NSG223/NSG 223 Final Exam V2 | Medical-
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A nurse is caring for a patient who has just been diagnosed with an Acute Myocardial
Infarction (AMI). Which of the following cardiac markers is most specific to cardiac muscle
injury and remains elevated for up to two weeks?
A. Myoglobin
B. Creatine Kinase-MB (CK-MB)
C. Troponin T
D. C-reactive protein
Correct Answer: C
Rationale: Troponin T and Troponin I are highly specific indicators of cardiac muscle
damage. While CK-MB rises quickly, it usually returns to baseline within 48 to 72 hours.
Troponin levels can remain elevated for 10 to 14 days, making them useful for diagnosing
an MI that occurred several days prior.
2. A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted with
acute respiratory distress. The ABG results are: pH 7.28, PaCO2 55, HCO3 28. How should the
nurse interpret these findings?
A. Compensated Metabolic Alkalosis
,B. Uncompensated Respiratory Acidosis
C. Partially Compensated Respiratory Acidosis
D. Partially Compensated Metabolic Acidosis
Correct Answer: C
Rationale: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated, indicating
a respiratory origin. The HCO3 is also elevated, which suggests the kidneys are attempting
to compensate for the high CO2 levels. Because the pH has not yet returned to the normal
range, the condition is considered partially compensated.
3. A patient is admitted to the ICU with a suspected Pulmonary Embolism (PE). Which of the
following is considered the gold standard diagnostic test for confirming the presence of a PE?
A. Chest X-ray
B. D-dimer assay
C. Pulmonary Angiography
D. Ventilation-Perfusion (V/Q) Scan
Correct Answer: C
Rationale: Pulmonary angiography is the most definitive and accurate test for diagnosing
pulmonary embolism. However, because it is invasive and expensive, CT pulmonary
angiography (CTPA) is more commonly used in clinical practice. The D-dimer test is
sensitive but not specific, meaning it can rule out a PE but cannot confirm one.
, 4. A patient with a C6 spinal cord injury is complaining of a sudden, severe throbbing
headache and has a blood pressure of 190/100 mmHg. What is the nurse’s priority action?
A. Check the patient for bladder distension
B. Administer PRN antihypertensive medication
C. Place the patient in a supine position
D. Notify the physician immediately
Correct Answer: A
Rationale: The patient is exhibiting signs of Autonomic Dysreflexia, a medical emergency
common in injuries at T6 or above. The most common trigger is bladder distension or fecal
impaction. The nurse should immediately sit the patient up and then identify/remove the
noxious stimulus, such as a kinked catheter.
5. A nurse is assessing a patient with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Pulmonary crackles
B. Jugular Venous Distension (JVD)
C. Dyspnea on exertion
D. Orthopnea
Correct Answer: B
Surgical Nursing II Q&A with Rationale |
Herzing University
1. A nurse is caring for a patient who has just been diagnosed with an Acute Myocardial
Infarction (AMI). Which of the following cardiac markers is most specific to cardiac muscle
injury and remains elevated for up to two weeks?
A. Myoglobin
B. Creatine Kinase-MB (CK-MB)
C. Troponin T
D. C-reactive protein
Correct Answer: C
Rationale: Troponin T and Troponin I are highly specific indicators of cardiac muscle
damage. While CK-MB rises quickly, it usually returns to baseline within 48 to 72 hours.
Troponin levels can remain elevated for 10 to 14 days, making them useful for diagnosing
an MI that occurred several days prior.
2. A patient with a history of Chronic Obstructive Pulmonary Disease (COPD) is admitted with
acute respiratory distress. The ABG results are: pH 7.28, PaCO2 55, HCO3 28. How should the
nurse interpret these findings?
A. Compensated Metabolic Alkalosis
,B. Uncompensated Respiratory Acidosis
C. Partially Compensated Respiratory Acidosis
D. Partially Compensated Metabolic Acidosis
Correct Answer: C
Rationale: The pH is below 7.35, indicating acidosis, and the PaCO2 is elevated, indicating
a respiratory origin. The HCO3 is also elevated, which suggests the kidneys are attempting
to compensate for the high CO2 levels. Because the pH has not yet returned to the normal
range, the condition is considered partially compensated.
3. A patient is admitted to the ICU with a suspected Pulmonary Embolism (PE). Which of the
following is considered the gold standard diagnostic test for confirming the presence of a PE?
A. Chest X-ray
B. D-dimer assay
C. Pulmonary Angiography
D. Ventilation-Perfusion (V/Q) Scan
Correct Answer: C
Rationale: Pulmonary angiography is the most definitive and accurate test for diagnosing
pulmonary embolism. However, because it is invasive and expensive, CT pulmonary
angiography (CTPA) is more commonly used in clinical practice. The D-dimer test is
sensitive but not specific, meaning it can rule out a PE but cannot confirm one.
, 4. A patient with a C6 spinal cord injury is complaining of a sudden, severe throbbing
headache and has a blood pressure of 190/100 mmHg. What is the nurse’s priority action?
A. Check the patient for bladder distension
B. Administer PRN antihypertensive medication
C. Place the patient in a supine position
D. Notify the physician immediately
Correct Answer: A
Rationale: The patient is exhibiting signs of Autonomic Dysreflexia, a medical emergency
common in injuries at T6 or above. The most common trigger is bladder distension or fecal
impaction. The nurse should immediately sit the patient up and then identify/remove the
noxious stimulus, such as a kinked catheter.
5. A nurse is assessing a patient with right-sided heart failure. Which clinical manifestation
should the nurse expect to find?
A. Pulmonary crackles
B. Jugular Venous Distension (JVD)
C. Dyspnea on exertion
D. Orthopnea
Correct Answer: B
