NUR 242 Exam 1: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 1: Advanced Medical-Surgical Nursing
Concepts 2026/2027 UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 242 Exam 1: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which electrocardiogram
(ECG) finding is the nurse most likely to observe?
A. Prominent U waves
B. Prolonged PR interval
C. Tall, peaked T waves
D. ST-segment depression
Answer: C
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on an ECG as tall, peaked T
waves, which can progress to widened QRS complexes and cardiac arrest. In practice, this guides the
nurse to set priorities and protect the client from harm. Safety, nutrition, and clear communication are
frequent priorities. Clear understanding of this concept improves both test performance and everyday
clinical judgment. Practice applying it to short case scenarios to lock the idea in place.
2. A patient is diagnosed with metabolic alkalosis. Which arterial blood gas (ABG) result is
consistent with this diagnosis?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.30, PaCO2 50, HCO3 28
C. pH 7.48, PaCO2 40, HCO3 30
D. pH 7.32, PaCO2 35, HCO3 18
Answer: C
Rationale: Metabolic alkalosis is characterized by an elevated pH (> 7.45) and an elevated
bicarbonate level (HCO3 > 26 mEq/L) with a normal or slightly elevated PaCO2 if compensation is
occurring. This is important because the nurse must choose the action that keeps the client safest
while still meeting their basic needs. Always think about safety first when answering these questions.
In practice, this guides the nurse to set priorities and protect the client from harm. Safety, nutrition, and
clear communication are frequent priorities.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 1: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
3. The nurse is caring for a patient with a serum sodium level of 120 mEq/L. Which
intervention is the priority?
A. Encourage oral fluid intake
B. Implement seizure precautions
C. Administer 0.45% normal saline
D. Restrict dietary intake of salt
Answer: B
Rationale: Severe hyponatremia (< 120 mEq/L) puts the patient at high risk for cerebral edema and
seizures, making safety and seizure precautions the immediate priority. Remembering this point will
help you decide the best nursing action when similar questions appear on the exam. Link the answer
to the client’s current condition and risk level. Knowing the reason behind the correct answer makes it
easier to rule out the wrong options quickly. Look for the choice that protects the client and matches
the priority need.
4. During the preoperative assessment, a patient reports a family history of sudden death
and high fever during surgery. The nurse should notify the surgical team of a risk for which
condition?
A. Malignant hyperthermia
B. Anaphylactic shock
C. Hypovolemic shock
D. Septicemia
Answer: A
Rationale: Malignant hyperthermia is a rare, life-threatening genetic disorder triggered by certain
anesthetic agents, characterized by a rapid rise in body temperature and muscle rigidity. In practice,
this guides the nurse to set priorities and protect the client from harm. Safety, nutrition, and clear
communication are frequent priorities. Clear understanding of this concept improves both test
performance and everyday clinical judgment. Practice applying it to short case scenarios to lock the
idea in place.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 1: Advanced Medical-Surgical Nursing
Concepts 2026/2027 UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 242 Exam 1: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient presents with a serum potassium level of 6.2 mEq/L. Which electrocardiogram
(ECG) finding is the nurse most likely to observe?
A. Prominent U waves
B. Prolonged PR interval
C. Tall, peaked T waves
D. ST-segment depression
Answer: C
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on an ECG as tall, peaked T
waves, which can progress to widened QRS complexes and cardiac arrest. In practice, this guides the
nurse to set priorities and protect the client from harm. Safety, nutrition, and clear communication are
frequent priorities. Clear understanding of this concept improves both test performance and everyday
clinical judgment. Practice applying it to short case scenarios to lock the idea in place.
2. A patient is diagnosed with metabolic alkalosis. Which arterial blood gas (ABG) result is
consistent with this diagnosis?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.30, PaCO2 50, HCO3 28
C. pH 7.48, PaCO2 40, HCO3 30
D. pH 7.32, PaCO2 35, HCO3 18
Answer: C
Rationale: Metabolic alkalosis is characterized by an elevated pH (> 7.45) and an elevated
bicarbonate level (HCO3 > 26 mEq/L) with a normal or slightly elevated PaCO2 if compensation is
occurring. This is important because the nurse must choose the action that keeps the client safest
while still meeting their basic needs. Always think about safety first when answering these questions.
In practice, this guides the nurse to set priorities and protect the client from harm. Safety, nutrition, and
clear communication are frequent priorities.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 1: Advanced Medical-Surgical Nursing… 2026/2027 • Verified • Assured Grade A+
3. The nurse is caring for a patient with a serum sodium level of 120 mEq/L. Which
intervention is the priority?
A. Encourage oral fluid intake
B. Implement seizure precautions
C. Administer 0.45% normal saline
D. Restrict dietary intake of salt
Answer: B
Rationale: Severe hyponatremia (< 120 mEq/L) puts the patient at high risk for cerebral edema and
seizures, making safety and seizure precautions the immediate priority. Remembering this point will
help you decide the best nursing action when similar questions appear on the exam. Link the answer
to the client’s current condition and risk level. Knowing the reason behind the correct answer makes it
easier to rule out the wrong options quickly. Look for the choice that protects the client and matches
the priority need.
4. During the preoperative assessment, a patient reports a family history of sudden death
and high fever during surgery. The nurse should notify the surgical team of a risk for which
condition?
A. Malignant hyperthermia
B. Anaphylactic shock
C. Hypovolemic shock
D. Septicemia
Answer: A
Rationale: Malignant hyperthermia is a rare, life-threatening genetic disorder triggered by certain
anesthetic agents, characterized by a rapid rise in body temperature and muscle rigidity. In practice,
this guides the nurse to set priorities and protect the client from harm. Safety, nutrition, and clear
communication are frequent priorities. Clear understanding of this concept improves both test
performance and everyday clinical judgment. Practice applying it to short case scenarios to lock the
idea in place.
Exam (Elaborations) • Detailed Rationales Page 3
