NH N480 Exam 2 V2 – Advanced Medical Surgical Nursing 2… 2026 Update • Verified Answers
✓ VERIFIED • 2026 UPDATE • 100% ACCURATE
NH N480 Exam 2 V2 – Advanced Medical Surgical
Nursing 2026 UPDATE
Actual Exam Questions & Verified Answers
with Detailed Rationales
Document Type: Exam (Elaborations)
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Full Rationales
Status: Verified & Updated for 2026
Exam (Elaborations) • Actual Questions & Rationales Page 1
,NH N480 Exam 2 V2 – Advanced Medical Surgical Nursing 2… 2026 Update • Verified Answers
Questions & Verified Answers
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mm Hg, and HCO3 26
mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a respiratory cause. Since
the HCO3 is within the normal range, it is uncompensated respiratory acidosis. Applying this knowledge in
clinical settings supports safe, evidence-based practice and improves patient outcomes.
2. Which clinical manifestation is a hallmark sign of Acute Respiratory Distress Syndrome
(ARDS)?
A. Bradypnea
B. Increased lung compliance
C. Refractory hypoxemia
D. Decreased pulmonary artery wedge pressure
Answer: C
Rationale: Refractory hypoxemia, where oxygen levels do not improve even with high concentrations of
supplemental oxygen, is a classic sign of ARDS. Exam questions often test the ability to distinguish this
concept from closely related distractors, making a clear rationale essential for mastery. Applying this knowledge
in clinical settings supports safe, evidence-based practice and improves patient outcomes.
3. The nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Check for a leak in the ventilator tubing
B. Assess the patient for the need for suctioning
C. Increase the oxygen concentration to 100%
D. Call the respiratory therapist immediately
Answer: B
Rationale: High-pressure alarms are often caused by obstructions like secretions, biting the tube, or kinks.
Suctioning the patient addresses one of the most common physiological causes. Exam questions often test the
ability to distinguish this concept from closely related distractors, making a clear rationale essential for mastery.
Exam (Elaborations) • Actual Questions & Rationales Page 2
, NH N480 Exam 2 V2 – Advanced Medical Surgical Nursing 2… 2026 Update • Verified Answers
4. In the early stages of septic shock (hyperdynamic phase), the nurse expects to find which
hemodynamic profile?
A. Increased cardiac output and decreased SVR
B. Decreased cardiac output and increased SVR
C. Decreased cardiac output and decreased SVR
D. Normal cardiac output and normal SVR
Answer: A
Rationale: Early septic shock is characterized by vasodilation (low SVR) and a compensatory increase in
cardiac output (hyperdynamic state). Exam questions often test the ability to distinguish this concept from
closely related distractors, making a clear rationale essential for mastery. Applying this knowledge in clinical
settings supports safe, evidence-based practice and improves patient outcomes.
5. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure (PAWP)
of 22 mm Hg. Which condition does the nurse suspect?
A. Hypovolemic shock
B. Left-sided heart failure
C. Dehydration
D. Septic shock
Answer: B
Rationale: Normal PAWP is 4-12 mm Hg. An elevated PAWP (22 mm Hg) indicates fluid volume overload or
left ventricular failure. This is an important clinical concept because selecting the correct answer (B) requires
understanding both the pathophysiology and the practical nursing implications. Recognizing this principle
allows the nurse to prioritize care, anticipate complications, and provide accurate patient education.
6. Which medication is considered the first-line treatment for a patient in Ventricular Fibrillation
(VF) who is unresponsive to the first shock?
A. Epinephrine
B. Atropine
C. Adenosine
D. Digoxin
Answer: A
Rationale: According to ACLS guidelines, Epinephrine is administered for pulseless rhythms like VF after the
initial defibrillation attempts have failed. Applying this knowledge in clinical settings supports safe,
evidence-based practice and improves patient outcomes. This is an important clinical concept because
selecting the correct answer (A) requires understanding both the pathophysiology and the practical nursing
implications.
Exam (Elaborations) • Actual Questions & Rationales Page 3
✓ VERIFIED • 2026 UPDATE • 100% ACCURATE
NH N480 Exam 2 V2 – Advanced Medical Surgical
Nursing 2026 UPDATE
Actual Exam Questions & Verified Answers
with Detailed Rationales
Document Type: Exam (Elaborations)
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Full Rationales
Status: Verified & Updated for 2026
Exam (Elaborations) • Actual Questions & Rationales Page 1
,NH N480 Exam 2 V2 – Advanced Medical Surgical Nursing 2… 2026 Update • Verified Answers
Questions & Verified Answers
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mm Hg, and HCO3 26
mEq/L. How should the nurse interpret these findings?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mm Hg indicates a respiratory cause. Since
the HCO3 is within the normal range, it is uncompensated respiratory acidosis. Applying this knowledge in
clinical settings supports safe, evidence-based practice and improves patient outcomes.
2. Which clinical manifestation is a hallmark sign of Acute Respiratory Distress Syndrome
(ARDS)?
A. Bradypnea
B. Increased lung compliance
C. Refractory hypoxemia
D. Decreased pulmonary artery wedge pressure
Answer: C
Rationale: Refractory hypoxemia, where oxygen levels do not improve even with high concentrations of
supplemental oxygen, is a classic sign of ARDS. Exam questions often test the ability to distinguish this
concept from closely related distractors, making a clear rationale essential for mastery. Applying this knowledge
in clinical settings supports safe, evidence-based practice and improves patient outcomes.
3. The nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Check for a leak in the ventilator tubing
B. Assess the patient for the need for suctioning
C. Increase the oxygen concentration to 100%
D. Call the respiratory therapist immediately
Answer: B
Rationale: High-pressure alarms are often caused by obstructions like secretions, biting the tube, or kinks.
Suctioning the patient addresses one of the most common physiological causes. Exam questions often test the
ability to distinguish this concept from closely related distractors, making a clear rationale essential for mastery.
Exam (Elaborations) • Actual Questions & Rationales Page 2
, NH N480 Exam 2 V2 – Advanced Medical Surgical Nursing 2… 2026 Update • Verified Answers
4. In the early stages of septic shock (hyperdynamic phase), the nurse expects to find which
hemodynamic profile?
A. Increased cardiac output and decreased SVR
B. Decreased cardiac output and increased SVR
C. Decreased cardiac output and decreased SVR
D. Normal cardiac output and normal SVR
Answer: A
Rationale: Early septic shock is characterized by vasodilation (low SVR) and a compensatory increase in
cardiac output (hyperdynamic state). Exam questions often test the ability to distinguish this concept from
closely related distractors, making a clear rationale essential for mastery. Applying this knowledge in clinical
settings supports safe, evidence-based practice and improves patient outcomes.
5. A patient with a pulmonary artery catheter has a Pulmonary Artery Wedge Pressure (PAWP)
of 22 mm Hg. Which condition does the nurse suspect?
A. Hypovolemic shock
B. Left-sided heart failure
C. Dehydration
D. Septic shock
Answer: B
Rationale: Normal PAWP is 4-12 mm Hg. An elevated PAWP (22 mm Hg) indicates fluid volume overload or
left ventricular failure. This is an important clinical concept because selecting the correct answer (B) requires
understanding both the pathophysiology and the practical nursing implications. Recognizing this principle
allows the nurse to prioritize care, anticipate complications, and provide accurate patient education.
6. Which medication is considered the first-line treatment for a patient in Ventricular Fibrillation
(VF) who is unresponsive to the first shock?
A. Epinephrine
B. Atropine
C. Adenosine
D. Digoxin
Answer: A
Rationale: According to ACLS guidelines, Epinephrine is administered for pulseless rhythms like VF after the
initial defibrillation attempts have failed. Applying this knowledge in clinical settings supports safe,
evidence-based practice and improves patient outcomes. This is an important clinical concept because
selecting the correct answer (A) requires understanding both the pathophysiology and the practical nursing
implications.
Exam (Elaborations) • Actual Questions & Rationales Page 3
