COMPREHENSIVE REVIEW EXAM QUESTIONS
WITH CORRECT ANSWERS 2025
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perfo
rm asSa priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours -SCORRECT ANSWER -
A. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-
converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypote
nsion. Therefore the nurse would check the client's blood pressure immediately before administering eac
h dose. Checking the client's peripheral pulses, the results of the most recent potassium level, and the int
ake and output for the previous 24 hours are not specifically associated with this mediation.
ASclient is scheduled to undergo an upper gastrointestinal (GI) series, and the licensed practical nurse rein
forces instructions to the client about the test. Which statement by the client indicates a need for further
instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the tes
t can be constipating." - CORRECT ANSWER -
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by
means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which
is administered in a flavored milkshake. Films are taken at intervals duringSthe test, which takes about 30
minutes. No special preparation is necessary before a GI series, except that NPO status must be maintain
ed for 8 hours before the test. After an upper GI series, the client is prescribed a laxative to hasten elimin
ation of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to f
ecal impaction.
,A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed me
dication is higher than the normal dose. The nurse calls the physician's answering service and is told that
the physician is off for the night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication butSconsult the physician when he becomes available -SCORRECT ANSWER -
B. Ask the answering service to contact the on-call physician
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a physician's p
rescription may be in error is responsible for clarifying the prescription before carrying it out. Therefore t
he nurse would not administer the medication; instead, the nurse would withhold the medication until th
e dose can be clarified. The nurse would not wait until the next morning to obtain clarification. It is prema
ture to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (
MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of pre
mature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines t
hat the PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. ContinuingSto monitor the client's cardiac statusS
D. Informing the client that PVCs are expected after an MI - CORRECT ANSWER -
B. Asking the ED physician to check the client
Rationale: PVCs are a resultSof increased irritability of ventricular cells. Peripheral pulses may be absent or
diminished with the PVCs themselves because the decreased stroke volume of the premature beats may
in turn decrease peripheral perfusion. Because other rhythms also cause widened QRS complexes, it is es
sential that the nurse determine whether the premature beats are resulting in perfusion of the extremitie
s. This is done by palpating the carotid, brachial, or femoral artery while observing the monitor for widen
ed complexes or by auscultating for apical heart sounds. In the situation of acute MI, PVCs may be consid
ered warning dysrhythmias, possibly heralding the onset of ventricular tachycardia or ventricular fibrillati
on. Therefore the nurse would not tell the client that the PVCs are expected. Although the nurse will conti
nue to monitor the client and document the findings, these are not the most appropriate actions of those
provided. The most appropriate action would be to ask Sthe ED physician to check the client.
,NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive t
herapy (ECT) at 1 p.m. On the morningSof the procedure, the nurse checks the client's record and notes th
at the client routinely takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT - CORRECT ANSWER -
A. Administer the antihypertensive with a small sip of water
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours before treatm
ent to helpSprevent aspiration. Exceptions include clients who routinely receive cardiacSmedications, antih
ypertensive agents, or histamine (H2) blockers, which should be administered several hours before treat
ment with a small sip of water. Withholding the antihypertensive and administeringSit at bedtime and wit
hholding the antihypertensive and resuming administration on the day after the ECT are incorrect actions
, because antihypertensives must be administered on time; otherwise, the risk for rebound hypertension
exists. The nurse would not administer a medication by way of a route that has not been prescribed.
ASclient who recently underwent coronary artery bypass graft surgery comes to the physician's office for a
follow-
up visit. On assessment, the client tells the nurse that he is feeling depressed. Which response by the nur
se is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over thisSdepression."
D. "Every client who has this surgery feels the same way for about a month." -SCORRECT ANSWER -
A. "Tell me more about what you're feeling."
Rationale: When a client expresses feelings of depression, it is extremely important for the nurse to furth
er explore these feelings with the client. In stating, "This is a normal response after this type of surgery" t
he nurse provides false reassurance and avoids addressing the client's feelings. "It will take time, but, I pr
omise you, you will get over the depression" is also a false reassurance, and it does not encourage the ex
pression of feelings. "Every client who has thisSsurgery feels the same way for about a month" is a general
ization that avoids the client's feelings.
, ASclient sin slabor sexperiences sspontaneous srupture sof sthe smembranes. sThe snurse simmediately scounts sthe sf
setal sheart srate s(FHR) sfor s1 sfull sminute sand sthen schecks sthe samniotic sfluid. sThe snurse snotes sthat sthe sfluid
sis syellow sand shas sa sstrong sodor. sWhich sof sthe sfollowing sactions sshould sbe sthe snurse's spriority?
A. sContacting sthe sphysician
B. sDocumenting sthe sfindings
C. sChecking sthe sfluid sfor sprotein
D. sContinuing sto smonitor sthe sclient sand sthe sFHR s-SCORRECT sANSWER s-A. sContacting sthe sphysician
Rationale: sThe sFHR sis sassessed sfor sat sleast s1 sminute swhen sthe smembranes srupture. sThe snurse salso
schecks sthe squantity, scolor, sand sodor sof sthe samniotic sfluid. sThe sfluid sshould sbe sclear s(often swith sbits sof
svernix) sand shave sa smild sodor. sFluid swith sa sfoul sor sstrong sodor, scloudy sappearance, sor syellow scoloration
ssuggests schorio samnionitis sand swarrants snotifying sthe sphysician. sA slarge samount sof svernix sin sthe sfluid
ssuggests sthat sthe sfet sus sis spreterm. sGreenish, smeconium-
stained sfluid smay sbe sseen sin scases sof spostterm sgestation sor splacental sinsufficiency. sChecking sthe sfluid sfor sp
srotein sis snot sassociated swith sthe sdata sin sthe squestion. sAlthough sthe snurse swould scontinue sto smonitor
sthe sclient sand sthe sFHR sand swould sdocument sthe sfindings, scontacting sthe sphysician sis sthe spriority.
A snurse shelps sprovide san seducational ssession sto scommunity smembers sabout scancer sof sthe scervix. sThe snur
sse sinforms sthe sgroup smembers sthat san searly ssign sof sthis stype sof scancer sis:
A. sDark, sfoul-smelling svaginal sdrainage
B. sAbdominal spain
C. sConstant, sprofuse sbleeding
D. sIrregular svaginal sbleedingSor sspotting s- sCORRECT sANSWER s-D. sIrregular svaginal sbleeding sor sspotting
Rationale: sEarly scancer sof sthe scervix sis susually sasymptomatic. sThe stwo schief ssymptoms sare sleukorrhea s(va
sginal sdischarge) sand sirregular svaginal sbleedingSor sspotting. sThe svaginal sdischarge sincreases sgradually sin
sa smount sand sbecomes swatery sand sfinally sdark sand sfoul ssmelling sbecause sof snecrosis sand sinfection sof sthe
stu smor smass. sAs sthe sdisease sprogresses, sthe sbleeding smay sbecome sconstant sand sincrease sin samount.
A ssurvivor sof ssexual sassault sbeing streated sin sthe semergency sdepartment ssays sto sthe snurse, s"I'm sreally
sworr sied sthat sI've sgot sHIV snow." sWhat sis sthe sappropriate sresponse sby sthe snurse?
A. s"HIV sis srarely san sissue sin ssurvivors sof ssexual sassault."
B. s"Every ssurvivor sof ssexual sassault sis sconcerned sabout sHIV."
WITH CORRECT ANSWERS 2025
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perfo
rm asSa priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours -SCORRECT ANSWER -
A. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-
converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypote
nsion. Therefore the nurse would check the client's blood pressure immediately before administering eac
h dose. Checking the client's peripheral pulses, the results of the most recent potassium level, and the int
ake and output for the previous 24 hours are not specifically associated with this mediation.
ASclient is scheduled to undergo an upper gastrointestinal (GI) series, and the licensed practical nurse rein
forces instructions to the client about the test. Which statement by the client indicates a need for further
instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the tes
t can be constipating." - CORRECT ANSWER -
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by
means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which
is administered in a flavored milkshake. Films are taken at intervals duringSthe test, which takes about 30
minutes. No special preparation is necessary before a GI series, except that NPO status must be maintain
ed for 8 hours before the test. After an upper GI series, the client is prescribed a laxative to hasten elimin
ation of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to f
ecal impaction.
,A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed me
dication is higher than the normal dose. The nurse calls the physician's answering service and is told that
the physician is off for the night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication butSconsult the physician when he becomes available -SCORRECT ANSWER -
B. Ask the answering service to contact the on-call physician
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a physician's p
rescription may be in error is responsible for clarifying the prescription before carrying it out. Therefore t
he nurse would not administer the medication; instead, the nurse would withhold the medication until th
e dose can be clarified. The nurse would not wait until the next morning to obtain clarification. It is prema
ture to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (
MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of pre
mature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines t
hat the PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. ContinuingSto monitor the client's cardiac statusS
D. Informing the client that PVCs are expected after an MI - CORRECT ANSWER -
B. Asking the ED physician to check the client
Rationale: PVCs are a resultSof increased irritability of ventricular cells. Peripheral pulses may be absent or
diminished with the PVCs themselves because the decreased stroke volume of the premature beats may
in turn decrease peripheral perfusion. Because other rhythms also cause widened QRS complexes, it is es
sential that the nurse determine whether the premature beats are resulting in perfusion of the extremitie
s. This is done by palpating the carotid, brachial, or femoral artery while observing the monitor for widen
ed complexes or by auscultating for apical heart sounds. In the situation of acute MI, PVCs may be consid
ered warning dysrhythmias, possibly heralding the onset of ventricular tachycardia or ventricular fibrillati
on. Therefore the nurse would not tell the client that the PVCs are expected. Although the nurse will conti
nue to monitor the client and document the findings, these are not the most appropriate actions of those
provided. The most appropriate action would be to ask Sthe ED physician to check the client.
,NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive t
herapy (ECT) at 1 p.m. On the morningSof the procedure, the nurse checks the client's record and notes th
at the client routinely takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT - CORRECT ANSWER -
A. Administer the antihypertensive with a small sip of water
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours before treatm
ent to helpSprevent aspiration. Exceptions include clients who routinely receive cardiacSmedications, antih
ypertensive agents, or histamine (H2) blockers, which should be administered several hours before treat
ment with a small sip of water. Withholding the antihypertensive and administeringSit at bedtime and wit
hholding the antihypertensive and resuming administration on the day after the ECT are incorrect actions
, because antihypertensives must be administered on time; otherwise, the risk for rebound hypertension
exists. The nurse would not administer a medication by way of a route that has not been prescribed.
ASclient who recently underwent coronary artery bypass graft surgery comes to the physician's office for a
follow-
up visit. On assessment, the client tells the nurse that he is feeling depressed. Which response by the nur
se is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over thisSdepression."
D. "Every client who has this surgery feels the same way for about a month." -SCORRECT ANSWER -
A. "Tell me more about what you're feeling."
Rationale: When a client expresses feelings of depression, it is extremely important for the nurse to furth
er explore these feelings with the client. In stating, "This is a normal response after this type of surgery" t
he nurse provides false reassurance and avoids addressing the client's feelings. "It will take time, but, I pr
omise you, you will get over the depression" is also a false reassurance, and it does not encourage the ex
pression of feelings. "Every client who has thisSsurgery feels the same way for about a month" is a general
ization that avoids the client's feelings.
, ASclient sin slabor sexperiences sspontaneous srupture sof sthe smembranes. sThe snurse simmediately scounts sthe sf
setal sheart srate s(FHR) sfor s1 sfull sminute sand sthen schecks sthe samniotic sfluid. sThe snurse snotes sthat sthe sfluid
sis syellow sand shas sa sstrong sodor. sWhich sof sthe sfollowing sactions sshould sbe sthe snurse's spriority?
A. sContacting sthe sphysician
B. sDocumenting sthe sfindings
C. sChecking sthe sfluid sfor sprotein
D. sContinuing sto smonitor sthe sclient sand sthe sFHR s-SCORRECT sANSWER s-A. sContacting sthe sphysician
Rationale: sThe sFHR sis sassessed sfor sat sleast s1 sminute swhen sthe smembranes srupture. sThe snurse salso
schecks sthe squantity, scolor, sand sodor sof sthe samniotic sfluid. sThe sfluid sshould sbe sclear s(often swith sbits sof
svernix) sand shave sa smild sodor. sFluid swith sa sfoul sor sstrong sodor, scloudy sappearance, sor syellow scoloration
ssuggests schorio samnionitis sand swarrants snotifying sthe sphysician. sA slarge samount sof svernix sin sthe sfluid
ssuggests sthat sthe sfet sus sis spreterm. sGreenish, smeconium-
stained sfluid smay sbe sseen sin scases sof spostterm sgestation sor splacental sinsufficiency. sChecking sthe sfluid sfor sp
srotein sis snot sassociated swith sthe sdata sin sthe squestion. sAlthough sthe snurse swould scontinue sto smonitor
sthe sclient sand sthe sFHR sand swould sdocument sthe sfindings, scontacting sthe sphysician sis sthe spriority.
A snurse shelps sprovide san seducational ssession sto scommunity smembers sabout scancer sof sthe scervix. sThe snur
sse sinforms sthe sgroup smembers sthat san searly ssign sof sthis stype sof scancer sis:
A. sDark, sfoul-smelling svaginal sdrainage
B. sAbdominal spain
C. sConstant, sprofuse sbleeding
D. sIrregular svaginal sbleedingSor sspotting s- sCORRECT sANSWER s-D. sIrregular svaginal sbleeding sor sspotting
Rationale: sEarly scancer sof sthe scervix sis susually sasymptomatic. sThe stwo schief ssymptoms sare sleukorrhea s(va
sginal sdischarge) sand sirregular svaginal sbleedingSor sspotting. sThe svaginal sdischarge sincreases sgradually sin
sa smount sand sbecomes swatery sand sfinally sdark sand sfoul ssmelling sbecause sof snecrosis sand sinfection sof sthe
stu smor smass. sAs sthe sdisease sprogresses, sthe sbleeding smay sbecome sconstant sand sincrease sin samount.
A ssurvivor sof ssexual sassault sbeing streated sin sthe semergency sdepartment ssays sto sthe snurse, s"I'm sreally
sworr sied sthat sI've sgot sHIV snow." sWhat sis sthe sappropriate sresponse sby sthe snurse?
A. s"HIV sis srarely san sissue sin ssurvivors sof ssexual sassault."
B. s"Every ssurvivor sof ssexual sassault sis sconcerned sabout sHIV."
