Nurs 400 Final Exam: (Latest 2026/2027 Update) Respiratory Failure &
Myocardial Infarction | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Medical-Surgical Nursing | Respiratory Failure, MI, Hemodynamics, Shock
Format: 20 questions - MCQs, SATA, Priority/Ordering | Clinical Judgment
Difficulty: NCLEX-RN / HESI Level | Critical Care & Physiological Adaptation
Includes: Answer key with detailed rationales and clinical insights
SECTION 1: CLINICAL JUDGMENT QUESTIONS
Respiratory Failure & Ventilator Management
1. A patient with acute respiratory failure presents with restlessness, combative behavior,
tachycardia, and hypoxemia. The nurse notes late cyanosis. What is the priority nursing
intervention?
A. Prepare for immediate intubation
B. Apply oxygen to maintain PaO2 above 60-70 mmHg
C. Administer a sedative to reduce agitation
D. Place the patient in supine position
2. A patient is being weaned from mechanical ventilation. Which finding indicates the patient is
ready for extubation? (Select all that apply) (Select all that apply)
A. PEEP of 10 cm H2O
B. Hemoglobin 12 g/dL
C. Temperature 101.8°F (38.8°C)
D. PaO2 88% on minimal FiO2
E. Negative inspiratory force (NIF) of -60 cm H2O
3. The nurse is caring for a patient on a mechanical ventilator. Which action is correct regarding
suctioning and ABG measurement?
A. Draw ABG immediately after suctioning
B. Wait 15 minutes after suctioning to obtain ABG
C. Hyperventilate the patient after suctioning
D. Suction every 15 minutes routinely
4. A patient has been on mechanical ventilation for 10 days. The healthcare provider
recommends a tracheostomy. The nurse understands that trach placement is typically considered
after how many days of ventilation?
A. 3-5 days
B. 7-14 days
C. 14-21 days
D. 21-28 days
, 5. A patient on a ventilator has PEEP of 10 cm H2O. The nurse is preparing for extubation. What
action should the nurse take?
A. Proceed with extubation as planned
B. Notify the provider that extubation is contraindicated with PEEP >8
C. Increase PEEP to wean faster
D. Administer a neuromuscular blocker
Myocardial Infarction & Cardiac Markers
6. A patient presents with chest pain unrelieved by nitroglycerin, ECG changes, and elevated
troponin. Which cardiac marker is considered the diagnostic of choice for myocardial
infarction?
A. CK-MB
B. Myoglobin
C. Troponin
D. BNP
7. The nurse reviews laboratory results for a patient suspected of having an MI. Which finding is
consistent with CK-MB timing?
A. Onset 2-4 hours, peak 6-12 hours
B. Onset 4-8 hours, peak 18-24 hours, duration 2-3 days
C. Onset 3-8 hours, peak 12-24 hours, duration 7-14 days
D. Onset 1-2 hours, peak 4-6 hours
8. A patient is discharged home after an MI. Which instruction regarding nitroglycerin is
correct?
A. Take one tablet daily at bedtime
B. Take one tablet every 5 minutes up to 3 doses for chest pain
C. Take two tablets immediately then call 911
D. Take only if pain lasts more than 30 minutes
9. Which of the following medications are indicated in the acute management of MI? (Select all
that apply) (Select all that apply)
A. Oxygen
B. Nitroglycerin
C. Morphine
D. Beta-blockers
E. Aspirin
F. Heparin
Hypertensive Crisis & Management
10. A patient presents with BP 210/130 mmHg and signs of papilledema, renal dysfunction, and
chest pain. The nurse recognizes this as:
A. Hypertensive urgency
B. Hypertensive crisis with end-organ dysfunction
C. Preeclampsia
D. White coat hypertension
Myocardial Infarction | Q&A | Grade A | 100% Correct (Verified Answers) –
Nursing Program
Subject: Medical-Surgical Nursing | Respiratory Failure, MI, Hemodynamics, Shock
Format: 20 questions - MCQs, SATA, Priority/Ordering | Clinical Judgment
Difficulty: NCLEX-RN / HESI Level | Critical Care & Physiological Adaptation
Includes: Answer key with detailed rationales and clinical insights
SECTION 1: CLINICAL JUDGMENT QUESTIONS
Respiratory Failure & Ventilator Management
1. A patient with acute respiratory failure presents with restlessness, combative behavior,
tachycardia, and hypoxemia. The nurse notes late cyanosis. What is the priority nursing
intervention?
A. Prepare for immediate intubation
B. Apply oxygen to maintain PaO2 above 60-70 mmHg
C. Administer a sedative to reduce agitation
D. Place the patient in supine position
2. A patient is being weaned from mechanical ventilation. Which finding indicates the patient is
ready for extubation? (Select all that apply) (Select all that apply)
A. PEEP of 10 cm H2O
B. Hemoglobin 12 g/dL
C. Temperature 101.8°F (38.8°C)
D. PaO2 88% on minimal FiO2
E. Negative inspiratory force (NIF) of -60 cm H2O
3. The nurse is caring for a patient on a mechanical ventilator. Which action is correct regarding
suctioning and ABG measurement?
A. Draw ABG immediately after suctioning
B. Wait 15 minutes after suctioning to obtain ABG
C. Hyperventilate the patient after suctioning
D. Suction every 15 minutes routinely
4. A patient has been on mechanical ventilation for 10 days. The healthcare provider
recommends a tracheostomy. The nurse understands that trach placement is typically considered
after how many days of ventilation?
A. 3-5 days
B. 7-14 days
C. 14-21 days
D. 21-28 days
, 5. A patient on a ventilator has PEEP of 10 cm H2O. The nurse is preparing for extubation. What
action should the nurse take?
A. Proceed with extubation as planned
B. Notify the provider that extubation is contraindicated with PEEP >8
C. Increase PEEP to wean faster
D. Administer a neuromuscular blocker
Myocardial Infarction & Cardiac Markers
6. A patient presents with chest pain unrelieved by nitroglycerin, ECG changes, and elevated
troponin. Which cardiac marker is considered the diagnostic of choice for myocardial
infarction?
A. CK-MB
B. Myoglobin
C. Troponin
D. BNP
7. The nurse reviews laboratory results for a patient suspected of having an MI. Which finding is
consistent with CK-MB timing?
A. Onset 2-4 hours, peak 6-12 hours
B. Onset 4-8 hours, peak 18-24 hours, duration 2-3 days
C. Onset 3-8 hours, peak 12-24 hours, duration 7-14 days
D. Onset 1-2 hours, peak 4-6 hours
8. A patient is discharged home after an MI. Which instruction regarding nitroglycerin is
correct?
A. Take one tablet daily at bedtime
B. Take one tablet every 5 minutes up to 3 doses for chest pain
C. Take two tablets immediately then call 911
D. Take only if pain lasts more than 30 minutes
9. Which of the following medications are indicated in the acute management of MI? (Select all
that apply) (Select all that apply)
A. Oxygen
B. Nitroglycerin
C. Morphine
D. Beta-blockers
E. Aspirin
F. Heparin
Hypertensive Crisis & Management
10. A patient presents with BP 210/130 mmHg and signs of papilledema, renal dysfunction, and
chest pain. The nurse recognizes this as:
A. Hypertensive urgency
B. Hypertensive crisis with end-organ dysfunction
C. Preeclampsia
D. White coat hypertension
