Download NUR 242 Exam Med-surg study questions Unit 7 & 8 with verified Answers 2025/2026 Galen and more Exams Nursing in PDF only on Docsity!
NUR 242 Exam 3 Med-surg study questions Unit 7 & 8 with Verified Rationalized Answers Updated (2025/2026) - Galen
- Thennursenimmediatelynchecksnonnthenpatientnandnfindsnthatnshenappearsnanxiousnand nhernvitalnsignsnarenasnfollows: ØBloodnpressure:n128/84nmmnHgnØHeartnrat e:n 114 n(sinusntachycardia) ØRespiratorynrate:n24,nlaborednandnrestlessnØTemperature:n99.4°nFn( axillary) ØO2nsaturation:n91%nonn40%nO2nviantrachncollar Whichnofnthesenfindingsnarencausenfornconcern?:nANS:nThenBPnisnwithinnnormalnrangenandnonl ynslightlynelevated.nThentemperaturenisnonlynslightlynelevated.n**Hernheartnratenisnelevated;nt hennursenshouldnchecknthenpatient'snmedicationsntonseenifnshenisnonnanbronchodilatornornothern medicationnthatncouldncausenhernheartnratentonincrease.nThenprioritynconcernnisnthenRESTLESS NESSnwithnincreasednrespiratorynratenandnthendecreasednoxygennsaturationndespitenthen40%no xygennsetting.
- Anpatientnwithnanhistorynofnchronicnobstructivenpulmonaryndiseasenisnadmit- ntednwithnshortnessnofnbreath.nWhichnnursingninterventionnisnmostnappropriate? A. Donnotnadministernoxygen. B. AdministernoxygennvianVenturinmask. C. Usennasalncannulantonadministernhighnflownoxygen. D. Administernoxygennatn6Lnpernsimplenfacenmask.:nANS:nB
Oxygenntherapynisnprescribednatnthenlowestnliternflownneededntonmanagenhypoxemia.nAnsystemnth atndeliversnmorenprecisenoxygennlevelsn(e.g.,nanVenturinmask)nisnpreferred.nMonitornthenpatient'snre sponsentontherapyncloselyntonensurenadequatengasnexchangenandncorrectionnofnhypoxemia.
- Whilensuctioningnanpatient,nvagalnstimulationnoccurs.nWhatnisnthenappropriatennursingnacti on? A. Instructnthenpatientntoncough. B. PlacenthenpatientninnanhighnFowler'snposition. C. Oxygenatenthenpatientnwithn100%noxygen. D. Instructnthenpatientntonbreathenslowlynandndeeply.:nANS:nC Vagalnstimulationnmaynoccurnduringnsuctioningnandnresultninnseverenbradycardia,nhypotension ,nheartnblock,nventricularntachycardia,nasystole,nornotherndysrhythmias.nIfnvagalnstimulationnoc curs,nstopnsuctioningnimmediatelynandnoxygenatenthenpatientnmanuallynwithn100%noxygen.nRe positioningnthenpatient,nslowndeepnbreathing,nandncoughingnwillnnotnaddressnthencardiovascul arneffectsnofnvagalnstimulation.
bendingnposture.nWithnseverendyspnea,ntheynexhibitnactivitynintolerancenandnactivitiesnsuchnasnb athingnandngroomingnarenavoided.
- Whennthenpatientnarrivesntonthenunit,nshenisnassessednandnisninnacutenrespira- ntoryndistress.nHernrespirationsnarenlaborednandnhernrespiratorynratenisn34.nShenstatesnthatns henhadnanpeaknflownmeternmeasurementnofn"RednZone"nonnthenwaynandnisnseverelynshortnofnair. nHernoxygennsaturationnisn82%nonnO2natn 2 nLnviannasalncannula. Basednonnthesenfindings,nwhatnshouldnthennursendonnext?:nANS:nThenRapidnResponsenTeamnsho uldnbennotifiednimmediately.nAllnofnthesenassessmentnfindingsnindicatenacutenrespiratoryndistress.n ThenpeaknflownmeternisninnthenREDnZone.nThenoxygennsaturationnshouldnbenatnleastn90%nonn 2 nLnpern NC.
- WhilenthenRapidnResponsenTeamnisnatnthenbedside,nthenpatient'snhealthcarenprovidernarri ves.nThenprovidernwritesnseveralnorders. Whichnordernisnmostnimportantnfornthennursentonimplementnimmediately? A. TransferntonICU B. IncreasenO2nton 3 nLnpernnasalncannula C. ABGsn 30 nminutesnafternoxygennisnincreased D. Methylprednisolonensodiumnsuccinaten(Solu-Medrol)n 40 nmgnIVP:nANS:nB Allnofnthenprovider'snordersnarenverynimportant,nbutnbasednonnthenpatient'snseverenshortnessnofn breath,nthenfirstnthingnthatnshouldnbendonenisntonincreasenhernoxygen.nOncenhernoxygennisnincre ased,nthennursenshouldnnotenthentimenandnrememberntoncallnfornstatnABGsninn 30 nminutes.nThenp atientnshouldnthennbentransferredntonthenICUnasnsoonnasnpossible.nOncenthenpatientnarrivesninnt henICU,ntheyncannadministernthenone-timendosenofnSolu-Medrol.
- ThenpatientnisninnthenICUnforn 3 ndaysnandnthenntransferrednbackntonthenpulmonarynstepdow nnunit.nShenisnstillnslightlynshortnofnbreathnwithnexertion.nHernO2nsaturationnisn99%nonnoxyge nnatn 2 nLnpernnasalncannula.nShendeniesnanynshortnessnofnbreathnwhennrestingnduringnthenass essment.nThenprovidernplansntondischargenthenpatientnonnhomenoxygenninnthenmorning. Whatnshouldnthennursenincludeninnthisnpatient'sndischargenteaching?:nANS:nMakensurenthatnt henpatientnunderstandsnanynnewnmedicationnregimen.nShenshouldnbeninstructedntoncalln 911 nforn anynseverenrespiratoryndistress.nBecausenshenisnbeingndischargednwithnhomenoxygen,nhomenhe althnservicesnshouldnbenarranged.
- AnpatientnwithnCOPDnpresentsnfornanroutinenfollownup.nThenpatientnsmokesn 1 nPPD.nWhichns
pillownindicatesnthatnthenpatientnmustnsleepnproppednupnbecausenbreathingnisnworsenwhilenlyingnd own.nTheynmaynnotnrecognizenthenincreasedndyspneanandntheyntryntoncompensatenbynusingnmultip lenpillowsninnorderntonrest.
- Thennursenisnassessingnanpatientnwithnanchestntubenfollowingnanpneumonec- ntomy.nWhichnassessmentnfindingnrequiresnintervention? A. Bandagenaroundnthenposteriorntubenisnloose. B. 2 ncmnofnwaternisninnthensecondnchestntubenchamber. C. Thenwaterninnthenwaternsealnchambernrisesnandnfallsnwithninhalation/exhala-ntion. D. Bubblingnpresentninnthenwaternsealnchambernwhennthenpatientncoughs.:nANS:nA Afternlungnsurgery,ntwontubes,nanteriornandnposterior,narenused.nDressingsnaroundnthenwoundnsho uldnnotnbenloose.nThenwoundsnshouldnbencoverednwithnairtightndressings.
- Anhomenhealthnpatientnwithnanhistorynofnasthmanisnhavingnshortnessnofnbreath.nThennur sendiscoversnthatnthenpeaknflowmeternindicatesnanpeaknexpi- nratorynflown(PEF)nreadingnthatnisninnthenrednzone.nWhatnisnthenprioritynnursingnaction? A. Calln 911 nimmediately. B. Takenthenpatient'snvitalnsigns. C. Notifynthenpatient'snprescriber. D. RepeatnthenPEFnreadingntonverifynthenresults.:nANS:nA AnPEFnreadingninnthenrednzonenindicatesnanrangenthatnisn50%nbelownthenpatient'snpersonalnbestnPE Fnreadingnandnindicatesnseriousnrespiratorynobstructionnrequiringn 911 nornrapidnresponse.nOffernm edicationsnandnstaynwithnthenpatient.nRepeatingnthenPEFnreadingnandntakingnvitalnsignsnarenalsonim portant,nbutndoingnsonfirstndelaysnthenadministrationnofnthenrescuendrugsnandnphysiciannnotificati
on.
- Thenpatientnisnassessednandnanbloodnglucosenlevelnandnvitalnsignsnarenobtainednup onnarrivalnonnthenunit.nResultsnarenasnfollows: BG — 239 nmg/dLnBP — 138/88nmmnHgnHR — 128 nRR — 36 nbreaths/min O2nsaturation — 88%n(roomnair)nTemperature — 101.6ºnF Whichnvitalnsignnorntestnresultnrequiresnthennurse'snimmediatenattention? A. Bloodnpressure B. Respiratorynrate C. Temperature
btainednbeforenthenIVPnAncefnisnadministered.
- Thennursenunderstandsnthatnwhichnofnthenfollowingnisnthenmostncommonnsymptomnofn pneumonianinnthenoldernadultnpatient? A. Fever B. Cough C. Confusion D. Weakness:nANS:nC Thenoldernadultnwithnpneumonianoftennhasnweakness,nfatigue,nlethargy,nconfusion,nandnpoorna ppetite.nFevernandncoughnmaynbenabsent,nbutnhypoxemianisnusuallynpresent.nThenmostncommo nnmanifestationnofnpneumonianinnthenoldernadultnpatientnisnconfusionnfromnhypoxianratherntha nnfevernorncough.
- Whichnassessmentnfindingnfornannoldernadultnpatientndoesnthennursenascribentonthennatura lnagingnprocess? A. Tighteningnofnthenvocalncords B. Andecreaseninnresidualnvolume C. Andecreaseninnthenanteroposteriorndiameter D. Andecreaseninnrespiratorynmusclenstrength:nANS:nD Asnanpersonnages,nvocalncordsnbecomenslack,nchangingnthenqualitynandnstrengthnofnthenvoice ;nthenanteroposteriorndiameternincreases;nrespiratorynmusclenstrengthndecreases;nandnthenr esidualnvolumenincreases.
- Thennursenknowsnthatnundernnormalnphysiologicnconditionsnofntissuenperfusion,nan patientnwillnhavenwhatnpercentnofnoxygenndissociatenfromnthenhemoglobinnmolecule? A. 25% B. 50% C. 75% D. 100%:nANS:nB Oxygenndissociatesnwithnthenhemoglobinnmoleculenbasednonnthenneednfornoxygenntonperfusentiss ues.nUndernnormalnconditions,n50%nofnhemoglobinnmoleculesncompletelyndissociatentheirnoxyg ennmoleculesnwhennbloodnperfusesntissuesnthatnhavenannoxygenntensionn(concentration)nofn 26 n mmnHg.nThisnisnconsiderednan"normal"npointnatnwhichn50%nofnhemoglobinnmoleculesnarennonlon gernsaturatednwithnoxygen.
condition.nChestnpainncannoccurnwithnothernhealthnproblems,nasnwellnasnwithnlungnproblems.
- AnpatientninnthenEDnhasnbeennexperiencingnuppernabdominalnpainnafternmealsnfornthen pastn 2 nmonths.nShenalsonnoticesnthatnwhennshentakesnannapnornsleepsnatnnight,nshenhasnpai n.nEatingnseemsntondecreasenpain.nShenhasnbeenntakingnOTCnantacidsnwithnsomenrelief. Whichnassessmentnfactornputsnthenpatientnatnrisknfornpepticnulcerndisease? A. Weightnlossnofn 35 npounds B. UsenofnNSAIDsntoncontrolnarthritisnpain C. GERDn 4 nyearsnago D. Usenofnprednisonen(Deltasone)nforninflammation:nANS:nB PepticnulcerndevelopmentnisnassociatednprimarilynwithnNSAIDnusenandnbacterialninfectionsnwithnH .npylori.
- Whichndiagnosticnresultsnsupportnthendiagnosisnofnpepticnulcerndisease?n(Selectnallnt hatnapply.) A. Lownhemoglobin B. LownWBCnlevel C. Lownhematocrit D. PositivenfornH.nPylorinbacteria E. Lownpotassiumnofn3.4nmEq/L.:nANS:nA,nC,nD LownHCTnandnHgbnoftennoccurnrelatedntonbleeding.nThenpresencenofninfectionnwithnH.npylorinisnthens econdnmostncommonnfactornassociatednwithnthendevelopmentnofnPUD.nThenpatientnwouldnhavenan high,nnotnlow,nWBCncount.nThenpotassiumnlevelnisnnotnandiagnosticnfactornfornPUD.
- AnnEGDnconfirmsnthatnthenpatientnhasnPUD.nThreenhoursnlater,nthenpatientnisnadmittednt
onthenmedicalnunitnfornworkupnandnfurtherntesting.nOnnadmissionnthenpatientnreportsnmidlin enepigastricntendernessnandnindigestionn(dyspepsia).nThenpatientnisnprescribedntriplenthera py. Whichndrugsnwillnthennursenexpectntonbenprescribednfornthenpatientnatnthisntime? A. Protonnpumpninhibitornandntwonantibiotics B. Histaminenantagonist,nantacid,nandnprotonnpumpninhibitor C. Antibioticnandntwonprotonnpumpninhibitors D. Antacid,nprotonnpumpninhibitor,nandnprostaglandinnanalogue:nANS:nA FornH.npylorininfections,nancommonndrugnregimennisntriplentherapy,nwhichnincludesna
Rationale:nLong- termnNSAIDnusencreatesnanhighnrisknfornacutengastritis.nNaproxennisnannNSAIDnthatnmaynbenusednt ontreatnarthritis.nOthernrisknfactorsnfornacutengastritisnincludenalcohol,ncaffeine,nandncorticoster oids.nIVnfluidsnmaynornmaynnotnbenneededntonreplacenanynfluidsnornbloodnlostnfromnthenpatient'sngas tritis.nStoolnguaiacnisnnonspecificnbutnmaynbenorderedntonconfirmnbloodninnthenstool,nandnanstoolnsa mplenmaynbenusedntontestnfornthenpresencenofnHelicobacternpylorininfection.nHowever,nitnisnnotna snaccuratenasnbloodnornbreathntests.
- WhatnisnthennursingnpriorityninnthenmanagementnofnanpatientnwithnannactivenuppernGInble ed? A. Obtainnvitalnsigns. B. Applynoxygennbynnasalncannula. C. Typenandncrossmatchnthenpatientnfornbloodnproducts. D. Notifynthenphysician.:nAnswer:nA
Rationale:nVitalnsignsnarenneededntonevaluatenthenseveritynofnthenpatient'snbleednandnhypovolem icnstatus.nOxygennwillnassistnwithndeliverynofnoxygenntonthentissuesnandnantypenandncrossmatch,n althoughnimportant,nisnnotnthenimmediatenpriority.nAssessmentndatansuchnasnthenpatient'snvitaln signsnarenneedednbeforencontactingnthenphysician.
- Anpatientnhasnrecentlynbeennplacednonncorticosteroidsnasntreatmentnfornulcerativencolit is.nThennursenshouldnmonitornthenpatient'snlaboratorynresultsnfornevidencenofnwhichnconditio n? A. Hypernatremia B. Hypercalcemia C. Hyperglycemia D. Hyperkalemia:nAnswer:nC Rationale:nLong- termnadverseneffectsnthatncommonlynoccurnwithnsteroidntherapynincludenhyperglycemia,nosteopo rosis,npepticnulcerndisease,nandnincreasednrisknforninfection
- Thennursenisncaringnfornanpatientnwithnanlongnhistorynofnosteoarthritis.nWhichnrisknfactorsnwi llnthennursenteachnthenpatientnthatnmayncontributentondevelopmentnofngastroesophagealnreflu xndiseasen(GERD)? A. Weightnofn 130 nlbs B. Walksn 20 nminutesnoncendaily C. FrequentlyntakesnNSAIDsnfornpain D. Consumesnfoodsnwithncalciumnsupplementation:nANS:nC
:nANS:nA Thenmostnimportantnrolenofnthennurseninncaringnfornanpatientnwithnanhiatalnhernianisnhealthnteaching ,nspecificallynnutritionnmanagementntonincludenweightnloss.nEducationnfornprescribednmedicationsn isnannimportantnnursingnfunction,nasnwellnasneducationnfornsignsnandnsymptomsnofninfectionnifnthenp atientnhasnanrollingnhiatalnhernia.
- AnpatientninnthenEDnhasnbeennexperiencingnuppernabdominalnpainnafternmealsnfornthenpa stnseveralnmonths.nShenreportsnpainnafternnappingnornsleepingnatnnight.nShenhasnbeenntakingn OTCnantacidsnwithnsomenrelief.nThennursenun- nderstandsnthatnwhichnassessmentnfindingnplacesnthenpatientnatnrisknfornpepticnulcerndiseas e? A. GERDn 4 nyearsnago B. Weightnlossnofn 35 nlbs C. UsenofnNSAIDsntoncontrolnarthritisnpain D. Recentndiscontinuationnofnprednisonen(Deltasone):nANS:nC Pepticnulcerndevelopmentnisnassociatednprimarilynwithnnonsteroidalnanti- inflammatoryndrugn(NSAID)nusenandnbacterialninfectionsnwithnHelicobacternpylori.
- Whichndiagnosticnresultsndoesnthennursenrecognizenthatnsupportnthendiag- nnosisnofnpepticnulcerndiseasen(PUD)?n(Selectnallnthatnapply.) A. Lownhemoglobinn(Hgb) B. Lownwhitenbloodncelln(WBC)nlevel C. Lownhematocritn(Hct)
D. PositivenfornH.npylorinbacteria E. Lownpotassiumnofn3.4nmEq/L:nANS:nA,nC,nD LownHctnandnHgbnoftennoccurnrelatedntonbleeding.nPresencenofninfectionnwithnH.npylorinisnthenseco ndnmostncommonnfactornassociatednwithndevelopmentnofnPUD.nThenpatientnwouldnhavenanhigh,nn otnlow,nWBCncount.nPotassiumnlevelnisnnotnandiagnosticnfactornfornPUD.
- AnnEGD,nEsophagogastroduodenoscopy.nconfirmsnthatnthenpatientnhasnPUD.nThreenhou rsnlater,nthenpatientnisnadmittedntonthenmedicalnunitnfornworkupnandnfurtherntesting.nOnnadmi ssionnthenpatientnreportsnmidlinenepigastricnten- ndernessnandnindigestionn(dyspepsia).nThenpatientnisnprescribedntriplentherapy.nWhichndrugs ndoesnthennursenpreparentonadminister? A. Protonnpumpninhibitorn(PPI)nandntwonantibiotics
