Nurs 3151 Advanced Medical-Surgical
Nursing Exam With Actual Questions
& Verified Answers ,Plus Explained
Rationales/Expert Verified For
Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
Nurs 3151: Advanced Medical-Surgical Nursing Exam
1. A patient with chronic heart failure presents with shortness of
breath and edema. Which medication is most appropriate to
reduce fluid overload?
a. Metoprolol
b. Furosemide
c. Digoxin
d. Lisinopril
b. Furosemide
Furosemide is a loop diuretic that reduces fluid overload by
increasing urinary excretion of sodium and water, which helps
relieve edema and pulmonary congestion.
2. Which lab value indicates a patient is at risk for bleeding when
on heparin therapy?
a. INR 1.0
b. aPTT 90 seconds
c. Platelet count 200,000/mm³
d. Hemoglobin 14 g/dL
, b. aPTT 90 seconds
An elevated aPTT above the therapeutic range (typically 60–
80 seconds) increases the risk of bleeding in patients receiving
heparin.
3. A nurse is caring for a patient with diabetic ketoacidosis (DKA).
What is the priority intervention?
a. Administer IV insulin
b. Start oral hypoglycemics
c. Provide high-calorie diet
d. Encourage ambulation
a. Administer IV insulin
IV insulin is essential to reduce hyperglycemia and stop ketone
production, which is life-threatening in DKA.
4. Which electrolyte imbalance is most commonly associated with
chronic kidney disease?
a. Hypokalemia
b. Hyperkalemia
c. Hyponatremia
d. Hypocalcemia
b. Hyperkalemia
CKD often impairs potassium excretion, leading to
hyperkalemia, which can cause cardiac arrhythmias.
5. A patient is prescribed warfarin. Which lab test should be
monitored regularly?
a. aPTT
b. PT/INR
c. Serum creatinine
d. WBC count
b. PT/INR
, PT/INR measures the anticoagulant effect of warfarin and
helps guide dosing to prevent bleeding or clotting
complications.
6. The nurse is assessing a patient with cirrhosis. Which finding
suggests hepatic encephalopathy?
a. Ascites
b. Jaundice
c. Asterixis
d. Edema
c. Asterixis
Asterixis, or “flapping tremor,” indicates a buildup of toxins
affecting the brain, characteristic of hepatic encephalopathy.
7. Which is the earliest sign of hypoxia in a patient?
a. Cyanosis
b. Tachypnea
c. Bradycardia
d. Confusion
b. Tachypnea
Tachypnea is an early compensatory response to low oxygen
levels; cyanosis and confusion occur later.
8. A patient is prescribed morphine for post-op pain. Which side
effect should the nurse monitor most closely?
a. Constipation
b. Respiratory depression
c. Sedation
d. Nausea
b. Respiratory depression
Morphine can depress the respiratory center; monitoring for
adequate breathing is critical, especially after surgery.
, 9. Which nursing intervention is priority for a patient with
neutropenia?
a. Encourage exercise
b. Place patient on neutropenic precautions
c. Administer iron supplements
d. Provide high-protein diet
b. Place patient on neutropenic precautions
Neutropenic patients are at high risk for infection; precautions
reduce exposure to pathogens.
10. A patient with COPD is prescribed oxygen therapy. What is
the safest oxygen delivery goal?
a. 100% saturation
b. 92–96% saturation
c. 88–92% saturation
d. 80–85% saturation
c. 88–92% saturation
Patients with COPD are at risk of CO2 retention; maintaining
oxygen at 88–92% prevents hypoxia without suppressing their
respiratory drive.
11. A patient with myocardial infarction is experiencing chest
pain. What is the priority nursing action?
a. Administer oxygen
b. Administer nitroglycerin
c. Obtain vital signs
d. Start IV fluids
a. Administer oxygen
Oxygen reduces myocardial ischemia and is the immediate
priority to prevent further heart damage.
Nursing Exam With Actual Questions
& Verified Answers ,Plus Explained
Rationales/Expert Verified For
Guaranteed Pass 2026/Latest
Update/Instant Download Pdf
Nurs 3151: Advanced Medical-Surgical Nursing Exam
1. A patient with chronic heart failure presents with shortness of
breath and edema. Which medication is most appropriate to
reduce fluid overload?
a. Metoprolol
b. Furosemide
c. Digoxin
d. Lisinopril
b. Furosemide
Furosemide is a loop diuretic that reduces fluid overload by
increasing urinary excretion of sodium and water, which helps
relieve edema and pulmonary congestion.
2. Which lab value indicates a patient is at risk for bleeding when
on heparin therapy?
a. INR 1.0
b. aPTT 90 seconds
c. Platelet count 200,000/mm³
d. Hemoglobin 14 g/dL
, b. aPTT 90 seconds
An elevated aPTT above the therapeutic range (typically 60–
80 seconds) increases the risk of bleeding in patients receiving
heparin.
3. A nurse is caring for a patient with diabetic ketoacidosis (DKA).
What is the priority intervention?
a. Administer IV insulin
b. Start oral hypoglycemics
c. Provide high-calorie diet
d. Encourage ambulation
a. Administer IV insulin
IV insulin is essential to reduce hyperglycemia and stop ketone
production, which is life-threatening in DKA.
4. Which electrolyte imbalance is most commonly associated with
chronic kidney disease?
a. Hypokalemia
b. Hyperkalemia
c. Hyponatremia
d. Hypocalcemia
b. Hyperkalemia
CKD often impairs potassium excretion, leading to
hyperkalemia, which can cause cardiac arrhythmias.
5. A patient is prescribed warfarin. Which lab test should be
monitored regularly?
a. aPTT
b. PT/INR
c. Serum creatinine
d. WBC count
b. PT/INR
, PT/INR measures the anticoagulant effect of warfarin and
helps guide dosing to prevent bleeding or clotting
complications.
6. The nurse is assessing a patient with cirrhosis. Which finding
suggests hepatic encephalopathy?
a. Ascites
b. Jaundice
c. Asterixis
d. Edema
c. Asterixis
Asterixis, or “flapping tremor,” indicates a buildup of toxins
affecting the brain, characteristic of hepatic encephalopathy.
7. Which is the earliest sign of hypoxia in a patient?
a. Cyanosis
b. Tachypnea
c. Bradycardia
d. Confusion
b. Tachypnea
Tachypnea is an early compensatory response to low oxygen
levels; cyanosis and confusion occur later.
8. A patient is prescribed morphine for post-op pain. Which side
effect should the nurse monitor most closely?
a. Constipation
b. Respiratory depression
c. Sedation
d. Nausea
b. Respiratory depression
Morphine can depress the respiratory center; monitoring for
adequate breathing is critical, especially after surgery.
, 9. Which nursing intervention is priority for a patient with
neutropenia?
a. Encourage exercise
b. Place patient on neutropenic precautions
c. Administer iron supplements
d. Provide high-protein diet
b. Place patient on neutropenic precautions
Neutropenic patients are at high risk for infection; precautions
reduce exposure to pathogens.
10. A patient with COPD is prescribed oxygen therapy. What is
the safest oxygen delivery goal?
a. 100% saturation
b. 92–96% saturation
c. 88–92% saturation
d. 80–85% saturation
c. 88–92% saturation
Patients with COPD are at risk of CO2 retention; maintaining
oxygen at 88–92% prevents hypoxia without suppressing their
respiratory drive.
11. A patient with myocardial infarction is experiencing chest
pain. What is the priority nursing action?
a. Administer oxygen
b. Administer nitroglycerin
c. Obtain vital signs
d. Start IV fluids
a. Administer oxygen
Oxygen reduces myocardial ischemia and is the immediate
priority to prevent further heart damage.
