NSG 430 FINAL EXAMINATION 2026/2027 Comprehensive
Test Bank with Verified Answers and Detailed Rationales
200 Questions for Nursing Students
EXAM INFORMATION
- Course: NSG 430 – Advanced Medical-Surgical Nursing
- Total Questions:200
- Format: Multiple Choice
TABLE OF CONTENTS
| 1 | Cardiovascular Emergencies | 1-30 |
| 2 | Respiratory Emergencies | 31-50 |
| 3 | Neurological Emergencies | 51-70 |
| 4 | Gastrointestinal Emergencies | 71-90 |
| 5 | Renal & Endocrine Emergencies | 91-110 |
| 6 | Burns & Trauma | 111-130 |
| 7 | Shock & Sepsis | 131-150 |
| 8 | Hematologic & Immunologic Disorders | 151-170 |
| 9 | Pharmacology & Medication Management | 171-190 |
| 10 | Nursing Assessment & Prioritization | 191-200 |
,## SECTION 1: CARDIOVASCULAR EMERGENCIES
Questions 1-30
Question 1
A patient recovering from heart surgery develops pericarditis and complains
of level 6 (0-10 scale) chest pain with deep breathing. Which PRN medication
would be most appropriate for the nurse to administer?
A) Fentanyl 1 mg IV
B) IV morphine sulfate 4 mg
C) Oral ibuprofen 600 mg
D) Oral acetaminophen 650 mg
Answer: C) Oral ibuprofen 600 mg
Rationale: Pericarditis is an inflammatory condition of the pericardial sac.
NSAIDs such as ibuprofen are the first-line treatment for pericarditis because
they reduce inflammation and pain. The pain is often pleuritic (worsened by
deep breathing). While opioids like fentanyl and morphine can treat pain,
they do not address the underlying inflammation and are not first-line for
pericarditis. Acetaminophen does not have significant anti-inflammatory
properties.
,Question 2
Which assessment data collected by the nurse for a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
A) The pain increases with deep breathing.
B) The pain has lasted longer than 30 minutes.
C) The pain is relieved after taking nitroglycerin.
D) The pain is reproducible when the patient raises the arms.
Answer: B) The pain has lasted longer than 30 minutes
Rationale: Myocardial infarction pain typically lasts longer than 30 minutes
and is not relieved by rest or nitroglycerin. Pain that increases with deep
breathing (A) suggests pericarditis or pleurisy. Pain relieved by nitroglycerin
(C) suggests stable angina. Pain reproducible with arm movement (D) suggests
musculoskeletal pain.
Question 3**
Which nursing action will be included in the plan of care for a patient being
treated for bleeding esophageal varices with balloon tamponade?
A) Instruct the patient to cough every hour.
B) Monitor the patient for shortness of breath.
C) Verify the position of the balloon every 4 hours.
D) Deflate the gastric balloon if the patient reports nausea.
, Answer: B) Monitor the patient for shortness of breath
Rationale: The primary concern with balloon tamponade is airway
compromise. The gastric and esophageal balloons can migrate and cause
airway obstruction, leading to respiratory distress. Monitoring for shortness
of breath is essential. Coughing (A) is not recommended as it can dislodge the
tube. Balloon position should be verified every 1-2 hours, not 4 hours (C). The
gastric balloon should only be deflated under specific circumstances, not for
nausea (D).
Question 4
When admitting a 42-year-old patient with a possible brain injury after a
motor vehicle accident (MVA), which finding is most important to report to
the healthcare provider?
A) Patient reports a headache
B) Patient has a Glasgow Coma Scale of 14
C) Patient states they regularly take warfarin (Coumadin)
D) Patient has a laceration on the forehead
Answer: C) Patient states they regularly take warfarin (Coumadin)
Rationale: Warfarin is an anticoagulant that significantly increases the risk of
intracranial hemorrhage in a patient with possible brain injury. This
information is critical for the healthcare provider to know before any invasive
procedures or decisions about reversal agents. A headache (A) and GCS of 14
(B) are concerning but expected findings. A forehead laceration (D) is a visible
injury but does not present the same immediate life-threatening risk.
Test Bank with Verified Answers and Detailed Rationales
200 Questions for Nursing Students
EXAM INFORMATION
- Course: NSG 430 – Advanced Medical-Surgical Nursing
- Total Questions:200
- Format: Multiple Choice
TABLE OF CONTENTS
| 1 | Cardiovascular Emergencies | 1-30 |
| 2 | Respiratory Emergencies | 31-50 |
| 3 | Neurological Emergencies | 51-70 |
| 4 | Gastrointestinal Emergencies | 71-90 |
| 5 | Renal & Endocrine Emergencies | 91-110 |
| 6 | Burns & Trauma | 111-130 |
| 7 | Shock & Sepsis | 131-150 |
| 8 | Hematologic & Immunologic Disorders | 151-170 |
| 9 | Pharmacology & Medication Management | 171-190 |
| 10 | Nursing Assessment & Prioritization | 191-200 |
,## SECTION 1: CARDIOVASCULAR EMERGENCIES
Questions 1-30
Question 1
A patient recovering from heart surgery develops pericarditis and complains
of level 6 (0-10 scale) chest pain with deep breathing. Which PRN medication
would be most appropriate for the nurse to administer?
A) Fentanyl 1 mg IV
B) IV morphine sulfate 4 mg
C) Oral ibuprofen 600 mg
D) Oral acetaminophen 650 mg
Answer: C) Oral ibuprofen 600 mg
Rationale: Pericarditis is an inflammatory condition of the pericardial sac.
NSAIDs such as ibuprofen are the first-line treatment for pericarditis because
they reduce inflammation and pain. The pain is often pleuritic (worsened by
deep breathing). While opioids like fentanyl and morphine can treat pain,
they do not address the underlying inflammation and are not first-line for
pericarditis. Acetaminophen does not have significant anti-inflammatory
properties.
,Question 2
Which assessment data collected by the nurse for a patient with chest pain
suggests that the pain is caused by an acute myocardial infarction (AMI)?
A) The pain increases with deep breathing.
B) The pain has lasted longer than 30 minutes.
C) The pain is relieved after taking nitroglycerin.
D) The pain is reproducible when the patient raises the arms.
Answer: B) The pain has lasted longer than 30 minutes
Rationale: Myocardial infarction pain typically lasts longer than 30 minutes
and is not relieved by rest or nitroglycerin. Pain that increases with deep
breathing (A) suggests pericarditis or pleurisy. Pain relieved by nitroglycerin
(C) suggests stable angina. Pain reproducible with arm movement (D) suggests
musculoskeletal pain.
Question 3**
Which nursing action will be included in the plan of care for a patient being
treated for bleeding esophageal varices with balloon tamponade?
A) Instruct the patient to cough every hour.
B) Monitor the patient for shortness of breath.
C) Verify the position of the balloon every 4 hours.
D) Deflate the gastric balloon if the patient reports nausea.
, Answer: B) Monitor the patient for shortness of breath
Rationale: The primary concern with balloon tamponade is airway
compromise. The gastric and esophageal balloons can migrate and cause
airway obstruction, leading to respiratory distress. Monitoring for shortness
of breath is essential. Coughing (A) is not recommended as it can dislodge the
tube. Balloon position should be verified every 1-2 hours, not 4 hours (C). The
gastric balloon should only be deflated under specific circumstances, not for
nausea (D).
Question 4
When admitting a 42-year-old patient with a possible brain injury after a
motor vehicle accident (MVA), which finding is most important to report to
the healthcare provider?
A) Patient reports a headache
B) Patient has a Glasgow Coma Scale of 14
C) Patient states they regularly take warfarin (Coumadin)
D) Patient has a laceration on the forehead
Answer: C) Patient states they regularly take warfarin (Coumadin)
Rationale: Warfarin is an anticoagulant that significantly increases the risk of
intracranial hemorrhage in a patient with possible brain injury. This
information is critical for the healthcare provider to know before any invasive
procedures or decisions about reversal agents. A headache (A) and GCS of 14
(B) are concerning but expected findings. A forehead laceration (D) is a visible
injury but does not present the same immediate life-threatening risk.
