LPN to ADN Bridge Comprehensive Final Exam 2026/2027 UPDATE
1. A nurse is caring for a client with a potassium level of 2.8 mEq/L. Which of the
following should be the nurse’s priority action?
A. Administer an oral potassium supplement
B. Increase oral fluid intake
C. Encourage a high-fiber diet
D. Place the client on a cardiac monitor
Answer: D
Rationale: A potassium level of 2.8 mEq/L indicates severe hypokalemia, which puts the
client at high risk for life-threatening cardiac dysrhythmias. Cardiac monitoring is the
priority.
2. Which of the following tasks is appropriate for the RN to delegate to an
unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of pain medication
B. Providing discharge instructions to a stable client
C. Performing an initial admission assessment
D. Assisting a client with ambulation on the second postoperative day
Answer: D
Rationale: UAPs can assist with stable tasks like ambulation. Evaluation, teaching, and
assessment require the judgment of a licensed nurse.
,3. A client is receiving a continuous intravenous infusion of heparin. Which
laboratory value should the nurse monitor to adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
Answer: A
Rationale: The aPTT is used to monitor the effectiveness and adjust the dose of heparin.
PT and INR are used for warfarin therapy.
4. A nurse is caring for a client who is 24 hours postoperative following a total
hip arthroplasty. Which of the following is a priority finding?
A. Pain level of 4 on a scale of 0 to 10
B. Serosanguineous drainage on the dressing
C. Sudden shortness of breath and chest pain
D. Decreased appetite
Answer: C
Rationale: Sudden shortness of breath and chest pain are signs of a pulmonary embolism,
a life-threatening complication of deep vein thrombosis following orthopedic surgery.
5. A client with Type 1 Diabetes Mellitus presents with Kussmaul respirations
and a fruity breath odor. The nurse should anticipate which condition?
A. Hypoglycemia
B. Hyperosmolar Hyperglycemic State (HHS)
C. Diabetic Ketoacidosis (DKA)
D. Respiratory Alkalosis
Answer: C
, Rationale: DKA is characterized by hyperglycemia, metabolic acidosis (Kussmaul
respirations), and the production of ketones (fruity breath). HHS usually lacks significant
ketosis.
6. The nurse is assessing a client with a history of heart failure. Which clinical
manifestation is most indicative of left-sided heart failure?
A. Crackles in the lungs
B. Jugular venous distention
C. Peripheral edema
D. Hepatosplenomegaly
Answer: A
Rationale: Left-sided heart failure leads to pulmonary congestion, causing crackles,
dyspnea, and orthopnea. Peripheral symptoms are associated with right-sided heart
failure.
7. Which arterial blood gas (ABG) result indicates compensated metabolic
acidosis?
A. pH 7.48, PaCO2 35, HCO3 30
B. pH 7.25, PaCO2 45, HCO3 16
C. pH 7.36, PaCO2 30, HCO3 18
D. pH 7.32, PaCO2 50, HCO3 28
Answer: C
Rationale: In compensated metabolic acidosis, the pH is within the normal range (7.35-
7.45), but the HCO3 is low (acidosis) and the PaCO2 is low (respiratory compensation).
1. A nurse is caring for a client with a potassium level of 2.8 mEq/L. Which of the
following should be the nurse’s priority action?
A. Administer an oral potassium supplement
B. Increase oral fluid intake
C. Encourage a high-fiber diet
D. Place the client on a cardiac monitor
Answer: D
Rationale: A potassium level of 2.8 mEq/L indicates severe hypokalemia, which puts the
client at high risk for life-threatening cardiac dysrhythmias. Cardiac monitoring is the
priority.
2. Which of the following tasks is appropriate for the RN to delegate to an
unlicensed assistive personnel (UAP)?
A. Evaluating the effectiveness of pain medication
B. Providing discharge instructions to a stable client
C. Performing an initial admission assessment
D. Assisting a client with ambulation on the second postoperative day
Answer: D
Rationale: UAPs can assist with stable tasks like ambulation. Evaluation, teaching, and
assessment require the judgment of a licensed nurse.
,3. A client is receiving a continuous intravenous infusion of heparin. Which
laboratory value should the nurse monitor to adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
Answer: A
Rationale: The aPTT is used to monitor the effectiveness and adjust the dose of heparin.
PT and INR are used for warfarin therapy.
4. A nurse is caring for a client who is 24 hours postoperative following a total
hip arthroplasty. Which of the following is a priority finding?
A. Pain level of 4 on a scale of 0 to 10
B. Serosanguineous drainage on the dressing
C. Sudden shortness of breath and chest pain
D. Decreased appetite
Answer: C
Rationale: Sudden shortness of breath and chest pain are signs of a pulmonary embolism,
a life-threatening complication of deep vein thrombosis following orthopedic surgery.
5. A client with Type 1 Diabetes Mellitus presents with Kussmaul respirations
and a fruity breath odor. The nurse should anticipate which condition?
A. Hypoglycemia
B. Hyperosmolar Hyperglycemic State (HHS)
C. Diabetic Ketoacidosis (DKA)
D. Respiratory Alkalosis
Answer: C
, Rationale: DKA is characterized by hyperglycemia, metabolic acidosis (Kussmaul
respirations), and the production of ketones (fruity breath). HHS usually lacks significant
ketosis.
6. The nurse is assessing a client with a history of heart failure. Which clinical
manifestation is most indicative of left-sided heart failure?
A. Crackles in the lungs
B. Jugular venous distention
C. Peripheral edema
D. Hepatosplenomegaly
Answer: A
Rationale: Left-sided heart failure leads to pulmonary congestion, causing crackles,
dyspnea, and orthopnea. Peripheral symptoms are associated with right-sided heart
failure.
7. Which arterial blood gas (ABG) result indicates compensated metabolic
acidosis?
A. pH 7.48, PaCO2 35, HCO3 30
B. pH 7.25, PaCO2 45, HCO3 16
C. pH 7.36, PaCO2 30, HCO3 18
D. pH 7.32, PaCO2 50, HCO3 28
Answer: C
Rationale: In compensated metabolic acidosis, the pH is within the normal range (7.35-
7.45), but the HCO3 is low (acidosis) and the PaCO2 is low (respiratory compensation).
