NP4 EXAM QUESTIONS WITH CORRECT ANSWERS LATEST UPDATE 2026/2027
1. Nurse Kim carries out the order for the client to have a diagnostic test. Which of the following
values indicate hyponatremia? A sodium level _____
*
1 point
A. Below 8.5 to 10.5 mg/dL
B. Between 3.5 and 5.5 mEgL
C. Above 145 mEg/L
D. Below 135 mEg/L - Answers D. Below 135 mEg/L
2. Nurse Kim is aware that the MOST common electrolyte abnormality in hospitalized patient is
______
*
1 point
A. Hyperkalemia
B. Hyponatremia
C. Hypernatremia
D. Hypokalemia - Answers B. Hyponatremia
3. Nurse Kim writes a nursing diagnosis. Which of the following diagnoses is MOST appropriate
for the client?
*
1 point
A. Excess Fluid Volume
B. Ineffective Breathing Pattern
C. Deficient Fluid Volume
D. Disturbed Thought Processes - Answers D. Disturbed Thought Processes
4. The physician prescribes intravenous solutions for the client. Which of the following solutions
is appropriate?
,*
1 point
A. 0.9 % Sodium Chloride
B. Dextran 6 % in sterile water
C. 0.3 % Sodium Chloride
D. Dextrose 5 % in water - Answers A. 0.9 % Sodium Chloride
5. An appropriate nursing intervention for the client is for Nurse Kim to________
*
1 point
A. Maintain body alignment and assist with movement
B. Monitor level of consciousness
C. Administer oral hygiene
D. Monitor laboratory findings - Answers B. Monitor level of consciousness
SITUATION 2
The nurse cares for a group of clients with allergies.
6. The nurse assesses the client who says he is highly allergic to many food items and
medications. Which of the following hypersensitivity reactions would be responsible for this
type of clinical manifestation?
*
1 point
A. Type 4, delayed sensitivity
B. Type 1, IgE mediated hypersensitivity
C. Type 2, cytotoxic hypersensitivity
D. Type 3, immune complex-mediated hypersensitivity - Answers B. Type 1, IgE mediated
hypersensitivity
7. The nurse assesses an atopic client who had serious Type 1 hypersensitivity reactions. The
,nurse is aware that the most severe form of a Type 1 hypersensitivity reaction is which of the
following conditions?
*
1 point
A. Cell-mediated sensitivity
B. Dermatitis
C. Anaphylaxis
D. Bronchial asthma - Answers C. Anaphylaxis
8. A client is experiencing anaphylaxis. Which of the following actions by the nurse takes
HIGHEST priority?
*
1 point
A. Administer epinephrine injection
B. Place the client in Trendelenburg position
C. Maintain an open airway
D. Administer emergency oxygen - Answers A. Administer epinephrine injection
9. The nurse develops a care plan for a client with a past history of anaphylaxis. Which drug
should the nurse instruct the client to always have it readily available to treat possible allergic
reaction?
*
1 point
A. Diphenhydramine
B. Acetaminophen
C. Epinephrine
D. Acetyl Salicylic Acid - Answers C. Epinephrine
10. A client with a history of Type 1 hypersensitivity reaction is receiving immunotherapy. The
nurse administers the allergen injection and asks the client to wait for how many minutes so
that the immediate reactions can be treated?
, *
1 point
A. 5 - 15 minutes
B. 30 - 40 minutes
C. 60 minutes
D. 15 - 25 minutes - Answers A. 5 - 15 minutes
11.The client is fortunate that the level of his injury did not affect his respiratory function. The
nurse understands that the cord segments involved in maintaining respiratory function are:
*
1 point
A. C1-2
B. C3-4
C. C5
D. C6 - Answers B. C3-4
12. Nurse Em understands that the LEAST effective method of preventing contractures of the
joints of the lower extremities would be to:
*
1 point
A. Passively move the extremities through range of motion exercises.
B. Provide the client with active exercise instructions.
C. Maintain proper alignment in bed.
D. Change the client's position every two hours. - Answers B. Provide the client with active
exercise instructions.
13. Nurse Em plans care for the client which includes turning the client every two hours. This
nursing measure is necessary to:
*
1 point
1. Nurse Kim carries out the order for the client to have a diagnostic test. Which of the following
values indicate hyponatremia? A sodium level _____
*
1 point
A. Below 8.5 to 10.5 mg/dL
B. Between 3.5 and 5.5 mEgL
C. Above 145 mEg/L
D. Below 135 mEg/L - Answers D. Below 135 mEg/L
2. Nurse Kim is aware that the MOST common electrolyte abnormality in hospitalized patient is
______
*
1 point
A. Hyperkalemia
B. Hyponatremia
C. Hypernatremia
D. Hypokalemia - Answers B. Hyponatremia
3. Nurse Kim writes a nursing diagnosis. Which of the following diagnoses is MOST appropriate
for the client?
*
1 point
A. Excess Fluid Volume
B. Ineffective Breathing Pattern
C. Deficient Fluid Volume
D. Disturbed Thought Processes - Answers D. Disturbed Thought Processes
4. The physician prescribes intravenous solutions for the client. Which of the following solutions
is appropriate?
,*
1 point
A. 0.9 % Sodium Chloride
B. Dextran 6 % in sterile water
C. 0.3 % Sodium Chloride
D. Dextrose 5 % in water - Answers A. 0.9 % Sodium Chloride
5. An appropriate nursing intervention for the client is for Nurse Kim to________
*
1 point
A. Maintain body alignment and assist with movement
B. Monitor level of consciousness
C. Administer oral hygiene
D. Monitor laboratory findings - Answers B. Monitor level of consciousness
SITUATION 2
The nurse cares for a group of clients with allergies.
6. The nurse assesses the client who says he is highly allergic to many food items and
medications. Which of the following hypersensitivity reactions would be responsible for this
type of clinical manifestation?
*
1 point
A. Type 4, delayed sensitivity
B. Type 1, IgE mediated hypersensitivity
C. Type 2, cytotoxic hypersensitivity
D. Type 3, immune complex-mediated hypersensitivity - Answers B. Type 1, IgE mediated
hypersensitivity
7. The nurse assesses an atopic client who had serious Type 1 hypersensitivity reactions. The
,nurse is aware that the most severe form of a Type 1 hypersensitivity reaction is which of the
following conditions?
*
1 point
A. Cell-mediated sensitivity
B. Dermatitis
C. Anaphylaxis
D. Bronchial asthma - Answers C. Anaphylaxis
8. A client is experiencing anaphylaxis. Which of the following actions by the nurse takes
HIGHEST priority?
*
1 point
A. Administer epinephrine injection
B. Place the client in Trendelenburg position
C. Maintain an open airway
D. Administer emergency oxygen - Answers A. Administer epinephrine injection
9. The nurse develops a care plan for a client with a past history of anaphylaxis. Which drug
should the nurse instruct the client to always have it readily available to treat possible allergic
reaction?
*
1 point
A. Diphenhydramine
B. Acetaminophen
C. Epinephrine
D. Acetyl Salicylic Acid - Answers C. Epinephrine
10. A client with a history of Type 1 hypersensitivity reaction is receiving immunotherapy. The
nurse administers the allergen injection and asks the client to wait for how many minutes so
that the immediate reactions can be treated?
, *
1 point
A. 5 - 15 minutes
B. 30 - 40 minutes
C. 60 minutes
D. 15 - 25 minutes - Answers A. 5 - 15 minutes
11.The client is fortunate that the level of his injury did not affect his respiratory function. The
nurse understands that the cord segments involved in maintaining respiratory function are:
*
1 point
A. C1-2
B. C3-4
C. C5
D. C6 - Answers B. C3-4
12. Nurse Em understands that the LEAST effective method of preventing contractures of the
joints of the lower extremities would be to:
*
1 point
A. Passively move the extremities through range of motion exercises.
B. Provide the client with active exercise instructions.
C. Maintain proper alignment in bed.
D. Change the client's position every two hours. - Answers B. Provide the client with active
exercise instructions.
13. Nurse Em plans care for the client which includes turning the client every two hours. This
nursing measure is necessary to:
*
1 point
