EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) WITH EXPLANATIONS ALREADY GRADED
A+ (MOST RECENT!!)
SECTION DISTRIBUTION
Section 1: Fundamentals & Safety ................... Q1 – Q30
Section 2: Fluid, Electrolyte, Acid-Base ........... Q31 – Q60
Section 3: Cardiovascular .......................... Q61 – Q90
Section 4: Respiratory ............................. Q91 – Q120
Section 5: Neurological ............................ Q121 – Q150
Section 6: Endocrine ............................... Q151 – Q180
Section 7: Renal & GU .............................. Q181 – Q210
Section 8: GI & Nutrition .......................... Q211 – Q240
Section 9: Pharmacology ............................ Q241 – Q270
Section 10: Leadership, Delegation, & Clinical Judgment Q271 – Q300
SECTION 1: FUNDAMENTALS & PATIENT SAFETY (Q1–Q30)
Q1. The nurse is reviewing lab values for a client with respiratory alkalosis.
Which results should the nurse expect? Select all that apply.
1. pH 7.50.
2. pH 7.30.
3. Carbon dioxide (CO2) 50.
4. CO2 28.
5. Oxygen saturation 85%.
Correct Answer - 1, 4
- pH 7.50. Correct – pH is elevated in respiratory alkalosis.
- CO2 28. Correct – In respiratory alkalosis, the client blows off too much CO2,
leading to a low level.
- pH 7.30 is acidosis; CO2 50 is acidosis; O2 sat 85% is hypoxemia, not
specific to alkalosis.
Q2. A client receiving warfarin (Coumadin) shows increased drowsiness, BP 90/57,
1
,pulse 108, and respirations 22. Which medication should the nurse prepare?
1. Vitamin K.
2. Metoprolol.
3. Protamine sulfate.
4. Naloxone.
Correct Answer - 1
- Vitamin K. Correct – These signs indicate warfarin overdose/bleeding; vitamin K
reverses warfarin.
- Metoprolol is for tachycardia/hypertension, not warfarin reversal.
- Protamine sulfate reverses heparin.
- Naloxone reverses opioids.
Q3. A client is placed on contact precautions for Clostridium difficile. Which
PPE is required for entry into the room?
1. N95 respirator and gown.
2. Gloves and gown.
3. Mask and gloves.
4. Gown and eye shield.
Correct Answer - 2
- Gloves and gown. Correct – Contact precautions require gloves and gown.
- N95 is airborne; mask is droplet; eye shield is for splash risk.
Q4. A client falls while ambulating. What is the nurse's first action?
1. Call the provider.
2. Assess the client for injuries.
3. Complete an incident report.
4. Notify the charge nurse.
Correct Answer - 2
- Assess for injuries. Correct – ABCs and safety are the immediate priority.
- Reporting and documentation come after assessment.
2
,Q5. Which finding indicates a Stage 2 pressure injury?
1. Non-blanchable erythema over a bony prominence.
2. Partial-thickness skin loss with exposed dermis.
3. Full-thickness tissue loss with visible bone.
4. Intact skin with a serum-filled blister.
Correct Answer - 2
- Partial-thickness skin loss with exposed dermis. Correct – This is the
definition of Stage 2.
- Non-blanchable erythema is Stage 1; visible bone is Stage 4; intact blister is
also Stage 2 but the best description is partial-thickness loss.
Q6. A client has an indwelling urinary catheter. Which finding requires
immediate action?
1. Cloudy, foul-smelling urine.
2. Urine output of 40 mL/hr.
3. Clear, yellow urine.
4. Client reports mild suprapubic discomfort.
Correct Answer - 1
- Cloudy, foul-smelling urine. Correct – Indicates infection; obtain a culture.
- Output 40 mL/hr is adequate; clear urine is normal; mild discomfort is common.
Q7. The nurse applies restraints to a confused client. Which action is correct?
1. Apply restraints tightly to prevent movement.
2. Tie restraints to the side rail for easy access.
3. Obtain a provider's order within 24 hours.
4. Remove restraints every 2 hours for ROM and skin checks.
Correct Answer - 4
- Remove every 2 hours. Correct – Prevents complications; must be done.
- Tight restraints impair circulation; tying to side rails is unsafe; orders must
3
, be obtained immediately, not within 24 hours.
Q8. A client is NPO. Which intervention is priority to prevent complications?
1. Provide oral care every 2 hours.
2. Place an "NPO" sign above the bed.
3. Assess for thirst and dry mucous membranes.
4. Keep water at the bedside.
Correct Answer - 1
- Oral care every 2 hours. Correct – Prevents dry mucous membranes and
infection.
- Signage and assessment are important but oral care is the direct preventive
action.
Q9. A client is on a clear liquid diet. Which item is appropriate to serve?
1. Orange juice with pulp.
2. Chicken broth.
3. Cream of wheat.
4. Vanilla pudding.
Correct Answer - 2
- Chicken broth. Correct – Clear liquids are transparent at room temperature.
- Pulp, cream of wheat, and pudding are not clear liquids.
Q10. The nurse prepares to administer subcutaneous heparin. Which site is best?
1. Deltoid muscle.
2. Ventrogluteal site.
3. Abdomen, 2 inches away from umbilicus.
4. Vastus lateralis.
Correct Answer - 3
- Abdomen (2 inches from umbilicus). Correct – Provides consistent absorption.
- Deltoid and vastus lateralis are IM sites; ventrogluteal is IM.
4