NUR 242 Medical Surgical Nursing Final Exam Practice Questions and Correct Answers/ NUR 242 Final Exam Study Questions and Correct Answers

NUR 242 Medical Surgical Nursing Final
Exam Practice Questions and Correct
Answers/ NUR 242 Final Exam Study
Questions and Correct Answers

SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A patient with left-sided heart failure is admitted with shortness of breath and
crackles in the lungs. Which pathophysiological mechanism explains these
findings?
• A) Blood backing up into the systemic circulation
• B) Blood backing up into the pulmonary circulation
• C) Decreased cardiac output to the kidneys
• D) Increased peripheral vascular resistance
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary congestion, crackles, and shortness of breath.
The other options are signs of right-sided heart failure .


Question 2
A patient is taking Digoxin for heart failure. Which electrolyte imbalance increases
the risk of Digoxin toxicity?
• A) Hypernatremia
• B) Hypokalemia

, • C) Hypercalcemia
• D) Hypomagnesemia
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium levels
should be monitored closely in patients taking digoxin. Hypokalemia can
precipitate dysrhythmias and digoxin toxicity .


Question 3
A patient with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor for?
• A) Hyperkalemia
• B) Hypokalemia
• C) Hypernatremia
• D) Hypocalcemia
Rationale: Furosemide is a loop diuretic that increases potassium excretion,
leading to hypokalemia. Hyperkalemia is more common with potassium-sparing
diuretics .


Question 4
A patient with atrial fibrillation is prescribed warfarin. Which food should the
nurse advise the patient to consume in consistent amounts?
• A) Citrus fruits
• B) Green leafy vegetables
• C) Dairy products
• D) Whole grains
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes
warfarin's effects. Patients should maintain consistent intake of vitamin K-rich

,foods to keep INR stable. Sudden increases or decreases in vitamin K intake can
alter warfarin's effectiveness .


Question 5
Which assessment finding indicates that a patient's AV fistula for hemodialysis is
patent?
• A) Absent pulse
• B) Cold extremity
• C) Cyanosis of the extremity
• D) Palpable thrill and audible bruit
Rationale: A palpable thrill and audible bruit indicate patency of the AV fistula.
Absent pulse, cold extremity, and cyanosis are signs of compromised blood flow or
vascular insufficiency .


Question 6
A patient with a new AV fistula should be instructed to:
• A) Use the AV fistula arm for all venipunctures
• B) Sleep on the AV fistula arm
• C) Wear tight sleeves over the fistula
• D) Avoid BP measurements and blood draws in that arm
Rationale: The AV fistula arm must be protected—no BP measurements, no blood
draws, no compression, and no tight clothing. This preserves the fistula for
hemodialysis access .


Question 7

, A patient with chronic kidney disease has a potassium level of 6.8 mEq/L. What is
the priority nursing action?
• A) Document the finding
• B) Notify the provider
• C) Administer oral potassium supplements
• D) Prepare for emergent treatment of hyperkalemia
Rationale: Hyperkalemia >6.5 mEq/L can cause cardiac arrest and requires
emergent treatment. Potassium levels in CKD must be closely monitored, and
levels this high warrant immediate intervention .


Question 8
A patient with CKD is prescribed calcium acetate (PhosLo). The nurse should
instruct the patient to take this medication:
• A) With meals
• B) On an empty stomach
• C) At bedtime
• D) First thing in the morning
Rationale: Phosphate binders like calcium acetate must be taken with meals to
bind dietary phosphorus in the gut. This prevents phosphorus absorption and
helps manage hyperphosphatemia in CKD .


Question 9
Which finding suggests a patient with end-stage renal disease (ESRD) is
experiencing fluid overload?
• A) Orthostatic hypotension
• B) Jugular vein distention and crackles