NUR 242 COMPREHENSIVE MED-SURG
NURSING EXAM (2026/2027) QUESTIONS
& ANSWERS 100% GUARANTEE PASS
1. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which of the following ECG changes should the nurse prioritize as an immediate concern?
A. Prominent U-waves
B. Shortened QT interval
C. Prolonged PR interval
D. Tall, peaked T-waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T-waves, which can
progress to ventricular fibrillation or asystole if not treated immediately.
2. A client is diagnosed with Metabolic Acidosis. Which of the following arterial blood gas
(ABG) results most likely represents this condition?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.48, PaCO2 45, HCO3 32
C. pH 7.30, PaCO2 50, HCO3 28
,D. pH 7.28, PaCO2 40, HCO3 18
Answer: D
Conceptual Explanation: Metabolic acidosis is characterized by a pH lower than 7.35 and
a bicarbonate (HCO3) level lower than 22 mEq/L.
3. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary crackles
B. Orthopnea
C. Jugular Venous Distension (JVD)
D. Frothy, pink-tinged sputum
Answer: C
Conceptual Explanation: Right-sided heart failure causes systemic congestion, leading to
JVD, peripheral edema, and hepatomegaly, whereas left-sided failure causes pulmonary
symptoms.
4. A post-operative patient exhibits tachycardia, muscle rigidity, and a rapidly rising
temperature. Which medication should the nurse expect to administer immediately?
A. Naloxone
B. Succinylcholine
C. Dantrolene sodium
, D. Atropine sulfate
Answer: C
Conceptual Explanation: These symptoms indicate Malignant Hyperthermia, a life-
threatening reaction to anesthesia. Dantrolene is the specific skeletal muscle relaxant used
for treatment.
5. A client in DKA has an initial blood glucose of 550 mg/dL. After starting a regular insulin
infusion, the nurse notices the glucose has dropped to 250 mg/dL. What is the next nursing
action?
A. Stop the insulin infusion immediately
B. Increase the insulin infusion rate
C. Add 5% Dextrose to the IV fluids
D. Bolus the patient with 50% Dextrose
Answer: C
Conceptual Explanation: In DKA, when glucose reaches 250-300 mg/dL, dextrose is
added to the IV fluids to prevent hypoglycemia and cerebral edema while continuing
insulin to clear ketones.
6. Which assessment finding is the most sensitive indicator of increased intracranial pressure
(ICP) in a patient with a head injury?
A. Change in Level of Consciousness (LOC)
NURSING EXAM (2026/2027) QUESTIONS
& ANSWERS 100% GUARANTEE PASS
1. A patient with chronic kidney disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which of the following ECG changes should the nurse prioritize as an immediate concern?
A. Prominent U-waves
B. Shortened QT interval
C. Prolonged PR interval
D. Tall, peaked T-waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T-waves, which can
progress to ventricular fibrillation or asystole if not treated immediately.
2. A client is diagnosed with Metabolic Acidosis. Which of the following arterial blood gas
(ABG) results most likely represents this condition?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.48, PaCO2 45, HCO3 32
C. pH 7.30, PaCO2 50, HCO3 28
,D. pH 7.28, PaCO2 40, HCO3 18
Answer: D
Conceptual Explanation: Metabolic acidosis is characterized by a pH lower than 7.35 and
a bicarbonate (HCO3) level lower than 22 mEq/L.
3. When assessing a patient with right-sided heart failure, which clinical manifestation should
the nurse expect to find?
A. Pulmonary crackles
B. Orthopnea
C. Jugular Venous Distension (JVD)
D. Frothy, pink-tinged sputum
Answer: C
Conceptual Explanation: Right-sided heart failure causes systemic congestion, leading to
JVD, peripheral edema, and hepatomegaly, whereas left-sided failure causes pulmonary
symptoms.
4. A post-operative patient exhibits tachycardia, muscle rigidity, and a rapidly rising
temperature. Which medication should the nurse expect to administer immediately?
A. Naloxone
B. Succinylcholine
C. Dantrolene sodium
, D. Atropine sulfate
Answer: C
Conceptual Explanation: These symptoms indicate Malignant Hyperthermia, a life-
threatening reaction to anesthesia. Dantrolene is the specific skeletal muscle relaxant used
for treatment.
5. A client in DKA has an initial blood glucose of 550 mg/dL. After starting a regular insulin
infusion, the nurse notices the glucose has dropped to 250 mg/dL. What is the next nursing
action?
A. Stop the insulin infusion immediately
B. Increase the insulin infusion rate
C. Add 5% Dextrose to the IV fluids
D. Bolus the patient with 50% Dextrose
Answer: C
Conceptual Explanation: In DKA, when glucose reaches 250-300 mg/dL, dextrose is
added to the IV fluids to prevent hypoglycemia and cerebral edema while continuing
insulin to clear ketones.
6. Which assessment finding is the most sensitive indicator of increased intracranial pressure
(ICP) in a patient with a head injury?
A. Change in Level of Consciousness (LOC)
