RN Adult Medical–Surgical Comprehensive Case Study Exam
RN Adult Medical–Surgical Comprehensive
Case Study Exam-Verified Questions And
Answers With Rationales For Grade A+
CASE STUDY 1: Acute Myocardial Infarction
A 62-year-old male presents to the ED with chest pressure radiating to the left arm. He is
diaphoretic and nauseated. BP 158/92, HR 104, RR 22, SpO₂ 94%.
1. What is the nurse’s priority action?
A. Obtain full history
B. Apply oxygen
C. Administer morphine
D. Obtain 12-lead ECG
Answer: D
Rationale: Early ECG confirms STEMI and guides treatment.
2. Which lab confirms myocardial injury?
A. BNP
B. CK-MB
C. Troponin I
D. Myoglobin
Answer: C
3. The nurse administers aspirin. The purpose is to:
A. Relieve pain
B. Reduce clot formation
1|Page
,RN Adult Medical–Surgical Comprehensive Case Study Exam
C. Lower BP
D. Improve oxygenation
Answer: B
4. Which finding requires immediate reporting?
A. HR 98
B. ST elevation
C. Nausea
D. BP 150/88
Answer: B
5. The provider orders nitroglycerin. The nurse should monitor for:
A. Hypertension
B. Hypotension
C. Hyperkalemia
D. Bradycardia
Answer: B
6. After PCI, which assessment is priority?
A. Lung sounds
B. Urine output
C. Pedal pulses
D. Bowel sounds
Answer: C
7. The client develops ventricular tachycardia. First action?
A. Call family
B. Defibrillate
2|Page
, RN Adult Medical–Surgical Comprehensive Case Study Exam
C. Administer aspirin
D. Check glucose
Answer: B
8. Which discharge teaching is essential? (SATA)
9. BNP is elevated. This indicates:
A. Renal failure
B. Heart failure
C. Infection
D. Stroke
Answer: B
10. The nurse delegates ambulation to UAP. This is appropriate because the
client is:
A. Unstable
B. Newly admitted
C. Hemodynamically stable
D. On IV vasopressors
Answer: C
CASE STUDY 2: COPD Exacerbation
A 70-year-old female with COPD presents with dyspnea and productive cough. SpO₂ 86%.
11. Priority action?
A. Antibiotics
B. Low-flow oxygen
C. Chest X-ray
D. ABG
Answer: B
3|Page
RN Adult Medical–Surgical Comprehensive
Case Study Exam-Verified Questions And
Answers With Rationales For Grade A+
CASE STUDY 1: Acute Myocardial Infarction
A 62-year-old male presents to the ED with chest pressure radiating to the left arm. He is
diaphoretic and nauseated. BP 158/92, HR 104, RR 22, SpO₂ 94%.
1. What is the nurse’s priority action?
A. Obtain full history
B. Apply oxygen
C. Administer morphine
D. Obtain 12-lead ECG
Answer: D
Rationale: Early ECG confirms STEMI and guides treatment.
2. Which lab confirms myocardial injury?
A. BNP
B. CK-MB
C. Troponin I
D. Myoglobin
Answer: C
3. The nurse administers aspirin. The purpose is to:
A. Relieve pain
B. Reduce clot formation
1|Page
,RN Adult Medical–Surgical Comprehensive Case Study Exam
C. Lower BP
D. Improve oxygenation
Answer: B
4. Which finding requires immediate reporting?
A. HR 98
B. ST elevation
C. Nausea
D. BP 150/88
Answer: B
5. The provider orders nitroglycerin. The nurse should monitor for:
A. Hypertension
B. Hypotension
C. Hyperkalemia
D. Bradycardia
Answer: B
6. After PCI, which assessment is priority?
A. Lung sounds
B. Urine output
C. Pedal pulses
D. Bowel sounds
Answer: C
7. The client develops ventricular tachycardia. First action?
A. Call family
B. Defibrillate
2|Page
, RN Adult Medical–Surgical Comprehensive Case Study Exam
C. Administer aspirin
D. Check glucose
Answer: B
8. Which discharge teaching is essential? (SATA)
9. BNP is elevated. This indicates:
A. Renal failure
B. Heart failure
C. Infection
D. Stroke
Answer: B
10. The nurse delegates ambulation to UAP. This is appropriate because the
client is:
A. Unstable
B. Newly admitted
C. Hemodynamically stable
D. On IV vasopressors
Answer: C
CASE STUDY 2: COPD Exacerbation
A 70-year-old female with COPD presents with dyspnea and productive cough. SpO₂ 86%.
11. Priority action?
A. Antibiotics
B. Low-flow oxygen
C. Chest X-ray
D. ABG
Answer: B
3|Page
