WGU C785: ADVANCED MED SURG
2026 PREMIUM UNIQUE QUESTION BANK
🔑 Key Advanced Concepts
• Endocrine: Use the "Rule of 15" for hypoglycemia (15g carbs, recheck in 15
mins).
• Renal: Monitor for Disequilibrium Syndrome after first dialysis (headache,
nausea).
• Cardiac: Nitro must be kept in dark glass bottles; it is light-sensitive.
• Neuro: Avoid lumbar punctures in clients with increased ICP (risk of herniation).
QUESTION 1
A nurse is assessing a client for Trousseau’s sign. Which electrolyte imbalance is
being tested?
Correct Answer: Hypocalcemia
Rationale: Trousseau's sign is a carpal spasm induced by inflating a BP cuff, indicating low calcium.
QUESTION 2
Which finding is part of Cushing’s Triad in a client with increased ICP?
Correct Answer: Widening pulse pressure
Rationale: Cushing's triad includes bradycardia, irregular respirations, and widening pulse pressure.
,QUESTION 3
A client has a potassium level of 6.8 mEq/L. Which ECG change should the nurse
expect?
Correct Answer: Tall peaked T waves
Rationale: Hyperkalemia causes peaked T waves, widened QRS, and potentially cardiac arrest.
QUESTION 4
Which acid-base imbalance is expected in a client with prolonged vomiting?
Correct Answer: Metabolic alkalosis
Rationale: Vomiting causes loss of gastric acid (HCl), leading to an increase in blood pH.
QUESTION 5
A nurse is caring for a client with Right-Sided Heart Failure. What is a typical
finding?
Correct Answer: Jugular Venous Distension (JVD)
Rationale: Right-sided failure causes systemic congestion, leading to JVD and peripheral edema.
QUESTION 6
In the Rule of Nines, what percentage is assigned to the entire right leg?
Correct Answer: 18%
Rationale: Each leg is 18% (9% anterior, 9% posterior).
QUESTION 7
What is the priority intervention for a client experiencing an anaphylactic reaction?
Correct Answer: Administer Epinephrine
Rationale: Epinephrine is the first-line treatment to reverse airway obstruction and hypotension.
,QUESTION 8
A client with Chronic Kidney Disease has low Erythropoietin. What is the result?
Correct Answer: Anemia
Rationale: Erythropoietin is produced by the kidneys to stimulate red blood cell production.
QUESTION 9
Which position is best for a client post-craniotomy to reduce ICP?
Correct Answer: Semi-Fowler’s (30-45 degrees)
Rationale: Elevating the head promotes venous drainage from the brain.
QUESTION 10
What is the hallmark sign of tension pneumothorax?
Correct Answer: Tracheal deviation to the unaffected side
Rationale: Pressure buildup pushes the mediastinum and trachea toward the opposite side.
QUESTION 11
A nurse notes a 'mousy' odor on the breath of a client with liver failure. What is this
called?
Correct Answer: Fetor hepaticus
Rationale: This occurs due to the accumulation of sulfur compounds the liver can't filter.
QUESTION 12
Which medication is the 'gold standard' for treating a manic episode in Bipolar
Disorder?
Correct Answer: Lithium carbonate
Rationale: Lithium is a mood stabilizer specifically effective for mania.
, QUESTION 13
A client has a HbA1c of 8.5%. What does this indicate?
Correct Answer: Poor long-term glucose control
Rationale: HbA1c reflects average blood sugar over the past 2-3 months; goal is usually <7%.
QUESTION 14
What is the primary risk for a client with Atrial Fibrillation?
Correct Answer: Embolic stroke
Rationale: Blood pools in the atria, forming clots that can travel to the brain.
QUESTION 15
A client with Addison’s disease is stressed. What is the major risk?
Correct Answer: Addisonian Crisis
Rationale: Stress increases the demand for cortisol, which these clients cannot produce.
QUESTION 16
Which sign indicates a positive response to fluid resuscitation in a burn patient?
Correct Answer: Urine output of 30-50 mL/hr
Rationale: Urine output is the most reliable indicator of organ perfusion.
QUESTION 17
A nurse is assessing a client with Appendicitis. Where is McBurney's point
located?
Correct Answer: Right Lower Quadrant
Rationale: Pain at McBurney's point is a classic sign of localized peritoneal inflammation in
appendicitis.
2026 PREMIUM UNIQUE QUESTION BANK
🔑 Key Advanced Concepts
• Endocrine: Use the "Rule of 15" for hypoglycemia (15g carbs, recheck in 15
mins).
• Renal: Monitor for Disequilibrium Syndrome after first dialysis (headache,
nausea).
• Cardiac: Nitro must be kept in dark glass bottles; it is light-sensitive.
• Neuro: Avoid lumbar punctures in clients with increased ICP (risk of herniation).
QUESTION 1
A nurse is assessing a client for Trousseau’s sign. Which electrolyte imbalance is
being tested?
Correct Answer: Hypocalcemia
Rationale: Trousseau's sign is a carpal spasm induced by inflating a BP cuff, indicating low calcium.
QUESTION 2
Which finding is part of Cushing’s Triad in a client with increased ICP?
Correct Answer: Widening pulse pressure
Rationale: Cushing's triad includes bradycardia, irregular respirations, and widening pulse pressure.
,QUESTION 3
A client has a potassium level of 6.8 mEq/L. Which ECG change should the nurse
expect?
Correct Answer: Tall peaked T waves
Rationale: Hyperkalemia causes peaked T waves, widened QRS, and potentially cardiac arrest.
QUESTION 4
Which acid-base imbalance is expected in a client with prolonged vomiting?
Correct Answer: Metabolic alkalosis
Rationale: Vomiting causes loss of gastric acid (HCl), leading to an increase in blood pH.
QUESTION 5
A nurse is caring for a client with Right-Sided Heart Failure. What is a typical
finding?
Correct Answer: Jugular Venous Distension (JVD)
Rationale: Right-sided failure causes systemic congestion, leading to JVD and peripheral edema.
QUESTION 6
In the Rule of Nines, what percentage is assigned to the entire right leg?
Correct Answer: 18%
Rationale: Each leg is 18% (9% anterior, 9% posterior).
QUESTION 7
What is the priority intervention for a client experiencing an anaphylactic reaction?
Correct Answer: Administer Epinephrine
Rationale: Epinephrine is the first-line treatment to reverse airway obstruction and hypotension.
,QUESTION 8
A client with Chronic Kidney Disease has low Erythropoietin. What is the result?
Correct Answer: Anemia
Rationale: Erythropoietin is produced by the kidneys to stimulate red blood cell production.
QUESTION 9
Which position is best for a client post-craniotomy to reduce ICP?
Correct Answer: Semi-Fowler’s (30-45 degrees)
Rationale: Elevating the head promotes venous drainage from the brain.
QUESTION 10
What is the hallmark sign of tension pneumothorax?
Correct Answer: Tracheal deviation to the unaffected side
Rationale: Pressure buildup pushes the mediastinum and trachea toward the opposite side.
QUESTION 11
A nurse notes a 'mousy' odor on the breath of a client with liver failure. What is this
called?
Correct Answer: Fetor hepaticus
Rationale: This occurs due to the accumulation of sulfur compounds the liver can't filter.
QUESTION 12
Which medication is the 'gold standard' for treating a manic episode in Bipolar
Disorder?
Correct Answer: Lithium carbonate
Rationale: Lithium is a mood stabilizer specifically effective for mania.
, QUESTION 13
A client has a HbA1c of 8.5%. What does this indicate?
Correct Answer: Poor long-term glucose control
Rationale: HbA1c reflects average blood sugar over the past 2-3 months; goal is usually <7%.
QUESTION 14
What is the primary risk for a client with Atrial Fibrillation?
Correct Answer: Embolic stroke
Rationale: Blood pools in the atria, forming clots that can travel to the brain.
QUESTION 15
A client with Addison’s disease is stressed. What is the major risk?
Correct Answer: Addisonian Crisis
Rationale: Stress increases the demand for cortisol, which these clients cannot produce.
QUESTION 16
Which sign indicates a positive response to fluid resuscitation in a burn patient?
Correct Answer: Urine output of 30-50 mL/hr
Rationale: Urine output is the most reliable indicator of organ perfusion.
QUESTION 17
A nurse is assessing a client with Appendicitis. Where is McBurney's point
located?
Correct Answer: Right Lower Quadrant
Rationale: Pain at McBurney's point is a classic sign of localized peritoneal inflammation in
appendicitis.
