Complete Questions and Verified Answers
with Detailed Rationales Medical Surgical
Nursing II 100% Correct Grade A Pass
Guaranteed - A+ Graded
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-25)
Q1: A 58-year-old patient with hypertension is prescribed lisinopril. The nurse should monitor
for which potential adverse effect?
A. Hyperkalemia
B. Hypokalemia
C. Dry, nonproductive cough. [CORRECT]
D. Tachycardia
Correct Answer: C
Rationale: Lisinopril is an ACE inhibitor that commonly causes a dry, nonproductive cough due
to accumulation of bradykinin in the lungs (C). ACE inhibitors may cause hyperkalemia (A), not
hypokalemia (B). Tachycardia (D) is not a typical adverse effect; hypotension is more common.
Q2: A patient with stable angina reports chest pain while walking upstairs. Which action should
the nurse instruct the patient to take first?
A. Sit down and rest immediately. [CORRECT]
B. Call 911 immediately
C. Take a nitroglycerin tablet and continue walking
D. Take an aspirin tablet
Correct Answer: A
Rationale: For stable angina, the first action is to stop the activity and rest, which typically
relieves the pain within minutes (A). If pain persists after rest and nitroglycerin, then emergency
,services should be contacted. Calling 911 (B) is appropriate for unstable angina or MI.
Continuing to walk (C) is contraindicated.
Q3: A patient with an ST-elevation myocardial infarction (STEMI) arrives in the emergency
department. The nurse prepares for which priority intervention?
A. Administration of fibrinolytics within 30 minutes or PCI within 90 minutes. [CORRECT]
B. Cardiac catheterization within 24 hours
C. Administration of beta-blockers only
D. Observation and serial troponin levels
Correct Answer: A
Rationale: The goal for STEMI treatment is reperfusion therapy—either primary PCI within 90
minutes of first medical contact or fibrinolytics within 30 minutes if PCI is not available (A).
Delays increase myocardial damage and mortality.
Q4: A nurse is caring for a patient with heart failure who has been receiving furosemide 40 mg
IV daily. Which laboratory value requires immediate intervention?
A. Sodium 135 mEq/L
B. Potassium 2.8 mEq/L. [CORRECT]
C. Creatinine 1.0 mg/dL
D. Hemoglobin 12.5 g/dL
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss, leading to
hypokalemia. A potassium level of 2.8 mEq/L is critically low and increases the risk of life-
threatening dysrhythmias (B). Sodium 135 mEq/L (A) is within normal range. Creatinine 1.0
mg/dL (C) is normal. Hemoglobin 12.5 g/dL (D) is within normal range for some populations.
Q5: A patient with atrial fibrillation is prescribed warfarin. The nurse understands that the
therapeutic INR range for this patient is:
A. 1.0-1.5
B. 2.0-3.0. [CORRECT]
C. 2.5-3.5
D. 3.0-4.0
Correct Answer: B
, Rationale: For atrial fibrillation, the target INR for warfarin therapy is typically 2.0-3.0 to
prevent thromboembolic stroke while minimizing bleeding risk (B). Higher ranges (C, D) are
used for mechanical heart valves.
Q6: A patient with aortic stenosis reports dyspnea, angina, and syncope. The nurse recognizes
these as the classic triad of symptoms. Which intervention is most appropriate?
A. Encourage vigorous exercise to improve cardiac output
B. Prepare for surgical valve replacement evaluation. [CORRECT]
C. Administer vasodilators to reduce afterload
D. Increase fluid intake to improve preload
Correct Answer: B
Rationale: Dyspnea, angina, and syncope constitute the classic triad of aortic stenosis and
indicate severe disease requiring surgical intervention (B). Vigorous exercise (A) is
contraindicated due to risk of syncope and sudden death. Vasodilators (C) can cause hypotension
in aortic stenosis.
Q7: A patient with peripheral arterial disease (PAD) complains of leg pain when walking that
resolves with rest. The nurse documents this as:
A. Rest pain
B. Intermittent claudication. [CORRECT]
C. Venous insufficiency
D. Deep vein thrombosis
Correct Answer: B
Rationale: Intermittent claudication is reproducible ischemic muscle pain occurring with exercise
and relieved by rest, characteristic of PAD (B). Rest pain (A) occurs at rest and indicates severe
disease. Venous insufficiency (C) causes different symptoms (edema, stasis dermatitis).
Q8: A patient with an abdominal aortic aneurysm (AAA) suddenly develops severe back pain
and hypotension. The nurse recognizes these findings as indicative of:
A. Stable aneurysm
B. Aneurysm rupture. [CORRECT]
C. Aortic dissection only
D. Renal colic