NSG 430 FINAL: (Latest 2026/2027 Update) Critical Care, Cardiology,
Neurology, Renal, & Emergency Nursing | Q&A | Grade A | 100% Correct
(Verified Answers)
Subject: Advanced Medical-Surgical / Critical Care
Source: NSG 430 FINAL – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: Which medication is contraindicated in patients with asthma and heart problems?
Correct Answer: Propranolol.
1. Propranolol is a non-selective beta-blocker that blocks beta-2 receptors in the lungs, causing
bronchospasm.
2. Use in asthma patients can trigger life-threatening bronchoconstriction.
3. Cardioselective beta-blockers (metoprolol, atenolol) are safer alternatives in cardiac patients with
asthma.
2: What is the treatment for Addisonian crisis?
Correct Answer: High dose hydrocortisone.
1. Addisonian crisis is life-threatening adrenal insufficiency requiring immediate glucocorticoid
replacement.
2. IV hydrocortisone 100 mg bolus followed by continuous infusion.
3. Also requires IV fluids (NS with dextrose) and correction of electrolytes.
3: Treatment for thyroid storm includes:
Correct Answer: Rest, minimal stimulation, artificial tears, dysrhythmias.
1. Thyroid storm requires decreased stimulation to reduce metabolic demand.
2. Artificial tears protect against exophthalmos complications.
3. Monitor for and treat dysrhythmias (beta-blockers for rate control).
4: CPAP must be used with caution in patients with?
Correct Answer: Myocardial compromise.
1. CPAP increases intrathoracic pressure, decreasing venous return and cardiac output.
2. Can worsen hypotension and cause hemodynamic instability.
3. Use with caution or avoid in cardiogenic shock and severe heart failure.
5: What type of murmur does mitral valve regurgitation cause?
Correct Answer: Holosystolic (blowing).
1. Mitral regurgitation murmur is holosystolic, best heard at apex with radiation to axilla.
2. Caused by blood flowing backward from LV to LA throughout systole.
3. Often described as a blowing quality.
,6: Symptoms of mitral valve stenosis include:
Correct Answer: SOB, pulmonary HTN, AFIB, left atrial hypertrophy.
1. Mitral stenosis obstructs LA emptying, causing LA enlargement and pulmonary congestion.
2. Pulmonary hypertension develops from back pressure.
3. Atrial fibrillation is common (30-40% of patients).
7: Symptoms of Hypertrophic Cardiomyopathy:
Correct Answer: Hypertrophy of left ventricle, aortic stenosis, syncope with exercise.
1. Hypertrophic cardiomyopathy causes LV outflow tract obstruction.
2. Syncope during exercise due to decreased cardiac output with increased contractility.
3. Leading cause of sudden cardiac death in young athletes.
8: A client complains of chest pain that started while walking in the park. The pain
radiated to the left arm and jaw lasting approximately 15 minutes. The pain subsided after
taking 2 SL doses of Nitroglycerin. The nurse knows this is suggestive of:
Correct Answer: Stable Angina.
1. Stable angina is predictable with exertion and relieved by rest or nitroglycerin.
2. Pain duration typically less than 15 minutes.
3. Unstable angina occurs at rest and does not resolve with nitroglycerin.
9: Symptoms of Pulmonary Contusion:
Correct Answer: Blunt trauma, tenderness to palpation, crackles in lung base.
1. Pulmonary contusion results from blunt chest trauma causing alveolar hemorrhage.
2. Crackles indicate fluid in the alveoli from injury.
3. May worsen over 24-48 hours as edema develops.
10: A client with a diagnosis of addisonian crisis is being admitted to the intensive care
unit. Which findings will the interprofessional health care team focus on?
Correct Answer: Hypotension, hyperkalemia, hyponatremia.
1. Addisonian crisis causes deficiency of aldosterone (Na loss, K retention).
2. Hypotension from volume depletion and decreased cortisol.
3. Hyponatremia and hyperkalemia are hallmark electrolyte abnormalities.
11: A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is
being assessed by the nurse. Which assessment findings would be consistent with acute
pancreatitis?
Correct Answer: Gray-blue color flank, abdominal guarding and tenderness, LUQ pain with
radiation, fever.
1. Gray-blue flank discoloration (Grey Turner sign) indicates retroperitoneal bleeding.
2. Pain often radiates to the back.
3. Abdominal guarding and fever indicate inflammation.
, 12: How do you know when cardiogenic shock has progressed to MODS?
Correct Answer: High serum creatinine levels.
1. MODS involves failure of two or more organ systems.
2. Elevated creatinine indicates acute kidney injury (renal failure).p>
3. Other signs include elevated LFTs (liver), coagulopathy, and altered mental status.
13: What blood product do you administer in a patient who has overdosed on warfarin?
Correct Answer: Fresh frozen plasma, vitamin K.
1. FFP provides immediate clotting factors.
2. Vitamin K takes 6-24 hours for effect (reverses warfarin synthesis).
3. For life-threatening bleeding, give FFP + vitamin K.
14: A patient is recovering from a heart surgery and develops pericarditis and complain of
a 6 out of 10 chest pain with deep breathing. Which prescribed PRN medication will be
most appropriate for the nurse to give?
Correct Answer: Oral ibuprofen 600 mg (Motrin).
1. NSAIDs are first-line treatment for pericarditis pain and inflammation.
2. Ibuprofen is commonly used for post-cardiac surgery pericarditis.
3. Avoid NSAIDs in acute MI but safe post-op pericarditis.
15: Which nursing action will be included in the plan of care for a patient who is being
treated for esophageal varies with a balloon tamponade?
Correct Answer: Monitor for SOB.
1. Balloon tamponade can cause aspiration or airway obstruction.
2. Monitor for respiratory distress (priority).
3. Keep scissors at bedside for emergency balloon deflation.
16: A patient suffered a brain injury after a motor vehicle accident - which statement
made by the patient is most concerning about medication?
Correct Answer: I take warfarin daily.
1. Warfarin increases risk of intracranial hemorrhage after head injury.
2. Anticoagulation worsens bleeding and outcomes.
3. Urgent reversal may be needed.
17: A patient develops pyelonephritis after being on vancomycin. What information would
the nurse tell the healthcare provider?
Correct Answer: Nephrotoxicity.
1. Vancomycin is nephrotoxic and can cause acute kidney injury.
2. Pyelonephritis is kidney infection; vancomycin-induced nephrotoxicity is a concern.
3. Monitor trough levels and renal function.
Neurology, Renal, & Emergency Nursing | Q&A | Grade A | 100% Correct
(Verified Answers)
Subject: Advanced Medical-Surgical / Critical Care
Source: NSG 430 FINAL – Comprehensive Review Format: Q&A Guide with Clinical Rationale
1: Which medication is contraindicated in patients with asthma and heart problems?
Correct Answer: Propranolol.
1. Propranolol is a non-selective beta-blocker that blocks beta-2 receptors in the lungs, causing
bronchospasm.
2. Use in asthma patients can trigger life-threatening bronchoconstriction.
3. Cardioselective beta-blockers (metoprolol, atenolol) are safer alternatives in cardiac patients with
asthma.
2: What is the treatment for Addisonian crisis?
Correct Answer: High dose hydrocortisone.
1. Addisonian crisis is life-threatening adrenal insufficiency requiring immediate glucocorticoid
replacement.
2. IV hydrocortisone 100 mg bolus followed by continuous infusion.
3. Also requires IV fluids (NS with dextrose) and correction of electrolytes.
3: Treatment for thyroid storm includes:
Correct Answer: Rest, minimal stimulation, artificial tears, dysrhythmias.
1. Thyroid storm requires decreased stimulation to reduce metabolic demand.
2. Artificial tears protect against exophthalmos complications.
3. Monitor for and treat dysrhythmias (beta-blockers for rate control).
4: CPAP must be used with caution in patients with?
Correct Answer: Myocardial compromise.
1. CPAP increases intrathoracic pressure, decreasing venous return and cardiac output.
2. Can worsen hypotension and cause hemodynamic instability.
3. Use with caution or avoid in cardiogenic shock and severe heart failure.
5: What type of murmur does mitral valve regurgitation cause?
Correct Answer: Holosystolic (blowing).
1. Mitral regurgitation murmur is holosystolic, best heard at apex with radiation to axilla.
2. Caused by blood flowing backward from LV to LA throughout systole.
3. Often described as a blowing quality.
,6: Symptoms of mitral valve stenosis include:
Correct Answer: SOB, pulmonary HTN, AFIB, left atrial hypertrophy.
1. Mitral stenosis obstructs LA emptying, causing LA enlargement and pulmonary congestion.
2. Pulmonary hypertension develops from back pressure.
3. Atrial fibrillation is common (30-40% of patients).
7: Symptoms of Hypertrophic Cardiomyopathy:
Correct Answer: Hypertrophy of left ventricle, aortic stenosis, syncope with exercise.
1. Hypertrophic cardiomyopathy causes LV outflow tract obstruction.
2. Syncope during exercise due to decreased cardiac output with increased contractility.
3. Leading cause of sudden cardiac death in young athletes.
8: A client complains of chest pain that started while walking in the park. The pain
radiated to the left arm and jaw lasting approximately 15 minutes. The pain subsided after
taking 2 SL doses of Nitroglycerin. The nurse knows this is suggestive of:
Correct Answer: Stable Angina.
1. Stable angina is predictable with exertion and relieved by rest or nitroglycerin.
2. Pain duration typically less than 15 minutes.
3. Unstable angina occurs at rest and does not resolve with nitroglycerin.
9: Symptoms of Pulmonary Contusion:
Correct Answer: Blunt trauma, tenderness to palpation, crackles in lung base.
1. Pulmonary contusion results from blunt chest trauma causing alveolar hemorrhage.
2. Crackles indicate fluid in the alveoli from injury.
3. May worsen over 24-48 hours as edema develops.
10: A client with a diagnosis of addisonian crisis is being admitted to the intensive care
unit. Which findings will the interprofessional health care team focus on?
Correct Answer: Hypotension, hyperkalemia, hyponatremia.
1. Addisonian crisis causes deficiency of aldosterone (Na loss, K retention).
2. Hypotension from volume depletion and decreased cortisol.
3. Hyponatremia and hyperkalemia are hallmark electrolyte abnormalities.
11: A client admitted to the hospital with a suspected diagnosis of acute pancreatitis is
being assessed by the nurse. Which assessment findings would be consistent with acute
pancreatitis?
Correct Answer: Gray-blue color flank, abdominal guarding and tenderness, LUQ pain with
radiation, fever.
1. Gray-blue flank discoloration (Grey Turner sign) indicates retroperitoneal bleeding.
2. Pain often radiates to the back.
3. Abdominal guarding and fever indicate inflammation.
, 12: How do you know when cardiogenic shock has progressed to MODS?
Correct Answer: High serum creatinine levels.
1. MODS involves failure of two or more organ systems.
2. Elevated creatinine indicates acute kidney injury (renal failure).p>
3. Other signs include elevated LFTs (liver), coagulopathy, and altered mental status.
13: What blood product do you administer in a patient who has overdosed on warfarin?
Correct Answer: Fresh frozen plasma, vitamin K.
1. FFP provides immediate clotting factors.
2. Vitamin K takes 6-24 hours for effect (reverses warfarin synthesis).
3. For life-threatening bleeding, give FFP + vitamin K.
14: A patient is recovering from a heart surgery and develops pericarditis and complain of
a 6 out of 10 chest pain with deep breathing. Which prescribed PRN medication will be
most appropriate for the nurse to give?
Correct Answer: Oral ibuprofen 600 mg (Motrin).
1. NSAIDs are first-line treatment for pericarditis pain and inflammation.
2. Ibuprofen is commonly used for post-cardiac surgery pericarditis.
3. Avoid NSAIDs in acute MI but safe post-op pericarditis.
15: Which nursing action will be included in the plan of care for a patient who is being
treated for esophageal varies with a balloon tamponade?
Correct Answer: Monitor for SOB.
1. Balloon tamponade can cause aspiration or airway obstruction.
2. Monitor for respiratory distress (priority).
3. Keep scissors at bedside for emergency balloon deflation.
16: A patient suffered a brain injury after a motor vehicle accident - which statement
made by the patient is most concerning about medication?
Correct Answer: I take warfarin daily.
1. Warfarin increases risk of intracranial hemorrhage after head injury.
2. Anticoagulation worsens bleeding and outcomes.
3. Urgent reversal may be needed.
17: A patient develops pyelonephritis after being on vancomycin. What information would
the nurse tell the healthcare provider?
Correct Answer: Nephrotoxicity.
1. Vancomycin is nephrotoxic and can cause acute kidney injury.
2. Pyelonephritis is kidney infection; vancomycin-induced nephrotoxicity is a concern.
3. Monitor trough levels and renal function.
