NUR 242 Exam 4 Galen Med-Surg Concepts (2026) UPDA… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 242 Exam 4 Galen Med-Surg Concepts (2026) UPDATE
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 4 Galen Med-Surg Concepts (2026) UPDA… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the resuscitative phase of a major burn injury has a potassium level of 6.2
mEq/L. Which physiological process best explains this finding?
A. Renal failure due to myoglobinuria
B. Excessive fluid resuscitation with Lactated Ringer’s
C. Massive cell destruction and release of intracellular ions
D. Metabolic alkalosis causing a potassium shift
Answer: C
Rationale: During the early phase of a burn (resuscitative phase), massive cell destruction leads to
the release of potassium from the intracellular space into the extracellular fluid, resulting in
hyperkalemia. 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.
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.
2. A client is admitted with suspected Diabetes Insipidus (DI) following a head injury. Which
laboratory finding most strongly supports this diagnosis?
A. Serum sodium of 128 mEq/L
B. Urine specific gravity of 1.002
C. Serum osmolality of 275 mOsm/kg
D. Urine osmolality of 1200 mOsm/kg
Answer: B
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the excretion of large
volumes of dilute urine. A low urine specific gravity (1.001 to 1.005) is a hallmark sign. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 4 Galen Med-Surg Concepts (2026) UPDA… 2026/2027 • Verified • Assured Grade A+
3. The nurse is caring for a patient in septic shock. The patient’s blood pressure is 82/46
mmHg after a 30 mL/kg fluid bolus. Which medication should the nurse anticipate
administering next?
A. Dobutamine
B. Nitroglycerin
C. Atropine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine is the first-line vasopressor recommended in septic shock when fluid
resuscitation fails to maintain adequate mean arterial pressure (MAP). 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.
4. A patient with a T4 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. The blood pressure is 190/110 mmHg. What is the priority nursing action?
A. Administer prescribed PRN hydralazine
B. Raise the head of the bed to 90 degrees
C. Perform a digital rectal exam to check for impaction
D. Check the patient’s bladder for distention
Answer: B
Rationale: The patient is experiencing autonomic dysreflexia. The immediate priority is to sit the
patient upright to utilize orthostatic pressure to lower the blood pressure before identifying the
triggering stimulus. 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 4 Galen Med-Surg Concepts (2026) UPDATE
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 4 Galen Med-Surg Concepts (2026) UPDA… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the resuscitative phase of a major burn injury has a potassium level of 6.2
mEq/L. Which physiological process best explains this finding?
A. Renal failure due to myoglobinuria
B. Excessive fluid resuscitation with Lactated Ringer’s
C. Massive cell destruction and release of intracellular ions
D. Metabolic alkalosis causing a potassium shift
Answer: C
Rationale: During the early phase of a burn (resuscitative phase), massive cell destruction leads to
the release of potassium from the intracellular space into the extracellular fluid, resulting in
hyperkalemia. 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.
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.
2. A client is admitted with suspected Diabetes Insipidus (DI) following a head injury. Which
laboratory finding most strongly supports this diagnosis?
A. Serum sodium of 128 mEq/L
B. Urine specific gravity of 1.002
C. Serum osmolality of 275 mOsm/kg
D. Urine osmolality of 1200 mOsm/kg
Answer: B
Rationale: Diabetes Insipidus is characterized by a deficiency of ADH, leading to the excretion of large
volumes of dilute urine. A low urine specific gravity (1.001 to 1.005) is a hallmark sign. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety. 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.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 242 Exam 4 Galen Med-Surg Concepts (2026) UPDA… 2026/2027 • Verified • Assured Grade A+
3. The nurse is caring for a patient in septic shock. The patient’s blood pressure is 82/46
mmHg after a 30 mL/kg fluid bolus. Which medication should the nurse anticipate
administering next?
A. Dobutamine
B. Nitroglycerin
C. Atropine
D. Norepinephrine
Answer: D
Rationale: Norepinephrine is the first-line vasopressor recommended in septic shock when fluid
resuscitation fails to maintain adequate mean arterial pressure (MAP). 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.
4. A patient with a T4 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. The blood pressure is 190/110 mmHg. What is the priority nursing action?
A. Administer prescribed PRN hydralazine
B. Raise the head of the bed to 90 degrees
C. Perform a digital rectal exam to check for impaction
D. Check the patient’s bladder for distention
Answer: B
Rationale: The patient is experiencing autonomic dysreflexia. The immediate priority is to sit the
patient upright to utilize orthostatic pressure to lower the blood pressure before identifying the
triggering stimulus. 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
