BSN Semester 6 Comprehensive Final Exam Prep 2026/2027 UPDATE
1. A nurse is caring for a client with a suspected diagnosis of increased
intracranial pressure (ICP). Which of the following is the earliest sign of
increased ICP?
A. Cushing’s triad
B. Fixed and dilated pupils
C. Projectile vomiting
D. Altered level of consciousness
Answer: D
Rationale: Altered level of consciousness (restlessness, irritability, or confusion) is the
most sensitive and earliest indicator of increased ICP. Cushing’s triad and fixed pupils are
late signs.
2. Which task can the RN safely delegate to a Licensed Practical Nurse (LPN) for
a stable client?
A. Performing the initial admission assessment
B. Creating a plan of care for a new diabetic
C. Administering oral medications
D. Providing discharge teaching
Answer: C
Rationale: LPNs can administer medications (excluding high-risk IV meds in some states).
Admission assessments, care plans, and teaching are the responsibility of the RN.
,3. A client is receiving Magnesium Sulfate for preeclampsia. The nurse notes
absent deep tendon reflexes and a respiratory rate of 10/min. What is the
priority action?
A. Notify the provider and prepare calcium gluconate
B. Document the findings as normal
C. Increase the IV fluid rate
D. Place the client in Trendelenburg position
Answer: A
Rationale: Absent reflexes and respiratory depression are signs of magnesium toxicity.
Calcium gluconate is the antagonist.
4. A child is admitted with suspected epiglottitis. Which action should the nurse
avoid?
A. Monitoring oxygen saturation
B. Preparing for emergency intubation
C. Keeping the child in an upright position
D. Examining the throat with a tongue depressor
Answer: D
Rationale: Examining the throat of a client with epiglottitis can cause a laryngospasm,
resulting in immediate airway obstruction.
5. The nurse identifies which heart rhythm as a ‘shockable’ rhythm for
defibrillation?
A. Asystole
B. Atrial Fibrillation
C. Ventricular Fibrillation
D. Normal Sinus Rhythm
Answer: C
, Rationale: Ventricular Fibrillation and pulseless Ventricular Tachycardia are the primary
rhythms treated with defibrillation. Asystole is treated with CPR and epinephrine.
6. Which lab value is most critical to monitor for a client receiving Heparin
therapy?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin Time (PT)
C. INR
D. Serum Potassium
Answer: A
Rationale: aPTT is the specific monitor for Heparin; PT and INR are used for Warfarin
therapy.
7. A client presents with ‘fruity breath’, Kussmaul respirations, and a blood
glucose of 450 mg/dL. The nurse suspects:
A. Hypoglycemia
B. Respiratory alkalosis
C. Hyperosmolar Hyperglycemic State (HHS)
D. Diabetic Ketoacidosis (DKA)
Answer: D
Rationale: Fruity breath (acetone) and Kussmaul respirations are classic signs of DKA due
to metabolic acidosis.
8. Which type of isolation precaution is required for a client with Pulmonary
Tuberculosis?
A. Contact Precautions
B. Droplet Precautions
C. Standard Precautions only
D. Airborne Precautions
Answer: D
1. A nurse is caring for a client with a suspected diagnosis of increased
intracranial pressure (ICP). Which of the following is the earliest sign of
increased ICP?
A. Cushing’s triad
B. Fixed and dilated pupils
C. Projectile vomiting
D. Altered level of consciousness
Answer: D
Rationale: Altered level of consciousness (restlessness, irritability, or confusion) is the
most sensitive and earliest indicator of increased ICP. Cushing’s triad and fixed pupils are
late signs.
2. Which task can the RN safely delegate to a Licensed Practical Nurse (LPN) for
a stable client?
A. Performing the initial admission assessment
B. Creating a plan of care for a new diabetic
C. Administering oral medications
D. Providing discharge teaching
Answer: C
Rationale: LPNs can administer medications (excluding high-risk IV meds in some states).
Admission assessments, care plans, and teaching are the responsibility of the RN.
,3. A client is receiving Magnesium Sulfate for preeclampsia. The nurse notes
absent deep tendon reflexes and a respiratory rate of 10/min. What is the
priority action?
A. Notify the provider and prepare calcium gluconate
B. Document the findings as normal
C. Increase the IV fluid rate
D. Place the client in Trendelenburg position
Answer: A
Rationale: Absent reflexes and respiratory depression are signs of magnesium toxicity.
Calcium gluconate is the antagonist.
4. A child is admitted with suspected epiglottitis. Which action should the nurse
avoid?
A. Monitoring oxygen saturation
B. Preparing for emergency intubation
C. Keeping the child in an upright position
D. Examining the throat with a tongue depressor
Answer: D
Rationale: Examining the throat of a client with epiglottitis can cause a laryngospasm,
resulting in immediate airway obstruction.
5. The nurse identifies which heart rhythm as a ‘shockable’ rhythm for
defibrillation?
A. Asystole
B. Atrial Fibrillation
C. Ventricular Fibrillation
D. Normal Sinus Rhythm
Answer: C
, Rationale: Ventricular Fibrillation and pulseless Ventricular Tachycardia are the primary
rhythms treated with defibrillation. Asystole is treated with CPR and epinephrine.
6. Which lab value is most critical to monitor for a client receiving Heparin
therapy?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin Time (PT)
C. INR
D. Serum Potassium
Answer: A
Rationale: aPTT is the specific monitor for Heparin; PT and INR are used for Warfarin
therapy.
7. A client presents with ‘fruity breath’, Kussmaul respirations, and a blood
glucose of 450 mg/dL. The nurse suspects:
A. Hypoglycemia
B. Respiratory alkalosis
C. Hyperosmolar Hyperglycemic State (HHS)
D. Diabetic Ketoacidosis (DKA)
Answer: D
Rationale: Fruity breath (acetone) and Kussmaul respirations are classic signs of DKA due
to metabolic acidosis.
8. Which type of isolation precaution is required for a client with Pulmonary
Tuberculosis?
A. Contact Precautions
B. Droplet Precautions
C. Standard Precautions only
D. Airborne Precautions
Answer: D
