2026
LATEST RELIABLE STUDY GUIDE; QUESTIONS, ANSWERS AN, Exams of
Nursing
Questions
1. A practical nurse (PN) is reinforcing teaching with a client who has a new prescription
for warfarin. Which statement by the client indicates understanding of the teaching?
• A. "I will double my dose if I miss one."
• B. "I should avoid foods high in vitamin K."
• C. "I can stop taking the medication anytime I want."
• D. "It is safe to take aspirin with warfarin."
Answer: B. I should avoid foods high in vitamin K.
Rationale: Warfarin is an anticoagulant that works by blocking the synthesis of
vitamin K-dependent clotting factors. Consuming a consistent amount of vitamin K is
crucial because fluctuations can alter the drug's effectiveness, increasing the risk of clots
(with increased intake) or bleeding (with decreased intake).
2. A PN is caring for a client receiving oxygen at 2 L/min via nasal cannula for COPD.
Which finding requires the nurse’s immediate intervention?
• A. Oxygen saturation of 92%
• B. Respiratory rate of 18/min
• C. Increasing drowsiness
• D. Productive cough
Answer: C. Increasing drowsiness
Rationale: For a client with COPD, increasing drowsiness or lethargy can be a sign
of carbon dioxide (CO₂) narcosis caused by hypoventilation. This is a medical
emergency requiring immediate intervention, as it indicates the client's respiratory drive
is being suppressed.
,3. A nurse is caring for a client with diabetes who reports feeling shaky and diaphoretic.
Which action should the nurse take first?
• A. Administer insulin.
• B. Check the client's blood glucose.
• C. Encourage the client to exercise.
• D. Notify the provider.
Answer: B. Check the client's blood glucose
Rationale: Shakiness and diaphoresis are classic signs of hypoglycemia (low blood
sugar). The priority action is to check the client's blood glucose level to confirm the
client's status before providing any treatment. Giving insulin would worsen the
condition, while exercise is contraindicated.
4. A PN is caring for a client who is at 33 weeks gestation and has just undergone an
amniocentesis. The nurse should monitor the client for which of the following
complications?
• A. Contractions
• B. Hypertension
• C. Epigastric pain
• D. Vomiting
Answer: A. Contractions
Rationale: Amniocentesis carries several maternal risks,
including contractions/preterm labor, hemorrhage, infection, and abruptio placentae.
While the procedure is typically done between 15 and 20 weeks, it can be performed
later for specific indications, but the risks remain.
5. A PN is providing discharge teaching to an older adult client about methods to
promote nighttime sleep. Which instruction should the nurse include?
• A. "Stay in bed for at least one hour if you are unable to fall asleep."
• B. "Take a one-hour nap during the day to make up for lost sleep."
• C. "Perform vigorous exercises right before bedtime to tire yourself out."
• D. "Eat a light snack, such as crackers or cereal, before going to bed."
Answer: D. Eat a light snack, such as crackers or cereal, before going to bed.
,Rationale: A light carbohydrate snack at bedtime can promote sleep by making
tryptophan, an amino acid that helps induce sleep, more available to the brain. In
contrast, staying in bed while awake, napping during the day, and exercising vigorously
right before bed can all disrupt nighttime sleep patterns.
6. A nurse on a telemetry unit finds a client unconscious and pulseless. The cardiac
monitor displays ventricular tachycardia. Which action should the nurse take first?
• A. Assess heart sounds
• B. Defibrillate
• C. Establish IV access
• D. Administer Epinephrine
Answer: B. Defibrillate
Rationale: For a client who is pulseless and unresponsive in ventricular tachycardia
(VT), the condition is unstable. The priority action is immediate defibrillation to
convert the rhythm back to normal. Medications like epinephrine and amiodarone are
given after defibrillation attempts and CPR have been initiated.
7. A PN is caring for four clients. Which client should the nurse assess first?
• A. A post-operative client requesting pain medication for 4/10 pain.
• B. A client with COPD who has new-onset confusion and a BP of 88/50 mmHg.
• C. A client with diabetes who is requesting a PRN snack due to hunger.
• D. A client with a fractured tibia asking for help to get to the bathroom.
Answer: B. A client with COPD who has new-onset confusion and a BP of 88/50
mmHg.
Rationale: New-onset confusion combined with hypotension (low blood pressure) in a
client with COPD is a critical sign of hypoxia or shock, indicating a significant change in
neurological and hemodynamic status. Using the ABCs (Airway, Breathing,
Circulation) framework, this client is the highest priority.
8. A PN is preparing to administer digoxin to a 2-month-old infant and assesses the
apical pulse to be 120 beats/minute. Based on this finding, what action should the PN
take?
• A. Administer the medication and alert the charge nurse.
• B. Hold the medication and document the cardiac assessment.
• C. Administer the medication and document the heart rate.
, • D. Hold the medication and recheck the heart rate in one hour.
Answer: C. Administer the medication and document the heart rate.
Rationale: For an infant, a heart rate of 120 beats/minute is within the normal range
(typically 110-160 beats per minute for infants). Therefore, the nurse should administer
the medication and document the heart rate. Digoxin would be held if the infant’s
heart rate were below the safe limit (usually <90-110 bpm for infants).
9. A PN is assisting with the plan of care for a client following a transurethral resection
of the prostate (TURP). Which intervention should the nurse include?
• A. Encourage the client to ambulate independently to prevent DVT.
• B. Irrigate the bladder using strict sterile technique.
• C. Encourage the client to increase intake of caffeinated beverages.
• D. Remove the indwelling catheter as soon as the client is stable.
Answer: B. Irrigate the bladder using strict sterile technique.
Rationale: Following a TURP, it is common to have a three-way indwelling catheter for
continuous bladder irrigation (CBI) to prevent clot formation and obstruction. The nurse
should irrigate the bladder using strict sterile technique to minimize the risk of
infection and maintain a closed drainage system.
10. A PN is reviewing a client's electronic medical record and finds that an assistive
personnel (AP) recorded the client's temperature as 35.3°C (95.5°F) two hours ago.
Which action should the nurse take first?
• A. Delegate the task of retaking the temperature to another AP.
• B. Administer a dose of acetaminophen (Tylenol).
• C. Check the client's temperature.
• D. Apply a cooling blanket.
Answer: C. Check the client's temperature.
Rationale: A temperature of 35.3°C (95.5°F) indicates hypothermia. The first action the
nurse must take is to verify the assessment data by retaking the client's temperature.
This ensures the finding is accurate before deciding on any interventions like rewarming
or notifying the provider
11. A PN is caring for a client who has a new diagnosis of tuberculosis (TB) and is
placed in airborne precautions. Which of the following actions should the PN take?