURGICAL NURSING – FINAL EXAM
(GALEN COLLEGE STYLE) Comprehensive Med-Surg
Concepts Questions with Answers
Key NUR 242 Final Exam Topics Covered:
Endocrine: Diabetes (Type 1, Type 2, DKA, HHS), thyroid, adrenal, SIADH, DI
Cardiovascular: Heart failure, MI, dysrhythmias, hypertension, shock (hypovolemic,
septic, cardiogenic)
Respiratory: COPD, pneumonia, PE, asthma, chest tubes, ABGs
Renal: AKI, CKD, ESRD, dialysis
Neuro: Stroke, increased ICP, seizures, meningitis, TBI, SCI, autonomic dysreflexia
GI: Cirrhosis, varices, pancreatitis, AAA, colostomy/ileostomy
Musculoskeletal: Hip fracture, joint replacement, osteoporosis, rheumatoid arthritis,
SLE
Integumentary: Burns, wounds, pressure ulcers
Hematology/Oncology: Anemia, DIC, cancer, chemotherapy, radiation
Infectious Disease: HIV/AIDS, sepsis, neutropenia
Devices/Procedures: CVC, urinary catheter, NG tube, tracheostomy, ventilator
Surgical: Mastectomy, prostatectomy, hysterectomy, thyroidectomy,
parathyroidectomy
Fluids/Electrolytes: IV fluids, shock, MODS, organ donation
1. Which are the classic “3 P’s” of Type 1 Diabetes?
A. Pallor, pain, paralysis
B. Polydipsia, polyphagia, polyuria
, C. Pneumonia, pleurisy, pulmonary embolism
D. Paresthesia, paresthesia, paralysis
2. A patient with Type 1 Diabetes has an onset typically:
A. After age 50
B. Younger than 30 years with abrupt onset
C. Gradual onset in adulthood
D. Only during pregnancy
3. Which are common symptoms of hypoglycemia?
A. Polyuria, polydipsia, polyphagia
B. Shakiness, tachycardia, sweating, dizziness, anxiety, hunger
C. Weight gain, fatigue, constipation
D. Hypertension, headache, blurred vision
4. What is the first step in treating mild hypoglycemia (BS <70 mg/dL)?
A. Administer IV dextrose
B. Give 15g of fast-acting carbohydrates (e.g., 4 oz juice, glucose tablets)
C. Administer insulin
D. Recheck blood sugar in 1 hour
5. Which are the “3 S’s” that raise blood glucose?
A. Salt, sugar, saturated fat
B. Stress, surgery, steroids
C. Sleep, swimming, stretching
D. Smoking, sitting, snacking
6. A patient with Type 2 Diabetes typically presents with:
A. Abrupt onset in childhood
B. Gradual onset, often asymptomatic, may present with fatigue, blurred
, vision, or vascular complications
C. Insulin dependence from diagnosis
D. Autoimmune beta-cell destruction
7. What is the pathophysiology of Type 1 Diabetes?
A. Insulin resistance
B. Autoimmune destruction of pancreatic beta cells
C. Excess insulin production
D. Genetic mutation
8. What is the pathophysiology of Type 2 Diabetes?
A. Autoimmune beta-cell destruction
B. Insulin resistance and relative insulin deficiency
C. Excess insulin production
D. Genetic mutation
9. What is the Somogyi effect?
A. Morning hyperglycemia due to insufficient insulin
B. Morning hyperglycemia due to counterregulatory hormone surge after
nighttime hypoglycemia
C. Evening hyperglycemia due to excessive carbs
D. Fasting hypoglycemia due to excessive insulin
10. What is the priority nursing intervention for a patient with DKA?
A. Administer oral glucose
B. IV fluids and insulin therapy
C. Administer oral hypoglycemics
D. Encourage high-carb diet
, 11. Which lab finding is expected in DKA?
A. Normal blood glucose
B. Blood glucose >250 mg/dL, low pH, positive ketones
C. High pH, negative ketones
D. Normal anion gap
12. A patient with hyperglycemic hyperosmolar syndrome (HHS) typically presents with:
A. Severe ketosis and acidosis
B. Severe hyperglycemia, hyperosmolality, and dehydration without significant
ketosis
C. Hypoglycemia and acidosis
D. Normal blood glucose and ketosis
13. What is the priority nursing intervention for a patient with HHS?
A. Administer oral glucose
B. Aggressive IV fluid replacement and insulin therapy
C. Administer oral hypoglycemics
D. Encourage high-carb diet
14. Which medication is first-line for Type 2 Diabetes?
A. Insulin
B. Metformin
C. Glipizide
D. Sitagliptin
15. What is the primary action of metformin?
A. Increase insulin secretion
B. Decrease hepatic glucose production and improve insulin sensitivity
(GALEN COLLEGE STYLE) Comprehensive Med-Surg
Concepts Questions with Answers
Key NUR 242 Final Exam Topics Covered:
Endocrine: Diabetes (Type 1, Type 2, DKA, HHS), thyroid, adrenal, SIADH, DI
Cardiovascular: Heart failure, MI, dysrhythmias, hypertension, shock (hypovolemic,
septic, cardiogenic)
Respiratory: COPD, pneumonia, PE, asthma, chest tubes, ABGs
Renal: AKI, CKD, ESRD, dialysis
Neuro: Stroke, increased ICP, seizures, meningitis, TBI, SCI, autonomic dysreflexia
GI: Cirrhosis, varices, pancreatitis, AAA, colostomy/ileostomy
Musculoskeletal: Hip fracture, joint replacement, osteoporosis, rheumatoid arthritis,
SLE
Integumentary: Burns, wounds, pressure ulcers
Hematology/Oncology: Anemia, DIC, cancer, chemotherapy, radiation
Infectious Disease: HIV/AIDS, sepsis, neutropenia
Devices/Procedures: CVC, urinary catheter, NG tube, tracheostomy, ventilator
Surgical: Mastectomy, prostatectomy, hysterectomy, thyroidectomy,
parathyroidectomy
Fluids/Electrolytes: IV fluids, shock, MODS, organ donation
1. Which are the classic “3 P’s” of Type 1 Diabetes?
A. Pallor, pain, paralysis
B. Polydipsia, polyphagia, polyuria
, C. Pneumonia, pleurisy, pulmonary embolism
D. Paresthesia, paresthesia, paralysis
2. A patient with Type 1 Diabetes has an onset typically:
A. After age 50
B. Younger than 30 years with abrupt onset
C. Gradual onset in adulthood
D. Only during pregnancy
3. Which are common symptoms of hypoglycemia?
A. Polyuria, polydipsia, polyphagia
B. Shakiness, tachycardia, sweating, dizziness, anxiety, hunger
C. Weight gain, fatigue, constipation
D. Hypertension, headache, blurred vision
4. What is the first step in treating mild hypoglycemia (BS <70 mg/dL)?
A. Administer IV dextrose
B. Give 15g of fast-acting carbohydrates (e.g., 4 oz juice, glucose tablets)
C. Administer insulin
D. Recheck blood sugar in 1 hour
5. Which are the “3 S’s” that raise blood glucose?
A. Salt, sugar, saturated fat
B. Stress, surgery, steroids
C. Sleep, swimming, stretching
D. Smoking, sitting, snacking
6. A patient with Type 2 Diabetes typically presents with:
A. Abrupt onset in childhood
B. Gradual onset, often asymptomatic, may present with fatigue, blurred
, vision, or vascular complications
C. Insulin dependence from diagnosis
D. Autoimmune beta-cell destruction
7. What is the pathophysiology of Type 1 Diabetes?
A. Insulin resistance
B. Autoimmune destruction of pancreatic beta cells
C. Excess insulin production
D. Genetic mutation
8. What is the pathophysiology of Type 2 Diabetes?
A. Autoimmune beta-cell destruction
B. Insulin resistance and relative insulin deficiency
C. Excess insulin production
D. Genetic mutation
9. What is the Somogyi effect?
A. Morning hyperglycemia due to insufficient insulin
B. Morning hyperglycemia due to counterregulatory hormone surge after
nighttime hypoglycemia
C. Evening hyperglycemia due to excessive carbs
D. Fasting hypoglycemia due to excessive insulin
10. What is the priority nursing intervention for a patient with DKA?
A. Administer oral glucose
B. IV fluids and insulin therapy
C. Administer oral hypoglycemics
D. Encourage high-carb diet
, 11. Which lab finding is expected in DKA?
A. Normal blood glucose
B. Blood glucose >250 mg/dL, low pH, positive ketones
C. High pH, negative ketones
D. Normal anion gap
12. A patient with hyperglycemic hyperosmolar syndrome (HHS) typically presents with:
A. Severe ketosis and acidosis
B. Severe hyperglycemia, hyperosmolality, and dehydration without significant
ketosis
C. Hypoglycemia and acidosis
D. Normal blood glucose and ketosis
13. What is the priority nursing intervention for a patient with HHS?
A. Administer oral glucose
B. Aggressive IV fluid replacement and insulin therapy
C. Administer oral hypoglycemics
D. Encourage high-carb diet
14. Which medication is first-line for Type 2 Diabetes?
A. Insulin
B. Metformin
C. Glipizide
D. Sitagliptin
15. What is the primary action of metformin?
A. Increase insulin secretion
B. Decrease hepatic glucose production and improve insulin sensitivity
