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DOC_RED · SOLUTIONS GUIDE / Comprehensive Practice Exam
Medical-Surgical Nursing Solutions ···
Guide
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108-Question Clinical Comprehensive Practice ExamAnswer Explanations
with Comprehensive
Cardiac, Respiratory, Renal, Neurological, GI & Endocrine Disorders
Neuron Structure Questions: 108 unique Q&A pairs
Subject: Medical-Surgical Nursing
Format: PDF · High-Yield Study Document
Year: Academic Series
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MEDICAL-SURGICAL NURSING SOLUTIONS GUIDE
TABLE OF CONTENTS·
Section 1: Chapter 1: Cardiac Disorders
Section 2: Chapter 2: Respiratory Disorders
Section 3: Chapter 3: Renal Disorders
Section 4: Chapter 4: Neurological Disorders
Section 5: Chapter 5: GI and Hepatic Disorders
Section 6: Chapter 6: Endocrine Disorders
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PART I · PRACTICE QUESTIONS (108 Questions)
Chapter 1: Cardiac Disorders
Q1.
A patient presents with crushing substernal chest pain radiating to the left arm,
diaphoresis, and nausea. The 12-lead ECG shows ST elevation in leads II, III, and aVF. Which
coronary artery is most likely occluded?
A) Left anterior descending artery
B) Right coronary artery
C) Left circumflex artery
D) Left main coronary artery
Q2.
A patient with acute MI is prescribed nitroglycerin SL. Before administering, the nurse
checks BP which is 88/52 mmHg. What is the correct action?
A) Give the nitroglycerin as ordered
B) Hold nitroglycerin and notify provider · hypotension is a contraindication
C) Give half the dose
D) Administer IV nitroglycerin instead
Q3.
Which finding on a telemetry strip indicates the most immediately life-threatening
dysrhythmia requiring defibrillation?
A) Atrial fibrillation with ventricular rate 88 bpm
B) Ventricular fibrillation
C) First-degree AV block
D) Sinus bradycardia at 52 bpm
Q4.
A patient with chronic heart failure is prescribed furosemide 40 mg IV daily. Which
assessment finding indicates a therapeutic response?
A) Blood pressure decreased from 150/90 to 120/75
B) Urine output increased to 800 mL in 2 hours after administration
C) Heart rate decreased from 100 to 78 bpm
D) Serum sodium increased from 132 to 138 mEq/L
Q5.
A patient with new-onset atrial fibrillation has a ventricular rate of 148 bpm and is
hemodynamically stable. Which medication would the nurse expect to administer first?
A) Atropine 0.5 mg IV
B) Diltiazem IV for rate control
C) Amiodarone 150 mg IV
D) Digoxin 0.5 mg IV
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Q6.
A patient with heart failure has: BP 90/60, HR 118, SpO2 88%, JVD, bilateral crackles, 3+
pitting edema. What position should the nurse use?
A) Supine with legs elevated
B) High Fowler's position (60-90 degrees)
C) Left lateral decubitus
D) Trendelenburg position
Q7.
Which daily assessment is the most sensitive early indicator of fluid retention in a patient
with chronic heart failure?
A) Blood pressure measurement
B) Daily weight at the same time each morning
C) Lung auscultation for crackles
D) Urine output measurement
Q8.
A patient post-CABG surgery is on telemetry. The nurse notes regular atrial activity at 300
bpm with a 2:1 block producing ventricular rate of 150 bpm. What rhythm is this?
A) Atrial fibrillation
B) Atrial flutter with 2:1 block
C) Supraventricular tachycardia
D) Ventricular tachycardia
Q9.
A patient with hypertensive crisis has BP 228/130 mmHg with headache and visual changes.
What is the goal for BP reduction in the first hour?
A) Lower BP to normal (120/80) as quickly as possible
B) Reduce MAP by no more than 25% in the first hour
C) Reduce SBP to below 180 immediately
D) Maintain BP at current level and reassess in 2 hours
Q10.
A patient with an MI is started on heparin infusion. Six hours later aPTT returns at 180
seconds (therapeutic: 60-100). What is the appropriate action?
A) Continue infusion at current rate
B) Decrease the heparin rate per protocol and recheck aPTT in 6 hours
C) Stop infusion immediately and give protamine sulfate
D) Increase the infusion rate
Q11.
A patient develops sudden onset severe dyspnea, hypoxia, and a new loud holosystolic murmur
3 days after an anterior MI. What complication does the nurse suspect?
A) Pericarditis
B) Ventricular septal rupture
C) Right ventricular infarction
D) Pulmonary embolism
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