WCU NH N480 Advanced MedicalSurgical Nursing Exam
1 | 200 Practice Questions & Detailed Answers | Latest
2026/2027 Update | A+ Graded
DOMAIN 1: FOUNDATIONS OF ADVANCED MEDICALSURGICAL NURSING (Questions 1–30)
1. The nurse is caring for a client with a complex medical condition. Which of the following best
describes the role of the advanced medicalsurgical nurse in managing this client's care?
A. Providing direct care only
B. Coordinating care and collaborating with the interprofessional team
C. Making independent medical diagnoses
D. Focusing exclusively on physical assessments
Correct Answer: B
Rationale: The advanced medicalsurgical nurse plays a pivotal role in coordinating care and collaborating
with the interprofessional team to manage complex patient conditions, ensuring a holistic and
integrated approach to care.
2. A client is admitted with a new diagnosis of heart failure. Which of the following is the most
important nursing intervention to prevent complications?
A. Administering diuretics as prescribed
B. Monitoring daily weights
C. Encouraging a lowsodium diet
D. All of the above
Correct Answer: D
Rationale: Effective management of heart failure requires a multifaceted approach, including
administering diuretics, monitoring daily weights to assess fluid status, and encouraging a lowsodium
diet to reduce fluid retention and prevent exacerbations.
,3. The nurse is assessing a client with a suspected myocardial infarction (MI). Which of the following
findings is most indicative of an MI?
A. Substernal chest pain radiating to the left arm
B. Sharp, pleuritic chest pain
C. Pain that is relieved by position change
D. Burning epigastric pain
Correct Answer: A
Rationale: Substernal chest pain radiating to the left arm is a classic sign of myocardial infarction. Sharp,
pleuritic chest pain (B) is more indicative of pericarditis or pulmonary embolism. Pain relieved by
position change (C) suggests musculoskeletal or pericardial causes.
4. The nurse is preparing to administer a medication to a client. Which of the following actions should
the nurse take to ensure safe medication administration?
A. Verify the client's identity using two identifiers
B. Administer the medication without checking the MAR
C. Crush all medications for easier administration
D. Administer medications based on the client's request
Correct Answer: A
Rationale: The nurse should verify the client's identity using at least two identifiers (e.g., name and date
of birth) before administering any medication. Checking the MAR (B) is essential; crushing medications
(C) should only be done if safe; and administering based on client request (D) is unsafe.
5. A client is experiencing respiratory distress. Which of the following is the priority nursing action?
A. Assess the client's airway, breathing, and circulation (ABCs)
B. Obtain a detailed medical history
C. Notify the family
D. Review the client's laboratory results
Correct Answer: A
,Rationale: The priority action in any emergency is to assess the client's airway, breathing, and circulation
(ABCs). This ensures immediate lifethreatening issues are addressed before other assessments or
notifications.
6. The nurse is caring for a client who is postoperative following abdominal surgery. Which of the
following findings should the nurse report to the provider immediately?
A. Wound edges that are wellapproximated
B. Serosanguineous drainage on the dressing
C. Wound dehiscence with visible organs
D. Pain at the incision site
Correct Answer: C
Rationale: Wound dehiscence with visible organs (evisceration) is a surgical emergency requiring
immediate intervention. Wellapproximated edges (A), serosanguineous drainage (B), and pain (D) are
expected postoperative findings.
7. The nurse is providing education to a client about infection prevention. Which of the following
statements by the client indicates understanding?
A. "I will wash my hands before and after touching my wound."
B. "I can share my personal care items with family members."
C. "Antibiotics will cure all types of infections."
D. "I only need to wash my hands if they look dirty."
Correct Answer: A
Rationale: Hand hygiene before and after wound care is essential for infection prevention. Sharing
personal care items (B) spreads infection; antibiotics do not treat viral infections (C); and hands should
be washed even if they appear clean (D).
8. The nurse is assessing a client's pain level using a 010 numeric rating scale. The client reports a pain
level of 8. Which of the following actions should the nurse take first?
A. Administer prescribed pain medication
B. Reassess the pain in 30 minutes
, C. Notify the provider
D. Document the pain score
Correct Answer: A
Rationale: A pain level of 8 indicates severe pain requiring immediate intervention. The nurse should
administer prescribed pain medication first, then reassess (B) and document (D). Notifying the provider
(C) may be necessary if pain is unrelieved.
9. The nurse is caring for a client who is at risk for falls. Which of the following interventions should the
nurse implement?
A. Keep the bed in the lowest position
B. Place the call light out of reach
C. Use restraints as the first line of defense
D. Leave the client unattended in the bathroom
Correct Answer: A
Rationale: Keeping the bed in the lowest position is a fall prevention intervention. The call light should
be within reach (B), restraints should be a last resort (C), and clients should not be left unattended in the
bathroom (D).
10. A client is receiving oxygen via nasal cannula at 2 L/min. Which of the following actions should the
nurse take?
A. Apply watersoluble lubricant to the client's nares
B. Use petroleumbased lubricant for comfort
C. Set the flow rate to 10 L/min
D. Remove the nasal cannula during meals
Correct Answer: A
Rationale: Watersoluble lubricant should be applied to the client's nares to prevent drying and irritation.
Petroleumbased lubricants (B) are flammable and should not be used with oxygen. Flow rates of 10
L/min (C) are not appropriate for nasal cannula, and the cannula should remain in place during meals (D)
unless otherwise ordered.
1 | 200 Practice Questions & Detailed Answers | Latest
2026/2027 Update | A+ Graded
DOMAIN 1: FOUNDATIONS OF ADVANCED MEDICALSURGICAL NURSING (Questions 1–30)
1. The nurse is caring for a client with a complex medical condition. Which of the following best
describes the role of the advanced medicalsurgical nurse in managing this client's care?
A. Providing direct care only
B. Coordinating care and collaborating with the interprofessional team
C. Making independent medical diagnoses
D. Focusing exclusively on physical assessments
Correct Answer: B
Rationale: The advanced medicalsurgical nurse plays a pivotal role in coordinating care and collaborating
with the interprofessional team to manage complex patient conditions, ensuring a holistic and
integrated approach to care.
2. A client is admitted with a new diagnosis of heart failure. Which of the following is the most
important nursing intervention to prevent complications?
A. Administering diuretics as prescribed
B. Monitoring daily weights
C. Encouraging a lowsodium diet
D. All of the above
Correct Answer: D
Rationale: Effective management of heart failure requires a multifaceted approach, including
administering diuretics, monitoring daily weights to assess fluid status, and encouraging a lowsodium
diet to reduce fluid retention and prevent exacerbations.
,3. The nurse is assessing a client with a suspected myocardial infarction (MI). Which of the following
findings is most indicative of an MI?
A. Substernal chest pain radiating to the left arm
B. Sharp, pleuritic chest pain
C. Pain that is relieved by position change
D. Burning epigastric pain
Correct Answer: A
Rationale: Substernal chest pain radiating to the left arm is a classic sign of myocardial infarction. Sharp,
pleuritic chest pain (B) is more indicative of pericarditis or pulmonary embolism. Pain relieved by
position change (C) suggests musculoskeletal or pericardial causes.
4. The nurse is preparing to administer a medication to a client. Which of the following actions should
the nurse take to ensure safe medication administration?
A. Verify the client's identity using two identifiers
B. Administer the medication without checking the MAR
C. Crush all medications for easier administration
D. Administer medications based on the client's request
Correct Answer: A
Rationale: The nurse should verify the client's identity using at least two identifiers (e.g., name and date
of birth) before administering any medication. Checking the MAR (B) is essential; crushing medications
(C) should only be done if safe; and administering based on client request (D) is unsafe.
5. A client is experiencing respiratory distress. Which of the following is the priority nursing action?
A. Assess the client's airway, breathing, and circulation (ABCs)
B. Obtain a detailed medical history
C. Notify the family
D. Review the client's laboratory results
Correct Answer: A
,Rationale: The priority action in any emergency is to assess the client's airway, breathing, and circulation
(ABCs). This ensures immediate lifethreatening issues are addressed before other assessments or
notifications.
6. The nurse is caring for a client who is postoperative following abdominal surgery. Which of the
following findings should the nurse report to the provider immediately?
A. Wound edges that are wellapproximated
B. Serosanguineous drainage on the dressing
C. Wound dehiscence with visible organs
D. Pain at the incision site
Correct Answer: C
Rationale: Wound dehiscence with visible organs (evisceration) is a surgical emergency requiring
immediate intervention. Wellapproximated edges (A), serosanguineous drainage (B), and pain (D) are
expected postoperative findings.
7. The nurse is providing education to a client about infection prevention. Which of the following
statements by the client indicates understanding?
A. "I will wash my hands before and after touching my wound."
B. "I can share my personal care items with family members."
C. "Antibiotics will cure all types of infections."
D. "I only need to wash my hands if they look dirty."
Correct Answer: A
Rationale: Hand hygiene before and after wound care is essential for infection prevention. Sharing
personal care items (B) spreads infection; antibiotics do not treat viral infections (C); and hands should
be washed even if they appear clean (D).
8. The nurse is assessing a client's pain level using a 010 numeric rating scale. The client reports a pain
level of 8. Which of the following actions should the nurse take first?
A. Administer prescribed pain medication
B. Reassess the pain in 30 minutes
, C. Notify the provider
D. Document the pain score
Correct Answer: A
Rationale: A pain level of 8 indicates severe pain requiring immediate intervention. The nurse should
administer prescribed pain medication first, then reassess (B) and document (D). Notifying the provider
(C) may be necessary if pain is unrelieved.
9. The nurse is caring for a client who is at risk for falls. Which of the following interventions should the
nurse implement?
A. Keep the bed in the lowest position
B. Place the call light out of reach
C. Use restraints as the first line of defense
D. Leave the client unattended in the bathroom
Correct Answer: A
Rationale: Keeping the bed in the lowest position is a fall prevention intervention. The call light should
be within reach (B), restraints should be a last resort (C), and clients should not be left unattended in the
bathroom (D).
10. A client is receiving oxygen via nasal cannula at 2 L/min. Which of the following actions should the
nurse take?
A. Apply watersoluble lubricant to the client's nares
B. Use petroleumbased lubricant for comfort
C. Set the flow rate to 10 L/min
D. Remove the nasal cannula during meals
Correct Answer: A
Rationale: Watersoluble lubricant should be applied to the client's nares to prevent drying and irritation.
Petroleumbased lubricants (B) are flammable and should not be used with oxygen. Flow rates of 10
L/min (C) are not appropriate for nasal cannula, and the cannula should remain in place during meals (D)
unless otherwise ordered.
