Comprehensive
Nursing Synthesis &
Professional Practice
Examination
2026/2027
**Question 1**
,The nurse is performing a cardiac assessment on a client. Which technique is most appropriate for
assessing the client's apical pulse?
A. Palpate the carotid artery
B. Auscultate at the fifth intercostal space, midclavicular line
C. Palpate the radial artery
D. Auscultate at the second intercostal space, right sternal border
💫RATIONALE✔️✔️: The apical pulse is best auscultated at the fifth intercostal space at the
midclavicular line (the point of maximal impulse, or PMI). This is where the apex of the heart is closest to
the chest wall. The carotid and radial pulses are peripheral pulses, and the second intercostal space is
where aortic and pulmonic sounds are best heard.
💫ANSWER✔️✔️: B. Auscultate at the fifth intercostal space, midclavicular line
---
**Question 2**
A client is prescribed propranolol (Inderal) for the treatment of hypertension. The nurse should assess
the client for which adverse effect?
A. Tachycardia
B. Bradycardia
C. Hypotension
D. Hyperglycemia
,💫RATIONALE✔️✔️: Propranolol is a non-selective beta-blocker. A common adverse effect is
bradycardia (decreased heart rate) due to its negative chronotropic effect on the heart. It can also cause
hypotension, but bradycardia is a more specific adverse effect. It may mask signs of hypoglycemia, but
does not cause hyperglycemia.
💫ANSWER✔️✔️: B. Bradycardia
---
**Question 3**
The nurse is assessing a client with a history of schizophrenia who is experiencing acute psychosis. The
client is agitated and pacing the room. Which nursing intervention is the priority?
A. Administer a PRN dose of haloperidol
B. Place the client in seclusion
C. Provide a quiet, low-stimulation environment
D. Ask the client to sit down and calm down
💫RATIONALE✔️✔️: A quiet, low-stimulation environment is the priority intervention to reduce
agitation and prevent escalation. This can help the client regain control. Seclusion and medication are
used only if less restrictive measures fail and the client is a danger to themselves or others.
💫ANSWER✔️✔️: C. Provide a quiet, low-stimulation environment
---
**Question 4**
, The nurse is caring for a client with a central venous catheter (CVC). Which action is essential when
changing the dressing?
A. Use sterile technique and apply a transparent dressing
B. Change the dressing only if it is visibly soiled
C. Apply an antibiotic ointment to the insertion site
D. Keep the dressing dry for 24 hours
💫RATIONALE✔️✔️: Sterile technique is essential when changing a CVC dressing to prevent infection.
Transparent dressings are preferred as they allow for site observation. Dressings should be changed at
least every 7 days or sooner if soiled, and antibiotic ointment is generally not recommended.
💫ANSWER✔️✔️: A. Use sterile technique and apply a transparent dressing
---
**Question 5**
The nurse is providing education to a client with a new diagnosis of heart failure. Which statement
indicates the client understands the importance of daily weights?
A. "I should weigh myself at the same time each day, before breakfast."
B. "I can weigh myself at any time of the day."
C. "I should weigh myself weekly to monitor my fluid status."
D. "I don't need to weigh myself if I feel well."
Nursing Synthesis &
Professional Practice
Examination
2026/2027
**Question 1**
,The nurse is performing a cardiac assessment on a client. Which technique is most appropriate for
assessing the client's apical pulse?
A. Palpate the carotid artery
B. Auscultate at the fifth intercostal space, midclavicular line
C. Palpate the radial artery
D. Auscultate at the second intercostal space, right sternal border
💫RATIONALE✔️✔️: The apical pulse is best auscultated at the fifth intercostal space at the
midclavicular line (the point of maximal impulse, or PMI). This is where the apex of the heart is closest to
the chest wall. The carotid and radial pulses are peripheral pulses, and the second intercostal space is
where aortic and pulmonic sounds are best heard.
💫ANSWER✔️✔️: B. Auscultate at the fifth intercostal space, midclavicular line
---
**Question 2**
A client is prescribed propranolol (Inderal) for the treatment of hypertension. The nurse should assess
the client for which adverse effect?
A. Tachycardia
B. Bradycardia
C. Hypotension
D. Hyperglycemia
,💫RATIONALE✔️✔️: Propranolol is a non-selective beta-blocker. A common adverse effect is
bradycardia (decreased heart rate) due to its negative chronotropic effect on the heart. It can also cause
hypotension, but bradycardia is a more specific adverse effect. It may mask signs of hypoglycemia, but
does not cause hyperglycemia.
💫ANSWER✔️✔️: B. Bradycardia
---
**Question 3**
The nurse is assessing a client with a history of schizophrenia who is experiencing acute psychosis. The
client is agitated and pacing the room. Which nursing intervention is the priority?
A. Administer a PRN dose of haloperidol
B. Place the client in seclusion
C. Provide a quiet, low-stimulation environment
D. Ask the client to sit down and calm down
💫RATIONALE✔️✔️: A quiet, low-stimulation environment is the priority intervention to reduce
agitation and prevent escalation. This can help the client regain control. Seclusion and medication are
used only if less restrictive measures fail and the client is a danger to themselves or others.
💫ANSWER✔️✔️: C. Provide a quiet, low-stimulation environment
---
**Question 4**
, The nurse is caring for a client with a central venous catheter (CVC). Which action is essential when
changing the dressing?
A. Use sterile technique and apply a transparent dressing
B. Change the dressing only if it is visibly soiled
C. Apply an antibiotic ointment to the insertion site
D. Keep the dressing dry for 24 hours
💫RATIONALE✔️✔️: Sterile technique is essential when changing a CVC dressing to prevent infection.
Transparent dressings are preferred as they allow for site observation. Dressings should be changed at
least every 7 days or sooner if soiled, and antibiotic ointment is generally not recommended.
💫ANSWER✔️✔️: A. Use sterile technique and apply a transparent dressing
---
**Question 5**
The nurse is providing education to a client with a new diagnosis of heart failure. Which statement
indicates the client understands the importance of daily weights?
A. "I should weigh myself at the same time each day, before breakfast."
B. "I can weigh myself at any time of the day."
C. "I should weigh myself weekly to monitor my fluid status."
D. "I don't need to weigh myself if I feel well."
