West Coast University NURS 480 / NURS480 Final Exam Advanced
Medical Surgical Nursing | Questions with Answers | Advanced
Med-Surg Nursing – West Coast University (2025/2026) | Graded
A+ Study Guide
1. A nurse is caring for a client who came to the ED reporting chest pain. The
provider may order a chest x-ray to rule out a myocardial infarction. While waiting for
the troponin levels report, the client asks, "What is the normal range for troponin
levels?" Which action is correct?
• A. Troponin is a protein found only in skeletal muscle
• B. Troponin is a heart muscle protein that appears in the bloodstream when
there is damage to the heart muscle
• C. Troponin levels are not used to diagnose myocardial infarction
• D. Troponin is only elevated in patients with kidney disease
Answer: B
2. A nurse is caring for a client who reports a new onset of severe chest pain. Which
actions should the nurse take to determine if the client is experiencing a myocardial
infarction?
• A. Administer oxygen
• B. Draw blood for cardiac enzymes
• C. Perform a 12-lead ECG
• D. Administer sublingual nitroglycerin
Answer: C
3. A patient who is recovering from an acute myocardial infarction (AMI) asks the
nurse to increase the rate of IV fluid infusion. Which action is correct?
• A. Increase the IV fluid rate to improve perfusion
• B. Administer a bolus of normal saline
• C. Sexual activity uses about as much energy as climbing two flights of stairs
, • D. Limit activity to bed rest for 48 hours
Answer: C
4. The patient is admitted with acute coronary syndrome (ACS). The ECG shows ST-
segment depression and T-wave inversion. What should the nurse know that this
indicates?
• A. Myocardial ischemia
• B. Myocardial injury
• C. Myocardial infarction
• D. Normal ECG findings
Answer: A
5. A client who has a history of myocardial infarction (MI) is prescribed aspirin 325
mg daily. The nurse recognizes that the aspirin is given due to which of the following
actions of the medication?
• A. Anti-inflammatory
• B. Analgesic
• C. Antiplatelet aggregate
• D. Antipyretic
Answer: C
6. A nurse is caring for a client with a ventricular pacemaker who is on ECG
monitoring. The nurse understands that the pacemaker is functioning properly when
which of the following appears?
• A. Wide QRS complexes
• B. Pacemaker spikes before each QRS complex
• C. Pacemaker spikes after each QRS complex
• D. Absent P waves
Answer: B
7. A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic, and
has a pulse pressure of 20 mm Hg. Which of the following is correct?
, • A. The patient is in a state of compensated shock
• B. The patient is in a state of uncompensated shock
• C. The patient is in a state of decompensated shock
• D. The patient is in a state of compensated shock
Answer: B
8. The nursing student is asked to demonstrate the Allen test on a fellow student.
Which best describes the Allen test?
• A. Test used to determine patency of the radial and ulnar arteries
• B. Test used to determine patency of the brachial artery
• C. Test used to determine patency of the femoral artery
• D. Test used to determine patency of the carotid artery
Answer: A
9. A patient who is recovering from an acute myocardial infarction (AMI) asks the
nurse about sexual activity. Which response is correct?
• A. Sexual activity should be avoided permanently
• B. Sexual activity uses about as much energy as climbing two flights of stairs
• C. Sexual activity uses more energy than climbing two flights of stairs
• D. Sexual activity uses less energy than climbing two flights of stairs
Answer: B
10. Which finding by the nurse caring for a patient with a right radial arterial line
indicates a need for the nurse to take immediate action?
• A. The right hand feels warmer than the left hand
• B. The right hand feels cooler than the left hand
• C. Capillary refill is less than 2 seconds
• D. Pulse oximetry is 98%
Answer: B
, 11. A nurse is caring for a client who has a recently placed central venous catheter
and hears a gurgling sound on the side of the catheter insertion. Which of the
following should the nurse suspect?
• A. Catheter occlusion
• B. Catheter migration
• C. Catheter infection
• D. Catheter irrigation
Answer: D
12. What is the purpose of administering protamine sulfate?
• A. To reverse the effects of heparin
• B. To enhance the effects of heparin
• C. To reverse the effects of warfarin
• D. To enhance the effects of warfarin
Answer: A
13. A nurse is caring for a client with heart failure. Which of the following findings
indicates worsening of the condition?
• A. Decreased jugular venous distension
• B. Weight loss
• C. Increased dyspnea and crackles
• D. Increased urine output
Answer: C
14. Which of the following is a classic sign of left-sided heart failure?
• A. Peripheral edema
• B. Jugular venous distension
• C. Pulmonary congestion (crackles, dyspnea)
• D. Hepatomegaly
Medical Surgical Nursing | Questions with Answers | Advanced
Med-Surg Nursing – West Coast University (2025/2026) | Graded
A+ Study Guide
1. A nurse is caring for a client who came to the ED reporting chest pain. The
provider may order a chest x-ray to rule out a myocardial infarction. While waiting for
the troponin levels report, the client asks, "What is the normal range for troponin
levels?" Which action is correct?
• A. Troponin is a protein found only in skeletal muscle
• B. Troponin is a heart muscle protein that appears in the bloodstream when
there is damage to the heart muscle
• C. Troponin levels are not used to diagnose myocardial infarction
• D. Troponin is only elevated in patients with kidney disease
Answer: B
2. A nurse is caring for a client who reports a new onset of severe chest pain. Which
actions should the nurse take to determine if the client is experiencing a myocardial
infarction?
• A. Administer oxygen
• B. Draw blood for cardiac enzymes
• C. Perform a 12-lead ECG
• D. Administer sublingual nitroglycerin
Answer: C
3. A patient who is recovering from an acute myocardial infarction (AMI) asks the
nurse to increase the rate of IV fluid infusion. Which action is correct?
• A. Increase the IV fluid rate to improve perfusion
• B. Administer a bolus of normal saline
• C. Sexual activity uses about as much energy as climbing two flights of stairs
, • D. Limit activity to bed rest for 48 hours
Answer: C
4. The patient is admitted with acute coronary syndrome (ACS). The ECG shows ST-
segment depression and T-wave inversion. What should the nurse know that this
indicates?
• A. Myocardial ischemia
• B. Myocardial injury
• C. Myocardial infarction
• D. Normal ECG findings
Answer: A
5. A client who has a history of myocardial infarction (MI) is prescribed aspirin 325
mg daily. The nurse recognizes that the aspirin is given due to which of the following
actions of the medication?
• A. Anti-inflammatory
• B. Analgesic
• C. Antiplatelet aggregate
• D. Antipyretic
Answer: C
6. A nurse is caring for a client with a ventricular pacemaker who is on ECG
monitoring. The nurse understands that the pacemaker is functioning properly when
which of the following appears?
• A. Wide QRS complexes
• B. Pacemaker spikes before each QRS complex
• C. Pacemaker spikes after each QRS complex
• D. Absent P waves
Answer: B
7. A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic, and
has a pulse pressure of 20 mm Hg. Which of the following is correct?
, • A. The patient is in a state of compensated shock
• B. The patient is in a state of uncompensated shock
• C. The patient is in a state of decompensated shock
• D. The patient is in a state of compensated shock
Answer: B
8. The nursing student is asked to demonstrate the Allen test on a fellow student.
Which best describes the Allen test?
• A. Test used to determine patency of the radial and ulnar arteries
• B. Test used to determine patency of the brachial artery
• C. Test used to determine patency of the femoral artery
• D. Test used to determine patency of the carotid artery
Answer: A
9. A patient who is recovering from an acute myocardial infarction (AMI) asks the
nurse about sexual activity. Which response is correct?
• A. Sexual activity should be avoided permanently
• B. Sexual activity uses about as much energy as climbing two flights of stairs
• C. Sexual activity uses more energy than climbing two flights of stairs
• D. Sexual activity uses less energy than climbing two flights of stairs
Answer: B
10. Which finding by the nurse caring for a patient with a right radial arterial line
indicates a need for the nurse to take immediate action?
• A. The right hand feels warmer than the left hand
• B. The right hand feels cooler than the left hand
• C. Capillary refill is less than 2 seconds
• D. Pulse oximetry is 98%
Answer: B
, 11. A nurse is caring for a client who has a recently placed central venous catheter
and hears a gurgling sound on the side of the catheter insertion. Which of the
following should the nurse suspect?
• A. Catheter occlusion
• B. Catheter migration
• C. Catheter infection
• D. Catheter irrigation
Answer: D
12. What is the purpose of administering protamine sulfate?
• A. To reverse the effects of heparin
• B. To enhance the effects of heparin
• C. To reverse the effects of warfarin
• D. To enhance the effects of warfarin
Answer: A
13. A nurse is caring for a client with heart failure. Which of the following findings
indicates worsening of the condition?
• A. Decreased jugular venous distension
• B. Weight loss
• C. Increased dyspnea and crackles
• D. Increased urine output
Answer: C
14. Which of the following is a classic sign of left-sided heart failure?
• A. Peripheral edema
• B. Jugular venous distension
• C. Pulmonary congestion (crackles, dyspnea)
• D. Hepatomegaly
