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NUR 242 MED SURG Newest Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+Brand New Version!!
1. A patient with chronic obstructive pulmonary disease (COPD) is
prescribed oxygen therapy at 2 liters per minute via nasal cannula.
Which assessment finding indicates that the oxygen therapy is
effective?
A) Respiratory rate of 28 breaths per minute
B) Pulse oximetry reading of 94%
C) Patient reporting increased dyspnea
D) Use of accessory muscles during inspiration
Answer: B) Pulse oximetry reading of 94%
Explanation: The goal of oxygen therapy in COPD is to maintain oxygen
saturation between 88% and 92% to prevent hypoxemia while avoiding
the suppression of the hypoxic drive. A reading of 94% is within the
acceptable target range. A respiratory rate of 28 is elevated, increased
dyspnea indicates ineffective therapy, and accessory muscle use
suggests respiratory distress. Therefore, a pulse oximetry reading of
94% is the best indicator of effective oxygenation.
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2. A nurse is caring for a patient who has just returned from the post-
anesthesia care unit (PACU) following a right total knee arthroplasty.
Which intervention should the nurse prioritize to prevent a deep vein
thrombosis (DVT)?
A) Encourage the patient to cough and deep breathe every two hours
B) Apply sequential compression devices (SCDs) to the bilateral lower
extremities
C) Administer the prescribed analgesic medication prior to physical
therapy
D) Elevate the patient's right leg on two pillows
Answer: B) Apply sequential compression devices (SCDs) to the bilateral
lower extremities
Explanation: Following total joint replacement, patients are at high risk
for venous thromboembolism. Sequential compression devices promote
venous return by mimicking the calf muscle pump, thereby reducing
venous stasis and the risk of DVT. Coughing and deep breathing prevent
pulmonary complications. Analgesics are important for pain
management but do not directly prevent DVT. Elevation of the surgical
leg is important for edema control but is not the primary prevention for
DVT.
3. A patient with heart failure is prescribed furosemide (Lasix). Which
laboratory value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
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C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle. It also promotes
the excretion of potassium, which can lead to hypokalemia.
Hypokalemia is a significant concern because it can predispose the
patient to cardiac arrhythmias, especially if the patient is also on
digoxin. Monitoring serum potassium is the priority. While sodium,
calcium, and magnesium can also be affected, potassium imbalance
poses the most immediate and severe risk.
4. A nurse is teaching a patient with type 2 diabetes mellitus about the
signs of hypoglycemia. Which of the following symptoms should the
nurse include in the teaching?
A) Polyuria and polydipsia
B) Fruity-scented breath and Kussmaul respirations
C) Diaphoresis and confusion
D) Blurred vision and slow wound healing
Answer: C) Diaphoresis and confusion
Explanation: Hypoglycemia, or low blood glucose, triggers the release of
epinephrine and glucagon, leading to autonomic symptoms such as
diaphoresis, tachycardia, palpitations, and tremors. Neuroglycopenic
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symptoms, resulting from a lack of glucose to the brain, include
confusion, slurred speech, and loss of consciousness. Polyuria,
polydipsia, fruity-scented breath, Kussmaul respirations, blurred vision,
and slow wound healing are classic signs of hyperglycemia, not
hypoglycemia.
5. The nurse is assessing a patient with suspected pneumonia. Which of
the following physical assessment findings is most consistent with this
diagnosis?
A) Bronchial breath sounds over the peripheral lung fields
B) Hyperresonance upon percussion of the posterior chest
C) Decreased tactile fremitus over the affected lobe
D) Vesicular breath sounds in the bases
Answer: A) Bronchial breath sounds over the peripheral lung fields
Explanation: In a normal healthy lung, bronchial breath sounds are
heard only over the trachea and mainstem bronchi. When the lung
parenchyma consolidates due to infection or fluid, as in pneumonia,
bronchial breath sounds are transmitted to the periphery. This finding is
highly suggestive of consolidation. Hyperresonance is associated with
trapped air, such as in emphysema or pneumothorax. Tactile fremitus is
increased, not decreased, in consolidation. Vesicular sounds are the
normal breath sounds heard over most of the lung fields.
6. A patient is receiving a blood transfusion and develops chills, fever,
and a headache approximately one hour after the transfusion began.
NUR 242 MED SURG Newest Exam Preparation
With Complete Questions And Correct Answers With
Rationales Already Graded A+Brand New Version!!
1. A patient with chronic obstructive pulmonary disease (COPD) is
prescribed oxygen therapy at 2 liters per minute via nasal cannula.
Which assessment finding indicates that the oxygen therapy is
effective?
A) Respiratory rate of 28 breaths per minute
B) Pulse oximetry reading of 94%
C) Patient reporting increased dyspnea
D) Use of accessory muscles during inspiration
Answer: B) Pulse oximetry reading of 94%
Explanation: The goal of oxygen therapy in COPD is to maintain oxygen
saturation between 88% and 92% to prevent hypoxemia while avoiding
the suppression of the hypoxic drive. A reading of 94% is within the
acceptable target range. A respiratory rate of 28 is elevated, increased
dyspnea indicates ineffective therapy, and accessory muscle use
suggests respiratory distress. Therefore, a pulse oximetry reading of
94% is the best indicator of effective oxygenation.
,2|Page
2. A nurse is caring for a patient who has just returned from the post-
anesthesia care unit (PACU) following a right total knee arthroplasty.
Which intervention should the nurse prioritize to prevent a deep vein
thrombosis (DVT)?
A) Encourage the patient to cough and deep breathe every two hours
B) Apply sequential compression devices (SCDs) to the bilateral lower
extremities
C) Administer the prescribed analgesic medication prior to physical
therapy
D) Elevate the patient's right leg on two pillows
Answer: B) Apply sequential compression devices (SCDs) to the bilateral
lower extremities
Explanation: Following total joint replacement, patients are at high risk
for venous thromboembolism. Sequential compression devices promote
venous return by mimicking the calf muscle pump, thereby reducing
venous stasis and the risk of DVT. Coughing and deep breathing prevent
pulmonary complications. Analgesics are important for pain
management but do not directly prevent DVT. Elevation of the surgical
leg is important for edema control but is not the primary prevention for
DVT.
3. A patient with heart failure is prescribed furosemide (Lasix). Which
laboratory value should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
,3|Page
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle. It also promotes
the excretion of potassium, which can lead to hypokalemia.
Hypokalemia is a significant concern because it can predispose the
patient to cardiac arrhythmias, especially if the patient is also on
digoxin. Monitoring serum potassium is the priority. While sodium,
calcium, and magnesium can also be affected, potassium imbalance
poses the most immediate and severe risk.
4. A nurse is teaching a patient with type 2 diabetes mellitus about the
signs of hypoglycemia. Which of the following symptoms should the
nurse include in the teaching?
A) Polyuria and polydipsia
B) Fruity-scented breath and Kussmaul respirations
C) Diaphoresis and confusion
D) Blurred vision and slow wound healing
Answer: C) Diaphoresis and confusion
Explanation: Hypoglycemia, or low blood glucose, triggers the release of
epinephrine and glucagon, leading to autonomic symptoms such as
diaphoresis, tachycardia, palpitations, and tremors. Neuroglycopenic
, 4|Page
symptoms, resulting from a lack of glucose to the brain, include
confusion, slurred speech, and loss of consciousness. Polyuria,
polydipsia, fruity-scented breath, Kussmaul respirations, blurred vision,
and slow wound healing are classic signs of hyperglycemia, not
hypoglycemia.
5. The nurse is assessing a patient with suspected pneumonia. Which of
the following physical assessment findings is most consistent with this
diagnosis?
A) Bronchial breath sounds over the peripheral lung fields
B) Hyperresonance upon percussion of the posterior chest
C) Decreased tactile fremitus over the affected lobe
D) Vesicular breath sounds in the bases
Answer: A) Bronchial breath sounds over the peripheral lung fields
Explanation: In a normal healthy lung, bronchial breath sounds are
heard only over the trachea and mainstem bronchi. When the lung
parenchyma consolidates due to infection or fluid, as in pneumonia,
bronchial breath sounds are transmitted to the periphery. This finding is
highly suggestive of consolidation. Hyperresonance is associated with
trapped air, such as in emphysema or pneumothorax. Tactile fremitus is
increased, not decreased, in consolidation. Vesicular sounds are the
normal breath sounds heard over most of the lung fields.
6. A patient is receiving a blood transfusion and develops chills, fever,
and a headache approximately one hour after the transfusion began.
