NUR 376 COMPREHENSIVE ADVANCED
MEDICAL-SURGICAL NURSING
QUESTIONS AND ANSWERS
1. A patient in the ICU develops a sudden onset of shortness of breath and chest pain. The
ECG shows Sinus Tachycardia. The nurse suspects a Pulmonary Embolism. Which diagnostic
test is considered the gold standard for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
D. CT Angiography (CTPA)
Answer: D
Conceptual Explanation: While D-dimer and ABGs are helpful, CT Angiography is the
primary gold standard for definitive diagnosis of Pulmonary Embolism.
2. When assessing a patient with a Suspected Traumatic Brain Injury, the nurse notes a
widening pulse pressure, bradycardia, and irregular respirations. What does this clinical triad
indicate?
A. Virchow’s Triad
,B. Beck’s Triad
C. Cushing’s Triad
D. Whipple’s Triad
Answer: C
Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure (ICP).
3. A patient presents with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L. How
should the nurse interpret these ABG results?
A. Respiratory Alkalosis, fully compensated
B. Metabolic Acidosis, partially compensated
C. Respiratory Acidosis, uncompensated
D. Metabolic Alkalosis, uncompensated
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is normal, indicating no compensation has occurred yet.
4. Which hemodynamic parameter best reflects the left ventricular end-diastolic pressure
(preload) in a critically ill patient?
A. Central Venous Pressure (CVP)
B. Pulmonary Artery Wedge Pressure (PAWP)
, C. Mean Arterial Pressure (MAP)
D. Systemic Vascular Resistance (SVR)
Answer: B
Conceptual Explanation: PAWP is the most accurate reflection of left-sided heart preload.
5. A patient with Acute Renal Failure is in the diuretic phase. Which electrolyte imbalance is
the nurse most likely to monitor for?
A. Hyperkalemia and Hypernatremia
B. Hypokalemia and Hyponatremia
C. Hypercalcemia and Hypophosphatemia
D. Hypocalcemia and Hypermagnesemia
Answer: B
Conceptual Explanation: During the diuretic phase, the kidneys excrete large amounts of
water and electrolytes, leading to potential hypokalemia and hyponatremia.
6. What is the primary physiological goal of applying Positive End-Expiratory Pressure (PEEP)
in a patient with ARDS?
A. To prevent alveolar collapse and increase functional residual capacity
B. To decrease the fraction of inspired oxygen (FiO2)
C. To increase the respiratory rate and clear CO2
MEDICAL-SURGICAL NURSING
QUESTIONS AND ANSWERS
1. A patient in the ICU develops a sudden onset of shortness of breath and chest pain. The
ECG shows Sinus Tachycardia. The nurse suspects a Pulmonary Embolism. Which diagnostic
test is considered the gold standard for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. Arterial Blood Gas (ABG)
D. CT Angiography (CTPA)
Answer: D
Conceptual Explanation: While D-dimer and ABGs are helpful, CT Angiography is the
primary gold standard for definitive diagnosis of Pulmonary Embolism.
2. When assessing a patient with a Suspected Traumatic Brain Injury, the nurse notes a
widening pulse pressure, bradycardia, and irregular respirations. What does this clinical triad
indicate?
A. Virchow’s Triad
,B. Beck’s Triad
C. Cushing’s Triad
D. Whipple’s Triad
Answer: C
Conceptual Explanation: Cushing’s Triad (widening pulse pressure, bradycardia, and
irregular respirations) is a late sign of increased intracranial pressure (ICP).
3. A patient presents with a pH of 7.25, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L. How
should the nurse interpret these ABG results?
A. Respiratory Alkalosis, fully compensated
B. Metabolic Acidosis, partially compensated
C. Respiratory Acidosis, uncompensated
D. Metabolic Alkalosis, uncompensated
Answer: C
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is normal, indicating no compensation has occurred yet.
4. Which hemodynamic parameter best reflects the left ventricular end-diastolic pressure
(preload) in a critically ill patient?
A. Central Venous Pressure (CVP)
B. Pulmonary Artery Wedge Pressure (PAWP)
, C. Mean Arterial Pressure (MAP)
D. Systemic Vascular Resistance (SVR)
Answer: B
Conceptual Explanation: PAWP is the most accurate reflection of left-sided heart preload.
5. A patient with Acute Renal Failure is in the diuretic phase. Which electrolyte imbalance is
the nurse most likely to monitor for?
A. Hyperkalemia and Hypernatremia
B. Hypokalemia and Hyponatremia
C. Hypercalcemia and Hypophosphatemia
D. Hypocalcemia and Hypermagnesemia
Answer: B
Conceptual Explanation: During the diuretic phase, the kidneys excrete large amounts of
water and electrolytes, leading to potential hypokalemia and hyponatremia.
6. What is the primary physiological goal of applying Positive End-Expiratory Pressure (PEEP)
in a patient with ARDS?
A. To prevent alveolar collapse and increase functional residual capacity
B. To decrease the fraction of inspired oxygen (FiO2)
C. To increase the respiratory rate and clear CO2
