MED-SURG 2 JERSEY COLLEGE
ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ -removing all bedding over the patient (with the possible exception of a light
sheet, towel, or small drape)-administering acetaminophen as
prescribed-giving cool sponge baths and allowing an electric fan to blow
over the patient to increase surface cooling-using a hypothermia
blanket-frequent temperature monitoring to assess the patient's response to
the therapy and to prevent an excessive decrease in temperature and
shivering.
Answer: Strategies for reducing fever/hyperthermia treatment
◍ What is the priority order for patient assessment?.
Answer: Airway → Breathing → Circulation (ABCs)
◍ What should be prioritized in an acute change versus chronic baseline?.
Answer: Acute change should be prioritized over chronic baseline.
◍ -change in LOC-agitation-slowing of speech-and delay in response to verbal
suggestions are other early indicators.
Answer: Early indicators of increasing ICP
◍ What is the first action if there is a life-threatening condition?.
Answer: Assess before acting, unless there's an immediate threat.
◍ What indicates an emergency when observing a patient?.
Answer: Stridor, swelling of lips and tongue, or pulsing trachea with
bleeding.
◍ 4 spontaneous3 to voice2 to pain1 none.
, Answer: GLASGOW COMA SCALE - Eye Opening
◍ What should be done when a patient has COPD regarding oxygen?.
Answer: Oxygen goals are often lower than normal; do not reflexively
administer 100% O₂.
◍ 5 oriented4 confused3 inappropriate words2 incomprehensible sounds1
none.
Answer: GLASGOW COMA SCALE -Best Verbal Response
◍ What is the correct position for a patient with respiratory distress?.
Answer: Head of bed (HOB) elevated.
◍ What is the gold standard for pain assessment?.
Answer: Self-report from the patient.
◍ 6 obeys commands5 localizes pain4 withdraws3 flexion2 extension1 none.
Answer: GLASGOW COMA SCALE - Best Motor Response
◍ How long should you wait to reassess after administering IV pain
medication?.
Answer: 15-30 minutes.
◍ Rectally or tympanic. NEVER BY MOUT
H. .
Answer: How should the patient who is unconscious have their temperature
taken?
◍ What are the signs of fluid volume deficiency?.
Answer: Tachycardia, hypotension, poor skin turgor, dry mucosa, low urine
output.
◍ -mouth care with antiseptic such as chlorhexidine-tongue scraper-electrical
toothbrush-pharmacologic moisturizers.
Answer: List interventions to decrease ventilator-associated pneumonia. (4)
◍ What are the signs of fluid volume excess?.
Answer: Crackles, edema, bounding pulse, jugular vein distension, weight
gain.
,◍ What does a low potassium (K⁺) level indicate?.
Answer: U waves, cramps, ileus.
◍ -incontinence-inadequate dietary intake-pressure on bony
prominences-edema.
Answer: Factors that contribute to impaired skin integrity (4)
◍ What is the first action for suspected carbon monoxide poisoning?.
Answer: Administer 100% oxygen via non-rebreather mask.
◍ increased ICP.
Answer: slow bounding pulse and respiratory irregularities suggest what?
◍ What is the purpose of a time-out in the intraoperative phase?.
Answer: To verify the right patient, procedure, and site.
◍ cerebral vasodilation, leading to increased cerebral blood flow and increased
ICP.
Answer: An increase in the partial pressure of arterial carbon dioxide
(PaCO2) causes ?
◍ What is a key sign of malignant hyperthermia?.
Answer: Rigidity, rising CO₂ levels, and hyperthermia.
◍ What should be monitored post-operatively?.
Answer: Airway, breathing, circulation, pain, temperature, incision/drains.
◍ What does diminished breath sounds in asthma indicate?.
Answer: Worsening condition ('silent chest').
◍ a vasocontrictive effect, limiting blood flow to the brain. Decreased venous
outflow may also increase cerebral blood volume, thus raising the ICP.
Answer: A decrease in PaCO2 causes?
◍ What is the most common complaint in pulmonary embolism (PE)?.
Answer: Sudden dyspnea, often with pleuritic chest pain.
◍ What indicates a flail chest?.
Answer: Paradoxical chest movement.
, ◍ CPP = MAP - ICPMAP = mean arterial pressureICP = intracranial pressure.
Answer: How to calculate Cerebral Perfusion Pressure (CPP)?
◍ Pain in the calf upon passive Dorsiflexion of the foot in DVT.
Answer: Homan's sign?
◍ -bradycardia-hypertension-bradypnea.
Answer: What are the three signs that make up Cushing's Triad?
◍ -cerebral ischemia-infarction-brain death.
Answer: Cessation of cerebral blood flow results in what three things?
◍ 80-120.
Answer: What level should the pressure of the wall suction unit be set to
when suctioning a trach patient?
◍ trochanter roll.
Answer: Rolled towel support placed against the hips and upper leg to
prevent external rotation of the leg ?
◍ What should you do if chest tube tidaling stops unexpectedly?.
Answer: Suspect obstruction or kink and assess the patient.
◍ -eye may be cleansed with a cotton ball moistened with sterile NS-artificial
tears -- if prescribed, can be instilled q2h-cold compresses -- ifprescribed
care must be exerted to avoid contact with the cornea-eye patches -- use
with caution to avoid corneal abrasion.
Answer: How to preserve corneal integrity? (4)
◍ What is the first step in tracheostomy care?.
Answer: Dry the nondisposable inner cannula thoroughly before reinserting.
◍ -pain-cloudy urine-foul odor-fever.
Answer: Signs of urinary infection? (4)
◍ What should be done before eating with a cuffed trach?.
Answer: Deflate the cuff to reduce aspiration risk.
◍ What are the signs of respiratory depression in opioid use?.
ACTUAL EXAM PAPER 2026
QUESTIONS WITH ANSWERS GRADED
A+
◍ -removing all bedding over the patient (with the possible exception of a light
sheet, towel, or small drape)-administering acetaminophen as
prescribed-giving cool sponge baths and allowing an electric fan to blow
over the patient to increase surface cooling-using a hypothermia
blanket-frequent temperature monitoring to assess the patient's response to
the therapy and to prevent an excessive decrease in temperature and
shivering.
Answer: Strategies for reducing fever/hyperthermia treatment
◍ What is the priority order for patient assessment?.
Answer: Airway → Breathing → Circulation (ABCs)
◍ What should be prioritized in an acute change versus chronic baseline?.
Answer: Acute change should be prioritized over chronic baseline.
◍ -change in LOC-agitation-slowing of speech-and delay in response to verbal
suggestions are other early indicators.
Answer: Early indicators of increasing ICP
◍ What is the first action if there is a life-threatening condition?.
Answer: Assess before acting, unless there's an immediate threat.
◍ What indicates an emergency when observing a patient?.
Answer: Stridor, swelling of lips and tongue, or pulsing trachea with
bleeding.
◍ 4 spontaneous3 to voice2 to pain1 none.
, Answer: GLASGOW COMA SCALE - Eye Opening
◍ What should be done when a patient has COPD regarding oxygen?.
Answer: Oxygen goals are often lower than normal; do not reflexively
administer 100% O₂.
◍ 5 oriented4 confused3 inappropriate words2 incomprehensible sounds1
none.
Answer: GLASGOW COMA SCALE -Best Verbal Response
◍ What is the correct position for a patient with respiratory distress?.
Answer: Head of bed (HOB) elevated.
◍ What is the gold standard for pain assessment?.
Answer: Self-report from the patient.
◍ 6 obeys commands5 localizes pain4 withdraws3 flexion2 extension1 none.
Answer: GLASGOW COMA SCALE - Best Motor Response
◍ How long should you wait to reassess after administering IV pain
medication?.
Answer: 15-30 minutes.
◍ Rectally or tympanic. NEVER BY MOUT
H. .
Answer: How should the patient who is unconscious have their temperature
taken?
◍ What are the signs of fluid volume deficiency?.
Answer: Tachycardia, hypotension, poor skin turgor, dry mucosa, low urine
output.
◍ -mouth care with antiseptic such as chlorhexidine-tongue scraper-electrical
toothbrush-pharmacologic moisturizers.
Answer: List interventions to decrease ventilator-associated pneumonia. (4)
◍ What are the signs of fluid volume excess?.
Answer: Crackles, edema, bounding pulse, jugular vein distension, weight
gain.
,◍ What does a low potassium (K⁺) level indicate?.
Answer: U waves, cramps, ileus.
◍ -incontinence-inadequate dietary intake-pressure on bony
prominences-edema.
Answer: Factors that contribute to impaired skin integrity (4)
◍ What is the first action for suspected carbon monoxide poisoning?.
Answer: Administer 100% oxygen via non-rebreather mask.
◍ increased ICP.
Answer: slow bounding pulse and respiratory irregularities suggest what?
◍ What is the purpose of a time-out in the intraoperative phase?.
Answer: To verify the right patient, procedure, and site.
◍ cerebral vasodilation, leading to increased cerebral blood flow and increased
ICP.
Answer: An increase in the partial pressure of arterial carbon dioxide
(PaCO2) causes ?
◍ What is a key sign of malignant hyperthermia?.
Answer: Rigidity, rising CO₂ levels, and hyperthermia.
◍ What should be monitored post-operatively?.
Answer: Airway, breathing, circulation, pain, temperature, incision/drains.
◍ What does diminished breath sounds in asthma indicate?.
Answer: Worsening condition ('silent chest').
◍ a vasocontrictive effect, limiting blood flow to the brain. Decreased venous
outflow may also increase cerebral blood volume, thus raising the ICP.
Answer: A decrease in PaCO2 causes?
◍ What is the most common complaint in pulmonary embolism (PE)?.
Answer: Sudden dyspnea, often with pleuritic chest pain.
◍ What indicates a flail chest?.
Answer: Paradoxical chest movement.
, ◍ CPP = MAP - ICPMAP = mean arterial pressureICP = intracranial pressure.
Answer: How to calculate Cerebral Perfusion Pressure (CPP)?
◍ Pain in the calf upon passive Dorsiflexion of the foot in DVT.
Answer: Homan's sign?
◍ -bradycardia-hypertension-bradypnea.
Answer: What are the three signs that make up Cushing's Triad?
◍ -cerebral ischemia-infarction-brain death.
Answer: Cessation of cerebral blood flow results in what three things?
◍ 80-120.
Answer: What level should the pressure of the wall suction unit be set to
when suctioning a trach patient?
◍ trochanter roll.
Answer: Rolled towel support placed against the hips and upper leg to
prevent external rotation of the leg ?
◍ What should you do if chest tube tidaling stops unexpectedly?.
Answer: Suspect obstruction or kink and assess the patient.
◍ -eye may be cleansed with a cotton ball moistened with sterile NS-artificial
tears -- if prescribed, can be instilled q2h-cold compresses -- ifprescribed
care must be exerted to avoid contact with the cornea-eye patches -- use
with caution to avoid corneal abrasion.
Answer: How to preserve corneal integrity? (4)
◍ What is the first step in tracheostomy care?.
Answer: Dry the nondisposable inner cannula thoroughly before reinserting.
◍ -pain-cloudy urine-foul odor-fever.
Answer: Signs of urinary infection? (4)
◍ What should be done before eating with a cuffed trach?.
Answer: Deflate the cuff to reduce aspiration risk.
◍ What are the signs of respiratory depression in opioid use?.
