NUR242/ NUR 242 Medical-Surgical Nursing Exam
Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass Guaranteed –
A+ Graded
Q1: A patient with type 1 diabetes has a blood glucose of 520 mg/dL, pH 7.18, and positive
serum ketones. Which intervention is priority?
A. Administer regular insulin IV infusion. [CORRECT]
B. Give subcutaneous insulin glargine.
C. Administer sodium bicarbonate bolus.
D. Restrict fluid intake.
Correct Answer: A
Rationale: Correct because DKA requires rapid IV regular insulin to reverse ketosis and lower
glucose; IV route allows immediate titration.
---
Q2: A patient with DKA has a potassium level of 3.2 mEq/L. Which action is priority before
initiating insulin?
A. Administer potassium replacement. [CORRECT]
B. Begin insulin infusion immediately.
C. Administer sodium bicarbonate.
D. Restrict potassium intake.
Correct Answer: A
Rationale: Correct because insulin drives potassium intracellularly, worsening hypokalemia and
risking fatal arrhythmias; potassium must be replaced first.
---
Q3: A patient with type 2 diabetes presents with blood glucose of 1,100 mg/dL, serum
osmolality of 350 mOsm/kg, and no ketones. Which condition is present?
A. Diabetic ketoacidosis
B. Hyperosmolar hyperglycemic state [CORRECT]
C. Hypoglycemia
D. Lactic acidosis
Correct Answer: B
Rationale: Correct because HHS presents with extreme hyperglycemia, hyperosmolality, and
minimal ketosis, typically in type 2 diabetes.
,---
Q4: A patient with hypoglycemia is unconscious. Which intervention is priority?
A. Administer glucagon IM. [CORRECT]
B. Give orange juice orally.
C. Administer insulin.
D. Place in supine position.
Correct Answer: A
Rationale: Correct because unconscious patients cannot safely swallow; IM glucagon or IV
dextrose is required to raise blood glucose rapidly.
---
Q5: Which finding indicates thyroid storm in a patient with Graves disease?
A. Fever, tachycardia, and agitation [CORRECT]
B. Bradycardia and hypothermia
C. Weight gain and constipation
D. Hypotension and lethargy
Correct Answer: A
Rationale: Correct because thyroid storm presents with hyperthermia, tachyarrhythmias, and
altered mental status from excessive thyroid hormone.
---
Q6: A patient with myxedema coma is admitted. Which intervention is priority?
A. Administer IV levothyroxine. [CORRECT]
B. Apply heating pads.
C. Restrict fluids.
D. Administer beta-blockers.
Correct Answer: A
Rationale: Correct because myxedema coma is a life-threatening emergency requiring
immediate IV thyroid hormone replacement.
---
Q7: A patient with Cushing syndrome is expected to have which laboratory finding?
A. Hyperglycemia and hypokalemia [CORRECT]
B. Hypoglycemia and hyperkalemia
C. Hyponatremia and hyperkalemia
D. Hypercalcemia and hypophosphatemia
, Correct Answer: A
Rationale: Correct because excess cortisol promotes gluconeogenesis and mineralocorticoid
effects cause potassium excretion.
---
Q8: A patient with Addison disease is at risk for which crisis?
A. Adrenal crisis with hypotension and hyperkalemia [CORRECT]
B. Hypertensive crisis
C. Thyroid storm
D. Hyperglycemic crisis
Correct Answer: A
Rationale: Correct because adrenal insufficiency causes aldosterone and cortisol deficiency,
leading to hypotension, hyperkalemia, and hyponatremia.
---
Q9: A patient with SIADH has a serum sodium of 122 mEq/L. Which intervention is appropriate?
A. Restrict fluid intake. [CORRECT]
B. Administer IV hypotonic fluids.
C. Encourage oral fluids.
D. Administer desmopressin.
Correct Answer: A
Rationale: Correct because SIADH causes water retention and dilutional hyponatremia; fluid
restriction is the primary treatment.
---
Q10: A patient with diabetes insipidus is prescribed desmopressin. Which finding indicates
therapeutic effect?
A. Decreased urine output [CORRECT]
B. Increased urine output
C. Weight loss
D. Increased thirst
Correct Answer: A
Rationale: Correct because desmopressin replaces ADH, reducing dilute urine output and
restoring fluid balance in diabetes insipidus.
---
Actual Exam 2026/2027 | Complete Exam-Style
Questions with Detailed Rationales | Pass Guaranteed –
A+ Graded
Q1: A patient with type 1 diabetes has a blood glucose of 520 mg/dL, pH 7.18, and positive
serum ketones. Which intervention is priority?
A. Administer regular insulin IV infusion. [CORRECT]
B. Give subcutaneous insulin glargine.
C. Administer sodium bicarbonate bolus.
D. Restrict fluid intake.
Correct Answer: A
Rationale: Correct because DKA requires rapid IV regular insulin to reverse ketosis and lower
glucose; IV route allows immediate titration.
---
Q2: A patient with DKA has a potassium level of 3.2 mEq/L. Which action is priority before
initiating insulin?
A. Administer potassium replacement. [CORRECT]
B. Begin insulin infusion immediately.
C. Administer sodium bicarbonate.
D. Restrict potassium intake.
Correct Answer: A
Rationale: Correct because insulin drives potassium intracellularly, worsening hypokalemia and
risking fatal arrhythmias; potassium must be replaced first.
---
Q3: A patient with type 2 diabetes presents with blood glucose of 1,100 mg/dL, serum
osmolality of 350 mOsm/kg, and no ketones. Which condition is present?
A. Diabetic ketoacidosis
B. Hyperosmolar hyperglycemic state [CORRECT]
C. Hypoglycemia
D. Lactic acidosis
Correct Answer: B
Rationale: Correct because HHS presents with extreme hyperglycemia, hyperosmolality, and
minimal ketosis, typically in type 2 diabetes.
,---
Q4: A patient with hypoglycemia is unconscious. Which intervention is priority?
A. Administer glucagon IM. [CORRECT]
B. Give orange juice orally.
C. Administer insulin.
D. Place in supine position.
Correct Answer: A
Rationale: Correct because unconscious patients cannot safely swallow; IM glucagon or IV
dextrose is required to raise blood glucose rapidly.
---
Q5: Which finding indicates thyroid storm in a patient with Graves disease?
A. Fever, tachycardia, and agitation [CORRECT]
B. Bradycardia and hypothermia
C. Weight gain and constipation
D. Hypotension and lethargy
Correct Answer: A
Rationale: Correct because thyroid storm presents with hyperthermia, tachyarrhythmias, and
altered mental status from excessive thyroid hormone.
---
Q6: A patient with myxedema coma is admitted. Which intervention is priority?
A. Administer IV levothyroxine. [CORRECT]
B. Apply heating pads.
C. Restrict fluids.
D. Administer beta-blockers.
Correct Answer: A
Rationale: Correct because myxedema coma is a life-threatening emergency requiring
immediate IV thyroid hormone replacement.
---
Q7: A patient with Cushing syndrome is expected to have which laboratory finding?
A. Hyperglycemia and hypokalemia [CORRECT]
B. Hypoglycemia and hyperkalemia
C. Hyponatremia and hyperkalemia
D. Hypercalcemia and hypophosphatemia
, Correct Answer: A
Rationale: Correct because excess cortisol promotes gluconeogenesis and mineralocorticoid
effects cause potassium excretion.
---
Q8: A patient with Addison disease is at risk for which crisis?
A. Adrenal crisis with hypotension and hyperkalemia [CORRECT]
B. Hypertensive crisis
C. Thyroid storm
D. Hyperglycemic crisis
Correct Answer: A
Rationale: Correct because adrenal insufficiency causes aldosterone and cortisol deficiency,
leading to hypotension, hyperkalemia, and hyponatremia.
---
Q9: A patient with SIADH has a serum sodium of 122 mEq/L. Which intervention is appropriate?
A. Restrict fluid intake. [CORRECT]
B. Administer IV hypotonic fluids.
C. Encourage oral fluids.
D. Administer desmopressin.
Correct Answer: A
Rationale: Correct because SIADH causes water retention and dilutional hyponatremia; fluid
restriction is the primary treatment.
---
Q10: A patient with diabetes insipidus is prescribed desmopressin. Which finding indicates
therapeutic effect?
A. Decreased urine output [CORRECT]
B. Increased urine output
C. Weight loss
D. Increased thirst
Correct Answer: A
Rationale: Correct because desmopressin replaces ADH, reducing dilute urine output and
restoring fluid balance in diabetes insipidus.
---
