NH N480 FINAL EXAM – ADVANCED MEDICAL SURGICAL NURSING
EXAM ACTUAL 2026 /2027 PRACTICE QUESTIONS AND CURRENTLY
UPDATED STUDY GUIDE COMPLETE ACCURATE EXAM APPROVED
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED ANSWERS) NEWEST
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |FULL
REVISED NH N480 FINAL EXAM – ADVANCED MEDICAL SURGICAL
NURSING TEST |INSTANT DOWNLOAD PDF
1. A patient presents with sudden onset of substernal chest pain
radiating to the left arm, diaphoresis, and nausea. The initial 12-lead
EKG shows ST-segment elevation in leads V1–V4. Which
intervention is the priority?
A. Administer sublingual nitroglycerin
B. Obtain cardiac enzymes
C. Prepare for emergent percutaneous coronary intervention (PCI)
D. Administer morphine sulfate
Correct Answer: C. Prepare for emergent percutaneous coronary
intervention (PCI)
Rationale: ST-segment elevation in leads V1–V4 indicates an
anterior wall STEMI. The priority is reperfusion therapy—either PCI
(preferred if available within 90 minutes of arrival) or fibrinolytics.
PCI is the gold standard for restoring coronary blood flow and
limiting myocardial damage.
,2. A patient with an acute myocardial infarction (MI) is receiving
oxygen therapy. The nurse understands that oxygen should be
administered to maintain SpO₂ at:
A. ≥85%
B. ≥90%
C. ≥92%
D. ≥95%
Correct Answer: C. ≥92%
Rationale: Current guidelines recommend supplemental oxygen for
patients with MI who have SpO₂ <90% or respiratory distress. The
target SpO₂ is ≥92%. Routine oxygen administration in all MI
patients is no longer recommended as it may cause vasoconstriction
and reduce coronary blood flow.
3. The nurse is assessing a patient who is 6 hours post-cardiac
catheterization via the femoral artery. Which finding requires
immediate intervention?
A. Pedal pulses palpable bilaterally
B. Small hematoma at the insertion site
,C. Complaints of mild discomfort at the site
D. Absent pedal pulse on the affected extremity
Correct Answer: D. Absent pedal pulse on the affected extremity
Rationale: Absent pedal pulse indicates possible arterial occlusion or
thrombus formation at the catheterization site, which requires
immediate intervention to prevent limb ischemia. Palpable pulses,
small hematomas, and mild discomfort are expected findings.
4. A patient with an aortic dissection is prescribed a beta-blocker.
The primary goal of this medication is to:
A. Increase cardiac output
B. Decrease heart rate and blood pressure
C. Vasodilate peripheral arteries
D. Prevent thrombus formation
Correct Answer: B. Decrease heart rate and blood pressure
Rationale: Beta-blockers are the mainstay of medical therapy for
aortic dissection. They reduce the force of ventricular contraction
(dp/dt) and lower heart rate and blood pressure, which decreases
shear stress on the aortic wall and prevents propagation of the
dissection.
, 5. A patient receiving IV heparin for a deep vein thrombosis has an
activated partial thromboplastin time (aPTT) of 110 seconds
(therapeutic range 60–80 seconds). The patient is bleeding from an
IV site. What action should the nurse take first?
A. Administer protamine sulfate IV as ordered
B. Stop the heparin infusion and notify the provider
C. Apply pressure to the site and continue the heparin infusion as
ordered
D. Repeat the aPTT in 4 hours and continue the current rate
Correct Answer: B. Stop the heparin infusion and notify the provider
Rationale: An aPTT of 110 seconds is significantly above the
therapeutic range and the patient is actively bleeding. The immediate
priority is to stop the heparin infusion to prevent further bleeding
complications and notify the provider for further orders.
6. A patient with chronic kidney disease is admitted with fluid
overload. The nurse administers furosemide 80 mg IV, and the
patient's urine output over the next 2 hours is 100 mL. The patient's
blood pressure is 88/50 mm Hg, and the heart rate is 110 beats/min.
Which action is most appropriate?
EXAM ACTUAL 2026 /2027 PRACTICE QUESTIONS AND CURRENTLY
UPDATED STUDY GUIDE COMPLETE ACCURATE EXAM APPROVED
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (100% CORRECT VERIFIED ANSWERS) NEWEST
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |FULL
REVISED NH N480 FINAL EXAM – ADVANCED MEDICAL SURGICAL
NURSING TEST |INSTANT DOWNLOAD PDF
1. A patient presents with sudden onset of substernal chest pain
radiating to the left arm, diaphoresis, and nausea. The initial 12-lead
EKG shows ST-segment elevation in leads V1–V4. Which
intervention is the priority?
A. Administer sublingual nitroglycerin
B. Obtain cardiac enzymes
C. Prepare for emergent percutaneous coronary intervention (PCI)
D. Administer morphine sulfate
Correct Answer: C. Prepare for emergent percutaneous coronary
intervention (PCI)
Rationale: ST-segment elevation in leads V1–V4 indicates an
anterior wall STEMI. The priority is reperfusion therapy—either PCI
(preferred if available within 90 minutes of arrival) or fibrinolytics.
PCI is the gold standard for restoring coronary blood flow and
limiting myocardial damage.
,2. A patient with an acute myocardial infarction (MI) is receiving
oxygen therapy. The nurse understands that oxygen should be
administered to maintain SpO₂ at:
A. ≥85%
B. ≥90%
C. ≥92%
D. ≥95%
Correct Answer: C. ≥92%
Rationale: Current guidelines recommend supplemental oxygen for
patients with MI who have SpO₂ <90% or respiratory distress. The
target SpO₂ is ≥92%. Routine oxygen administration in all MI
patients is no longer recommended as it may cause vasoconstriction
and reduce coronary blood flow.
3. The nurse is assessing a patient who is 6 hours post-cardiac
catheterization via the femoral artery. Which finding requires
immediate intervention?
A. Pedal pulses palpable bilaterally
B. Small hematoma at the insertion site
,C. Complaints of mild discomfort at the site
D. Absent pedal pulse on the affected extremity
Correct Answer: D. Absent pedal pulse on the affected extremity
Rationale: Absent pedal pulse indicates possible arterial occlusion or
thrombus formation at the catheterization site, which requires
immediate intervention to prevent limb ischemia. Palpable pulses,
small hematomas, and mild discomfort are expected findings.
4. A patient with an aortic dissection is prescribed a beta-blocker.
The primary goal of this medication is to:
A. Increase cardiac output
B. Decrease heart rate and blood pressure
C. Vasodilate peripheral arteries
D. Prevent thrombus formation
Correct Answer: B. Decrease heart rate and blood pressure
Rationale: Beta-blockers are the mainstay of medical therapy for
aortic dissection. They reduce the force of ventricular contraction
(dp/dt) and lower heart rate and blood pressure, which decreases
shear stress on the aortic wall and prevents propagation of the
dissection.
, 5. A patient receiving IV heparin for a deep vein thrombosis has an
activated partial thromboplastin time (aPTT) of 110 seconds
(therapeutic range 60–80 seconds). The patient is bleeding from an
IV site. What action should the nurse take first?
A. Administer protamine sulfate IV as ordered
B. Stop the heparin infusion and notify the provider
C. Apply pressure to the site and continue the heparin infusion as
ordered
D. Repeat the aPTT in 4 hours and continue the current rate
Correct Answer: B. Stop the heparin infusion and notify the provider
Rationale: An aPTT of 110 seconds is significantly above the
therapeutic range and the patient is actively bleeding. The immediate
priority is to stop the heparin infusion to prevent further bleeding
complications and notify the provider for further orders.
6. A patient with chronic kidney disease is admitted with fluid
overload. The nurse administers furosemide 80 mg IV, and the
patient's urine output over the next 2 hours is 100 mL. The patient's
blood pressure is 88/50 mm Hg, and the heart rate is 110 beats/min.
Which action is most appropriate?
