NUR 242 – Medical-Surgical Nursing
Midterm Exam With Actual 120
Questions & Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
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NUR 242 MED-SURG MIDTERM PRACTICE EXAM
1. A patient with heart failure is prescribed furosemide. Which laboratory value is most
important to monitor?
a) Calcium
b) Potassium
c) Sodium
d) Glucose
Answer: b) Potassium
Rationale: Loop diuretics like furosemide cause potassium loss, increasing the risk for
hypokalemia, arrhythmias, and muscle weakness.
2. A nurse is caring for a client post-thyroidectomy. Which complication should the
nurse monitor for first?
a) Hypocalcemia
b) Hypoglycemia
c) Hypotension
d) Hypothermia
Answer: a) Hypocalcemia
Rationale: Injury to the parathyroid glands during thyroidectomy can cause
hypocalcemia, leading to tetany and laryngeal spasms.
3. Which nursing intervention has the highest priority for a client with a tracheostomy?
a) Providing oral hygiene
, b) Suctioning secretions
c) Humidifying inspired air
d) Administering antibiotics
Answer: b) Suctioning secretions
Rationale: Airway patency is always the highest priority; suctioning prevents
obstruction from mucus plugs.
4. A patient with type 1 diabetes reports nausea, abdominal pain, and fruity-smelling
breath. Which condition does the nurse suspect?
a) Hypoglycemia
b) Diabetic ketoacidosis
c) Hyperosmolar hyperglycemic state
d) Lactic acidosis
Answer: b) Diabetic ketoacidosis
Rationale: DKA is characterized by hyperglycemia, ketonuria, metabolic acidosis, and
fruity breath odor.
5. Which assessment finding is most concerning in a client with pneumonia?
a) Temperature 38.3°C (101°F)
b) Productive cough
c) SpO₂ 86% on room air
d) Crackles in lower lobes
Answer: c) SpO₂ 86% on room air
Rationale: Severe hypoxemia is the most critical finding and requires immediate
intervention with oxygen therapy.
6. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The nurse notes
drowsiness and decreased respiratory rate. What should the nurse do first?
a) Notify the provider
b) Lower the oxygen flow rate
c) Increase fluids
d) Position in high Fowler’s
Answer: b) Lower the oxygen flow rate
Rationale: High oxygen flow in COPD can suppress hypoxic drive, causing CO₂
retention and respiratory depression.
7. A patient with cirrhosis has ascites. Which intervention is most effective?
a) Low-sodium diet
b) Paracentesis
c) Fluid restriction
d) Diuretics
Answer: b) Paracentesis
, Rationale: While diet and diuretics help, paracentesis provides the most immediate
relief of ascites.
8. Which dietary teaching is appropriate for a client with chronic kidney disease?
a) Increase potassium intake
b) Limit protein intake
c) Encourage high-sodium foods
d) Avoid carbohydrates
Answer: b) Limit protein intake
Rationale: Protein restriction reduces nitrogenous waste, which the kidneys cannot
excrete effectively.
9. A client with a history of DVT is receiving warfarin. Which lab value indicates
therapeutic effect?
a) INR 1.0
b) INR 2.5
c) INR 5.0
d) INR 0.8
Answer: b) INR 2.5
Rationale: The therapeutic INR range for anticoagulation is typically 2.0–3.0 for DVT
management.
10. A nurse assesses a client with myasthenia gravis and notes drooping eyelids and
difficulty swallowing. What is the priority nursing concern?
a) Risk for aspiration
b) Altered body image
c) Chronic pain
d) Knowledge deficit
Answer: a) Risk for aspiration
Rationale: Dysphagia in myasthenia gravis increases aspiration risk, which is life-
threatening.
11. A patient with hypertension is prescribed lisinopril. Which side effect should the
nurse monitor for?
a) Constipation
b) Dry cough
c) Hypoglycemia
d) Weight gain
Answer: b) Dry cough
Rationale: ACE inhibitors often cause a persistent dry cough due to bradykinin
buildup.
Midterm Exam With Actual 120
Questions & Verified Answers,Plus
Rationales/Expert Verified For
Guaranteed Pass Graded A+/
2025/2026 /Latest Update/Instant
Download Pdf
NUR 242 MED-SURG MIDTERM PRACTICE EXAM
1. A patient with heart failure is prescribed furosemide. Which laboratory value is most
important to monitor?
a) Calcium
b) Potassium
c) Sodium
d) Glucose
Answer: b) Potassium
Rationale: Loop diuretics like furosemide cause potassium loss, increasing the risk for
hypokalemia, arrhythmias, and muscle weakness.
2. A nurse is caring for a client post-thyroidectomy. Which complication should the
nurse monitor for first?
a) Hypocalcemia
b) Hypoglycemia
c) Hypotension
d) Hypothermia
Answer: a) Hypocalcemia
Rationale: Injury to the parathyroid glands during thyroidectomy can cause
hypocalcemia, leading to tetany and laryngeal spasms.
3. Which nursing intervention has the highest priority for a client with a tracheostomy?
a) Providing oral hygiene
, b) Suctioning secretions
c) Humidifying inspired air
d) Administering antibiotics
Answer: b) Suctioning secretions
Rationale: Airway patency is always the highest priority; suctioning prevents
obstruction from mucus plugs.
4. A patient with type 1 diabetes reports nausea, abdominal pain, and fruity-smelling
breath. Which condition does the nurse suspect?
a) Hypoglycemia
b) Diabetic ketoacidosis
c) Hyperosmolar hyperglycemic state
d) Lactic acidosis
Answer: b) Diabetic ketoacidosis
Rationale: DKA is characterized by hyperglycemia, ketonuria, metabolic acidosis, and
fruity breath odor.
5. Which assessment finding is most concerning in a client with pneumonia?
a) Temperature 38.3°C (101°F)
b) Productive cough
c) SpO₂ 86% on room air
d) Crackles in lower lobes
Answer: c) SpO₂ 86% on room air
Rationale: Severe hypoxemia is the most critical finding and requires immediate
intervention with oxygen therapy.
6. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The nurse notes
drowsiness and decreased respiratory rate. What should the nurse do first?
a) Notify the provider
b) Lower the oxygen flow rate
c) Increase fluids
d) Position in high Fowler’s
Answer: b) Lower the oxygen flow rate
Rationale: High oxygen flow in COPD can suppress hypoxic drive, causing CO₂
retention and respiratory depression.
7. A patient with cirrhosis has ascites. Which intervention is most effective?
a) Low-sodium diet
b) Paracentesis
c) Fluid restriction
d) Diuretics
Answer: b) Paracentesis
, Rationale: While diet and diuretics help, paracentesis provides the most immediate
relief of ascites.
8. Which dietary teaching is appropriate for a client with chronic kidney disease?
a) Increase potassium intake
b) Limit protein intake
c) Encourage high-sodium foods
d) Avoid carbohydrates
Answer: b) Limit protein intake
Rationale: Protein restriction reduces nitrogenous waste, which the kidneys cannot
excrete effectively.
9. A client with a history of DVT is receiving warfarin. Which lab value indicates
therapeutic effect?
a) INR 1.0
b) INR 2.5
c) INR 5.0
d) INR 0.8
Answer: b) INR 2.5
Rationale: The therapeutic INR range for anticoagulation is typically 2.0–3.0 for DVT
management.
10. A nurse assesses a client with myasthenia gravis and notes drooping eyelids and
difficulty swallowing. What is the priority nursing concern?
a) Risk for aspiration
b) Altered body image
c) Chronic pain
d) Knowledge deficit
Answer: a) Risk for aspiration
Rationale: Dysphagia in myasthenia gravis increases aspiration risk, which is life-
threatening.
11. A patient with hypertension is prescribed lisinopril. Which side effect should the
nurse monitor for?
a) Constipation
b) Dry cough
c) Hypoglycemia
d) Weight gain
Answer: b) Dry cough
Rationale: ACE inhibitors often cause a persistent dry cough due to bradykinin
buildup.
