ADVANCED MEDICAL-SURGICAL
NURSING COMPREHENSIVE EXAM
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A client with Chronic Obstructive Pulmonary Disease (COPD) presents with a pH of 7.28,
PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is the client
experiencing?
A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high, indicating the kidneys are attempting to compensate but the pH is
not yet normal, hence partial compensation.
2. Which clinical manifestation should the nurse prioritize when assessing a client suspected
of having a Tension Pneumothorax?
A. Bradycardia and hypertension
,B. Dullness on percussion of the affected side
C. Increased breath sounds on the affected side
D. Tracheal deviation to the unaffected side
Answer: D
Conceptual Explanation: Tracheal deviation is a late and critical sign of tension
pneumothorax, indicating significant mediastinal shift that can lead to obstructive shock.
3. A nurse is caring for a client with a Glascow Coma Scale (GCS) score of 7. Which
intervention is the highest priority?
A. Administering intravenous fluids
B. Assessing pupillary response
C. Performing a detailed neurological exam
D. Preparing for endotracheal intubation
Answer: D
Conceptual Explanation: A GCS score of 8 or less typically indicates a need for airway
protection; ‘Less than 8, intubate’ is a standard clinical guideline for airway management.
4. In a client with Acute Pancreatitis, which laboratory value is most specific for confirming
the diagnosis?
A. Elevated Serum Amylase
B. Decreased Serum Calcium
, C. Elevated Serum Lipase
D. Elevated White Blood Cell count
Answer: C
Conceptual Explanation: Lipase remains elevated longer than amylase and is more
specific to the pancreas for diagnostic purposes in acute pancreatitis.
5. Which medication is the treatment of choice for a client experiencing Malignant
Hyperthermia during surgery?
A. Succinylcholine
B. Atropine Sulfate
C. Dantrolene Sodium
D. Pancuronium
Answer: C
Conceptual Explanation: Dantrolene is a skeletal muscle relaxant that specifically treats
the underlying pathophysiology of malignant hyperthermia by inhibiting calcium release.
6. A client presents with a sudden onset of ‘the worst headache of my life.’ Which diagnostic
test does the nurse anticipate being ordered first?
A. Non-contrast Computed Tomography (CT) scan
B. Lumbar Puncture
C. Magnetic Resonance Imaging (MRI)
NURSING COMPREHENSIVE EXAM
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A client with Chronic Obstructive Pulmonary Disease (COPD) presents with a pH of 7.28,
PaCO2 of 55 mmHg, and HCO3 of 28 mEq/L. Which acid-base imbalance is the client
experiencing?
A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory alkalosis
D. Uncompensated respiratory acidosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is high, indicating the kidneys are attempting to compensate but the pH is
not yet normal, hence partial compensation.
2. Which clinical manifestation should the nurse prioritize when assessing a client suspected
of having a Tension Pneumothorax?
A. Bradycardia and hypertension
,B. Dullness on percussion of the affected side
C. Increased breath sounds on the affected side
D. Tracheal deviation to the unaffected side
Answer: D
Conceptual Explanation: Tracheal deviation is a late and critical sign of tension
pneumothorax, indicating significant mediastinal shift that can lead to obstructive shock.
3. A nurse is caring for a client with a Glascow Coma Scale (GCS) score of 7. Which
intervention is the highest priority?
A. Administering intravenous fluids
B. Assessing pupillary response
C. Performing a detailed neurological exam
D. Preparing for endotracheal intubation
Answer: D
Conceptual Explanation: A GCS score of 8 or less typically indicates a need for airway
protection; ‘Less than 8, intubate’ is a standard clinical guideline for airway management.
4. In a client with Acute Pancreatitis, which laboratory value is most specific for confirming
the diagnosis?
A. Elevated Serum Amylase
B. Decreased Serum Calcium
, C. Elevated Serum Lipase
D. Elevated White Blood Cell count
Answer: C
Conceptual Explanation: Lipase remains elevated longer than amylase and is more
specific to the pancreas for diagnostic purposes in acute pancreatitis.
5. Which medication is the treatment of choice for a client experiencing Malignant
Hyperthermia during surgery?
A. Succinylcholine
B. Atropine Sulfate
C. Dantrolene Sodium
D. Pancuronium
Answer: C
Conceptual Explanation: Dantrolene is a skeletal muscle relaxant that specifically treats
the underlying pathophysiology of malignant hyperthermia by inhibiting calcium release.
6. A client presents with a sudden onset of ‘the worst headache of my life.’ Which diagnostic
test does the nurse anticipate being ordered first?
A. Non-contrast Computed Tomography (CT) scan
B. Lumbar Puncture
C. Magnetic Resonance Imaging (MRI)
