Advanced Medical-Surgical Nursing Exam Practice Tests
Course Introduction
Advanced Medical-Surgical Nursing is designed to deepen students' understanding of complex health conditions and evidence-based interventions in adult patient care. This course emphasizes clinical reasoning, advanced assessment skills, and the integration of pathophysiological knowledge to manage critically ill or multi-system-compromised patients. Learners explore advanced topics such as hemodynamic monitoring, ventilator management, pharmacological therapies, and the coordination of interdisciplinary care. The curriculum prepares nurses to function as critical thinkers and leaders within acute and specialized care settings, focusing on optimizing patient outcomes through advanced nursing interventions and collaborative practice.
Recommended Textbook
Introduction to Critical Care Nursing 7th Edition by Sole
Available Study Resources on Quizplus
21 Chapters
757 Verified Questions
757 Flashcards
Source URL: https://quizplus.com/study-set/570 Page 2
Chapter 1: Overview of Critical Care Nursing
Available Study Resources on Quizplus for this Chatper
24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/10613
Sample Questions
Q1) The synergy model of practice focuses on
A) allowing unrestricted visiting for the patient 24 hours a day.
B) holistic and alternative therapies.
C) the needs of patients and their families, which drive nursing competency.
D) patients' needs for energy and support.
Answer: C
Q2) The family members of a critically ill patient bring a copy of the patient's living will to the hospital,which identifies the patient's wishes regarding health care.You discuss contents of the living will with the patient's physician.This is an example of implementation of which of the AACN Standards of Professional Performance?
A) Acquires and maintains current knowledge of practice
B) Acts ethically on the behalf of the patient and family
C) Considers factors related to safe patient care
D) Uses clinical inquiry and integrates research findings in practice
Answer: B
To view all questions and flashcards with answers, click on the resource link above.
3
Chapter 2: Patient and Family Response to the Critical Care Experience
Available Study Resources on Quizplus for this Chatper
28 Verified Questions
28 Flashcards
Source URL: https://quizplus.com/quiz/10614
Sample Questions
Q1) The nurse is assigned to care for a patient who is a non-native English speaker.What is the best way to communicate with the patient and family to provide updates and explain procedures?
A) Conduct a Google search on the computer to identify resources for the patient and family in their native language.Print these for their use.
B) Contact the hospital's interpreter service for someone to translate.
C) Get in touch with one of the residents who you know is fluent in the native language and ask him if he can come up to the unit.
D) Use the patient's 8-year-old child who is fluent in both English and the native language to translate for you.
Answer: B
Q2) The constant noise of a ventilator,monitor alarms,and infusion pumps predisposes the patient to:
A) anxiety.
B) pain.
C) powerlessness.
D) sensory overload.
Answer: D
To view all questions and flashcards with answers, click on the resource link above. Page 4
Chapter 4: End-of-Life Care and Palliative Care in Critical Care Settings
Available Study Resources on Quizplus for this Chatper
26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/10616
Sample Questions
Q1) The patient's spouse is terrified by the prospect of removing life-sustaining treatments from the patient and asks why anyone would do that.The nurse explains,
A) "It is to save you money so that you won't have such a large financial burden."
B) "It will preserve limited resources for the hospital so that other patients may benefit from them."
C) "It is to discontinue treatments that are not helping your loved one and that may be very uncomfortable."
D) "We have done all we can for your loved one, and any more treatment would be futile."
Q2) Which statement made by a staff nurse identifying guidelines for palliative care would need to be corrected?
A) Basic nursing care is a critical element in palliative care management.
B) Common conditions that require palliative management are nausea, agitation, and sleep disturbance.
C) Palliative care practices are reserved for the dying client.
D) Palliative care practices relieve symptoms that negatively affect the quality of life of a patient.
To view all questions and flashcards with answers, click on the resource link above.
Page 6
Chapter 5: Comfort and Sedation
Available Study Resources on Quizplus for this Chatper
33 Verified Questions
33 Flashcards
Source URL: https://quizplus.com/quiz/10617
Sample Questions
Q1) The nurse recognizes that which patient is likely to benefit most from patient-controlled analgesia ( PCA )?
A) Patient with a C4 fracture and quadriplegia
B) Patient with a femur fracture and closed head injury
C) Postoperative patient who had elective bariatric surgery
D) Postoperative cardiac surgery patient with mild dementia
Q2) Both the electroencephalogram (EEG)monitor and the Bispectral Index Score (BIS)or Patient State Index (PSI)analyzer monitors are used to assess patient sedation levels in critically ill patients.The BIS and PSI monitors are simpler to use because they
A) can be used only on heavily sedated patients.
B) can be used only on pediatric patients.
C) provide raw EEG data and a numeric value.
D) require only five leads.
Q3) The most important nursing intervention for patients who receive neuromuscular blocking agents is to
A) administer sedatives in conjunction with the neuromuscular blocking agents.
B) assess neurological status every 30 minutes.
C) avoid interaction with the patient, because he or she won't be able to hear.
D) restrain the patient to avoid self-extubation.
To view all questions and flashcards with answers, click on the resource link above.
Page 7
Chapter 6: Nutritional Support
Available Study Resources on Quizplus for this Chatper
30 Verified Questions
30 Flashcards
Source URL: https://quizplus.com/quiz/10618
Sample Questions
Q1) A critically ill patient has a nonhealing wound and malnutrition.Which component of nutritional supplementation is most important for this patient to receive?
A) Arginine
B) Omega-3 fatty acids
C) Branched-chain amino acids
D) Vitamin A
Q2) The correct order of actions for a patient starting enteral nutrition with a feeding tube is:
A)initiate tube feeding
B)insert feeding tube
C)flush tube to verify patency
D)obtain chest radiograph
E)assess residuals
Q3) The best nursing approach to prevent feeding tube obstruction is to
A) dilute the feeding to make it flow more easily.
B) flush the tube every 4 hours with 20 to 30 mL of tap water.
C) pass a stylet daily to keep the tubing clear.
D) use a larger bore tube where possible.
To view all questions and flashcards with answers, click on the resource link above. Page 8
Chapter 7: Dysrhythmia Interpretation and Management
Available Study Resources on Quizplus for this Chatper
59 Verified Questions
59 Flashcards
Source URL: https://quizplus.com/quiz/10619
Sample Questions
Q1) The nurse is examining the patient's cardiac rhythm strip in lead II and notices that all of the P waves are upright and look the same except one that has a different shape and is inverted.The nurse realizes that the P wave with the abnormal shape is probably A) from the SA node because all P waves come from the SA node.
B) from some area in the atria other than the SA node.
C) indicative of ventricular depolarization.
D) normal even though it is inverted in lead II.
Q2) The nurse using cardiac monitoring understands that each horizontal box on the electrocardiogram (ECG)paper indicates
A) 200 milliseconds or 0.20 seconds duration.
B) 40 milliseconds or 0.04 seconds duration.
C) 3 seconds duration.
D) millivolts of amplitude.
Q3) The nurse understands that in a third-degree AV block
A) every P wave is conducted to the ventricles.
B) some P waves are conducted to the ventricles.
C) none of the P waves are conducted to the ventricles.
D) the PR interval is prolonged.
To view all questions and flashcards with answers, click on the resource link above. Page 9
Chapter 8: Hemodynamic Monitoring
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10620
Sample Questions
Q1) The nurse returns from the cardiac catheterization laboratory with a patient following insertion of a pulmonary artery catheter and assists in transferring the patient from the stretcher to the bed.Before obtaining a cardiac output,which action is most important for the nurse to complete?
A) Document a pulmonary artery catheter occlusion pressure.
B) Zero reference the transducer system at the phlebostatic axis.
C) Inflate the pulmonary artery catheter balloon with 1 mL air.
D) Inject 10 mL of 0.9% normal saline into the proximal port.
Q2) Which nursing actions are most important for a patient with a right radial arterial line? (Select all that apply.)
A) Checking the circulation to the right hand every 2 hours
B) Maintaining a pressurized flush solution to the arterial line setup
C) Monitoring the waveform on the monitor for dampening
D) Restraining all four extremities with soft limb restraints
E) Ensuring all junctions remain tightly connected
To view all questions and flashcards with answers, click on the resource link above.
10
Chapter 9: Ventilatory Assistance
Available Study Resources on Quizplus for this Chatper
36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10621
Sample Questions
Q1) The nurse is assessing the exhaled tidal volume (EV<sub>T</sub>)in a mechanically ventilated patient.The rationale for this assessment is to
A) assess for tension pneumothorax.
B) assess the level of positive end-expiratory pressure.
C) compare the tidal volume delivered with the tidal volume prescribed.
D) determine the patient's work of breathing.
Q2) The nurse notes that the patient's arterial blood gas levels indicate hypoxemia.The patient is not intubated and has a respiratory rate of 22 breaths/min.The nurse's first intervention to relieve hypoxemia is to:
A) call the provider for an emergency intubation procedure.
B) obtain an order for bilevel positive airway pressure (BiPAP).
C) notify the provider of values and obtain a prescription for oxygen.
D) suction secretions from the oropharynx.
Q3) A PaCO<sub>2 </sub>of 48 mm Hg is associated with A) hyperventilation.
B) hypoventilation.
C) increased absorption of O<sub>2</sub>.
D) increased excretion of HCO<sub>3</sub>.
To view all questions and flashcards with answers, click on the resource link above.
11
Chapter 10: Rapid Response Teams and Code Management
Available Study Resources on Quizplus for this Chatper
31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10622
Sample Questions
Q1) During a code situation,the nurse would prepare to use which preferred intravenous fluid?
A) 5% dextrose in 0.45% normal saline
B) 5% dextrose in water
C) Dopamine infusion
D) Normal saline
Q2) A patient is admitted to the critical care unit with bradycardia at a heart rate of 39 beats/min and frequent premature ventricular contractions.The nurse notes that the patient is lethargic and reports dizziness for the past 12 hours.Which of the following are acceptable initial treatments for this patient? (Select all that apply.)
A) Atropine
B) Epinephrine
C) Lidocaine
D) Transcutaneous pacemaker
E) Magnesium sulfate infusion
To view all questions and flashcards with answers, click on the resource link above. Page 12
Chapter 11: Organ Donation
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10623
Sample Questions
Q1) A nurse is preparing to admit a post-heart transplant patient for a second myocardial biopsy in 3 weeks.What conclusion does the nurse draw from this admission information?
A) The patient is having rejection.
B) The patient is being monitored for rejection.
C) The new heart is functioning poorly.
D) The patient is being evaluated for a repeat transplant.
Q2) The nurse is caring for a mechanically ventilated patient following bilateral lung transplantation.When planning the care of this patient,what is the priority nursing intervention?
A) Thirty-degree elevation of head of bed
B) Endotracheal suctioning as needed
C) Frequent side to side repositioning
D) Sequential compression stockings
Q3) Which statement best represents appropriate donor-to-recipient criteria for liver transplantation?
A) Blood type and HLA tissue type
B) HLA tissue type and body type
C) Blood type and body size
D) Blood type and donor history
To view all questions and flashcards with answers, click on the resource link above. Page 13
Chapter 12: Shock,Sepsis,and Multiple Organ Dysfunction Syndrome
Available Study Resources on Quizplus for this Chatper
34 Verified Questions
34 Flashcards
Source URL: https://quizplus.com/quiz/10624
Sample Questions
Q1) Which patient being cared for in the emergency department is most at risk for developing hypovolemic shock?
A) A patient admitted with abdominal pain and an elevated white blood cell count
B) A patient with a temperature of 102° F and a general dermal rash
C) A patient with a 2-day history of nausea, vomiting, and diarrhea
D) A patient with slight rectal bleeding from inflamed hemorrhoids
Q2) The nurse is caring for a patient admitted with hypovolemic shock.The nurse palpates thready brachial pulses but is unable to auscultate a blood pressure.What is the best nursing action?
A) Assess the blood pressure by Doppler.
B) Estimate the systolic pressure as 60 mm Hg.
C) Obtain an electronic blood pressure monitor.
D) Record the blood pressure as "not assessable."
Q3) While monitoring a patient for signs of shock,the nurse understands which system assessment to be of priority?
A) Central nervous system
B) Gastrointestinal system
C) Renal system
D) Respiratory system
Page 14
To view all questions and flashcards with answers, click on the resource link above.
Chapter 13: Cardiovascular Alterations
Available Study Resources on Quizplus for this Chatper
37 Verified Questions
37 Flashcards
Source URL: https://quizplus.com/quiz/10625
Sample Questions
Q1) The patient is admitted with a suspected acute myocardial infarction (AMI).In assessing the 12-lead electrocardiogram (ECG)changes,which findings would indicate to the nurse that the patient is in the process of an evolving Q wave myocardial infarction (MI)?
A) ST-segment elevation on ECG and elevated CPK-MB or troponin levels
B) Depressed ST-segment on ECG and elevated total CPK
C) Depressed ST-segment on ECG and normal cardiac enzymes
D) Q wave on ECG with normal enzymes and troponin levels
Q2) The patient has undergone open chest surgery for coronary artery bypass grafting.One of the nurse's responsibilities is to monitor the patient for which common postoperative dysrhythmia?
A) Second-degree heart block
B) Atrial fibrillation or flutter
C) Ventricular ectopy
D) Premature junctional contractions
Q3) An essential aspect of teaching that may prevent recurrence of heart failure is
A) notifying the provider if a 2-lb weight gain occurs in 24 hours.
B) compliance with diuretic therapy.
C) taking nitroglycerin if chest pain occurs.
D) assessment of an apical pulse.
To view all questions and flashcards with answers, click on the resource link above. Page 15
Chapter 14: Nervous System Alterations
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10626
Sample Questions
Q1) The nurse is caring for a patient who has a diminished level of consciousness and who is mechanically ventilated.While performing endotracheal suctioning,the patient reaches up in an attempt to grab the suction catheter.What is the best interpretation by the nurse?
A) The patient is exhibiting extension posturing.
B) The patient is exhibiting flexion posturing.
C) The patient is exhibiting purposeful movement.
D) The patient is withdrawing to stimulation.
Q2) The nurse is preparing to monitor intracranial pressure (ICP)with a fluid-filled monitoring system.The nurse understands which principles and/or components to be essential when implementing ICP monitoring? (Select all that apply.)
A) Use of a heparin flush solution
B) Manually flushing the device "prn"
C) Recording ICP as a "mean" value
D) Use of a pressurized flush system
E) Zero referencing the transducer system
To view all questions and flashcards with answers, click on the resource link above.
Chapter 15: Acute Respiratory Failure
Available Study Resources on Quizplus for this Chatper
36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/10627
Sample Questions
Q1) A strategy for preventing pulmonary embolism in patients at risk who cannot take anticoagulants is
A) administration of two aspirin tablets every 4 hours.
B) infusion of thrombolytics.
C) insertion of a vena cava filter.
D) subcutaneous heparin administration every 12 hours.
Q2) The nurse is caring for a mechanically ventilated patient.The nurse understands that strategies to prevent ventilator-associated pneumonia include which of the following? (Select all that apply.)
A) Drain condensate from the ventilator tubing away from the patient.
B) Elevate the head of the bed 30 to 45 degrees.
C) Instill normal saline as part of the suctioning procedure.
D) Perform regular oral care with chlorhexidine.
E) Awaken the patient daily to determine the need for continued ventilation.
Q3) In assessing a patient,the nurse understands that an early sign of hypoxemia is
A) clubbing of nail beds.
B) cyanosis.
C) hypotension.
D) restlessness.
To view all questions and flashcards with answers, click on the resource link above.
Page 17
Chapter 16: Acute Kidney Injury
Available Study Resources on Quizplus for this Chatper
50 Verified Questions
50 Flashcards
Source URL: https://quizplus.com/quiz/10628
Sample Questions
Q1) The nurse is caring for a patient who has sustained blunt trauma to the left flank area,and is evaluating the patient's urinalysis results.The nurse should become concerned when
A) creatinine levels in the urine are similar to blood levels of creatinine.
B) sodium and chloride are found in the urine.
C) urine uric acid levels have the same values as serum levels.
D) red blood cells and albumin are found in the urine.
Q2) The patient's potassium level is 7.0 mEq/L.Besides dialysis,which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
A) Sodium polystyrene sulfonate
B) Sodium polystyrene sulfonate with sorbitol
C) Regular insulin
D) Calcium gluconate
Q3) Renin plays a role in blood pressure regulation by
A) activating the renin-angiotensin-aldosterone cascade.
B) suppressing angiotensin production.
C) decreasing sodium reabsorption.
D) inhibiting aldosterone release.
To view all questions and flashcards with answers, click on the resource link above.
Page 18
Chapter 17: Hematological and Immune Disorders
Available Study Resources on Quizplus for this Chatper
56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/10629
Sample Questions
Q1) Lymphocytes are made up of B cells and T cells.B cells
A) mature in lymphoid tissue.
B) mediate humoral immunity.
C) migrate to the thymus gland.
D) destroy virus-infected cells.
Q2) The nurse examines the patient's complete blood count with differential analysis and notices that the patient's neutrophils are elevated but that the lymphocytes are lower than normal.The drop in lymphocyte count in the differential is most likely due to
A) the increase in neutrophil count.
B) a new viral infection.
C) a decreased number of "bands."
D) the lack of immature neutrophils.
Q3) The nurse is assessing a patient being admitted for anemia.The nurse sees no overt signs of bleeding.The nurse understands that
A) all patients with bleeding disorders demonstrate active bleeding.
B) many patients have bleeding that is not obvious.
C) mucous membranes have a high threshold for bleeding.
D) capillaries in mucous membranes lie deep in the membrane.
To view all questions and flashcards with answers, click on the resource link above. Page 19
Chapter 18: Gastrointestinal Alterations
Available Study Resources on Quizplus for this Chatper
52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/10630
Sample Questions
Q1) The nurse is caring for a patient with severe pancreatitis who is orally intubated and on mechanical ventilation.The patient's calcium level this morning was 5.5 mg/dL.The nurse notifies the provider and
A) places the patient on seizure precautions.
B) expects that the provider will come and remove the endotracheal tube.
C) withholds any further calcium treatments.
D) places an oral airway at the bedside.
Q2) The patient is being admitted with GI bleeding.Blood work includes serial hemoglobin and hematocrit levels.The nurse understands that
A) the hematocrit is a direct reflection of quick blood loss.
B) as extravascular fluid enters the vascular space, the hematocrit increases.
C) the hematocrit value does not change substantially during the first few hours.
D) the administration of intravenous fluids has no effect on hematocrit levels.
Q3) The patient is admitted with acute pancreatitis.The nurse should A) assess pain level because pancreatic pain is unique in character.
B) examine laboratory values for low amylase levels.
C) expect lipase levels to decrease within 24 hours.
D) evaluate C-reactive protein as a gauge of severity.
To view all questions and flashcards with answers, click on the resource link above. Page 20
Chapter 19: Endocrine Alterations
Available Study Resources on Quizplus for this Chatper
35 Verified Questions
35 Flashcards
Source URL: https://quizplus.com/quiz/10631
Sample Questions
Q1) The nurse is caring for a patient with a diagnosis of head trauma.The nurse notes that the patient's urine output has increased tremendously over the past 18 hours.The nurse suspects that the patient may be developing
A) diabetes insipidus.
B) diabetic ketoacidosis.
C) hyperosmolar hyperglycemic syndrome.
D) syndrome of inappropriate secretion of antidiuretic hormone.
Q2) A patient presents to the emergency department with suspected thyroid storm.The nurse should be alert to which of the following cardiac rhythms while providing care to this patient?
A) Atrial fibrillation
B) Idioventricular rhythm
C) Junctional rhythm
D) Sinus bradycardia
Q3) Acute adrenal crisis is caused by
A) acute renal failure.
B) deficiency of corticosteroids.
C) high doses of corticosteroids.
D) overdose of testosterone.
To view all questions and flashcards with answers, click on the resource link above.
Chapter 20: Trauma and Surgical Management
Available Study Resources on Quizplus for this Chatper
31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10632
Sample Questions
Q1) It is important to prevent hypothermia in the trauma patient because hypothermia is associated with which of the following? (Select all that apply.)
A) ARDS
B) Coagulopathies
C) Dysrhythmias
D) Myocardial dysfunction
E) Fat embolism
Q2) Which of the following interventions would not be appropriate for a patient who is admitted with a suspected basilar skull fracture?
A) Insertion of a nasotracheal tube
B) Insertion of an indwelling urinary catheter
C) Endotracheal intubation
D) Placement of an oral airway
Q3) Which of the following best defines the term traumatic injury?
A) All trauma patients can be successfully rehabilitated.
B) Traumatic injuries cause more deaths than heart disease and cancer.
C) Alcohol consumption, drug abuse, or other substance abuse contribute to traumatic events.
D) Trauma mainly affects the older adult population.
To view all questions and flashcards with answers, click on the resource link above.
Page 22
Chapter 21: Burns
Available Study Resources on Quizplus for this Chatper
31 Verified Questions
31 Flashcards
Source URL: https://quizplus.com/quiz/10633
Sample Questions
Q1) Tissue damage from burn injury activates an inflammatory response that increases the patient's risk for
A) acute kidney injury.
B) acute respiratory distress syndrome.
C) infection.
D) stress ulcers.
Q2) Which of the following infection control strategies should the nurse implement to decrease the risk of infection in the burn-injured patient? (Select all that apply.)
A) Apply topical antibacterial wound ointments/dressings.
B) Change indwelling urinary catheter every 7 days.
C) Daily assess the need for central IV catheters.
D) Restrict family visitation.
E) Maintain strict aseptic technique during burn wound management.
Q3) In patients with extensive burns,edema occurs in both burned and unburned areas because of
A) catecholamine-induced vasoconstriction.
B) decreased glomerular filtration.
C) increased capillary permeability.
D) loss of integument barrier.
To view all questions and flashcards with answers, click on the resource link above.
Page 23