NURS 322 EXAM 4 | PRACTICE QUESTIONS & ANSWERS | COMPREHENSIVE NCLEX NURSING
STUDY GUIDE 2026/2027
A nurse is caring for a client hospitalized for an open reduction of a fractured femur and
application of a cast. The most important nursing action for the care of this client is to
a) medicate the client for pain.
b) use the palms of the hands when moving an extremity with a wet cast.
c) perform neurovascular checks of the extremities.
d) petal the edges of the cast to provide smooth edges. - ANS ✔✔c) perform neurovascular
checks of the extremities.
1. A nurse in a cardiac care unit is caring for a client with acute heart failure. Which of the
following findings should the nurse expect?
a) Decreased brain natriuretic peptide (BNP).
b) Elevated central venous pressure (CVP).
c) Decreased pulmonary pressure.
d) Increased urinary output. - ANS ✔✔b) Elevated central venous pressure (CVP).
1. A nurse is providing teaching for a client who has a new diagnosis of angina pectoris. The
nurse should give the client which of the following information about anginal pain?
a) The pain usually lasts more than 20 min.
b) The pain often radiates to the jaw or the back.
c) The pain persists with rest and organic nitrates.
d) Exertion and anxiety can trigger the pain. - ANS ✔✔d) Exertion and anxiety can trigger the
pain.
1. A nurse is assessing a client who has a left lower arm fracture. Which of the following findings
indicates impaired venous return in the affected arm?
,a) A bounding distal pulse
b) Acute pain
c) Ecchymosis of the surrounding skin
d) Increasing edema - ANS ✔✔d) Increasing edema
1. A nurse on a medical-surgical unit is caring for a client who reports pain in the jaw, back and
shoulder, shortness of breath and nausea. Which of the following actions should the nurse
perform first?
a. Administer oxygen.
b. Begin ECG monitoring.
c. Ensure a patent airway.
d. Assess pain using the pain scale (0 to 10). - ANS ✔✔c. Ensure a patent airway.
1. A nurse is giving a presentation to a community group about preventing atherosclerosis.
Which of the following should the nurse include as a modifiable risk factor for this disorder?
(Select all that apply.)
a. Genetic predisposition
b. Hypercholesterolemia
c. Hypertension
d. Obesity
e. Smoking - ANS ✔✔b. Hypercholesterolemia
c. Hypertension
d. Obesity
e. Smoking
1. A nurse is caring for a client in the critical care unit following a knife wound to the chest. The
nurse suspects the client is developing cardiac tamponade. Which of the following findings
supports this suspicion?
,a. Widening pulse pressure.
b. Muffled heart sounds.
c. Elevating systolic blood pressure.
d. Decreasing venous pressure. - ANS ✔✔b. Muffled heart sounds.
1. A nurse is caring for a male client who has peripheral vascular disease and is taking dietary
supplements and has a new prescription for warfarin (Coumadin). The nurse should instruct the
client to stop which of the following supplements prior to starting the warfarin? (Select all that
apply.)
a) Saw palmetto
b) Echinacea
c) Glucosamine
d) Black cohosh
e) Gingko biloba - ANS ✔✔a) Saw palmetto
c) Glucosamine
e) Gingko biloba
1. A nurse is caring for a client who has a cast in place for a fractured tibia. Of the following,
which nursing action is the priority immediately after the provider has applied the cast?
a. Checking capillary refill
b. Discussing cast care
c. Managing pain
d. Performing range of motion - ANS ✔✔a. Checking capillary refill
1. A nurse is caring for a client who enters the emergency department of severe chest pain.
Which of the following interventions should the nurse implement to determine if the client is
experiencing a myocardial infarction?
a. Check the client's blood pressure.
, b. Auscultate heart tones.
c. Perform a 12-lead ECG
d. Determine if pain radiates to the left arm. - ANS ✔✔c. Perform a 12-lead ECG
1. A nurse is caring for a client who has a blood pressure of 156/98. Which of the following
findings would the client manifest with Stage 1 hypertension?
a. Vertigo
b. Uremia
c. Blurred vision
d. Dyspnea - ANS ✔✔a. Vertigo
1. A nurse is assessing a client following the application of a leg cast for the treatment of a
fracture. Which of the following findings should the nurse expect to find first if the cast is too
tight?
a. Change in temperature of the toes.
b. Pallor of the toes.
c. Edema of the toes.
d. Inability to move toes. - ANS ✔✔b. Pallor of the toes.
1. A nurse caring for a client who has a femur fracture suspects fat embolism syndrome. Which
of the following findings is the nurse's earliest warning that this complication is developing?
a. Petechiae
b. Confusion
c. Tachycardia
d. Crackles - ANS ✔✔b. Confusion
STUDY GUIDE 2026/2027
A nurse is caring for a client hospitalized for an open reduction of a fractured femur and
application of a cast. The most important nursing action for the care of this client is to
a) medicate the client for pain.
b) use the palms of the hands when moving an extremity with a wet cast.
c) perform neurovascular checks of the extremities.
d) petal the edges of the cast to provide smooth edges. - ANS ✔✔c) perform neurovascular
checks of the extremities.
1. A nurse in a cardiac care unit is caring for a client with acute heart failure. Which of the
following findings should the nurse expect?
a) Decreased brain natriuretic peptide (BNP).
b) Elevated central venous pressure (CVP).
c) Decreased pulmonary pressure.
d) Increased urinary output. - ANS ✔✔b) Elevated central venous pressure (CVP).
1. A nurse is providing teaching for a client who has a new diagnosis of angina pectoris. The
nurse should give the client which of the following information about anginal pain?
a) The pain usually lasts more than 20 min.
b) The pain often radiates to the jaw or the back.
c) The pain persists with rest and organic nitrates.
d) Exertion and anxiety can trigger the pain. - ANS ✔✔d) Exertion and anxiety can trigger the
pain.
1. A nurse is assessing a client who has a left lower arm fracture. Which of the following findings
indicates impaired venous return in the affected arm?
,a) A bounding distal pulse
b) Acute pain
c) Ecchymosis of the surrounding skin
d) Increasing edema - ANS ✔✔d) Increasing edema
1. A nurse on a medical-surgical unit is caring for a client who reports pain in the jaw, back and
shoulder, shortness of breath and nausea. Which of the following actions should the nurse
perform first?
a. Administer oxygen.
b. Begin ECG monitoring.
c. Ensure a patent airway.
d. Assess pain using the pain scale (0 to 10). - ANS ✔✔c. Ensure a patent airway.
1. A nurse is giving a presentation to a community group about preventing atherosclerosis.
Which of the following should the nurse include as a modifiable risk factor for this disorder?
(Select all that apply.)
a. Genetic predisposition
b. Hypercholesterolemia
c. Hypertension
d. Obesity
e. Smoking - ANS ✔✔b. Hypercholesterolemia
c. Hypertension
d. Obesity
e. Smoking
1. A nurse is caring for a client in the critical care unit following a knife wound to the chest. The
nurse suspects the client is developing cardiac tamponade. Which of the following findings
supports this suspicion?
,a. Widening pulse pressure.
b. Muffled heart sounds.
c. Elevating systolic blood pressure.
d. Decreasing venous pressure. - ANS ✔✔b. Muffled heart sounds.
1. A nurse is caring for a male client who has peripheral vascular disease and is taking dietary
supplements and has a new prescription for warfarin (Coumadin). The nurse should instruct the
client to stop which of the following supplements prior to starting the warfarin? (Select all that
apply.)
a) Saw palmetto
b) Echinacea
c) Glucosamine
d) Black cohosh
e) Gingko biloba - ANS ✔✔a) Saw palmetto
c) Glucosamine
e) Gingko biloba
1. A nurse is caring for a client who has a cast in place for a fractured tibia. Of the following,
which nursing action is the priority immediately after the provider has applied the cast?
a. Checking capillary refill
b. Discussing cast care
c. Managing pain
d. Performing range of motion - ANS ✔✔a. Checking capillary refill
1. A nurse is caring for a client who enters the emergency department of severe chest pain.
Which of the following interventions should the nurse implement to determine if the client is
experiencing a myocardial infarction?
a. Check the client's blood pressure.
, b. Auscultate heart tones.
c. Perform a 12-lead ECG
d. Determine if pain radiates to the left arm. - ANS ✔✔c. Perform a 12-lead ECG
1. A nurse is caring for a client who has a blood pressure of 156/98. Which of the following
findings would the client manifest with Stage 1 hypertension?
a. Vertigo
b. Uremia
c. Blurred vision
d. Dyspnea - ANS ✔✔a. Vertigo
1. A nurse is assessing a client following the application of a leg cast for the treatment of a
fracture. Which of the following findings should the nurse expect to find first if the cast is too
tight?
a. Change in temperature of the toes.
b. Pallor of the toes.
c. Edema of the toes.
d. Inability to move toes. - ANS ✔✔b. Pallor of the toes.
1. A nurse caring for a client who has a femur fracture suspects fat embolism syndrome. Which
of the following findings is the nurse's earliest warning that this complication is developing?
a. Petechiae
b. Confusion
c. Tachycardia
d. Crackles - ANS ✔✔b. Confusion
