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NH N480 Exam 1 – Advanced Medical Surgical Nursing
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
JUST RELEASED
NH N480 Exam 1 – Advanced Medical Surgical Nursing
(With Answers & Rationales)
1. A nurse is assessing a client with a suspected pleural effusion. Which assessment finding would
indicate a pleural effusion?
A) Clear lung sounds on both sides
B) Diminished breath sounds on the affected side
C) Increased tactile fremitus on the affected side
D) Hyperresonant percussion note on the affected side
Answer: B – Pleural effusion causes diminished or absent breath sounds over the affected area due to
fluid accumulation. Tactile fremitus is decreased, and percussion is dull, not hyperresonant.
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2. A nurse is caring for a patient with a pneumothorax and a chest tube. Which task is appropriate to
delegate to an LPN?
A) Assessing the patient's respiratory status and documenting findings
B) Administering pain medication as prescribed
C) Teaching the patient about the purpose of the chest tube
D) Changing the chest tube drainage system
Answer: B – Administering pain medication (within the LPN scope of practice) is appropriate.
Assessment, teaching, and changing the chest tube drainage system are RN responsibilities.
3. A nurse has been assigned to check the emergency crash cart on the unit. Which is a correct step for
this process?
A) Restock the cart with extra supplies that may be needed during the shift
B) Check the cart only if it does not interfere with patient care
C) Perform a detailed inspection of the cart once a week
D) Verify that all supplies and medications are within their expiration dates
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Answer: D – Verifying expiration dates is a critical safety step for crash cart checks. Restocking and
inspections are also part of the process, but checking expiration dates is specifically listed as a correct
action.
4. The nurse is caring for a patient who was given succinylcholine for intubation. The patient develops a
spike in temperature and muscle rigidity. Which medication would the nurse prepare to administer?
A) Flumazenil
B) Neostigmine
C) Rocuronium
D) Dantrolene
Answer: D – The patient is exhibiting signs of malignant hyperthermia, a life-threatening reaction to
succinylcholine. Dantrolene is the specific antidote.
5. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which abnormality on the
client's EKG should the nurse interpret as a sign of hypokalemia?
A) Abnormally prominent U wave
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B) Elevated ST segment
C) Wide QRS
D) Inverted P wave
Answer: A – Prominent U waves are a classic EKG finding in hypokalemia. Prolonged vomiting causes
potassium loss, leading to this electrolyte imbalance.
6. The nurse is monitoring a telemetry strip showing regular wide QRS complexes without visible P
waves, occurring at a rate of 180/min. The patient is unresponsive and pulseless. Which action should
the nurse take first?
A) Administer amiodarone IV push
B) Begin CPR
C) Prepare for synchronized cardioversion
D) Defibrillate the patient
Answer: B – The rhythm is pulseless ventricular tachycardia. CPR should be started immediately while
preparing for defibrillation. Defibrillation is the definitive treatment, but CPR is the priority first action.
NH N480 Exam 1 – Advanced Medical Surgical Nursing
QUESTIONS AND VERIFIED ANSWERS WITH RATIONALES
JUST RELEASED
NH N480 Exam 1 – Advanced Medical Surgical Nursing
(With Answers & Rationales)
1. A nurse is assessing a client with a suspected pleural effusion. Which assessment finding would
indicate a pleural effusion?
A) Clear lung sounds on both sides
B) Diminished breath sounds on the affected side
C) Increased tactile fremitus on the affected side
D) Hyperresonant percussion note on the affected side
Answer: B – Pleural effusion causes diminished or absent breath sounds over the affected area due to
fluid accumulation. Tactile fremitus is decreased, and percussion is dull, not hyperresonant.
, Page 2 of 143
2. A nurse is caring for a patient with a pneumothorax and a chest tube. Which task is appropriate to
delegate to an LPN?
A) Assessing the patient's respiratory status and documenting findings
B) Administering pain medication as prescribed
C) Teaching the patient about the purpose of the chest tube
D) Changing the chest tube drainage system
Answer: B – Administering pain medication (within the LPN scope of practice) is appropriate.
Assessment, teaching, and changing the chest tube drainage system are RN responsibilities.
3. A nurse has been assigned to check the emergency crash cart on the unit. Which is a correct step for
this process?
A) Restock the cart with extra supplies that may be needed during the shift
B) Check the cart only if it does not interfere with patient care
C) Perform a detailed inspection of the cart once a week
D) Verify that all supplies and medications are within their expiration dates
, Page 3 of 143
Answer: D – Verifying expiration dates is a critical safety step for crash cart checks. Restocking and
inspections are also part of the process, but checking expiration dates is specifically listed as a correct
action.
4. The nurse is caring for a patient who was given succinylcholine for intubation. The patient develops a
spike in temperature and muscle rigidity. Which medication would the nurse prepare to administer?
A) Flumazenil
B) Neostigmine
C) Rocuronium
D) Dantrolene
Answer: D – The patient is exhibiting signs of malignant hyperthermia, a life-threatening reaction to
succinylcholine. Dantrolene is the specific antidote.
5. A nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which abnormality on the
client's EKG should the nurse interpret as a sign of hypokalemia?
A) Abnormally prominent U wave
, Page 4 of 143
B) Elevated ST segment
C) Wide QRS
D) Inverted P wave
Answer: A – Prominent U waves are a classic EKG finding in hypokalemia. Prolonged vomiting causes
potassium loss, leading to this electrolyte imbalance.
6. The nurse is monitoring a telemetry strip showing regular wide QRS complexes without visible P
waves, occurring at a rate of 180/min. The patient is unresponsive and pulseless. Which action should
the nurse take first?
A) Administer amiodarone IV push
B) Begin CPR
C) Prepare for synchronized cardioversion
D) Defibrillate the patient
Answer: B – The rhythm is pulseless ventricular tachycardia. CPR should be started immediately while
preparing for defibrillation. Defibrillation is the definitive treatment, but CPR is the priority first action.
