NUR 242 ADVANCED MEDICAL-
SURGICAL NURSING EXAM REVIEW
QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a pH of 7.28,
PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Uncompensated Metabolic Acidosis
B. Uncompensated Respiratory Acidosis
C. Fully Compensated Respiratory Alkalosis
D. Partially Compensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated, indicating the kidneys are attempting to compensate, but the pH
is not yet normal.
,2. Which assessment finding is most indicative of a tension pneumothorax in a patient with a
chest injury?
A. Inspiratory crackles in the lung bases
B. Muffled heart sounds
C. Tracheal deviation to the unaffected side
D. Hyperresonance on the affected side
Answer: C
Conceptual Explanation: Tracheal deviation to the unaffected side is a late and classic
sign of tension pneumothorax due to mediastinal shift.
3. The nurse is caring for a patient with acute pancreatitis. Which laboratory value should the
nurse monitor most closely as the most specific indicator of pancreatic damage?
A. Serum Amylase
B. White Blood Cell Count
C. Serum Lipase
D. Serum Calcium
Answer: C
Conceptual Explanation: Serum lipase is more specific to the pancreas than amylase and
stays elevated longer, making it the preferred diagnostic marker.
, 4. A patient with a traumatic brain injury (TBI) has a Glasgow Coma Scale (GCS) score of 7.
What is the nurse’s priority action?
A. Assess the patient’s pupillary response
B. Prepare the patient for immediate intubation
C. Monitor the patient’s intracranial pressure
D. Administer intravenous mannitol
Answer: B
Conceptual Explanation: A GCS score of 8 or less indicates a severe brain injury and the
inability to maintain a patent airway; therefore, ‘8, we intubate’ is the standard of care.
5. Which medication is the priority for a patient experiencing a thyroid storm?
A. Levothyroxine
B. Propylthiouracil (PTU)
C. Amiodarone
D. Magnesium Sulfate
Answer: B
Conceptual Explanation: PTU blocks the synthesis of thyroid hormones and inhibits the
peripheral conversion of T4 to T3, which is critical in a thyroid storm.
SURGICAL NURSING EXAM REVIEW
QUESTIONS & ANSWERS 100%
GUARANTEE PASS
1. A patient with chronic obstructive pulmonary disease (COPD) presents with a pH of 7.28,
PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is the patient
experiencing?
A. Uncompensated Metabolic Acidosis
B. Uncompensated Respiratory Acidosis
C. Fully Compensated Respiratory Alkalosis
D. Partially Compensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is elevated, indicating the kidneys are attempting to compensate, but the pH
is not yet normal.
,2. Which assessment finding is most indicative of a tension pneumothorax in a patient with a
chest injury?
A. Inspiratory crackles in the lung bases
B. Muffled heart sounds
C. Tracheal deviation to the unaffected side
D. Hyperresonance on the affected side
Answer: C
Conceptual Explanation: Tracheal deviation to the unaffected side is a late and classic
sign of tension pneumothorax due to mediastinal shift.
3. The nurse is caring for a patient with acute pancreatitis. Which laboratory value should the
nurse monitor most closely as the most specific indicator of pancreatic damage?
A. Serum Amylase
B. White Blood Cell Count
C. Serum Lipase
D. Serum Calcium
Answer: C
Conceptual Explanation: Serum lipase is more specific to the pancreas than amylase and
stays elevated longer, making it the preferred diagnostic marker.
, 4. A patient with a traumatic brain injury (TBI) has a Glasgow Coma Scale (GCS) score of 7.
What is the nurse’s priority action?
A. Assess the patient’s pupillary response
B. Prepare the patient for immediate intubation
C. Monitor the patient’s intracranial pressure
D. Administer intravenous mannitol
Answer: B
Conceptual Explanation: A GCS score of 8 or less indicates a severe brain injury and the
inability to maintain a patent airway; therefore, ‘8, we intubate’ is the standard of care.
5. Which medication is the priority for a patient experiencing a thyroid storm?
A. Levothyroxine
B. Propylthiouracil (PTU)
C. Amiodarone
D. Magnesium Sulfate
Answer: B
Conceptual Explanation: PTU blocks the synthesis of thyroid hormones and inhibits the
peripheral conversion of T4 to T3, which is critical in a thyroid storm.
