MED-SURG ADVANCED PRACTICE
EXAM QUESTIONS AND VERIFIED
ANSWERS |GRADE A+| JUST RELEASED
1. A patient with a T6 spinal cord injury reports a severe, pounding headache and nasal
congestion. The nurse notes a blood pressure of 210/110 mmHg. What is the priority nursing
action?
A. Administer the prescribed PRN dose of hydralazine.
B. Place the patient in a sitting position and lower the legs.
C. Check the patient’s urinary catheter for kinks or obstruction.
D. Notify the healthcare provider immediately.
Answer: B
Conceptual Explanation: The first action in autonomic dysreflexia is to sit the patient up
to utilize orthostatic pressure to lower the blood pressure while the cause is identified.
2. A patient with Diabetic Ketoacidosis (DKA) has a serum glucose of 450 mg/dL and a serum
potassium of 3.2 mEq/L. Which action should the nurse prioritize?
A. Monitor heart rate and rhythm.
B. Administer intravenous regular insulin bolus.
C. Start a normal saline infusion at 1000 mL/hr.
,D. Initiate potassium replacement therapy.
Answer: D
Conceptual Explanation: Insulin causes potassium to shift into cells, which would further
lower the serum potassium level. Potassium must be replaced before or during insulin
therapy to prevent fatal arrhythmias.
3. A client with SIADH has a serum sodium of 118 mEq/L. Which complication is the nurse
most concerned about?
A. Hypovolemic shock
B. Cardiac arrest
C. Acute renal failure
D. Seizures and cerebral edema
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) in SIADH leads to
water moving into brain cells, causing cerebral edema and seizures.
4. Which finding in a patient with Addisonian crisis requires the most immediate
intervention?
A. Skin hyperpigmentation
B. Severe hypotension
C. Hyperkalemia
, D. Hyponatremia
Answer: B
Conceptual Explanation: Addisonian crisis is a life-threatening emergency characterized
by vascular collapse and severe hypotension due to cortisol deficiency.
5. The nurse is assessing a patient with acute pancreatitis and notes a positive Trousseau’s
sign. This finding is indicative of:
A. Hypermagnesemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Answer: B
Conceptual Explanation: Trousseau’s sign (carpal spasm) is a classic sign of
hypocalcemia, often seen in pancreatitis due to fat necrosis and soap formation.
6. A patient with a chest tube for a pneumothorax shows constant bubbling in the water-seal
chamber. The nurse should:
A. Check the system for an air leak.
B. Document this as a normal finding for pneumothorax.
C. Increase the suction pressure.
D. Clamp the chest tube immediately.
EXAM QUESTIONS AND VERIFIED
ANSWERS |GRADE A+| JUST RELEASED
1. A patient with a T6 spinal cord injury reports a severe, pounding headache and nasal
congestion. The nurse notes a blood pressure of 210/110 mmHg. What is the priority nursing
action?
A. Administer the prescribed PRN dose of hydralazine.
B. Place the patient in a sitting position and lower the legs.
C. Check the patient’s urinary catheter for kinks or obstruction.
D. Notify the healthcare provider immediately.
Answer: B
Conceptual Explanation: The first action in autonomic dysreflexia is to sit the patient up
to utilize orthostatic pressure to lower the blood pressure while the cause is identified.
2. A patient with Diabetic Ketoacidosis (DKA) has a serum glucose of 450 mg/dL and a serum
potassium of 3.2 mEq/L. Which action should the nurse prioritize?
A. Monitor heart rate and rhythm.
B. Administer intravenous regular insulin bolus.
C. Start a normal saline infusion at 1000 mL/hr.
,D. Initiate potassium replacement therapy.
Answer: D
Conceptual Explanation: Insulin causes potassium to shift into cells, which would further
lower the serum potassium level. Potassium must be replaced before or during insulin
therapy to prevent fatal arrhythmias.
3. A client with SIADH has a serum sodium of 118 mEq/L. Which complication is the nurse
most concerned about?
A. Hypovolemic shock
B. Cardiac arrest
C. Acute renal failure
D. Seizures and cerebral edema
Answer: D
Conceptual Explanation: Severe hyponatremia (below 120 mEq/L) in SIADH leads to
water moving into brain cells, causing cerebral edema and seizures.
4. Which finding in a patient with Addisonian crisis requires the most immediate
intervention?
A. Skin hyperpigmentation
B. Severe hypotension
C. Hyperkalemia
, D. Hyponatremia
Answer: B
Conceptual Explanation: Addisonian crisis is a life-threatening emergency characterized
by vascular collapse and severe hypotension due to cortisol deficiency.
5. The nurse is assessing a patient with acute pancreatitis and notes a positive Trousseau’s
sign. This finding is indicative of:
A. Hypermagnesemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Answer: B
Conceptual Explanation: Trousseau’s sign (carpal spasm) is a classic sign of
hypocalcemia, often seen in pancreatitis due to fat necrosis and soap formation.
6. A patient with a chest tube for a pneumothorax shows constant bubbling in the water-seal
chamber. The nurse should:
A. Check the system for an air leak.
B. Document this as a normal finding for pneumothorax.
C. Increase the suction pressure.
D. Clamp the chest tube immediately.
