NUR242 / NUR 242 Medical-Surgical Nursing 2025 100%
Verified Questions and Correct Answers | Graded A+ | Galen
College Actual Test Review
1. A patient with a history of chronic obstructive pulmonary disease (COPD) is admit-
ted with dyspnea and a respiratory rate of 28 breaths per minute. Which assessment
finding requires immediate intervention?
A. Oxygen saturation of 88%
B. Use of accessory muscles
C. Clear lung sounds bilaterally
D. Productive cough with green sputum
Correct Answer: B
Rationale: The use of accessory muscles indicates severe respiratory distress, as the
patient is compensating for inadequate oxygenation. This requires immediate inter-
vention to prevent respiratory failure. An oxygen saturation of 88% is concerning
but expected in COPD and managed with supplemental oxygen. Clear lung sounds
are normal, and a productive cough, while needing attention, is not immediately life-
threatening.
2. A patient post-pneumonectomy has a chest tube in place. Which finding indicates a
need for intervention?
A. Tidaling in the water seal chamber
B. Loose dressing around the chest tube
C. 2 cm of water in the suction control chamber
D. Bubbling in the water seal chamber when coughing
Correct Answer: B
Rationale: A loose dressing around a chest tube can lead to air leaks, compromising
the airtight system and risking pneumothorax. Tidaling and bubbling during coughing
are expected findings in a functioning chest tube system. The suction control chamber
should maintain a prescribed water level, and 2 cm is within normal limits.
3. A patient with peptic ulcer disease (PUD) reports severe epigastric pain. Which diag-
nostic result supports this diagnosis?
A. Negative Helicobacter pylori test
B. Elevated serum amylase levels
C. Positive fecal occult blood test
D. Normal gastric pH levels
Correct Answer: C
Rationale: A positive fecal occult blood test indicates gastrointestinal bleeding, a com-
mon complication of PUD due to ulcer erosion. A negative H. pylori test does not rule
out PUD, as other causes exist. Elevated amylase suggests pancreatitis, not PUD.
Normal gastric pH is nonspecific and does not confirm PUD.
4. A patient with type 2 diabetes mellitus is prescribed metformin. Which laboratory
result requires immediate notification of the provider?
1
, A. Hemoglobin A1c of 7.2%
B. Serum creatinine of 2.1 mg/dL
C. Fasting blood glucose of 140 mg/dL
D. Low-density lipoprotein of 130 mg/dL
Correct Answer: B
Rationale: Metformin is contraindicated in renal impairment due to the risk of lactic
acidosis. A serum creatinine of 2.1 mg/dL indicates renal dysfunction, requiring im-
mediate provider notification. A1c of 7.2% and fasting glucose of 140 mg/dL reflect
suboptimal control but are not urgent. Elevated LDL is a long-term concern.
5. A patient with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B
Rationale: Furosemide, a loop diuretic, increases potassium excretion, leading to hy-
pokalemia. Hyperkalemia is more common with potassium-sparing diuretics. Hyper-
natremia and hypocalcemia are not typically associated with furosemide use.
6. A patient with a new colostomy reports leakage around the appliance. What is the
nurses priority action?
A. Assess the stoma size and skin integrity
B. Change the appliance immediately
C. Administer an antidiarrheal medication
D. Encourage increased fluid intake
Correct Answer: A
Rationale: Leakage often results from an improperly sized appliance or poor skin
integrity. Assessing the stoma and surrounding skin is the priority to determine the
cause and correct fit. Changing the appliance without assessment may not resolve the
issue. Antidiarrheals and fluids address output but not appliance fit.
7. A patient with atrial fibrillation is prescribed warfarin. Which food should the nurse
advise the patient to consume in consistent amounts?
A. Citrus fruits
B. Green leafy vegetables
C. Whole grains
D. Lean proteins
Correct Answer: B
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarins
anticoagulant effect. Consistent intake prevents fluctuations in INR. Citrus fruits,
whole grains, and lean proteins do not significantly affect warfarin.
8. A patient with acute pancreatitis reports severe abdominal pain. Which position
should the nurse recommend?
2
, A. Supine with legs extended
B. Prone with head elevated
C. Fetal position with knees drawn up
D. Sitting upright at 90 degrees
Correct Answer: C
Rationale: The fetal position reduces pressure on the pancreas, alleviating pain in
acute pancreatitis. Supine, prone, or upright positions may exacerbate discomfort due
to increased abdominal tension.
9. A patient with a suspected stroke is in the emergency department. Which diagnostic
test is the priority?
A. Magnetic resonance imaging (MRI)
B. Non-contrast computed tomography (CT)
C. Electroencephalogram (EEG)
D. Lumbar puncture
Correct Answer: B
Rationale: A non-contrast CT scan is the priority to differentiate ischemic from hem-
orrhagic stroke, guiding urgent treatment decisions. MRI is more detailed but slower.
EEG and lumbar puncture are not indicated for initial stroke evaluation.
10. A patient with chronic kidney disease is prescribed erythropoietin. What is the ex-
pected therapeutic effect?
A. Reduced blood pressure
B. Increased red blood cell production
C. Improved electrolyte balance
D. Enhanced urine output
Correct Answer: B
Rationale: Erythropoietin stimulates red blood cell production, treating anemia com-
mon in chronic kidney disease. It does not directly affect blood pressure, electrolytes,
or urine output.
11. A patient with a hip fracture is scheduled for surgery. Which preoperative teaching is
most important?
A. How to use a bedside commode
B. Deep breathing and coughing exercises
C. Dietary restrictions post-surgery
D. Ambulation techniques with a walker
Correct Answer: B
Rationale: Deep breathing and coughing exercises prevent postoperative pneumonia,
a common complication after hip surgery due to immobility. Commode use, dietary
restrictions, and ambulation are important but secondary to respiratory prevention.
12. A patient with cirrhosis develops ascites. Which dietary restriction should the nurse
reinforce?
A. Low protein
B. Low sodium
3
Verified Questions and Correct Answers | Graded A+ | Galen
College Actual Test Review
1. A patient with a history of chronic obstructive pulmonary disease (COPD) is admit-
ted with dyspnea and a respiratory rate of 28 breaths per minute. Which assessment
finding requires immediate intervention?
A. Oxygen saturation of 88%
B. Use of accessory muscles
C. Clear lung sounds bilaterally
D. Productive cough with green sputum
Correct Answer: B
Rationale: The use of accessory muscles indicates severe respiratory distress, as the
patient is compensating for inadequate oxygenation. This requires immediate inter-
vention to prevent respiratory failure. An oxygen saturation of 88% is concerning
but expected in COPD and managed with supplemental oxygen. Clear lung sounds
are normal, and a productive cough, while needing attention, is not immediately life-
threatening.
2. A patient post-pneumonectomy has a chest tube in place. Which finding indicates a
need for intervention?
A. Tidaling in the water seal chamber
B. Loose dressing around the chest tube
C. 2 cm of water in the suction control chamber
D. Bubbling in the water seal chamber when coughing
Correct Answer: B
Rationale: A loose dressing around a chest tube can lead to air leaks, compromising
the airtight system and risking pneumothorax. Tidaling and bubbling during coughing
are expected findings in a functioning chest tube system. The suction control chamber
should maintain a prescribed water level, and 2 cm is within normal limits.
3. A patient with peptic ulcer disease (PUD) reports severe epigastric pain. Which diag-
nostic result supports this diagnosis?
A. Negative Helicobacter pylori test
B. Elevated serum amylase levels
C. Positive fecal occult blood test
D. Normal gastric pH levels
Correct Answer: C
Rationale: A positive fecal occult blood test indicates gastrointestinal bleeding, a com-
mon complication of PUD due to ulcer erosion. A negative H. pylori test does not rule
out PUD, as other causes exist. Elevated amylase suggests pancreatitis, not PUD.
Normal gastric pH is nonspecific and does not confirm PUD.
4. A patient with type 2 diabetes mellitus is prescribed metformin. Which laboratory
result requires immediate notification of the provider?
1
, A. Hemoglobin A1c of 7.2%
B. Serum creatinine of 2.1 mg/dL
C. Fasting blood glucose of 140 mg/dL
D. Low-density lipoprotein of 130 mg/dL
Correct Answer: B
Rationale: Metformin is contraindicated in renal impairment due to the risk of lactic
acidosis. A serum creatinine of 2.1 mg/dL indicates renal dysfunction, requiring im-
mediate provider notification. A1c of 7.2% and fasting glucose of 140 mg/dL reflect
suboptimal control but are not urgent. Elevated LDL is a long-term concern.
5. A patient with heart failure is prescribed furosemide. Which electrolyte imbalance
should the nurse monitor?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: B
Rationale: Furosemide, a loop diuretic, increases potassium excretion, leading to hy-
pokalemia. Hyperkalemia is more common with potassium-sparing diuretics. Hyper-
natremia and hypocalcemia are not typically associated with furosemide use.
6. A patient with a new colostomy reports leakage around the appliance. What is the
nurses priority action?
A. Assess the stoma size and skin integrity
B. Change the appliance immediately
C. Administer an antidiarrheal medication
D. Encourage increased fluid intake
Correct Answer: A
Rationale: Leakage often results from an improperly sized appliance or poor skin
integrity. Assessing the stoma and surrounding skin is the priority to determine the
cause and correct fit. Changing the appliance without assessment may not resolve the
issue. Antidiarrheals and fluids address output but not appliance fit.
7. A patient with atrial fibrillation is prescribed warfarin. Which food should the nurse
advise the patient to consume in consistent amounts?
A. Citrus fruits
B. Green leafy vegetables
C. Whole grains
D. Lean proteins
Correct Answer: B
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarins
anticoagulant effect. Consistent intake prevents fluctuations in INR. Citrus fruits,
whole grains, and lean proteins do not significantly affect warfarin.
8. A patient with acute pancreatitis reports severe abdominal pain. Which position
should the nurse recommend?
2
, A. Supine with legs extended
B. Prone with head elevated
C. Fetal position with knees drawn up
D. Sitting upright at 90 degrees
Correct Answer: C
Rationale: The fetal position reduces pressure on the pancreas, alleviating pain in
acute pancreatitis. Supine, prone, or upright positions may exacerbate discomfort due
to increased abdominal tension.
9. A patient with a suspected stroke is in the emergency department. Which diagnostic
test is the priority?
A. Magnetic resonance imaging (MRI)
B. Non-contrast computed tomography (CT)
C. Electroencephalogram (EEG)
D. Lumbar puncture
Correct Answer: B
Rationale: A non-contrast CT scan is the priority to differentiate ischemic from hem-
orrhagic stroke, guiding urgent treatment decisions. MRI is more detailed but slower.
EEG and lumbar puncture are not indicated for initial stroke evaluation.
10. A patient with chronic kidney disease is prescribed erythropoietin. What is the ex-
pected therapeutic effect?
A. Reduced blood pressure
B. Increased red blood cell production
C. Improved electrolyte balance
D. Enhanced urine output
Correct Answer: B
Rationale: Erythropoietin stimulates red blood cell production, treating anemia com-
mon in chronic kidney disease. It does not directly affect blood pressure, electrolytes,
or urine output.
11. A patient with a hip fracture is scheduled for surgery. Which preoperative teaching is
most important?
A. How to use a bedside commode
B. Deep breathing and coughing exercises
C. Dietary restrictions post-surgery
D. Ambulation techniques with a walker
Correct Answer: B
Rationale: Deep breathing and coughing exercises prevent postoperative pneumonia,
a common complication after hip surgery due to immobility. Commode use, dietary
restrictions, and ambulation are important but secondary to respiratory prevention.
12. A patient with cirrhosis develops ascites. Which dietary restriction should the nurse
reinforce?
A. Low protein
B. Low sodium
3
