RNSG 2539 FINAL EXAM 2026 | 200 QUESTIONS
AND ANSWERS | LATEST UPDATE | 100%
VERIFIED SOLUTIONS | REAL EXAM PREP STUDY
GUIDE
• This 200-question verified exam prep guide covers all core RNSG 2539
competencies with real exam-style questions, correct answers, and EXPERT
RATIONALE to reinforce clinical reasoning.
• Study by attempting each question first before revealing the answer — use the
EXPERT RATIONALE to understand why the correct option is right, not just
memorize it.
RNSG 2539 FINAL EXAM 2026 200 QUESTIONS AND ANSWERS | LATEST UPDATE
| 100% VERIFIED SOLUTIONS
1. A nurse is caring for a client with heart failure who has an order for
furosemide (Lasix) 40 mg IV. Which assessment finding requires the nurse to
hold the medication and notify the provider?
A. Blood pressure of 138/88 mmHg
B. Serum potassium of 2.9 mEq/L
C. Urine output of 60 mL/hr
D. Weight gain of 1 lb in 24 hours
E. Respiratory rate of 18 breaths/min
✔ Correct Answer: B. Serum potassium of 2.9 mEq/L
EXPERT RATIONALE: Furosemide is a loop diuretic that causes potassium wasting. A
serum potassium of 2.9 mEq/L is below the normal range (3.5–5.0 mEq/L) indicating
hypokalemia, which can lead to life-threatening dysrhythmias. The nurse should hold the
medication and notify the provider before administration.
,2. A nurse is assessing a client who is 24 hours post-operative following
abdominal surgery. Which finding is the priority concern?
A. Pain level of 6/10 at the incision site
B. Absence of bowel sounds
C. Temperature of 38.8°C (101.8°F)
D. Scant serosanguineous drainage on dressing
E. Urine output of 50 mL/hr
✔ Correct Answer: C. Temperature of 38.8°C (101.8°F)
EXPERT RATIONALE: A temperature above 38.5°C within the first 24–48 hours post-
operatively may indicate a developing infection or other serious complication such as
atelectasis or anastomotic leak. This is the priority concern requiring immediate
notification of the provider. Absent bowel sounds are expected post-operatively, and
mild pain and scant drainage are normal findings.
3. A client is admitted with diabetic ketoacidosis (DKA). Which arterial blood
gas result is consistent with this condition?
A. pH 7.50, PaCO₂ 30, HCO₃ 28
B. pH 7.30, PaCO₂ 28, HCO₃ 14
C. pH 7.35, PaCO₂ 45, HCO₃ 24
D. pH 7.48, PaCO₂ 50, HCO₃ 30
E. pH 7.32, PaCO₂ 50, HCO₃ 26
✔ Correct Answer: B. pH 7.30, PaCO₂ 28, HCO₃ 14
EXPERT RATIONALE: DKA causes metabolic acidosis due to the accumulation of
ketoacids. The ABG in DKA shows a low pH (<7.35), low HCO₃ (<22), and compensatory
low PaCO₂ as the lungs attempt to blow off CO₂ to raise pH. Option B reflects this
pattern correctly.
,4. A nurse is caring for a client receiving heparin infusion for deep vein
thrombosis. The aPTT result is 120 seconds. What is the nurse's best action?
A. Continue the infusion at the current rate
B. Increase the infusion rate by 2 units/kg/hr
C. Stop the infusion and notify the provider
D. Administer protamine sulfate immediately
E. Draw a repeat aPTT in 6 hours
✔ Correct Answer: C. Stop the infusion and notify the provider
EXPERT RATIONALE: The therapeutic aPTT range for heparin therapy is 60–100 seconds
(1.5–2.5 times normal). An aPTT of 120 seconds is supratherapeutic, indicating excessive
anticoagulation and increased bleeding risk. The nurse should stop the infusion and
notify the provider immediately for further orders.
5. A nurse is preparing to administer a blood transfusion. Which action is
most important before initiating the transfusion?
A. Obtain baseline vital signs
B. Verify the client's identity and blood compatibility with another nurse
C. Ensure large-bore IV access is in place
D. Pre-medicate the client with diphenhydramine
E. Flush the IV line with normal saline
✔ Correct Answer: B. Verify the client's identity and blood compatibility with
another nurse
EXPERT RATIONALE: Two-nurse verification of the client's identity and blood product
compatibility is the most critical safety step before transfusion to prevent a potentially
fatal hemolytic transfusion reaction due to ABO incompatibility. While baseline vitals
and saline flushing are also important, identity and compatibility verification is the top
priority.
, 6. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which ECG change should the nurse anticipate?
A. Prolonged QT interval
B. ST segment depression
C. Peaked T waves
D. U waves
E. Widened P wave
✔ Correct Answer: C. Peaked T waves
EXPERT RATIONALE: Hyperkalemia (K⁺ > 5.0 mEq/L) causes characteristic ECG changes,
the earliest of which are tall, peaked T waves. As hyperkalemia worsens, the QRS
complex widens and ventricular fibrillation may develop. Peaked T waves serve as an
early warning to the nurse that intervention is needed.
7. A nurse is caring for a client with increased intracranial pressure (ICP).
Which position is most appropriate?
A. Supine with head flat
B. Prone with legs elevated
C. Head of bed elevated 30 degrees with head in neutral alignment
D. Trendelenburg position
E. Left lateral with knees bent
✔ Correct Answer: C. Head of bed elevated 30 degrees with head in neutral
alignment
EXPERT RATIONALE: Elevating the head of bed to 30 degrees promotes venous drainage
from the brain, reducing ICP. Keeping the head in neutral alignment prevents jugular
vein compression, which would impede venous outflow and further increase ICP.
Trendelenburg and flat positions increase ICP and are contraindicated.
AND ANSWERS | LATEST UPDATE | 100%
VERIFIED SOLUTIONS | REAL EXAM PREP STUDY
GUIDE
• This 200-question verified exam prep guide covers all core RNSG 2539
competencies with real exam-style questions, correct answers, and EXPERT
RATIONALE to reinforce clinical reasoning.
• Study by attempting each question first before revealing the answer — use the
EXPERT RATIONALE to understand why the correct option is right, not just
memorize it.
RNSG 2539 FINAL EXAM 2026 200 QUESTIONS AND ANSWERS | LATEST UPDATE
| 100% VERIFIED SOLUTIONS
1. A nurse is caring for a client with heart failure who has an order for
furosemide (Lasix) 40 mg IV. Which assessment finding requires the nurse to
hold the medication and notify the provider?
A. Blood pressure of 138/88 mmHg
B. Serum potassium of 2.9 mEq/L
C. Urine output of 60 mL/hr
D. Weight gain of 1 lb in 24 hours
E. Respiratory rate of 18 breaths/min
✔ Correct Answer: B. Serum potassium of 2.9 mEq/L
EXPERT RATIONALE: Furosemide is a loop diuretic that causes potassium wasting. A
serum potassium of 2.9 mEq/L is below the normal range (3.5–5.0 mEq/L) indicating
hypokalemia, which can lead to life-threatening dysrhythmias. The nurse should hold the
medication and notify the provider before administration.
,2. A nurse is assessing a client who is 24 hours post-operative following
abdominal surgery. Which finding is the priority concern?
A. Pain level of 6/10 at the incision site
B. Absence of bowel sounds
C. Temperature of 38.8°C (101.8°F)
D. Scant serosanguineous drainage on dressing
E. Urine output of 50 mL/hr
✔ Correct Answer: C. Temperature of 38.8°C (101.8°F)
EXPERT RATIONALE: A temperature above 38.5°C within the first 24–48 hours post-
operatively may indicate a developing infection or other serious complication such as
atelectasis or anastomotic leak. This is the priority concern requiring immediate
notification of the provider. Absent bowel sounds are expected post-operatively, and
mild pain and scant drainage are normal findings.
3. A client is admitted with diabetic ketoacidosis (DKA). Which arterial blood
gas result is consistent with this condition?
A. pH 7.50, PaCO₂ 30, HCO₃ 28
B. pH 7.30, PaCO₂ 28, HCO₃ 14
C. pH 7.35, PaCO₂ 45, HCO₃ 24
D. pH 7.48, PaCO₂ 50, HCO₃ 30
E. pH 7.32, PaCO₂ 50, HCO₃ 26
✔ Correct Answer: B. pH 7.30, PaCO₂ 28, HCO₃ 14
EXPERT RATIONALE: DKA causes metabolic acidosis due to the accumulation of
ketoacids. The ABG in DKA shows a low pH (<7.35), low HCO₃ (<22), and compensatory
low PaCO₂ as the lungs attempt to blow off CO₂ to raise pH. Option B reflects this
pattern correctly.
,4. A nurse is caring for a client receiving heparin infusion for deep vein
thrombosis. The aPTT result is 120 seconds. What is the nurse's best action?
A. Continue the infusion at the current rate
B. Increase the infusion rate by 2 units/kg/hr
C. Stop the infusion and notify the provider
D. Administer protamine sulfate immediately
E. Draw a repeat aPTT in 6 hours
✔ Correct Answer: C. Stop the infusion and notify the provider
EXPERT RATIONALE: The therapeutic aPTT range for heparin therapy is 60–100 seconds
(1.5–2.5 times normal). An aPTT of 120 seconds is supratherapeutic, indicating excessive
anticoagulation and increased bleeding risk. The nurse should stop the infusion and
notify the provider immediately for further orders.
5. A nurse is preparing to administer a blood transfusion. Which action is
most important before initiating the transfusion?
A. Obtain baseline vital signs
B. Verify the client's identity and blood compatibility with another nurse
C. Ensure large-bore IV access is in place
D. Pre-medicate the client with diphenhydramine
E. Flush the IV line with normal saline
✔ Correct Answer: B. Verify the client's identity and blood compatibility with
another nurse
EXPERT RATIONALE: Two-nurse verification of the client's identity and blood product
compatibility is the most critical safety step before transfusion to prevent a potentially
fatal hemolytic transfusion reaction due to ABO incompatibility. While baseline vitals
and saline flushing are also important, identity and compatibility verification is the top
priority.
, 6. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L.
Which ECG change should the nurse anticipate?
A. Prolonged QT interval
B. ST segment depression
C. Peaked T waves
D. U waves
E. Widened P wave
✔ Correct Answer: C. Peaked T waves
EXPERT RATIONALE: Hyperkalemia (K⁺ > 5.0 mEq/L) causes characteristic ECG changes,
the earliest of which are tall, peaked T waves. As hyperkalemia worsens, the QRS
complex widens and ventricular fibrillation may develop. Peaked T waves serve as an
early warning to the nurse that intervention is needed.
7. A nurse is caring for a client with increased intracranial pressure (ICP).
Which position is most appropriate?
A. Supine with head flat
B. Prone with legs elevated
C. Head of bed elevated 30 degrees with head in neutral alignment
D. Trendelenburg position
E. Left lateral with knees bent
✔ Correct Answer: C. Head of bed elevated 30 degrees with head in neutral
alignment
EXPERT RATIONALE: Elevating the head of bed to 30 degrees promotes venous drainage
from the brain, reducing ICP. Keeping the head in neutral alignment prevents jugular
vein compression, which would impede venous outflow and further increase ICP.
Trendelenburg and flat positions increase ICP and are contraindicated.
