KAPLAN ADULT HEALTH A PRACTICE TEST 100 QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT DOWNLOAD PDF
### Core Domains
*- Cardiovascular System Assessment and Management*
- Respiratory System Disorders and Interventions
- Renal and Urinary System Care
- Endocrine Disorders and Metabolic Conditions
- Gastrointestinal System Management
- Neurological System Assessment
- Infectious Diseases and Immunity
Electrolyte Imbalances and Fluid Management
- Medication Safety and Pharmacology
- Ethics, Legal Compliance, and Professional Standards
### Introduction
This practice assessment is designed to prepare nursing students and professionals for the Adult Health A examination, focusing on medical-
surgical nursing competency across major body systems. The exam evaluates critical knowledge in patient assessment, clinical decision-making,
intervention prioritization, and evidence-based care practices for adult patients with acute and chronic conditions. Through 100 multiple-choice
and scenario-based questions, this test assesses your ability to apply theoretical knowledge to real-world clinical situations, prioritize care using
the nursing process, recognize complications, and make safe, defensible decisions under pressure. Emphasis is placed on critical thinking, patient
safety, regulatory compliance, ethical standards, and the integration of pharmacological and non-pharmacological interventions. Successful
performance demonstrates readiness for clinical practice and NCLEX-RN success.
SECTION ONE: QUESTIONS 1–100
Question 1
A 65-year-old patient with coronary artery disease presents with sudden onset of crackles in both lung bases, dyspnea, and orthopnea. The nurse
suspects which complication?
,A. Pulmonary embolism
B. Acute heart failure
C. Pneumonia
D. Myocardial ischemia
🟢 Correct answer: B
🔴 RATIONALE: Crackles in lung bases, dyspnea, and orthopnea are classic signs of fluid accumulation in the lungs due to acute heart failure.
Pulmonary embolism typically presents with sudden chest pain and hypoxia without crackles. Pneumonia would include fever and productive cough.
Ischemia presents with chest pain, not pulmonary signs.
Question 2
Which electrolyte imbalance is most concerning for a patient receiving digoxin (digitalis) therapy?
A. Hypercalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypomagnesemia
🟢 Correct answer: B
🔴 RATIONALE: Hypokalemia increases digoxin toxicity risk because potassium and digoxin compete for the same binding sites on cardiac cells.
Low potassium allows more digoxin binding, leading to toxicity. Hypercalcemia can also increase toxicity but hypokalemia is more common and
clinically significant.
Question 3
A patient with COPD has an oxygen saturation of 88%. The nurse should:
A. Administer 6L oxygen via nasal cannula
B. Increase oxygen to maintain saturation above 95%
C. Administer oxygen at 2L and monitor closely
D. Immediately intubate the patient
🟢 Correct answer: C
,🔴 RATIONALE: COPD patients may have CO2 retention and high oxygen can suppress their respiratory drive. Target saturation is 88-92%. Starting
at 2L is conservative and safe. High oxygen (6L) or targeting >95% risks CO2 narcosis. Intubation is not indicated without respiratory failure signs.
Question 4
Which assessment finding in a patient with acute kidney injury requires immediate intervention?
A. Urine output of 250 mL in 8 hours
B. Serum potassium of 6.2 mEq/L
C. Blood pressure of 148/92 mmHg
D. Serum creatinine of 2.8 mg/dL
🟢 Correct answer: B
🔴 RATIONALE: Potassium of 6.2 mEq/L indicates severe hyperkalemia, which can cause fatal cardiac arrhythmias and requires immediate
treatment. Low urine output, elevated creatinine, and hypertension are expected in AKI but less immediately dangerous.
Question 5
A patient with type 2 diabetes presents with blood glucose of 450 mg/dL, pH 7.25, and positive serum ketones. The nurse anticipates treatment for:
A. Hyperosmolar hyperglycemic state (HHS)
B. Diabetic ketoacidosis (DKA)
C. Lactic acidosis
D. Insulin overdose
🟢 Correct answer: B
🔴 RATIONALE: DKA is characterized by hyperglycemia (>250), acidosis (pH <7.3), and ketosis. HHS has higher glucose (>600) without significant
ketosis or acidosis. The presence of ketones and acidosis confirms DKA.
Question 6
Which medication is contraindicated in a patient with suspected myocardial infarction and recent stroke?
, A. Aspirin
B. Metoprolol
C. Nitroglycerin
D. Clopidogrel
🟢 Correct answer: A
🔴 RATIONALE: Aspirin is contraindicated in patients with recent hemorrhagic stroke due to increased bleeding risk. While aspirin is standard for
MI, the stroke history requires alternative antiplatelet therapy. Beta-blockers, nitroglycerin, and clopidogrel are not contraindicated.
Question 7
A patient with pulmonary embolism develops sudden severe hypoxia and right-sided chest pain. The nurse should prioritize:
A. Administering oral analgesics
B. Preparing for emergency thrombolytic therapy
C. Encouraging deep breathing exercises
D. Applying warm compresses to the chest
🟢 Correct answer: B
🔴 RATIONALE: Severe hypoxia and chest pain suggest massive PE with hemodynamic instability. Thrombolytics are indicated for massive PE.
Analgesics, breathing exercises, and warm compresses are not priority interventions for life-threatening PE.
Question 8
Which finding indicates effective treatment of hypovolemic shock?
A. Urine output of 15 mL/hour
B. Heart rate of 118 bpm
C. Blood pressure of 118/74 mmHg
D. Serum lactate of 4.5 mg/dL
🟢 Correct answer: C
🔴 RATIONALE: Normal blood pressure indicates adequate perfusion and shock resolution. Low urine output (<30 mL/hr), elevated heart rate, and
high lactate (>2 mg/dL) indicate ongoing shock.
RATIONALES 2026 Q&A |STUDY GUIDE| INSTANT DOWNLOAD PDF
### Core Domains
*- Cardiovascular System Assessment and Management*
- Respiratory System Disorders and Interventions
- Renal and Urinary System Care
- Endocrine Disorders and Metabolic Conditions
- Gastrointestinal System Management
- Neurological System Assessment
- Infectious Diseases and Immunity
Electrolyte Imbalances and Fluid Management
- Medication Safety and Pharmacology
- Ethics, Legal Compliance, and Professional Standards
### Introduction
This practice assessment is designed to prepare nursing students and professionals for the Adult Health A examination, focusing on medical-
surgical nursing competency across major body systems. The exam evaluates critical knowledge in patient assessment, clinical decision-making,
intervention prioritization, and evidence-based care practices for adult patients with acute and chronic conditions. Through 100 multiple-choice
and scenario-based questions, this test assesses your ability to apply theoretical knowledge to real-world clinical situations, prioritize care using
the nursing process, recognize complications, and make safe, defensible decisions under pressure. Emphasis is placed on critical thinking, patient
safety, regulatory compliance, ethical standards, and the integration of pharmacological and non-pharmacological interventions. Successful
performance demonstrates readiness for clinical practice and NCLEX-RN success.
SECTION ONE: QUESTIONS 1–100
Question 1
A 65-year-old patient with coronary artery disease presents with sudden onset of crackles in both lung bases, dyspnea, and orthopnea. The nurse
suspects which complication?
,A. Pulmonary embolism
B. Acute heart failure
C. Pneumonia
D. Myocardial ischemia
🟢 Correct answer: B
🔴 RATIONALE: Crackles in lung bases, dyspnea, and orthopnea are classic signs of fluid accumulation in the lungs due to acute heart failure.
Pulmonary embolism typically presents with sudden chest pain and hypoxia without crackles. Pneumonia would include fever and productive cough.
Ischemia presents with chest pain, not pulmonary signs.
Question 2
Which electrolyte imbalance is most concerning for a patient receiving digoxin (digitalis) therapy?
A. Hypercalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypomagnesemia
🟢 Correct answer: B
🔴 RATIONALE: Hypokalemia increases digoxin toxicity risk because potassium and digoxin compete for the same binding sites on cardiac cells.
Low potassium allows more digoxin binding, leading to toxicity. Hypercalcemia can also increase toxicity but hypokalemia is more common and
clinically significant.
Question 3
A patient with COPD has an oxygen saturation of 88%. The nurse should:
A. Administer 6L oxygen via nasal cannula
B. Increase oxygen to maintain saturation above 95%
C. Administer oxygen at 2L and monitor closely
D. Immediately intubate the patient
🟢 Correct answer: C
,🔴 RATIONALE: COPD patients may have CO2 retention and high oxygen can suppress their respiratory drive. Target saturation is 88-92%. Starting
at 2L is conservative and safe. High oxygen (6L) or targeting >95% risks CO2 narcosis. Intubation is not indicated without respiratory failure signs.
Question 4
Which assessment finding in a patient with acute kidney injury requires immediate intervention?
A. Urine output of 250 mL in 8 hours
B. Serum potassium of 6.2 mEq/L
C. Blood pressure of 148/92 mmHg
D. Serum creatinine of 2.8 mg/dL
🟢 Correct answer: B
🔴 RATIONALE: Potassium of 6.2 mEq/L indicates severe hyperkalemia, which can cause fatal cardiac arrhythmias and requires immediate
treatment. Low urine output, elevated creatinine, and hypertension are expected in AKI but less immediately dangerous.
Question 5
A patient with type 2 diabetes presents with blood glucose of 450 mg/dL, pH 7.25, and positive serum ketones. The nurse anticipates treatment for:
A. Hyperosmolar hyperglycemic state (HHS)
B. Diabetic ketoacidosis (DKA)
C. Lactic acidosis
D. Insulin overdose
🟢 Correct answer: B
🔴 RATIONALE: DKA is characterized by hyperglycemia (>250), acidosis (pH <7.3), and ketosis. HHS has higher glucose (>600) without significant
ketosis or acidosis. The presence of ketones and acidosis confirms DKA.
Question 6
Which medication is contraindicated in a patient with suspected myocardial infarction and recent stroke?
, A. Aspirin
B. Metoprolol
C. Nitroglycerin
D. Clopidogrel
🟢 Correct answer: A
🔴 RATIONALE: Aspirin is contraindicated in patients with recent hemorrhagic stroke due to increased bleeding risk. While aspirin is standard for
MI, the stroke history requires alternative antiplatelet therapy. Beta-blockers, nitroglycerin, and clopidogrel are not contraindicated.
Question 7
A patient with pulmonary embolism develops sudden severe hypoxia and right-sided chest pain. The nurse should prioritize:
A. Administering oral analgesics
B. Preparing for emergency thrombolytic therapy
C. Encouraging deep breathing exercises
D. Applying warm compresses to the chest
🟢 Correct answer: B
🔴 RATIONALE: Severe hypoxia and chest pain suggest massive PE with hemodynamic instability. Thrombolytics are indicated for massive PE.
Analgesics, breathing exercises, and warm compresses are not priority interventions for life-threatening PE.
Question 8
Which finding indicates effective treatment of hypovolemic shock?
A. Urine output of 15 mL/hour
B. Heart rate of 118 bpm
C. Blood pressure of 118/74 mmHg
D. Serum lactate of 4.5 mg/dL
🟢 Correct answer: C
🔴 RATIONALE: Normal blood pressure indicates adequate perfusion and shock resolution. Low urine output (<30 mL/hr), elevated heart rate, and
high lactate (>2 mg/dL) indicate ongoing shock.
