NURS 403 COMPREHENSIVE EXIT EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A client with chronic obstructive pulmonary disease (COPD) has a prescription for a low-flow oxygen
therapy at 2 L/min via nasal cannula. Which assessment finding indicates the therapy is effective?
A. Increased respiratory rate from 22 to 26 breaths per minute
B. Decreased level of consciousness
C. Oxygen saturation of 92% on pulse oximetry
D. PaCO2 level of 52 mm Hg on arterial blood gas
🟢C
🔴 RATIONALE: For clients with COPD, the goal of oxygen therapy is to maintain oxygen saturation between
88% and 92% to provide adequate tissue oxygenation while avoiding the risk of suppressing the hypoxic drive.
An SpO2 of 92% indicates effective therapy.
2. A nurse is providing discharge teaching to a client with a new diagnosis of heart failure. Which statement
by the client indicates a need for further teaching?
A. "I will weigh myself daily at the same time each morning."
B. "I should restrict my daily fluid intake as prescribed."
C. "I can use table salt to season my food while cooking."
D. "I will notify my provider if I experience sudden weight gain."
🟢C
🔴 RATIONALE: Clients with heart failure require a low-sodium diet to prevent fluid retention. Using table salt
,during cooking or at the table is contraindicated. Daily weights and fluid restriction are correct self-
management strategies.
3. A nurse is caring for a client who is postoperative and reports severe pain. The prescription is for
morphine 4 mg IV push. The medication vial contains 10 mg/mL. How many mL should the nurse administer?
A. 0.4 mL
B. 2.5 mL
C. 4.0 mL
D. 0.25 mL
🟢A
🔴 RATIONALE: Use the formula: Desired dose / Available dose x Volume. 4 mg / 10 mg x 1 mL = 0.4 mL. The
nurse should administer 0.4 mL of the medication.
4. A client with diabetes mellitus type 1 is experiencing diaphoresis, tachycardia, and confusion. The client is
awake but unable to swallow. What is the priority nursing action?
A. Administer glucagon 1 mg intramuscularly
B. Offer a glass of orange juice
C. Check blood glucose level
D. Administer dextrose 50% IV push
🟢C
🔴 RATIONALE: While the client is exhibiting signs of hypoglycemia, the priority action is to obtain a blood
glucose level to confirm the diagnosis before treatment. Since the client is unable to swallow, oral glucose is
contraindicated. Glucagon or IV dextrose may be administered after confirmation.
5. A nurse is preparing to administer a blood transfusion to a client. Which action is most important to
prevent a transfusion reaction?
A. Verify the client's identification with two unique identifiers
,B. Prime the IV tubing with normal saline
C. Check the expiration date on the blood unit
D. Obtain the client's vital signs prior to the transfusion
🟢A
🔴 RATIONALE: The most critical action to prevent a transfusion reaction is to verify the client's identity using
two unique identifiers (e.g., name and date of birth) and match them to the blood unit. While other actions are
part of safe transfusion practice, correct identification is the primary safeguard.
6. A client on a mechanical ventilator has an arterial blood gas (ABG) result of pH 7.28, PaCO2 55 mm Hg,
and HCO3 24 mEq/L. Which condition does this indicate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
🟢C
🔴 RATIONALE: This ABG shows a decreased pH (acidosis), an elevated PaCO2 (above normal 35-45 mm Hg),
and a normal HCO3 (22-26 mEq/L). This pattern indicates respiratory acidosis, which is caused by
hypoventilation or inadequate carbon dioxide excretion.
7. A nurse is caring for a client with major depression who is prescribed phenelzine. The nurse should
instruct the client to avoid which food item?
A. Grilled chicken breast
B. Fresh fruit salad
C. Aged cheddar cheese
D. Pasta with tomato sauce
🟢C
, 🔴 RATIONALE: Phenelzine is a monoamine oxidase inhibitor (MAOI). Clients taking MAOIs must avoid foods
high in tyramine to prevent a hypertensive crisis. Aged cheeses, such as cheddar, are high in tyramine and are
strictly prohibited.
8. A client with cirrhosis of the liver has ascites and an order for spironolactone. The nurse monitors the
client for which therapeutic effect?
A. Decreased abdominal girth
B. Increased serum sodium level
C. Increased urine output
D. Decreased blood pressure
🟢A
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic used to manage ascites in clients with cirrhosis.
The therapeutic effect is the reduction of fluid retention, which is best measured by a decrease in abdominal
girth and daily weight.
9. The nurse is assessing a newborn infant. Which finding should be reported to the healthcare provider
immediately?
A. Heart rate of 140 beats per minute
B. Respiratory rate of 50 breaths per minute
C. Acrocyanosis of the hands and feet
D. Grunting respirations with nasal flaring
🟢D
🔴 RATIONALE: Grunting respirations and nasal flaring are signs of respiratory distress in a newborn. A heart
rate of 140, respiratory rate of 50, and acrocyanosis are normal findings in the immediate newborn period.
10. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate for the
nurse to delegate?
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027
SECTION ONE: QUESTIONS 1-100
1. A client with chronic obstructive pulmonary disease (COPD) has a prescription for a low-flow oxygen
therapy at 2 L/min via nasal cannula. Which assessment finding indicates the therapy is effective?
A. Increased respiratory rate from 22 to 26 breaths per minute
B. Decreased level of consciousness
C. Oxygen saturation of 92% on pulse oximetry
D. PaCO2 level of 52 mm Hg on arterial blood gas
🟢C
🔴 RATIONALE: For clients with COPD, the goal of oxygen therapy is to maintain oxygen saturation between
88% and 92% to provide adequate tissue oxygenation while avoiding the risk of suppressing the hypoxic drive.
An SpO2 of 92% indicates effective therapy.
2. A nurse is providing discharge teaching to a client with a new diagnosis of heart failure. Which statement
by the client indicates a need for further teaching?
A. "I will weigh myself daily at the same time each morning."
B. "I should restrict my daily fluid intake as prescribed."
C. "I can use table salt to season my food while cooking."
D. "I will notify my provider if I experience sudden weight gain."
🟢C
🔴 RATIONALE: Clients with heart failure require a low-sodium diet to prevent fluid retention. Using table salt
,during cooking or at the table is contraindicated. Daily weights and fluid restriction are correct self-
management strategies.
3. A nurse is caring for a client who is postoperative and reports severe pain. The prescription is for
morphine 4 mg IV push. The medication vial contains 10 mg/mL. How many mL should the nurse administer?
A. 0.4 mL
B. 2.5 mL
C. 4.0 mL
D. 0.25 mL
🟢A
🔴 RATIONALE: Use the formula: Desired dose / Available dose x Volume. 4 mg / 10 mg x 1 mL = 0.4 mL. The
nurse should administer 0.4 mL of the medication.
4. A client with diabetes mellitus type 1 is experiencing diaphoresis, tachycardia, and confusion. The client is
awake but unable to swallow. What is the priority nursing action?
A. Administer glucagon 1 mg intramuscularly
B. Offer a glass of orange juice
C. Check blood glucose level
D. Administer dextrose 50% IV push
🟢C
🔴 RATIONALE: While the client is exhibiting signs of hypoglycemia, the priority action is to obtain a blood
glucose level to confirm the diagnosis before treatment. Since the client is unable to swallow, oral glucose is
contraindicated. Glucagon or IV dextrose may be administered after confirmation.
5. A nurse is preparing to administer a blood transfusion to a client. Which action is most important to
prevent a transfusion reaction?
A. Verify the client's identification with two unique identifiers
,B. Prime the IV tubing with normal saline
C. Check the expiration date on the blood unit
D. Obtain the client's vital signs prior to the transfusion
🟢A
🔴 RATIONALE: The most critical action to prevent a transfusion reaction is to verify the client's identity using
two unique identifiers (e.g., name and date of birth) and match them to the blood unit. While other actions are
part of safe transfusion practice, correct identification is the primary safeguard.
6. A client on a mechanical ventilator has an arterial blood gas (ABG) result of pH 7.28, PaCO2 55 mm Hg,
and HCO3 24 mEq/L. Which condition does this indicate?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
🟢C
🔴 RATIONALE: This ABG shows a decreased pH (acidosis), an elevated PaCO2 (above normal 35-45 mm Hg),
and a normal HCO3 (22-26 mEq/L). This pattern indicates respiratory acidosis, which is caused by
hypoventilation or inadequate carbon dioxide excretion.
7. A nurse is caring for a client with major depression who is prescribed phenelzine. The nurse should
instruct the client to avoid which food item?
A. Grilled chicken breast
B. Fresh fruit salad
C. Aged cheddar cheese
D. Pasta with tomato sauce
🟢C
, 🔴 RATIONALE: Phenelzine is a monoamine oxidase inhibitor (MAOI). Clients taking MAOIs must avoid foods
high in tyramine to prevent a hypertensive crisis. Aged cheeses, such as cheddar, are high in tyramine and are
strictly prohibited.
8. A client with cirrhosis of the liver has ascites and an order for spironolactone. The nurse monitors the
client for which therapeutic effect?
A. Decreased abdominal girth
B. Increased serum sodium level
C. Increased urine output
D. Decreased blood pressure
🟢A
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic used to manage ascites in clients with cirrhosis.
The therapeutic effect is the reduction of fluid retention, which is best measured by a decrease in abdominal
girth and daily weight.
9. The nurse is assessing a newborn infant. Which finding should be reported to the healthcare provider
immediately?
A. Heart rate of 140 beats per minute
B. Respiratory rate of 50 breaths per minute
C. Acrocyanosis of the hands and feet
D. Grunting respirations with nasal flaring
🟢D
🔴 RATIONALE: Grunting respirations and nasal flaring are signs of respiratory distress in a newborn. A heart
rate of 140, respiratory rate of 50, and acrocyanosis are normal findings in the immediate newborn period.
10. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate for the
nurse to delegate?
