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WCU Advanced Med–Surg (NURS 480) Exam 1 |
Updated 2026/2027 Prep Guide | Verified
Practice Questions & Answers | Grade A Review
NURS 480 / NURS480 EXAM 1 (2026/2027)
Advanced Medical Surgical Health Nursing | WCU
Actual Exam Review with 100% Verified Questions & Correct Answers
Overview
This 2026/2027 updated NURS 480 Exam 1 resource provides a complete set of verified questions
and correct answers aligned with West Coast University’s Advanced Medical Surgical Health
Nursing curriculum. It is designed for nursing students preparing for major course assessments and
reinforces clinical reasoning, pathophysiology, priority-setting, and evidence-based medical-surgical
practice.
Key Features
✓ Complete Exam 1 Question Bank (Verified Correct Answers)
✓ High-yield med-surg clinical scenarios
✓ Evidence-based nursing interventions & rationales
✓ Updated WCU 2026/2027 exam blueprint alignment
✓ Prioritization, delegation, & safety-based questions (NCLEX style)
Content Domains
• Complex Adult Health Conditions (Cardiac, Respiratory, Neuro)
• Fluid, Electrolytes & Acid–Base Imbalances
• Critical Care Principles & Emergency Response
• Pharmacological & Parenteral Therapies
• Infection Control & Safety Management
• Nursing Priorities & Clinical Judgment
,Answer Format
All answers are presented in bold green and include:
• Clinical rationale and reasoning steps
• Priority-level justification (ABCs / safety / Maslow)
• Medication mechanism or nursing implication notes
• Evidence-supported interventions
Critical Updates 2026/2027
◆ NEW – Updated med-surg disease management pathways
◆ UPDATED – Pharmacology content and dosage considerations
◆ REVISED – Sepsis, stroke, and cardiac emergency protocols
◆ ENHANCED – Clinical judgment and decision-making emphasis (NGN style)
Which action should the nurse take first when a patient complains of acute chest pain and
dyspnea soon after insertion of a centrally inserted IV catheter?
a. Notify the health care provider.
b. Offer reassurance to the patient.
c. Auscultate the patients breath sounds.
d. Give the prescribed PRN morphine sulfate IV.
ANS: C
The initial action should be to assess the patient further because the history and symptoms are
consistent with several possible complications of central line insertion, including embolism and
pneumothorax. The other actions may be appropriate, but further assessment of the patient is
needed before notifying the health care provider, offering reassurance, or administration of
morphine
The nurse palpates the posterior chest while the patient says 99 and notes absent fremitus. Which
action should the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep breathe.
c. Review the chest x-ray report for evidence of pneumonia.
d. Auscultate anterior and posterior breath sounds bilaterally.
ANS: D
To assess for tactile fremitus, the nurse should use the palms of the hands to assess for vibration
when the patient repeats a word or phrase such as 99. After noting absent fremitus, the nurse
should then auscultate the lungs to assess for the presence or absence of breath sounds. Absent
fremitus may be noted with pneumothorax or atelectasis. The vibration is increased in conditions
, such as pneumonia, lung tumors, thick bronchial secretions, and pleural effusion. Turning,
coughing, and deep breathing is an appropriate intervention for atelectasis, but the nurse needs to
first assess breath sounds. Fremitus is decreased if the hand is farther from the lung or the lung is
hyperinflated (barrel chest).The anterior of the chest is more difficult to palpate for fremitus
because of the presence of large muscles and breast tissue.
The nurse monitors a patient after chest tube placement for a hemopneumothorax. The nurse is
most concerned if which assessment finding is observed?
a. A large air leak in the water-seal chamber
b. 400 mL of blood in the collection chamber
c. Complaint of pain with each deep inspiration
d. Subcutaneous emphysema at the insertion site
ANS: B
The large amount of blood may indicate that the patient is in danger of developing hypovolemic
shock. An air leak would be expected immediately after chest tube placement for a
pneumothorax. Initially, brisk bubbling of air occurs in this chamber when a pneumothorax is
evacuated. The pain should be treated but is not as urgent a concern as the possibility of
continued hemorrhage. Subcutaneous emphysema should be monitored but is not unusual in a
patient with pneumothorax. A small amount of subcutaneous air is harmless and will be
reabsorbed.
A patient who has a right-sided chest tube following a thoracotomy has continuous bubbling in
the suction-control chamber of the collection device. Which action by the nurse is most
appropriate?
a. Document the presence of a large air leak.
b. Notify the surgeon of a possible pneumothorax.
c. Take no further action with the collection device.
d. Adjust the dial on the wall regulator to decrease suction.
ANS: C
Continuous bubbling is expected in the suction-control chamber and indicates that the suction-
control chamber is connected to suction. An air leak would be detected in the water-seal
chamber. There is no evidence of pneumothorax. Increasing or decreasing the vacuum source
will not adjust the suction pressure. The amount of suction applied is regulated by the amount of
water in this chamber and not by the amount of suction applied to the system.
The nurse cares for a patient who has just had a thoracentesis. Which assessment information
obtained by the nurse is a priority to communicate to the health care provider?
a. Oxygen saturation is 88%.
b. Blood pressure is 145/90 mm Hg.
WCU Advanced Med–Surg (NURS 480) Exam 1 |
Updated 2026/2027 Prep Guide | Verified
Practice Questions & Answers | Grade A Review
NURS 480 / NURS480 EXAM 1 (2026/2027)
Advanced Medical Surgical Health Nursing | WCU
Actual Exam Review with 100% Verified Questions & Correct Answers
Overview
This 2026/2027 updated NURS 480 Exam 1 resource provides a complete set of verified questions
and correct answers aligned with West Coast University’s Advanced Medical Surgical Health
Nursing curriculum. It is designed for nursing students preparing for major course assessments and
reinforces clinical reasoning, pathophysiology, priority-setting, and evidence-based medical-surgical
practice.
Key Features
✓ Complete Exam 1 Question Bank (Verified Correct Answers)
✓ High-yield med-surg clinical scenarios
✓ Evidence-based nursing interventions & rationales
✓ Updated WCU 2026/2027 exam blueprint alignment
✓ Prioritization, delegation, & safety-based questions (NCLEX style)
Content Domains
• Complex Adult Health Conditions (Cardiac, Respiratory, Neuro)
• Fluid, Electrolytes & Acid–Base Imbalances
• Critical Care Principles & Emergency Response
• Pharmacological & Parenteral Therapies
• Infection Control & Safety Management
• Nursing Priorities & Clinical Judgment
,Answer Format
All answers are presented in bold green and include:
• Clinical rationale and reasoning steps
• Priority-level justification (ABCs / safety / Maslow)
• Medication mechanism or nursing implication notes
• Evidence-supported interventions
Critical Updates 2026/2027
◆ NEW – Updated med-surg disease management pathways
◆ UPDATED – Pharmacology content and dosage considerations
◆ REVISED – Sepsis, stroke, and cardiac emergency protocols
◆ ENHANCED – Clinical judgment and decision-making emphasis (NGN style)
Which action should the nurse take first when a patient complains of acute chest pain and
dyspnea soon after insertion of a centrally inserted IV catheter?
a. Notify the health care provider.
b. Offer reassurance to the patient.
c. Auscultate the patients breath sounds.
d. Give the prescribed PRN morphine sulfate IV.
ANS: C
The initial action should be to assess the patient further because the history and symptoms are
consistent with several possible complications of central line insertion, including embolism and
pneumothorax. The other actions may be appropriate, but further assessment of the patient is
needed before notifying the health care provider, offering reassurance, or administration of
morphine
The nurse palpates the posterior chest while the patient says 99 and notes absent fremitus. Which
action should the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep breathe.
c. Review the chest x-ray report for evidence of pneumonia.
d. Auscultate anterior and posterior breath sounds bilaterally.
ANS: D
To assess for tactile fremitus, the nurse should use the palms of the hands to assess for vibration
when the patient repeats a word or phrase such as 99. After noting absent fremitus, the nurse
should then auscultate the lungs to assess for the presence or absence of breath sounds. Absent
fremitus may be noted with pneumothorax or atelectasis. The vibration is increased in conditions
, such as pneumonia, lung tumors, thick bronchial secretions, and pleural effusion. Turning,
coughing, and deep breathing is an appropriate intervention for atelectasis, but the nurse needs to
first assess breath sounds. Fremitus is decreased if the hand is farther from the lung or the lung is
hyperinflated (barrel chest).The anterior of the chest is more difficult to palpate for fremitus
because of the presence of large muscles and breast tissue.
The nurse monitors a patient after chest tube placement for a hemopneumothorax. The nurse is
most concerned if which assessment finding is observed?
a. A large air leak in the water-seal chamber
b. 400 mL of blood in the collection chamber
c. Complaint of pain with each deep inspiration
d. Subcutaneous emphysema at the insertion site
ANS: B
The large amount of blood may indicate that the patient is in danger of developing hypovolemic
shock. An air leak would be expected immediately after chest tube placement for a
pneumothorax. Initially, brisk bubbling of air occurs in this chamber when a pneumothorax is
evacuated. The pain should be treated but is not as urgent a concern as the possibility of
continued hemorrhage. Subcutaneous emphysema should be monitored but is not unusual in a
patient with pneumothorax. A small amount of subcutaneous air is harmless and will be
reabsorbed.
A patient who has a right-sided chest tube following a thoracotomy has continuous bubbling in
the suction-control chamber of the collection device. Which action by the nurse is most
appropriate?
a. Document the presence of a large air leak.
b. Notify the surgeon of a possible pneumothorax.
c. Take no further action with the collection device.
d. Adjust the dial on the wall regulator to decrease suction.
ANS: C
Continuous bubbling is expected in the suction-control chamber and indicates that the suction-
control chamber is connected to suction. An air leak would be detected in the water-seal
chamber. There is no evidence of pneumothorax. Increasing or decreasing the vacuum source
will not adjust the suction pressure. The amount of suction applied is regulated by the amount of
water in this chamber and not by the amount of suction applied to the system.
The nurse cares for a patient who has just had a thoracentesis. Which assessment information
obtained by the nurse is a priority to communicate to the health care provider?
a. Oxygen saturation is 88%.
b. Blood pressure is 145/90 mm Hg.
