NUR 242 Med-Surg Nursing Exams 1-4 Prep Document |
2026/2027 Edition | 200 Verified Questions - 179 Questions
with Answers
NUR 242 Med-Surg Nursing Exams 1-4 2026-179 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive prep document consolidates 200 verified questions from NUR 242 Med-Surg
Nursing Exams 1-4 for the 2026/2027 academic year. It is meticulously organized to reflect the latest
Galen College curriculum and NCLEX-RN standards, offering a robust review of adult
medical-surgical nursing concepts. Each question is paired with a correct answer and a detailed
rationale to reinforce critical thinking and clinical judgment. Ideal for exam preparation, this resource
ensures students are thoroughly equipped to excel in their nursing assessments.
Key Features:
Comprehensive coverage of adult medical-surgical nursing topics across all four exams
200 verified questions with correct answers and rationales
Aligned with 2026/2027 Galen College curriculum and NCLEX-RN test plan
Includes priority nursing interventions, pharmacology, and patient education
Designed to enhance clinical judgment and critical thinking skills
Graded A+ quality, ensuring accuracy and reliability
Updates for 2026:
- Revised to incorporate the latest evidence-based practice guidelines
- Updated to reflect current NCLEX-RN test plan and Galen College syllabus
- Enhanced rationales to include deeper pathophysiological explanations
- Added new questions on emerging topics such as sepsis management and opioid safety
- Reorganized content to mirror the exam sequence for efficient study
Abstract:
This exam preparation document is a scholarly compilation of 200 verified questions derived from NUR 242
Med-Surg Nursing Exams 1-4 at Galen College, tailored for the 2026/2027 academic year. The content spans a
broad spectrum of adult medical-surgical nursing, including cardiovascular, respiratory, renal, endocrine,
gastrointestinal, neurological, and musculoskeletal systems, as well as perioperative care and fluid/electrolyte
balance. Each question is accompanied by a correct answer and a comprehensive rationale that explains the
underlying pathophysiology, nursing interventions, and pharmacological considerations. The document is
structured to promote active recall and clinical reasoning, with questions categorized by exam and content area to
facilitate targeted study. Updated to align with the latest NCLEX-RN test plan and evidence-based practice, this
resource serves as an indispensable tool for nursing students seeking to achieve a high level of proficiency and
pass their exams with confidence.
Keywords:
Med-Surg Nursing, NUR 242, Galen College, NCLEX-RN, Exam Prep, Nursing Questions, Clinical Judgment,
2026/2027
Answer Format:
Each question is presented in a multiple-choice format followed by the correct answer and a detailed rationale.
Rationales explain why the correct answer is appropriate and why the distractors are incorrect, incorporating
pathophysiological concepts, nursing priorities, and pharmacological principles. This format reinforces learning
and helps students apply knowledge to clinical scenarios.
Page 1
,Compliance Checklist:
Aligned with Galen College NUR 242 course objectives
Reflects the latest NCLEX-RN test plan (2023-2026)
Includes evidence-based practice guidelines updated for 2026/2027
Verified for accuracy by nursing educators
Suitable for self-assessment and group study
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular & Respiratory 1-40 Heart failure, MI, COPD, pneumonia, 20%
asthma, hypertension
Renal & Endocrine 41-80 Acute kidney injury, chronic kidney disease, 20%
diabetes mellitus, thyroid disorders
Gastrointestinal & Nutrition 81-120 GI bleed, pancreatitis, liver disease, enteral 20%
nutrition, fluid/electrolytes
Neurological & Musculoskeletal 121-160 Stroke, seizures, Parkinson's, fractures, 20%
osteoarthritis, osteoporosis
Perioperative & Other Systems 161-200 Pre/post-op care, wound healing, shock, 20%
sepsis, oncology emergencies
Page 2
,Q1. A patient with chronic heart failure (HFrEF) is started on sacubitril/valsartan.
Which parameter requires the most vigilant monitoring during the first month of
therapy?
A. Serum potassium levels
B. Blood pressure and renal function
C. Liver function tests
D. Serum digoxin levels
Correct Answer: B. Blood pressure and renal function
Rationale: Sacubitril/valsartan can cause profound hypotension and renal impairment,
especially in patients on ACE inhibitors or ARBs. The PARADIGM-HF trial emphasized
monitoring blood pressure and renal function. Hyperkalemia is also a concern but less
acute than hypotension.
Why Wrong:
A - Hyperkalemia is a risk but not the most critical parameter in the first month.
C - Liver function is not typically affected by sacubitril/valsartan.
D - Digoxin levels are not directly affected by sacubitril/valsartan.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 24
Q2. In a patient with acute respiratory distress syndrome (ARDS), which ventilator
strategy is most consistent with lung-protective ventilation?
A. Tidal volume 10 mL/kg ideal body weight and plateau pressure 30 cm H2O
B. Tidal volume 6 mL/kg ideal body weight and plateau pressure 30 cm H2O
C. Tidal volume 6 mL/kg actual body weight and PEEP 5 cm H2O
D. Tidal volume 8 mL/kg ideal body weight with permissive hypercapnia
Correct Answer: B. Tidal volume 6 mL/kg ideal body weight and plateau pressure 30
cm H2O
Rationale: Lung-protective ventilation uses low tidal volumes (4-6 mL/kg IBW) and
limited plateau pressures to prevent ventilator-induced lung injury. The ARDSNet trial
demonstrated reduced mortality. Option B is the only one that meets both criteria.
Why Wrong:
A - 10 mL/kg is too high and increases risk of volutrauma.
C - Actual body weight overestimates lung size; PEEP alone doesn't protect lungs.
D - 8 mL/kg exceeds the recommended limit for ARDS.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing, 9th Ed., Ch. 12
Q3. Which laboratory finding is most indicative of disseminated intravascular
coagulation (DIC) in a patient with sepsis?
A. Elevated fibrinogen level
Page 3
, B. Elevated D-dimer and prolonged PT/PTT with thrombocytopenia
C. Decreased international normalized ratio (INR)
D. Elevated platelet count with normal fibrinogen
Correct Answer: B. Elevated D-dimer and prolonged PT/PTT with thrombocytopenia
Rationale: DIC is characterized by consumption of clotting factors and platelets, leading
to prolonged PT/PTT, thrombocytopenia, and elevated D-dimer due to fibrinolysis.
Fibrinogen is typically low, not elevated.
Why Wrong:
A - Fibrinogen is usually decreased due to consumption.
C - INR is prolonged, not decreased.
D - Platelets are low, not elevated.
Reference: Ignatavicius, D.D., et al. (2026). Medical-Surgical Nursing, 10th Ed., Ch. 18
Q4. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). Which
instruction is critical to include in patient teaching?
A. Take the medication with food to reduce gastrointestinal upset.
B. Report any signs of sore throat or fever immediately.
C. The medication will have a therapeutic effect within 24 hours.
D. Avoid foods high in iodine, such as shellfish.
Correct Answer: B. Report any signs of sore throat or fever immediately.
Rationale: PTU can cause agranulocytosis, a life-threatening drop in white blood cells.
Patients must report sore throat, fever, or other signs of infection immediately. This is a
priority safety concern.
Why Wrong:
A - PTU can be taken without regard to meals; GI upset is not the main concern.
C - Therapeutic effects take several weeks, not 24 hours.
D - Iodine restriction is not required with PTU; it is more relevant for radioactive
iodine therapy.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 49
Q5. Which assessment finding is most concerning in a patient with syndrome of
inappropriate antidiuretic hormone (SIADH)?
A. Serum sodium of 128 mEq/L
B. Serum sodium of 132 mEq/L
C. Serum sodium of 120 mEq/L with confusion
D. Serum sodium of 135 mEq/L with mild headache
Correct Answer: C. Serum sodium of 120 mEq/L with confusion
Page 4
2026/2027 Edition | 200 Verified Questions - 179 Questions
with Answers
NUR 242 Med-Surg Nursing Exams 1-4 2026-179 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive prep document consolidates 200 verified questions from NUR 242 Med-Surg
Nursing Exams 1-4 for the 2026/2027 academic year. It is meticulously organized to reflect the latest
Galen College curriculum and NCLEX-RN standards, offering a robust review of adult
medical-surgical nursing concepts. Each question is paired with a correct answer and a detailed
rationale to reinforce critical thinking and clinical judgment. Ideal for exam preparation, this resource
ensures students are thoroughly equipped to excel in their nursing assessments.
Key Features:
Comprehensive coverage of adult medical-surgical nursing topics across all four exams
200 verified questions with correct answers and rationales
Aligned with 2026/2027 Galen College curriculum and NCLEX-RN test plan
Includes priority nursing interventions, pharmacology, and patient education
Designed to enhance clinical judgment and critical thinking skills
Graded A+ quality, ensuring accuracy and reliability
Updates for 2026:
- Revised to incorporate the latest evidence-based practice guidelines
- Updated to reflect current NCLEX-RN test plan and Galen College syllabus
- Enhanced rationales to include deeper pathophysiological explanations
- Added new questions on emerging topics such as sepsis management and opioid safety
- Reorganized content to mirror the exam sequence for efficient study
Abstract:
This exam preparation document is a scholarly compilation of 200 verified questions derived from NUR 242
Med-Surg Nursing Exams 1-4 at Galen College, tailored for the 2026/2027 academic year. The content spans a
broad spectrum of adult medical-surgical nursing, including cardiovascular, respiratory, renal, endocrine,
gastrointestinal, neurological, and musculoskeletal systems, as well as perioperative care and fluid/electrolyte
balance. Each question is accompanied by a correct answer and a comprehensive rationale that explains the
underlying pathophysiology, nursing interventions, and pharmacological considerations. The document is
structured to promote active recall and clinical reasoning, with questions categorized by exam and content area to
facilitate targeted study. Updated to align with the latest NCLEX-RN test plan and evidence-based practice, this
resource serves as an indispensable tool for nursing students seeking to achieve a high level of proficiency and
pass their exams with confidence.
Keywords:
Med-Surg Nursing, NUR 242, Galen College, NCLEX-RN, Exam Prep, Nursing Questions, Clinical Judgment,
2026/2027
Answer Format:
Each question is presented in a multiple-choice format followed by the correct answer and a detailed rationale.
Rationales explain why the correct answer is appropriate and why the distractors are incorrect, incorporating
pathophysiological concepts, nursing priorities, and pharmacological principles. This format reinforces learning
and helps students apply knowledge to clinical scenarios.
Page 1
,Compliance Checklist:
Aligned with Galen College NUR 242 course objectives
Reflects the latest NCLEX-RN test plan (2023-2026)
Includes evidence-based practice guidelines updated for 2026/2027
Verified for accuracy by nursing educators
Suitable for self-assessment and group study
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular & Respiratory 1-40 Heart failure, MI, COPD, pneumonia, 20%
asthma, hypertension
Renal & Endocrine 41-80 Acute kidney injury, chronic kidney disease, 20%
diabetes mellitus, thyroid disorders
Gastrointestinal & Nutrition 81-120 GI bleed, pancreatitis, liver disease, enteral 20%
nutrition, fluid/electrolytes
Neurological & Musculoskeletal 121-160 Stroke, seizures, Parkinson's, fractures, 20%
osteoarthritis, osteoporosis
Perioperative & Other Systems 161-200 Pre/post-op care, wound healing, shock, 20%
sepsis, oncology emergencies
Page 2
,Q1. A patient with chronic heart failure (HFrEF) is started on sacubitril/valsartan.
Which parameter requires the most vigilant monitoring during the first month of
therapy?
A. Serum potassium levels
B. Blood pressure and renal function
C. Liver function tests
D. Serum digoxin levels
Correct Answer: B. Blood pressure and renal function
Rationale: Sacubitril/valsartan can cause profound hypotension and renal impairment,
especially in patients on ACE inhibitors or ARBs. The PARADIGM-HF trial emphasized
monitoring blood pressure and renal function. Hyperkalemia is also a concern but less
acute than hypotension.
Why Wrong:
A - Hyperkalemia is a risk but not the most critical parameter in the first month.
C - Liver function is not typically affected by sacubitril/valsartan.
D - Digoxin levels are not directly affected by sacubitril/valsartan.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 24
Q2. In a patient with acute respiratory distress syndrome (ARDS), which ventilator
strategy is most consistent with lung-protective ventilation?
A. Tidal volume 10 mL/kg ideal body weight and plateau pressure 30 cm H2O
B. Tidal volume 6 mL/kg ideal body weight and plateau pressure 30 cm H2O
C. Tidal volume 6 mL/kg actual body weight and PEEP 5 cm H2O
D. Tidal volume 8 mL/kg ideal body weight with permissive hypercapnia
Correct Answer: B. Tidal volume 6 mL/kg ideal body weight and plateau pressure 30
cm H2O
Rationale: Lung-protective ventilation uses low tidal volumes (4-6 mL/kg IBW) and
limited plateau pressures to prevent ventilator-induced lung injury. The ARDSNet trial
demonstrated reduced mortality. Option B is the only one that meets both criteria.
Why Wrong:
A - 10 mL/kg is too high and increases risk of volutrauma.
C - Actual body weight overestimates lung size; PEEP alone doesn't protect lungs.
D - 8 mL/kg exceeds the recommended limit for ARDS.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing, 9th Ed., Ch. 12
Q3. Which laboratory finding is most indicative of disseminated intravascular
coagulation (DIC) in a patient with sepsis?
A. Elevated fibrinogen level
Page 3
, B. Elevated D-dimer and prolonged PT/PTT with thrombocytopenia
C. Decreased international normalized ratio (INR)
D. Elevated platelet count with normal fibrinogen
Correct Answer: B. Elevated D-dimer and prolonged PT/PTT with thrombocytopenia
Rationale: DIC is characterized by consumption of clotting factors and platelets, leading
to prolonged PT/PTT, thrombocytopenia, and elevated D-dimer due to fibrinolysis.
Fibrinogen is typically low, not elevated.
Why Wrong:
A - Fibrinogen is usually decreased due to consumption.
C - INR is prolonged, not decreased.
D - Platelets are low, not elevated.
Reference: Ignatavicius, D.D., et al. (2026). Medical-Surgical Nursing, 10th Ed., Ch. 18
Q4. A patient with hyperthyroidism is prescribed propylthiouracil (PTU). Which
instruction is critical to include in patient teaching?
A. Take the medication with food to reduce gastrointestinal upset.
B. Report any signs of sore throat or fever immediately.
C. The medication will have a therapeutic effect within 24 hours.
D. Avoid foods high in iodine, such as shellfish.
Correct Answer: B. Report any signs of sore throat or fever immediately.
Rationale: PTU can cause agranulocytosis, a life-threatening drop in white blood cells.
Patients must report sore throat, fever, or other signs of infection immediately. This is a
priority safety concern.
Why Wrong:
A - PTU can be taken without regard to meals; GI upset is not the main concern.
C - Therapeutic effects take several weeks, not 24 hours.
D - Iodine restriction is not required with PTU; it is more relevant for radioactive
iodine therapy.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 49
Q5. Which assessment finding is most concerning in a patient with syndrome of
inappropriate antidiuretic hormone (SIADH)?
A. Serum sodium of 128 mEq/L
B. Serum sodium of 132 mEq/L
C. Serum sodium of 120 mEq/L with confusion
D. Serum sodium of 135 mEq/L with mild headache
Correct Answer: C. Serum sodium of 120 mEq/L with confusion
Page 4
