Latest NUR 242 Medical-Surgical Nursing Practice Exam verified with correct
answers 2026/2027 version
1. A nurse is caring for a patient with heart failure. Which assessment finding
indicates worsening left-sided heart failure?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in both lungs
D. Hepatomegaly
Answer: C. Crackles in both lungs
Rationale: Left-sided heart failure causes pulmonary congestion, leading to
crackles, dyspnea, and decreased oxygenation.
2. Which laboratory value should concern the nurse most in a patient
receiving furosemide?
A. Sodium 140 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 102 mEq/L
D. Calcium 9.2 mg/dL
Answer: B. Potassium 2.9 mEq/L
Rationale: Furosemide is a potassium-wasting diuretic. Severe hypokalemia
increases the risk of cardiac dysrhythmias.
3. Which action should the nurse take first for a patient experiencing chest
pain?
A. Obtain a 12-lead ECG
B. Administer oxygen if indicated
C. Assess pain characteristics
D. Notify the provider
,Answer: C. Assess pain characteristics
Rationale: Assessment comes first. The nurse must evaluate the pain before
initiating additional interventions unless the patient is unstable.
4. Which finding is expected in diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Kussmaul respirations
C. Hypoglycemia
D. Weight gain
Answer: B. Kussmaul respirations
Rationale: Deep, rapid respirations help compensate for metabolic acidosis in
DKA.
5. Which electrolyte imbalance commonly occurs with prolonged vomiting?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Vomiting causes loss of gastric fluids and potassium, resulting in
hypokalemia.
6. A patient with COPD is receiving oxygen therapy. What oxygen saturation
should the nurse generally aim for?
A. 100%
B. 98–100%
C. 88–92%
D. Above 95%
,Answer: C. 88–92%
Rationale: Many COPD patients require controlled oxygen therapy to avoid
suppressing respiratory drive while maintaining adequate oxygenation.
7. Which assessment finding is most concerning after thyroidectomy?
A. Mild neck pain
B. Hoarseness immediately after surgery
C. Tingling around the mouth
D. Fatigue
Answer: C. Tingling around the mouth
Rationale: Perioral tingling suggests hypocalcemia due to parathyroid injury and
requires prompt intervention.
8. Which patient is at greatest risk for developing a pressure injury?
A. Ambulatory patient with pneumonia
B. Patient on bed rest with limited mobility
C. Patient with hypertension
D. Patient with seasonal allergies
Answer: B. Patient on bed rest with limited mobility
Rationale: Immobility is one of the greatest risk factors for pressure injuries.
9. Which assessment finding is expected in hypoglycemia?
A. Warm, dry skin
B. Fruity breath odor
C. Diaphoresis and tremors
D. Kussmaul respirations
Answer: C. Diaphoresis and tremors
, Rationale: Hypoglycemia stimulates the sympathetic nervous system, causing
sweating, shakiness, and tachycardia.
10. Which intervention best prevents hospital-acquired infections?
A. Routine antibiotics
B. Strict hand hygiene
C. Daily chest X-rays
D. Bed rest
Answer: B. Strict hand hygiene
Rationale: Proper hand hygiene is the single most effective method of preventing
infection transmission.
11. Which ABG value indicates metabolic acidosis?
A. pH 7.30, HCO₃⁻ 18 mEq/L
B. pH 7.50, HCO₃⁻ 30 mEq/L
C. pH 7.46, PaCO₂ 30 mmHg
D. pH 7.38, PaCO₂ 40 mmHg
Answer: A. pH 7.30, HCO₃⁻ 18 mEq/L
Rationale: A low pH with a decreased bicarbonate level indicates metabolic
acidosis.
12. A nurse is caring for a patient with acute kidney injury. Which finding
requires immediate reporting?
A. Urine output of 20 mL/hour
B. Blood pressure 140/84 mmHg
C. Pulse 82 beats/min
D. Temperature 37°C
Answer: A. Urine output of 20 mL/hour
answers 2026/2027 version
1. A nurse is caring for a patient with heart failure. Which assessment finding
indicates worsening left-sided heart failure?
A. Jugular vein distention
B. Peripheral edema
C. Crackles in both lungs
D. Hepatomegaly
Answer: C. Crackles in both lungs
Rationale: Left-sided heart failure causes pulmonary congestion, leading to
crackles, dyspnea, and decreased oxygenation.
2. Which laboratory value should concern the nurse most in a patient
receiving furosemide?
A. Sodium 140 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 102 mEq/L
D. Calcium 9.2 mg/dL
Answer: B. Potassium 2.9 mEq/L
Rationale: Furosemide is a potassium-wasting diuretic. Severe hypokalemia
increases the risk of cardiac dysrhythmias.
3. Which action should the nurse take first for a patient experiencing chest
pain?
A. Obtain a 12-lead ECG
B. Administer oxygen if indicated
C. Assess pain characteristics
D. Notify the provider
,Answer: C. Assess pain characteristics
Rationale: Assessment comes first. The nurse must evaluate the pain before
initiating additional interventions unless the patient is unstable.
4. Which finding is expected in diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Kussmaul respirations
C. Hypoglycemia
D. Weight gain
Answer: B. Kussmaul respirations
Rationale: Deep, rapid respirations help compensate for metabolic acidosis in
DKA.
5. Which electrolyte imbalance commonly occurs with prolonged vomiting?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Vomiting causes loss of gastric fluids and potassium, resulting in
hypokalemia.
6. A patient with COPD is receiving oxygen therapy. What oxygen saturation
should the nurse generally aim for?
A. 100%
B. 98–100%
C. 88–92%
D. Above 95%
,Answer: C. 88–92%
Rationale: Many COPD patients require controlled oxygen therapy to avoid
suppressing respiratory drive while maintaining adequate oxygenation.
7. Which assessment finding is most concerning after thyroidectomy?
A. Mild neck pain
B. Hoarseness immediately after surgery
C. Tingling around the mouth
D. Fatigue
Answer: C. Tingling around the mouth
Rationale: Perioral tingling suggests hypocalcemia due to parathyroid injury and
requires prompt intervention.
8. Which patient is at greatest risk for developing a pressure injury?
A. Ambulatory patient with pneumonia
B. Patient on bed rest with limited mobility
C. Patient with hypertension
D. Patient with seasonal allergies
Answer: B. Patient on bed rest with limited mobility
Rationale: Immobility is one of the greatest risk factors for pressure injuries.
9. Which assessment finding is expected in hypoglycemia?
A. Warm, dry skin
B. Fruity breath odor
C. Diaphoresis and tremors
D. Kussmaul respirations
Answer: C. Diaphoresis and tremors
, Rationale: Hypoglycemia stimulates the sympathetic nervous system, causing
sweating, shakiness, and tachycardia.
10. Which intervention best prevents hospital-acquired infections?
A. Routine antibiotics
B. Strict hand hygiene
C. Daily chest X-rays
D. Bed rest
Answer: B. Strict hand hygiene
Rationale: Proper hand hygiene is the single most effective method of preventing
infection transmission.
11. Which ABG value indicates metabolic acidosis?
A. pH 7.30, HCO₃⁻ 18 mEq/L
B. pH 7.50, HCO₃⁻ 30 mEq/L
C. pH 7.46, PaCO₂ 30 mmHg
D. pH 7.38, PaCO₂ 40 mmHg
Answer: A. pH 7.30, HCO₃⁻ 18 mEq/L
Rationale: A low pH with a decreased bicarbonate level indicates metabolic
acidosis.
12. A nurse is caring for a patient with acute kidney injury. Which finding
requires immediate reporting?
A. Urine output of 20 mL/hour
B. Blood pressure 140/84 mmHg
C. Pulse 82 beats/min
D. Temperature 37°C
Answer: A. Urine output of 20 mL/hour
