BSN Year 2 Final Exam Comprehensive Study Guide 2026/2027
UPDATE
1. A nurse is caring for a client receiving Digoxin. Which of the following
laboratory results should the nurse monitor most closely to prevent toxicity?
A. Serum sodium level
B. Serum calcium level
C. Serum potassium level
D. Serum glucose level
Answer: C
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
2. A client is diagnosed with Right-Sided Heart Failure. Which clinical
manifestation should the nurse expect to find?
A. Peripheral edema
B. Dyspnea on exertion
C. Crackles in the lungs
D. Orthopnea
Answer: A
Rationale: Right-sided heart failure causes systemic congestion, leading to peripheral
edema, jugular venous distention, and hepatomegaly. Crackles and dyspnea are signs of
left-sided failure.
,3. Which of the following is an early sign of hypoglycemia in a client with Type 1
Diabetes?
A. Diaphoresis
B. Fruity breath odor
C. Excessive thirst
D. Abdominal pain
Answer: A
Rationale: Diaphoresis (sweating), shakiness, and tachycardia are early sympathetic
nervous system responses to hypoglycemia. Thirst and fruity breath are signs of
hyperglycemia/DKA.
4. A nurse is preparing to administer Warfarin. Which lab value is used to
monitor the therapeutic effect of this medication?
A. aPTT
B. PT/INR
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: PT (Prothrombin Time) and INR (International Normalized Ratio) are used to
monitor Warfarin. aPTT is used for Heparin monitoring.
5. In the development of a toddler (1-3 years), which of Erikson’s psychosocial
stages is expected?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: B
, Rationale: Toddlers are in the Autonomy vs. Shame and Doubt stage as they learn to
control their physical skills and develop a sense of independence.
6. A client is 12 hours postoperative following a total hip arthroplasty. Which
position is most appropriate for the affected leg?
A. Adduction with internal rotation
B. External rotation
C. Flexed at 120 degrees
D. Abduction with a wedge pillow
Answer: D
Rationale: Abduction prevents dislocation of the new prosthesis. Adduction and extreme
flexion must be avoided.
7. Which fetal heart rate pattern requires immediate nursing intervention
during labor?
A. Early decelerations
B. Accelerations
C. Late decelerations
D. Moderate variability
Answer: C
Rationale: Late decelerations indicate uteroplacental insufficiency and are a non-
reassuring sign that requires immediate intervention (oxygen, positioning, etc.).
8. A nurse is assessing a client with a Suspected Pulmonary Embolism. Which is
the most common initial symptom?
A. Bradycardia
B. Productive cough
C. High-grade fever
D. Sudden onset chest pain
Answer: D
UPDATE
1. A nurse is caring for a client receiving Digoxin. Which of the following
laboratory results should the nurse monitor most closely to prevent toxicity?
A. Serum sodium level
B. Serum calcium level
C. Serum potassium level
D. Serum glucose level
Answer: C
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
2. A client is diagnosed with Right-Sided Heart Failure. Which clinical
manifestation should the nurse expect to find?
A. Peripheral edema
B. Dyspnea on exertion
C. Crackles in the lungs
D. Orthopnea
Answer: A
Rationale: Right-sided heart failure causes systemic congestion, leading to peripheral
edema, jugular venous distention, and hepatomegaly. Crackles and dyspnea are signs of
left-sided failure.
,3. Which of the following is an early sign of hypoglycemia in a client with Type 1
Diabetes?
A. Diaphoresis
B. Fruity breath odor
C. Excessive thirst
D. Abdominal pain
Answer: A
Rationale: Diaphoresis (sweating), shakiness, and tachycardia are early sympathetic
nervous system responses to hypoglycemia. Thirst and fruity breath are signs of
hyperglycemia/DKA.
4. A nurse is preparing to administer Warfarin. Which lab value is used to
monitor the therapeutic effect of this medication?
A. aPTT
B. PT/INR
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: PT (Prothrombin Time) and INR (International Normalized Ratio) are used to
monitor Warfarin. aPTT is used for Heparin monitoring.
5. In the development of a toddler (1-3 years), which of Erikson’s psychosocial
stages is expected?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: B
, Rationale: Toddlers are in the Autonomy vs. Shame and Doubt stage as they learn to
control their physical skills and develop a sense of independence.
6. A client is 12 hours postoperative following a total hip arthroplasty. Which
position is most appropriate for the affected leg?
A. Adduction with internal rotation
B. External rotation
C. Flexed at 120 degrees
D. Abduction with a wedge pillow
Answer: D
Rationale: Abduction prevents dislocation of the new prosthesis. Adduction and extreme
flexion must be avoided.
7. Which fetal heart rate pattern requires immediate nursing intervention
during labor?
A. Early decelerations
B. Accelerations
C. Late decelerations
D. Moderate variability
Answer: C
Rationale: Late decelerations indicate uteroplacental insufficiency and are a non-
reassuring sign that requires immediate intervention (oxygen, positioning, etc.).
8. A nurse is assessing a client with a Suspected Pulmonary Embolism. Which is
the most common initial symptom?
A. Bradycardia
B. Productive cough
C. High-grade fever
D. Sudden onset chest pain
Answer: D
