NSG 4800 Comprehensive Exam 2026/2027 –
Actual Test Questions & Detailed Answers
Latest Update
The nurse is monitoring a client in the immediate postpartum period for signs of
hemorrhage. Which sign, if noted, would be an early sign of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute - correct
answer-B, During the fourth stage of labor, the maternal blood pressure, pulse,
and respiration should be checked every 15 minutes during the first hour. An
increasing pulse is an early sign of excessive blood loss because the heart pumps
faster to compensate for reduced blood volume. A slight increase in temperature
is normal. The blood pressure decreases as the blood volume diminishes, but a
decreased blood pressure would not be the earliest sign of hemorrhage. The
respiratory rate is slightly increased from normal.
The nurse in the ambulatory care unit is providing home care instructions to a
client after cryotherapy for the treatment of malignant skin lesions. Which
statement would be most appropriate for the nurse to include in the home care
instructions for this client?
"Apply ice to the site to prevent swelling."
,"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care provider in 1
week." - correct answer-3, Cryotherapy involves the local application of liquid
nitrogen to the lesion; this causes cell death and tissue destruction. Tissue
freezing is followed in 1 to 2 days by hemorrhagic blister formation; therefore, ice
is not applied to the site. The application of a warm, damp washcloth
intermittently to the site will provide relief of any discomfort. The nurse instructs
the client to clean the site with the prescribed solution to prevent secondary
infection. A topical antibiotic also may be prescribed. Alcohol would cause
irritation to the skin. There is no reason for the client to avoid showering or
bathing.
The registered nurse is caring for the following clients. It would be a priority for
the nurse to initiate a multidisciplinary conference for the client who is
A.12 years old with Autism who is starting a new school and recently had a URI
(upper respiratory tract infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a recent
Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon
(pyridostigmine) and is employed as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports hearing non
threatening voices. - correct answer-B
A client with uncontrolled Diabetes Mellitus would require the greatest number
of disciplines (multidisciplinary) to manage their care i.e. Medicine, Nursing, Social
Work, Nutritionist; the other choices do not require as many providers of care to
meet their needs.
, A client is scheduled to begin therapy with carbamazepine. The nurse should
assess the results of which test(s) before administering the first dose of this
medication to the client?
Liver function tests
Renal function tests
Pancreatic enzyme studies
Complete blood cell count - correct answer-D. Carbamazepine may be used to
treat a seizure disorder. It can cause leukopenia, anemia, thrombocytopenia, and,
very rarely, fatal aplastic anemia. To reduce the risk of serious hematological
effects, a complete blood cell count should be done before treatment and
periodically thereafter. This medication should be avoided in clients with
preexisting hematological abnormalities. The client also is told to report the
occurrence of fever, sore throat, pallor, weakness, infection, easy bruising, and
petechiae. The results of the remaining tests listed in the options are not
associated with the use of this medication.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA).
The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous
intravenous (IV) infusion of short-acting insulin is initiated, along with IV
rehydration with normal saline. The serum glucose level is now decreased to 240
mg/dL (13.7 mmol/L). The nurse would next prepare to administer which
medication?
An ampule of 50% dextrose
NPH insulin subcutaneously
IV fluids containing dextrose
Phenytoin for the prevention of seizures - correct answer-C. Emergency
management of DKA focuses on correcting fluid and electrolyte imbalances and
normalizing the serum glucose level. If the corrections occur too quickly, serious
consequences, including hypoglycemia and cerebral edema, can occur. During
management of DKA, when the blood glucose level falls to 250 to 300 mg/dL (14.2
Actual Test Questions & Detailed Answers
Latest Update
The nurse is monitoring a client in the immediate postpartum period for signs of
hemorrhage. Which sign, if noted, would be an early sign of excessive blood loss?
A .temperature of 100.4°F (38°C)
B. An increase in the pulse rate from 88 to 102 beats/minute
C. A blood pressure change from 130/88 to 124/80 mm Hg
D. An increase in the respiratory rate from 18 to 22 breaths/minute - correct
answer-B, During the fourth stage of labor, the maternal blood pressure, pulse,
and respiration should be checked every 15 minutes during the first hour. An
increasing pulse is an early sign of excessive blood loss because the heart pumps
faster to compensate for reduced blood volume. A slight increase in temperature
is normal. The blood pressure decreases as the blood volume diminishes, but a
decreased blood pressure would not be the earliest sign of hemorrhage. The
respiratory rate is slightly increased from normal.
The nurse in the ambulatory care unit is providing home care instructions to a
client after cryotherapy for the treatment of malignant skin lesions. Which
statement would be most appropriate for the nurse to include in the home care
instructions for this client?
"Apply ice to the site to prevent swelling."
,"Clean the site with alcohol 3 times daily."
"Apply a warm, damp washcloth if discomfort occurs."
"Avoid showering or taking baths until seen by the health care provider in 1
week." - correct answer-3, Cryotherapy involves the local application of liquid
nitrogen to the lesion; this causes cell death and tissue destruction. Tissue
freezing is followed in 1 to 2 days by hemorrhagic blister formation; therefore, ice
is not applied to the site. The application of a warm, damp washcloth
intermittently to the site will provide relief of any discomfort. The nurse instructs
the client to clean the site with the prescribed solution to prevent secondary
infection. A topical antibiotic also may be prescribed. Alcohol would cause
irritation to the skin. There is no reason for the client to avoid showering or
bathing.
The registered nurse is caring for the following clients. It would be a priority for
the nurse to initiate a multidisciplinary conference for the client who is
A.12 years old with Autism who is starting a new school and recently had a URI
(upper respiratory tract infection)
B.39 years old, has type 2 Diabetes Mellitus, is homeless and had a recent
Hemoglobin A1c of 13%
C.52 years old, with Myasthenia Gravis, recently prescribed Mestinon
(pyridostigmine) and is employed as a mail carrier
D.79 years old, has bipolar and schizophrenia, lives alone and reports hearing non
threatening voices. - correct answer-B
A client with uncontrolled Diabetes Mellitus would require the greatest number
of disciplines (multidisciplinary) to manage their care i.e. Medicine, Nursing, Social
Work, Nutritionist; the other choices do not require as many providers of care to
meet their needs.
, A client is scheduled to begin therapy with carbamazepine. The nurse should
assess the results of which test(s) before administering the first dose of this
medication to the client?
Liver function tests
Renal function tests
Pancreatic enzyme studies
Complete blood cell count - correct answer-D. Carbamazepine may be used to
treat a seizure disorder. It can cause leukopenia, anemia, thrombocytopenia, and,
very rarely, fatal aplastic anemia. To reduce the risk of serious hematological
effects, a complete blood cell count should be done before treatment and
periodically thereafter. This medication should be avoided in clients with
preexisting hematological abnormalities. The client also is told to report the
occurrence of fever, sore throat, pallor, weakness, infection, easy bruising, and
petechiae. The results of the remaining tests listed in the options are not
associated with the use of this medication.
A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA).
The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous
intravenous (IV) infusion of short-acting insulin is initiated, along with IV
rehydration with normal saline. The serum glucose level is now decreased to 240
mg/dL (13.7 mmol/L). The nurse would next prepare to administer which
medication?
An ampule of 50% dextrose
NPH insulin subcutaneously
IV fluids containing dextrose
Phenytoin for the prevention of seizures - correct answer-C. Emergency
management of DKA focuses on correcting fluid and electrolyte imbalances and
normalizing the serum glucose level. If the corrections occur too quickly, serious
consequences, including hypoglycemia and cerebral edema, can occur. During
management of DKA, when the blood glucose level falls to 250 to 300 mg/dL (14.2
