Advanced Medical-Surgical Nursing Exam 4 Practice 2026
|Galen College UPDATED ACTUAL Questions and CORRECT
Answers
1. A patient with atrial fibrillation is at high risk for which of the following
complications?
A. Ventricular Tachycardia
B. Ischemic Stroke
C. Pulmonary Hypertension
D. Cardiac Tamponade
Answer: B
Rationale: Atrial fibrillation causes blood to pool in the atria, increasing the risk of
thrombus formation which can embolize to the brain, causing a stroke.
2. Which rhythm is characterized by a ‘sawtooth’ pattern on the EKG?
A. Atrial Fibrillation
B. Atrial Flutter
C. Ventricular Fibrillation
D. Sinus Tachycardia
Answer: B
Rationale: Atrial flutter is classically identified by the presence of ‘F’ waves that look like a
sawtooth pattern.
,3. A nurse identifies a patient is in Ventricular Fibrillation. What is the priority
action?
A. Administer Epinephrine
B. Defibrillate immediately
C. Perform Synchronized Cardioversion
D. Administer Amiodarone
Answer: B
Rationale: For pulseless ventricular fibrillation, immediate defibrillation is the most
effective treatment to restore a perfusing rhythm.
4. In First-Degree Heart Block, what is the defining EKG characteristic?
A. Dropped QRS complexes
B. PR interval greater than 0.20 seconds
C. Inverted T waves
D. Variable PR intervals
Answer: B
Rationale: First-degree heart block is defined by a consistent delay in conduction through
the AV node, resulting in a PR interval >0.20s.
5. Which type of shock is characterized by bradycardia and hypotension?
A. Hypovolemic Shock
B. Neurogenic Shock
C. Septic Shock
D. Anaphylactic Shock
Answer: B
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to
vasodilation and bradycardia, unlike other forms of shock.
, 6. What is the primary pathophysiology of ARDS?
A. Decreased cardiac output leading to pulmonary edema
B. Bronchospasm and airway constriction
C. Increased alveolar-capillary membrane permeability
D. Obstruction of the pulmonary artery
Answer: C
Rationale: ARDS is characterized by damage to the alveolar-capillary membrane, leading
to non-cardiogenic pulmonary edema and severe hypoxia.
7. The nurse notes the high-pressure alarm sounding on a mechanical ventilator.
What is a possible cause?
A. Patient biting the ET tube
B. Cuff leak in the ET tube
C. Disconnection of the tubing
D. Extubation
Answer: A
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
kinking of the tube, or the patient biting the tube.
8. Which lab value is most critical to monitor for a patient receiving Gentamicin?
A. Serum Potassium
B. Creatinine and BUN
C. Alanine Aminotransferase (ALT)
D. Prothrombin Time
Answer: B
Rationale: Gentamicin is an aminoglycoside which is nephrotoxic; monitoring renal
function (BUN/Creatinine) is essential.
|Galen College UPDATED ACTUAL Questions and CORRECT
Answers
1. A patient with atrial fibrillation is at high risk for which of the following
complications?
A. Ventricular Tachycardia
B. Ischemic Stroke
C. Pulmonary Hypertension
D. Cardiac Tamponade
Answer: B
Rationale: Atrial fibrillation causes blood to pool in the atria, increasing the risk of
thrombus formation which can embolize to the brain, causing a stroke.
2. Which rhythm is characterized by a ‘sawtooth’ pattern on the EKG?
A. Atrial Fibrillation
B. Atrial Flutter
C. Ventricular Fibrillation
D. Sinus Tachycardia
Answer: B
Rationale: Atrial flutter is classically identified by the presence of ‘F’ waves that look like a
sawtooth pattern.
,3. A nurse identifies a patient is in Ventricular Fibrillation. What is the priority
action?
A. Administer Epinephrine
B. Defibrillate immediately
C. Perform Synchronized Cardioversion
D. Administer Amiodarone
Answer: B
Rationale: For pulseless ventricular fibrillation, immediate defibrillation is the most
effective treatment to restore a perfusing rhythm.
4. In First-Degree Heart Block, what is the defining EKG characteristic?
A. Dropped QRS complexes
B. PR interval greater than 0.20 seconds
C. Inverted T waves
D. Variable PR intervals
Answer: B
Rationale: First-degree heart block is defined by a consistent delay in conduction through
the AV node, resulting in a PR interval >0.20s.
5. Which type of shock is characterized by bradycardia and hypotension?
A. Hypovolemic Shock
B. Neurogenic Shock
C. Septic Shock
D. Anaphylactic Shock
Answer: B
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to
vasodilation and bradycardia, unlike other forms of shock.
, 6. What is the primary pathophysiology of ARDS?
A. Decreased cardiac output leading to pulmonary edema
B. Bronchospasm and airway constriction
C. Increased alveolar-capillary membrane permeability
D. Obstruction of the pulmonary artery
Answer: C
Rationale: ARDS is characterized by damage to the alveolar-capillary membrane, leading
to non-cardiogenic pulmonary edema and severe hypoxia.
7. The nurse notes the high-pressure alarm sounding on a mechanical ventilator.
What is a possible cause?
A. Patient biting the ET tube
B. Cuff leak in the ET tube
C. Disconnection of the tubing
D. Extubation
Answer: A
Rationale: High-pressure alarms are triggered by increased resistance, such as secretions,
kinking of the tube, or the patient biting the tube.
8. Which lab value is most critical to monitor for a patient receiving Gentamicin?
A. Serum Potassium
B. Creatinine and BUN
C. Alanine Aminotransferase (ALT)
D. Prothrombin Time
Answer: B
Rationale: Gentamicin is an aminoglycoside which is nephrotoxic; monitoring renal
function (BUN/Creatinine) is essential.
