NUR265 Advanced Concepts of Medical-Surgical Nursing Actual Exam
2026/2027: Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Time Allowed: 90 Minutes | Total Questions: 50
1.
A patient with acute myocardial infarction is prescribed aspirin 325 mg chewable. The
nurse understands that the primary mechanism of action for aspirin in this setting is
which of the following?
A) Dissolving the coronary thrombus
B) Inhibiting platelet aggregation ✓
C) Reducing myocardial oxygen demand
D) Dilating coronary arteries
Correct Answer: B) Inhibiting platelet aggregation
Rationale: Aspirin irreversibly inhibits platelet cyclooxygenase, preventing thromboxane
A2 formation and platelet aggregation, which limits clot propagation in acute MI.
2.
Which assessment finding is most consistent with left-sided heart failure?
A) Jugular venous distension
B) Hepatomegaly
C) Pulmonary crackles ✓
D) Peripheral edema
Correct Answer: C) Pulmonary crackles
Rationale: Left-sided heart failure causes pulmonary congestion due to backward fluid
accumulation in the lungs, resulting in crackles, dyspnea, and orthopnea.
3.
The nurse is caring for a patient with atrial fibrillation who is prescribed warfarin. Which
laboratory value will the nurse monitor to evaluate therapeutic effectiveness?
A) Activated partial thromboplastin time
,B) International normalized ratio ✓
C) Platelet count
D) Bleeding time
Correct Answer: B) International normalized ratio
Rationale: Warfarin therapy is monitored using the INR, with a typical therapeutic range
of 2.0 to 3.0 for atrial fibrillation.
4.
A patient with heart failure has the following vital signs: blood pressure 92/58 mmHg,
heart rate 118 beats/minute, respiratory rate 24 breaths/minute, and oxygen saturation
88% on 2 L nasal cannula. Which action should the nurse take first?
A) Administer IV furosemide
B) Increase oxygen flow rate ✓
C) Obtain a 12-lead ECG
D) Insert a Foley catheter
Correct Answer: B) Increase oxygen flow rate
Rationale: The patient is hypoxemic with an SpO2 of 88%; increasing oxygen delivery is
the priority to improve tissue oxygenation before other interventions.
5.
The nurse is reviewing the medication list for a patient with hypertension. Which
medication works by blocking calcium channels in vascular smooth muscle?
A) Lisinopril
B) Metoprolol
C) Amlodipine ✓
D) Hydrochlorothiazide
Correct Answer: C) Amlodipine
Rationale: Amlodipine is a dihydropyridine calcium channel blocker that causes
vasodilation by inhibiting calcium influx into vascular smooth muscle cells.
6.
A patient with dilated cardiomyopathy asks the nurse why the heart is enlarged. Which
explanation by the nurse is most accurate?
A) The heart muscle has become thickened and stiff
B) The ventricular walls are stretched and thinned, reducing contractility ✓
, C) The pericardial sac is filled with excess fluid
D) The coronary arteries are narrowed and obstructed
Correct Answer: B) The ventricular walls are stretched and thinned, reducing
contractility
Rationale: Dilated cardiomyopathy is characterized by ventricular dilation and impaired
systolic function due to stretched, thinned walls and reduced contractility.
7.
The nurse is caring for a patient with an abdominal aortic aneurysm who reports
sudden, severe back pain and hypotension. Which complication should the nurse
suspect?
A) Aortic dissection
B) Aneurysm rupture ✓
C) Mesenteric ischemia
D) Renal artery stenosis
Correct Answer: B) Aneurysm rupture
Rationale: Sudden severe back or abdominal pain with hypotension in a patient with an
AAA is classic for aneurysm rupture, a surgical emergency.
8.
The nurse is delegating care for four patients. Which task is most appropriate to assign
to an unlicensed assistive personnel (UAP)?
A) Evaluating a patient's response to antidysrhythmic medication
B) Measuring and recording intake and output for a patient with heart failure ✓
C) Teaching a patient about sodium restriction
D) Assessing heart sounds in a patient with chest pain
Correct Answer: B) Measuring and recording intake and output for a patient with heart
failure
Rationale: UAPs can perform routine data collection such as measuring I&O; nursing
judgment tasks like assessment, teaching, and evaluation must be performed by
licensed personnel.
9.
2026/2027: Complete Exam-Style Questions with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Time Allowed: 90 Minutes | Total Questions: 50
1.
A patient with acute myocardial infarction is prescribed aspirin 325 mg chewable. The
nurse understands that the primary mechanism of action for aspirin in this setting is
which of the following?
A) Dissolving the coronary thrombus
B) Inhibiting platelet aggregation ✓
C) Reducing myocardial oxygen demand
D) Dilating coronary arteries
Correct Answer: B) Inhibiting platelet aggregation
Rationale: Aspirin irreversibly inhibits platelet cyclooxygenase, preventing thromboxane
A2 formation and platelet aggregation, which limits clot propagation in acute MI.
2.
Which assessment finding is most consistent with left-sided heart failure?
A) Jugular venous distension
B) Hepatomegaly
C) Pulmonary crackles ✓
D) Peripheral edema
Correct Answer: C) Pulmonary crackles
Rationale: Left-sided heart failure causes pulmonary congestion due to backward fluid
accumulation in the lungs, resulting in crackles, dyspnea, and orthopnea.
3.
The nurse is caring for a patient with atrial fibrillation who is prescribed warfarin. Which
laboratory value will the nurse monitor to evaluate therapeutic effectiveness?
A) Activated partial thromboplastin time
,B) International normalized ratio ✓
C) Platelet count
D) Bleeding time
Correct Answer: B) International normalized ratio
Rationale: Warfarin therapy is monitored using the INR, with a typical therapeutic range
of 2.0 to 3.0 for atrial fibrillation.
4.
A patient with heart failure has the following vital signs: blood pressure 92/58 mmHg,
heart rate 118 beats/minute, respiratory rate 24 breaths/minute, and oxygen saturation
88% on 2 L nasal cannula. Which action should the nurse take first?
A) Administer IV furosemide
B) Increase oxygen flow rate ✓
C) Obtain a 12-lead ECG
D) Insert a Foley catheter
Correct Answer: B) Increase oxygen flow rate
Rationale: The patient is hypoxemic with an SpO2 of 88%; increasing oxygen delivery is
the priority to improve tissue oxygenation before other interventions.
5.
The nurse is reviewing the medication list for a patient with hypertension. Which
medication works by blocking calcium channels in vascular smooth muscle?
A) Lisinopril
B) Metoprolol
C) Amlodipine ✓
D) Hydrochlorothiazide
Correct Answer: C) Amlodipine
Rationale: Amlodipine is a dihydropyridine calcium channel blocker that causes
vasodilation by inhibiting calcium influx into vascular smooth muscle cells.
6.
A patient with dilated cardiomyopathy asks the nurse why the heart is enlarged. Which
explanation by the nurse is most accurate?
A) The heart muscle has become thickened and stiff
B) The ventricular walls are stretched and thinned, reducing contractility ✓
, C) The pericardial sac is filled with excess fluid
D) The coronary arteries are narrowed and obstructed
Correct Answer: B) The ventricular walls are stretched and thinned, reducing
contractility
Rationale: Dilated cardiomyopathy is characterized by ventricular dilation and impaired
systolic function due to stretched, thinned walls and reduced contractility.
7.
The nurse is caring for a patient with an abdominal aortic aneurysm who reports
sudden, severe back pain and hypotension. Which complication should the nurse
suspect?
A) Aortic dissection
B) Aneurysm rupture ✓
C) Mesenteric ischemia
D) Renal artery stenosis
Correct Answer: B) Aneurysm rupture
Rationale: Sudden severe back or abdominal pain with hypotension in a patient with an
AAA is classic for aneurysm rupture, a surgical emergency.
8.
The nurse is delegating care for four patients. Which task is most appropriate to assign
to an unlicensed assistive personnel (UAP)?
A) Evaluating a patient's response to antidysrhythmic medication
B) Measuring and recording intake and output for a patient with heart failure ✓
C) Teaching a patient about sodium restriction
D) Assessing heart sounds in a patient with chest pain
Correct Answer: B) Measuring and recording intake and output for a patient with heart
failure
Rationale: UAPs can perform routine data collection such as measuring I&O; nursing
judgment tasks like assessment, teaching, and evaluation must be performed by
licensed personnel.
9.
