COMPREHENSIVE MED-SURG
ADVANCED NURSING REVIEW
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A patient with acute decompensated heart failure presents with orthopnea and pink frothy
sputum. Which intervention is the nurse’s immediate priority?
A. Administering prescribed intravenous furosemide
B. Obtaining a stat portable chest X-ray
C. Assisting the patient into a high-Fowler’s position
D. Preparing the patient for intubation and mechanical ventilation
Answer: C
Conceptual Explanation: High-Fowler’s position immediately reduces venous return
(preload) and improves gas exchange by allowing maximum chest expansion. This is the
fastest nursing action to stabilize the patient before administering medications like
diuretics.
2. A client is admitted with a suspected pheochromocytoma. Which assessment finding
should the nurse report to the provider immediately?
A. Complaint of a severe headache
,B. Blood pressure of 210/110 mmHg
C. Hyperglycemia of 145 mg/dL
D. Heart rate of 98 beats per minute
Answer: B
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release. A
hypertensive crisis (BP 210/110) is the most life-threatening complication, risking stroke
or organ damage, and requires immediate intervention.
3. Which arterial blood gas (ABG) result is most consistent with a patient in the early stages of
a pulmonary embolism?
A. pH 7.48, PaCO2 30, HCO3 23
B. pH 7.30, PaCO2 55, HCO3 26
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.50, PaCO2 45, HCO3 35
Answer: A
Conceptual Explanation: In early pulmonary embolism, patients typically hyperventilate
due to hypoxia and anxiety, leading to Respiratory Alkalosis (high pH, low PaCO2).
4. The nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingertips and around the mouth. Which medication should the nurse have readily available?
A. Potassium chloride
, B. Magnesium sulfate
C. Sodium bicarbonate
D. Calcium gluconate
Answer: D
Conceptual Explanation: Tingling in extremities (paresthesia) and circumoral numbness
are signs of hypocalcemia, often caused by accidental damage to the parathyroid glands
during thyroid surgery. IV calcium gluconate is the treatment.
5. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which ECG change should the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Shortened PR interval
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) classically causes tall, peaked T waves,
followed by PR prolongation and QRS widening as levels rise higher.
6. Which clinical manifestation is a hallmark sign of the ‘compensatory stage’ of shock?
A. Narrowed pulse pressure and increased heart rate
B. Lethargy and decreased urine output
ADVANCED NURSING REVIEW
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+| JUST RELEASED
1. A patient with acute decompensated heart failure presents with orthopnea and pink frothy
sputum. Which intervention is the nurse’s immediate priority?
A. Administering prescribed intravenous furosemide
B. Obtaining a stat portable chest X-ray
C. Assisting the patient into a high-Fowler’s position
D. Preparing the patient for intubation and mechanical ventilation
Answer: C
Conceptual Explanation: High-Fowler’s position immediately reduces venous return
(preload) and improves gas exchange by allowing maximum chest expansion. This is the
fastest nursing action to stabilize the patient before administering medications like
diuretics.
2. A client is admitted with a suspected pheochromocytoma. Which assessment finding
should the nurse report to the provider immediately?
A. Complaint of a severe headache
,B. Blood pressure of 210/110 mmHg
C. Hyperglycemia of 145 mg/dL
D. Heart rate of 98 beats per minute
Answer: B
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release. A
hypertensive crisis (BP 210/110) is the most life-threatening complication, risking stroke
or organ damage, and requires immediate intervention.
3. Which arterial blood gas (ABG) result is most consistent with a patient in the early stages of
a pulmonary embolism?
A. pH 7.48, PaCO2 30, HCO3 23
B. pH 7.30, PaCO2 55, HCO3 26
C. pH 7.35, PaCO2 40, HCO3 24
D. pH 7.50, PaCO2 45, HCO3 35
Answer: A
Conceptual Explanation: In early pulmonary embolism, patients typically hyperventilate
due to hypoxia and anxiety, leading to Respiratory Alkalosis (high pH, low PaCO2).
4. The nurse is caring for a patient post-thyroidectomy. The patient reports tingling in the
fingertips and around the mouth. Which medication should the nurse have readily available?
A. Potassium chloride
, B. Magnesium sulfate
C. Sodium bicarbonate
D. Calcium gluconate
Answer: D
Conceptual Explanation: Tingling in extremities (paresthesia) and circumoral numbness
are signs of hypocalcemia, often caused by accidental damage to the parathyroid glands
during thyroid surgery. IV calcium gluconate is the treatment.
5. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which ECG change should the nurse expect to see?
A. Prominent U waves
B. Tall, peaked T waves
C. ST-segment depression
D. Shortened PR interval
Answer: B
Conceptual Explanation: Hyperkalemia (K+ > 5.0) classically causes tall, peaked T waves,
followed by PR prolongation and QRS widening as levels rise higher.
6. Which clinical manifestation is a hallmark sign of the ‘compensatory stage’ of shock?
A. Narrowed pulse pressure and increased heart rate
B. Lethargy and decreased urine output
