NUR 242 FINAL EXAM 2026/2027 -
ADVANCED MEDICAL-SURGICAL
NURSING QUESTIONS & ANSWERS
100% GUARANTEE PASS
1. A patient with a traumatic brain injury has a blood pressure of 160/60 mmHg, a pulse of 52
bpm, and irregular respirations. Which condition does the nurse suspect?
A. Hypovolemic shock
B. Cardiac tamponade
C. Autonomic dysreflexia
D. Cushing’s triad
Answer: D
Conceptual Explanation: Cushing’s triad consists of widened pulse pressure (systolic
hypertension), bradycardia, and irregular respirations, indicating increased intracranial
pressure.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. pH 7.35, PaCO2 45, PaO2 80
,B. pH 7.28, PaCO2 55, PaO2 70
C. pH 7.48, PaCO2 30, PaO2 55
D. pH 7.32, PaCO2 40, PaO2 90
Answer: C
Conceptual Explanation: Early ARDS is characterized by respiratory alkalosis (due to
hyperventilation) and refractory hypoxemia.
3. A patient is receiving a continuous heparin infusion for a pulmonary embolism. The aPTT is
110 seconds (control 30s). What is the priority nursing action?
A. Stop the infusion and prepare protamine sulfate
B. Decrease the rate by 100 units/hour
C. Continue the infusion as it is therapeutic
D. Increase the infusion rate
Answer: A
Conceptual Explanation: An aPTT of 110 seconds is significantly above the therapeutic
range (usually 1.5 to 2.5 times the control). The infusion must be stopped and the antidote,
protamine sulfate, prepared.
4. Which assessment finding in a patient with acute pancreatitis requires immediate
intervention by the nurse?
A. Amylase level three times the normal limit
, B. Epigastric pain radiating to the back
C. Positive Trousseau’s sign
D. Steatorrhea
Answer: C
Conceptual Explanation: A positive Trousseau’s sign indicates hypocalcemia, a common
and potentially life-threatening complication of acute pancreatitis that can lead to tetany
and seizures.
5. A patient is admitted with a diagnosis of Pheochromocytoma. Which vital sign
measurement is the nurse’s priority concern?
A. Temperature 101.2 F
B. Heart rate 110 bpm
C. Blood pressure 210/115 mmHg
D. Respiratory rate 24 breaths/min
Answer: C
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release,
leading to severe hypertensive crisis, which is the most critical risk for stroke or organ
damage.
ADVANCED MEDICAL-SURGICAL
NURSING QUESTIONS & ANSWERS
100% GUARANTEE PASS
1. A patient with a traumatic brain injury has a blood pressure of 160/60 mmHg, a pulse of 52
bpm, and irregular respirations. Which condition does the nurse suspect?
A. Hypovolemic shock
B. Cardiac tamponade
C. Autonomic dysreflexia
D. Cushing’s triad
Answer: D
Conceptual Explanation: Cushing’s triad consists of widened pulse pressure (systolic
hypertension), bradycardia, and irregular respirations, indicating increased intracranial
pressure.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. pH 7.35, PaCO2 45, PaO2 80
,B. pH 7.28, PaCO2 55, PaO2 70
C. pH 7.48, PaCO2 30, PaO2 55
D. pH 7.32, PaCO2 40, PaO2 90
Answer: C
Conceptual Explanation: Early ARDS is characterized by respiratory alkalosis (due to
hyperventilation) and refractory hypoxemia.
3. A patient is receiving a continuous heparin infusion for a pulmonary embolism. The aPTT is
110 seconds (control 30s). What is the priority nursing action?
A. Stop the infusion and prepare protamine sulfate
B. Decrease the rate by 100 units/hour
C. Continue the infusion as it is therapeutic
D. Increase the infusion rate
Answer: A
Conceptual Explanation: An aPTT of 110 seconds is significantly above the therapeutic
range (usually 1.5 to 2.5 times the control). The infusion must be stopped and the antidote,
protamine sulfate, prepared.
4. Which assessment finding in a patient with acute pancreatitis requires immediate
intervention by the nurse?
A. Amylase level three times the normal limit
, B. Epigastric pain radiating to the back
C. Positive Trousseau’s sign
D. Steatorrhea
Answer: C
Conceptual Explanation: A positive Trousseau’s sign indicates hypocalcemia, a common
and potentially life-threatening complication of acute pancreatitis that can lead to tetany
and seizures.
5. A patient is admitted with a diagnosis of Pheochromocytoma. Which vital sign
measurement is the nurse’s priority concern?
A. Temperature 101.2 F
B. Heart rate 110 bpm
C. Blood pressure 210/115 mmHg
D. Respiratory rate 24 breaths/min
Answer: C
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release,
leading to severe hypertensive crisis, which is the most critical risk for stroke or organ
damage.
