Advanced Medical-Surgical Nursing Exam 9 Practice
Questions 2026 UPDATED ACTUAL Questions and
CORRECT Answers
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation. Which setting change is most likely to improve oxygenation by
keeping the alveoli open at the end of expiration?
A. Increasing the Respiratory Rate
B. Increasing the Positive End-Expiratory Pressure (PEEP)
C. Decreasing the Tidal Volume
D. Decreasing the Fraction of Inspired Oxygen (FiO2)
Answer: B
Rationale: PEEP provides pressure at the end of expiration to prevent alveolar collapse
and improve gas exchange in patients with ARDS.
2. Which clinical finding is considered a hallmark sign of the compensatory stage
of shock?
A. Bradycardia and hypertension
B. Metabolic acidosis and lethargy
C. Narrowed pulse pressure and cool, clammy skin
D. Anuria and peripheral edema
Answer: C
Rationale: In the compensatory stage of shock, the body attempts to maintain
homeostasis, resulting in a narrowed pulse pressure and cool skin due to peripheral
vasoconstriction.
,3. A nurse is caring for a patient with a traumatic brain injury. The patient’s
Glasgow Coma Scale (GCS) score has dropped from 10 to 7. What is the priority
nursing action?
A. Notify the family about the change in status
B. Administer a bolus of intravenous fluids
C. Re-assess the GCS in 30 minutes
D. Prepare for immediate endotracheal intubation
Answer: D
Rationale: A GCS score of 8 or less typically indicates that the patient cannot protect their
airway and requires intubation.
4. In a patient with Acute Kidney Injury (AKI), which electrolyte abnormality is
most life-threatening and requires immediate intervention?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Answer: C
Rationale: Hyperkalemia can lead to lethal cardiac dysrhythmias and is the most urgent
electrolyte concern in AKI.
5. A patient presents with muffled heart sounds, jugular venous distention, and
hypotension. The nurse recognizes these as signs of which condition?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Myocardial infarction
Answer: B
, Rationale: Beck’s triad (muffled heart sounds, JVD, and hypotension) is classic for cardiac
tamponade.
6. What is the primary goal of administering Nitroprusside to a patient in
cardiogenic shock?
A. To increase heart rate
B. To decrease preload and afterload
C. To increase myocardial contractility
D. To promote diuresis
Answer: B
Rationale: Nitroprusside is a potent vasodilator used to reduce the workload of the heart
by decreasing preload and afterload.
7. A nurse is monitoring a patient for Autonomic Dysreflexia. Which spinal cord
injury level is most associated with this complication?
A. Below T12
B. Sacral nerves
C. L1 to L5
D. T6 or higher
Answer: D
Rationale: Autonomic dysreflexia occurs in patients with spinal cord injuries at or above
the T6 level.
8. Which of the following laboratory results is most indicative of Disseminated
Intravascular Coagulation (DIC)?
A. Increased D-dimer and decreased Fibrinogen
B. Decreased D-dimer and increased Fibrinogen
C. Increased Platelets and decreased PT/PTT
D. Normal INR and decreased Hemoglobin
Answer: A
Questions 2026 UPDATED ACTUAL Questions and
CORRECT Answers
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is on mechanical
ventilation. Which setting change is most likely to improve oxygenation by
keeping the alveoli open at the end of expiration?
A. Increasing the Respiratory Rate
B. Increasing the Positive End-Expiratory Pressure (PEEP)
C. Decreasing the Tidal Volume
D. Decreasing the Fraction of Inspired Oxygen (FiO2)
Answer: B
Rationale: PEEP provides pressure at the end of expiration to prevent alveolar collapse
and improve gas exchange in patients with ARDS.
2. Which clinical finding is considered a hallmark sign of the compensatory stage
of shock?
A. Bradycardia and hypertension
B. Metabolic acidosis and lethargy
C. Narrowed pulse pressure and cool, clammy skin
D. Anuria and peripheral edema
Answer: C
Rationale: In the compensatory stage of shock, the body attempts to maintain
homeostasis, resulting in a narrowed pulse pressure and cool skin due to peripheral
vasoconstriction.
,3. A nurse is caring for a patient with a traumatic brain injury. The patient’s
Glasgow Coma Scale (GCS) score has dropped from 10 to 7. What is the priority
nursing action?
A. Notify the family about the change in status
B. Administer a bolus of intravenous fluids
C. Re-assess the GCS in 30 minutes
D. Prepare for immediate endotracheal intubation
Answer: D
Rationale: A GCS score of 8 or less typically indicates that the patient cannot protect their
airway and requires intubation.
4. In a patient with Acute Kidney Injury (AKI), which electrolyte abnormality is
most life-threatening and requires immediate intervention?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia
Answer: C
Rationale: Hyperkalemia can lead to lethal cardiac dysrhythmias and is the most urgent
electrolyte concern in AKI.
5. A patient presents with muffled heart sounds, jugular venous distention, and
hypotension. The nurse recognizes these as signs of which condition?
A. Tension pneumothorax
B. Cardiac tamponade
C. Pulmonary embolism
D. Myocardial infarction
Answer: B
, Rationale: Beck’s triad (muffled heart sounds, JVD, and hypotension) is classic for cardiac
tamponade.
6. What is the primary goal of administering Nitroprusside to a patient in
cardiogenic shock?
A. To increase heart rate
B. To decrease preload and afterload
C. To increase myocardial contractility
D. To promote diuresis
Answer: B
Rationale: Nitroprusside is a potent vasodilator used to reduce the workload of the heart
by decreasing preload and afterload.
7. A nurse is monitoring a patient for Autonomic Dysreflexia. Which spinal cord
injury level is most associated with this complication?
A. Below T12
B. Sacral nerves
C. L1 to L5
D. T6 or higher
Answer: D
Rationale: Autonomic dysreflexia occurs in patients with spinal cord injuries at or above
the T6 level.
8. Which of the following laboratory results is most indicative of Disseminated
Intravascular Coagulation (DIC)?
A. Increased D-dimer and decreased Fibrinogen
B. Decreased D-dimer and increased Fibrinogen
C. Increased Platelets and decreased PT/PTT
D. Normal INR and decreased Hemoglobin
Answer: A
