NUR 242 MEDICAL-SURGICAL NURSING
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with left-sided heart failure is most likely to exhibit which of the following clinical
manifestations?
A. Peripheral edema and jugular venous distention
B. Crackles in the lungs and dyspnea
C. Hepatomegaly and abdominal bloating
D. Splenomegaly and weight gain
Answer: B
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion, crackles, and shortness of breath.
2. Which arterial blood gas (ABG) result is most indicative of fully compensated respiratory
acidosis?
A. pH 7.35, PaCO2 50, HCO3 30
B. pH 7.25, PaCO2 55, HCO3 24
,C. pH 7.48, PaCO2 30, HCO3 20
D. pH 7.32, PaCO2 40, HCO3 18
Answer: A
Conceptual Explanation: Full compensation occurs when the pH returns to the normal
range (7.35-7.45) while the opposing system (bicarbonate) adjusts for the primary
respiratory issue.
3. A nurse is caring for a patient in a thyroid storm. Which medication should the nurse
anticipate administering first to block the peripheral conversion of T4 to T3?
A. Levothyroxine
B. Methimazole
C. Iodine solution
D. Propylthiouracil (PTU)
Answer: D
Conceptual Explanation: PTU is preferred in thyroid storm because it inhibits the
synthesis of thyroid hormones and prevents the peripheral conversion of T4 to the more
active T3.
4. Which of the following is an early sign of compartment syndrome in a patient with a lower
leg fracture?
A. Pulselessness
, B. Paralysis
C. Paresthesia
D. Pallor
Answer: C
Conceptual Explanation: Paresthesia (numbness or tingling) is one of the earliest signs of
compartment syndrome; pulselessness and paralysis are late signs indicating permanent
damage.
5. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and a cough with
hemoptysis. Which condition should the nurse suspect?
A. Myocardial Infarction
B. Pulmonary Embolism
C. Pneumonia
D. Pneumothorax
Answer: B
Conceptual Explanation: The classic triad for pulmonary embolism includes dyspnea,
chest pain, and hemoptysis.
6. When caring for a patient with Addisonian crisis, which electrolyte abnormality is most
expected?
A. Hypernatremia and hypokalemia
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with left-sided heart failure is most likely to exhibit which of the following clinical
manifestations?
A. Peripheral edema and jugular venous distention
B. Crackles in the lungs and dyspnea
C. Hepatomegaly and abdominal bloating
D. Splenomegaly and weight gain
Answer: B
Conceptual Explanation: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion, crackles, and shortness of breath.
2. Which arterial blood gas (ABG) result is most indicative of fully compensated respiratory
acidosis?
A. pH 7.35, PaCO2 50, HCO3 30
B. pH 7.25, PaCO2 55, HCO3 24
,C. pH 7.48, PaCO2 30, HCO3 20
D. pH 7.32, PaCO2 40, HCO3 18
Answer: A
Conceptual Explanation: Full compensation occurs when the pH returns to the normal
range (7.35-7.45) while the opposing system (bicarbonate) adjusts for the primary
respiratory issue.
3. A nurse is caring for a patient in a thyroid storm. Which medication should the nurse
anticipate administering first to block the peripheral conversion of T4 to T3?
A. Levothyroxine
B. Methimazole
C. Iodine solution
D. Propylthiouracil (PTU)
Answer: D
Conceptual Explanation: PTU is preferred in thyroid storm because it inhibits the
synthesis of thyroid hormones and prevents the peripheral conversion of T4 to the more
active T3.
4. Which of the following is an early sign of compartment syndrome in a patient with a lower
leg fracture?
A. Pulselessness
, B. Paralysis
C. Paresthesia
D. Pallor
Answer: C
Conceptual Explanation: Paresthesia (numbness or tingling) is one of the earliest signs of
compartment syndrome; pulselessness and paralysis are late signs indicating permanent
damage.
5. A patient presents with sudden onset of pleuritic chest pain, dyspnea, and a cough with
hemoptysis. Which condition should the nurse suspect?
A. Myocardial Infarction
B. Pulmonary Embolism
C. Pneumonia
D. Pneumothorax
Answer: B
Conceptual Explanation: The classic triad for pulmonary embolism includes dyspnea,
chest pain, and hemoptysis.
6. When caring for a patient with Addisonian crisis, which electrolyte abnormality is most
expected?
A. Hypernatremia and hypokalemia
