NUR242 MEDICAL-SURGICAL NURSING
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with left-sided heart failure is being assessed. Which clinical finding should the
nurse expect to observe?
A. Crackles upon auscultation of the lungs
B. Peripheral edema in the lower extremities
C. Jugular venous distension (JVD)
D. Hepatomegaly and ascites
Answer: A
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood efficiently into the systemic circulation, causing fluid
to back up into the lungs. Findings like edema and JVD are associated with right-sided heart
failure.
,2. An arterial blood gas (ABG) result shows: pH 7.31, PaCO2 52 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis), and the PaCO2 is above 45
mmHg (respiratory cause), while the HCO3 is within the normal range, indicating
uncompensated respiratory acidosis.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which clinical manifestation is
most characteristic of this condition?
A. Profuse diaphoresis and tremors
B. Bradycardia and hypertension
C. Hyporeflexia and weight gain
D. Kussmaul respirations and fruity breath
Answer: D
, Conceptual Explanation: DKA involves metabolic acidosis, leading the body to attempt
compensation via Kussmaul respirations (deep, rapid breathing) to blow off CO2. Ketone
production results in a fruity odor on the breath.
4. Which medication is considered the gold standard for decreasing intracranial pressure (ICP)
by pulling fluid from brain cells into the vascular space?
A. Mannitol
B. Dexamethasone
C. Phenytoin
D. Furosemide
Answer: A
Conceptual Explanation: Mannitol is an osmotic diuretic that increases osmotic pressure
in the glomerular filtrate, inhibiting reabsorption of water and electrolytes, specifically
used to reduce cerebral edema and ICP.
5. A nurse is caring for a patient with a new arteriovenous (AV) fistula in the left arm. Which
action is essential for the nurse to perform?
A. Apply a tight pressure dressing to the site for the first 24 hours
B. Measure blood pressure on the left arm to ensure patency
C. Draw routine lab samples from the left arm distal to the site
D. Auscultate for a bruit and palpate for a thrill every shift
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with left-sided heart failure is being assessed. Which clinical finding should the
nurse expect to observe?
A. Crackles upon auscultation of the lungs
B. Peripheral edema in the lower extremities
C. Jugular venous distension (JVD)
D. Hepatomegaly and ascites
Answer: A
Conceptual Explanation: Left-sided heart failure leads to pulmonary congestion because
the left ventricle cannot pump blood efficiently into the systemic circulation, causing fluid
to back up into the lungs. Findings like edema and JVD are associated with right-sided heart
failure.
,2. An arterial blood gas (ABG) result shows: pH 7.31, PaCO2 52 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Conceptual Explanation: The pH is below 7.35 (acidosis), and the PaCO2 is above 45
mmHg (respiratory cause), while the HCO3 is within the normal range, indicating
uncompensated respiratory acidosis.
3. A patient is admitted with Diabetic Ketoacidosis (DKA). Which clinical manifestation is
most characteristic of this condition?
A. Profuse diaphoresis and tremors
B. Bradycardia and hypertension
C. Hyporeflexia and weight gain
D. Kussmaul respirations and fruity breath
Answer: D
, Conceptual Explanation: DKA involves metabolic acidosis, leading the body to attempt
compensation via Kussmaul respirations (deep, rapid breathing) to blow off CO2. Ketone
production results in a fruity odor on the breath.
4. Which medication is considered the gold standard for decreasing intracranial pressure (ICP)
by pulling fluid from brain cells into the vascular space?
A. Mannitol
B. Dexamethasone
C. Phenytoin
D. Furosemide
Answer: A
Conceptual Explanation: Mannitol is an osmotic diuretic that increases osmotic pressure
in the glomerular filtrate, inhibiting reabsorption of water and electrolytes, specifically
used to reduce cerebral edema and ICP.
5. A nurse is caring for a patient with a new arteriovenous (AV) fistula in the left arm. Which
action is essential for the nurse to perform?
A. Apply a tight pressure dressing to the site for the first 24 hours
B. Measure blood pressure on the left arm to ensure patency
C. Draw routine lab samples from the left arm distal to the site
D. Auscultate for a bruit and palpate for a thrill every shift
