1
, NUR 242 Med-Surg (Exams 1–4) Complete Exam
Bundle | Galen College (PDF)
Question 1
A patient with heart failure has crackles in both lung
bases, oxygen saturation 88%, and +3 pedal edema.
Which diuretic does the nurse expect to be prescribed
first?
A) Hydrochlorothiazide
B) Spironolactone
C) Furosemide
D) Mannitol
Correct Answer: C
Rationale: Furosemide is a loop diuretic that rapidly
reduces preload in acute heart failure exacerbation.
HCTZ is for mild hypertension, spironolactone is adjunctive,
mannitol is for cerebral edema.
2
,Question 2
A patient post-myocardial infarction develops jugular
vein distention, hypotension, and muffled heart sounds.
What action is priority?
A) Administer nitroglycerin
B) Prepare for pericardiocentesis
C) Increase IV fluids
D) Give morphine
Correct Answer: B
Rationale: These signs indicate cardiac tamponade.
Pericardiocentesis relieves compression. Nitroglycerin and
morphine would worsen hypotension.
Question 3
A patient with chronic kidney disease has potassium 6.8
mEq/L. Which intervention is most urgent?
A) Restrict dietary potassium
B) Administer furosemide
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, C) Give IV calcium gluconate
D) Start spironolactone
Correct Answer: C
Rationale: Calcium gluconate stabilizes cardiac
membranes in severe hyperkalemia to prevent
dysrhythmias. Removal of potassium is secondary.
Question 4
A diabetic patient is sweating, tachycardic, and confused.
Blood glucose is 45 mg/dL. What should the nurse give
first?
A) 15 g oral glucose (3 glucose tablets)
B) 1 mg glucagon IV
C) 50% dextrose IV push
D) Orange juice with peanut butter
Correct Answer: A
Rationale: The patient is conscious and able to swallow, so
4
, NUR 242 Med-Surg (Exams 1–4) Complete Exam
Bundle | Galen College (PDF)
Question 1
A patient with heart failure has crackles in both lung
bases, oxygen saturation 88%, and +3 pedal edema.
Which diuretic does the nurse expect to be prescribed
first?
A) Hydrochlorothiazide
B) Spironolactone
C) Furosemide
D) Mannitol
Correct Answer: C
Rationale: Furosemide is a loop diuretic that rapidly
reduces preload in acute heart failure exacerbation.
HCTZ is for mild hypertension, spironolactone is adjunctive,
mannitol is for cerebral edema.
2
,Question 2
A patient post-myocardial infarction develops jugular
vein distention, hypotension, and muffled heart sounds.
What action is priority?
A) Administer nitroglycerin
B) Prepare for pericardiocentesis
C) Increase IV fluids
D) Give morphine
Correct Answer: B
Rationale: These signs indicate cardiac tamponade.
Pericardiocentesis relieves compression. Nitroglycerin and
morphine would worsen hypotension.
Question 3
A patient with chronic kidney disease has potassium 6.8
mEq/L. Which intervention is most urgent?
A) Restrict dietary potassium
B) Administer furosemide
3
, C) Give IV calcium gluconate
D) Start spironolactone
Correct Answer: C
Rationale: Calcium gluconate stabilizes cardiac
membranes in severe hyperkalemia to prevent
dysrhythmias. Removal of potassium is secondary.
Question 4
A diabetic patient is sweating, tachycardic, and confused.
Blood glucose is 45 mg/dL. What should the nurse give
first?
A) 15 g oral glucose (3 glucose tablets)
B) 1 mg glucagon IV
C) 50% dextrose IV push
D) Orange juice with peanut butter
Correct Answer: A
Rationale: The patient is conscious and able to swallow, so
4
