,NURS 480 exam 1 Advanced Medical Surgical Nursing Questions And
Answers 2026/2027 West Coast University
Q1. A patient develops sudden chest pain and dyspnea shortly after
insertion of a central venous catheter. Which assessment should the nurse
perform first?
A. Assess bilateral breath sounds
B. Administer prescribed opioid analgesia
C. Call the family
D. Encourage deep breathing
Correct Answer: A
Rationale: Sudden chest pain and dyspnea after central-line insertion may
indicate pneumothorax or another mechanical complication. Immediate
respiratory assessment helps identify deterioration.
Q2. A patient has absent breath sounds on one side following central venous
catheter placement. Which complication should the nurse suspect?
A. Pneumothorax
B. Pulmonary edema
C. Pleural effusion from heart failure
D. Atelectasis only
Correct Answer: A
Rationale: Unilateral absent breath sounds after central-line insertion are
concerning for pneumothorax caused by pleural injury.
Q3. Which finding is most concerning after thoracentesis?
A. Oxygen saturation of 88%
B. Respiratory rate of 18/min
C. Mild soreness at the puncture site
D. Improved breathing
Correct Answer: A
Rationale: A new drop in oxygen saturation after thoracentesis can indicate
a complication such as pneumothorax and requires prompt assessment.
Q4. A patient has an open chest wound with a sucking sound. Which
intervention is appropriate?
, A. Apply a sterile occlusive dressing taped on three sides
B. Apply an occlusive dressing on all four sides immediately
C. Leave the wound completely uncovered
D. Place the patient prone
Correct Answer: A
Rationale: A three-sided occlusive dressing allows trapped air to escape
during expiration while limiting air entry during inspiration.
Q5. Which finding is characteristic of tension pneumothorax?
A. Severe respiratory distress with hypotension and unilateral absent breath
sounds
B. Bilateral crackles with hypertension
C. Bradycardia with peripheral edema
D. Productive cough without dyspnea
Correct Answer: A
Rationale: Tension pneumothorax increases intrathoracic pressure, impairs
venous return, and can cause respiratory distress, hypotension, and
unilateral absent breath sounds.
Q6. A trauma patient has absent breath sounds on the right and increasing
respiratory distress. Which intervention should the nurse anticipate?
A. Chest-tube insertion
B. Incentive spirometry
C. Oral antibiotics only
D. Fluid restriction
Correct Answer: A
Rationale: A significant pneumothorax or hemothorax commonly requires
chest-tube drainage to restore lung expansion.
Q7. A patient with acute respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. Which ventilator change may reduce the risk of
additional pressure-related lung injury?
A. Reduce excessive PEEP as prescribed
B. Increase tidal volume substantially
C. Eliminate oxygen monitoring
D. Increase airway pressure indefinitely
Answers 2026/2027 West Coast University
Q1. A patient develops sudden chest pain and dyspnea shortly after
insertion of a central venous catheter. Which assessment should the nurse
perform first?
A. Assess bilateral breath sounds
B. Administer prescribed opioid analgesia
C. Call the family
D. Encourage deep breathing
Correct Answer: A
Rationale: Sudden chest pain and dyspnea after central-line insertion may
indicate pneumothorax or another mechanical complication. Immediate
respiratory assessment helps identify deterioration.
Q2. A patient has absent breath sounds on one side following central venous
catheter placement. Which complication should the nurse suspect?
A. Pneumothorax
B. Pulmonary edema
C. Pleural effusion from heart failure
D. Atelectasis only
Correct Answer: A
Rationale: Unilateral absent breath sounds after central-line insertion are
concerning for pneumothorax caused by pleural injury.
Q3. Which finding is most concerning after thoracentesis?
A. Oxygen saturation of 88%
B. Respiratory rate of 18/min
C. Mild soreness at the puncture site
D. Improved breathing
Correct Answer: A
Rationale: A new drop in oxygen saturation after thoracentesis can indicate
a complication such as pneumothorax and requires prompt assessment.
Q4. A patient has an open chest wound with a sucking sound. Which
intervention is appropriate?
, A. Apply a sterile occlusive dressing taped on three sides
B. Apply an occlusive dressing on all four sides immediately
C. Leave the wound completely uncovered
D. Place the patient prone
Correct Answer: A
Rationale: A three-sided occlusive dressing allows trapped air to escape
during expiration while limiting air entry during inspiration.
Q5. Which finding is characteristic of tension pneumothorax?
A. Severe respiratory distress with hypotension and unilateral absent breath
sounds
B. Bilateral crackles with hypertension
C. Bradycardia with peripheral edema
D. Productive cough without dyspnea
Correct Answer: A
Rationale: Tension pneumothorax increases intrathoracic pressure, impairs
venous return, and can cause respiratory distress, hypotension, and
unilateral absent breath sounds.
Q6. A trauma patient has absent breath sounds on the right and increasing
respiratory distress. Which intervention should the nurse anticipate?
A. Chest-tube insertion
B. Incentive spirometry
C. Oral antibiotics only
D. Fluid restriction
Correct Answer: A
Rationale: A significant pneumothorax or hemothorax commonly requires
chest-tube drainage to restore lung expansion.
Q7. A patient with acute respiratory distress syndrome (ARDS) is receiving
mechanical ventilation. Which ventilator change may reduce the risk of
additional pressure-related lung injury?
A. Reduce excessive PEEP as prescribed
B. Increase tidal volume substantially
C. Eliminate oxygen monitoring
D. Increase airway pressure indefinitely
