KBN-KENTUCKY BOARD OF NURSING EXAM– QUESTIONS AND
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1. A registered nurse is preparing to administer a prescribed medication to a client in a
medical-surgical unit. Which of the following actions best demonstrates adherence to safe
medication administration standards?
A. Asking the client to state their full name and room number before administration
B. Comparing the medication administration record with the client identification band
and asking for date of birth
C. Relying on the nurse's familiarity with the client to bypass standard scanning procedures
during emergencies
D. Leaving the medication at the bedside table if the client is currently asleep and unavailable
Using two distinct identifiers, such as the client's full name and date of birth checked against
the identification band and medication administration record, is the gold standard for patient
safety. Room numbers are never acceptable identifiers. Leaving medication unattended
violates core safety protocols, and familiarity does not replace formal verification.
2. A nurse is caring for an adult client admitted with acute exacerbation of chronic
obstructive pulmonary disease. The client appears increasingly anxious, and pulse
oximetry reveals an oxygen saturation of 85% on room air. Which of the following
interventions should the nurse initiate first?
A. Administering low-flow oxygen via nasal cannula as prescribed
B. Drawing arterial blood gases to confirm baseline carbon dioxide retention
C. Placing the client in a supine position to maximize comfort
D. Contacting the primary healthcare provider immediately to request intubation
Hypoxemia requires immediate correction to prevent tissue damage and organ failure. Low-
flow oxygen is the primary intervention for acute exacerbations of chronic obstructive
pulmonary disease. The supine position worsens dyspnea, and diagnostic testing should not
delay life-saving oxygen therapy.
3. An assistive personnel reports to the charge nurse that a client diagnosed with major
depressive disorder refused morning hygiene care and stated, "Nothing matters anymore; I
just want to stay in bed." Which of the following actions should the registered nurse take
first?
A. Reassure the assistive personnel that depressive clients often lack motivation in the morning
,B. Document the client's refusal in the electronic health record and reassess later in the shift
C. Personally assess the client for active suicidal ideation and implement safety
precautions
D. Instruct the assistive personnel to return to the room and encourage the client firmly to get up
Statements reflecting hopelessness and worthlessness are major warning signs of potential
self-harm in depressed clients. The registered nurse must conduct a direct assessment rather
than delegating or dismissing the remark. Safety is the top priority in psychiatric nursing.
4. A nurse is reviewing laboratory results for a client receiving intravenous heparin
therapy for deep vein thrombosis. Which of the following findings requires immediate
notification of the healthcare provider?
A. Activated partial thromboplastin time of 75 seconds
B. International Normalized Ratio of 1.1
C. Platelet count of 75,000/mcL
D. Hemoglobin level of 13.5 g/dL
Heparin-induced thrombocytopenia is a serious immune-mediated adverse effect characterized
by a significant drop in platelets, often defined as a count below 100,000/mcL or a 50%
reduction from baseline. This requires immediate cessation of heparin. An activated partial
thromboplastin time of 75 seconds is typically within the therapeutic range for heparin
therapy.
5. A community health nurse is planning an educational seminar regarding hypertension
management for a diverse adult population. Which of the following teaching strategies is
most effective for adult learners?
A. Distributing complex medical journals detailing the pathophysiology of vascular resistance
B. Utilizing interactive case studies and practical lifestyle modification examples
C. Providing a strict lecture format without allowing participant interruptions
D. Expecting participants to memorize normal blood pressure numerical thresholds
Adult learners learn best when education is practical, relevant to their daily lives, and
interactive. Case studies bridge the gap between theory and real-world application, whereas
lectures and rote memorization are less effective for behavior change.
6. A nurse is assessing a client who has returned to the post-anesthesia care unit following a
thyroidectomy. Which of the following assessment findings should be reported
immediately?
A. Mild drowsiness and soreness at the surgical incision site
B. Stridor and frequent clearing of the throat
C. Blood pressure of 120/80 mm Hg and heart rate of 78 beats/min
D. Pain rating of 4 out of 10 managed with prescribed analgesics
,Stridor indicates laryngeal edema or airway obstruction, which is a life-threatening
complication following a thyroidectomy due to the proximity of the surgical site to the trachea.
Mild pain, stable vitals, and normal post-operative drowsiness are expected findings.
7. A client with type 1 diabetes mellitus is found unconscious in their hospital room. A
point-of-care blood glucose test reveals a value of 45 mg/dL. Which of the following
interventions should the nurse perform first?
A. Administer subcutaneous regular insulin per sliding scale
B. Administer 50% dextrose in water intravenously as prescribed
C. Offer the client 4 ounces of regular orange juice orally
D. Document the blood glucose finding and recheck in 30 minutes
An unconscious client cannot safely swallow oral carbohydrates due to the immediate risk of
aspiration. Intravenous administration of concentrated dextrose is the required emergency
treatment for severe hypoglycemia when oral intake is impossible.
8. A charge nurse is making assignments for a medical-surgical unit. Which of the
following clients is most appropriate to assign to an experienced licensed practical nurse?
A. A newly admitted client experiencing acute chest pain of uncertain etiology
B. A client with chronic stable heart disease requiring scheduled oral medications and
routine dressing changes
C. A client scheduled for discharge teaching following complex abdominal surgery
D. A client exhibiting sudden neurological deficits indicative of a transient ischemic attack
Licensed practical nurses can care for stable clients with predictable outcomes. Unstable
clients, new admissions requiring comprehensive assessment, complex initial discharge
teaching, and acute neurological changes must be managed by the registered nurse.
9. A nurse is providing discharge instructions to a client prescribed warfarin therapy.
Which of the following statements by the client indicates a need for further instruction?
A. "I will use a soft-bristled toothbrush and an electric razor."
B. "I should maintain a consistent daily intake of green leafy vegetables containing vitamin K."
C. "I can take aspirin for occasional headaches without consulting my doctor."
D. "I will keep all scheduled appointments for blood testing."
Aspirin and other nonsteroidal anti-inflammatory drugs increase the risk of bleeding when
taken concurrently with anticoagulants like warfarin. Clients must consult their provider
before taking any over-the-counter medications. All other statements reflect correct safety
practices.
10. A nurse enters the room of a client who is receiving enteral nutrition via a nasogastric
tube and discovers the client coughing violently with respiratory distress. Which of the
following actions should the nurse take first?
, A. Immediately stop the enteral feeding infusion
B. Flush the nasogastric tube with 30 mL of sterile water
C. Increase the rate of the enteral feeding pump to complete the dose
D. Auscultate the client's abdomen for bowel sounds
Coughing and respiratory distress during enteral feeding strongly suggest tube displacement
or pulmonary aspiration of formula. Stopping the infusion immediately prevents further
aspiration. Assessing lung sounds and positioning the client follow this critical first step.
11. A nurse is assessing an infant during a routine well-child visit. Which of the following
developmental milestones is expected for a 6-month-old infant?
A. Walking independently while holding onto furniture
B. Rolling from back to abdomen
C. Speaking three-word sentences clearly
D. Showing stranger anxiety and sitting unsupported
By 6 months of age, most infants can sit unsupported and frequently exhibit stranger anxiety
as part of cognitive development. Walking independently occurs closer to 12 to 15 months, and
three-word sentences emerge in toddlerhood.
12. A nurse is caring for a client with severe burns covering 40% of their total body surface
area during the resuscitation phase. Which of the following laboratory values is
characteristic of this initial phase?
A. Serum potassium level of 2.8 mEq/L
B. Serum sodium level of 150 mEq/L
C. Serum potassium level of 5.8 mEq/L
D. Hematocrit level of 32%
Cellular destruction during severe burns releases large amounts of intracellular potassium
into the extracellular fluid, resulting in hyperkalemia during the emergent resuscitation
phase. Fluid shifts also cause hemoconcentration, elevating the hematocrit rather than
lowering it.
13. A nurse receives a telephone order from a healthcare provider for an urgent medication
adjustment. Which of the following actions is required to ensure safe transcription of the
order?
A. Write the order down, read it back to the provider, and obtain confirmation before
entering it into the system
B. Enter the order directly into the computer system without reading it back to save time in an
emergency
C. Ask another nurse to listen in on the telephone speakerphone without documenting verbal
confirmation
D. Wait until the provider arrives at the unit later in the shift to sign the order
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE |
EXAM PREP | STUDY GUIDE | PRACTICE TEST| DOWNLOAD
INSTANT PDF
1. A registered nurse is preparing to administer a prescribed medication to a client in a
medical-surgical unit. Which of the following actions best demonstrates adherence to safe
medication administration standards?
A. Asking the client to state their full name and room number before administration
B. Comparing the medication administration record with the client identification band
and asking for date of birth
C. Relying on the nurse's familiarity with the client to bypass standard scanning procedures
during emergencies
D. Leaving the medication at the bedside table if the client is currently asleep and unavailable
Using two distinct identifiers, such as the client's full name and date of birth checked against
the identification band and medication administration record, is the gold standard for patient
safety. Room numbers are never acceptable identifiers. Leaving medication unattended
violates core safety protocols, and familiarity does not replace formal verification.
2. A nurse is caring for an adult client admitted with acute exacerbation of chronic
obstructive pulmonary disease. The client appears increasingly anxious, and pulse
oximetry reveals an oxygen saturation of 85% on room air. Which of the following
interventions should the nurse initiate first?
A. Administering low-flow oxygen via nasal cannula as prescribed
B. Drawing arterial blood gases to confirm baseline carbon dioxide retention
C. Placing the client in a supine position to maximize comfort
D. Contacting the primary healthcare provider immediately to request intubation
Hypoxemia requires immediate correction to prevent tissue damage and organ failure. Low-
flow oxygen is the primary intervention for acute exacerbations of chronic obstructive
pulmonary disease. The supine position worsens dyspnea, and diagnostic testing should not
delay life-saving oxygen therapy.
3. An assistive personnel reports to the charge nurse that a client diagnosed with major
depressive disorder refused morning hygiene care and stated, "Nothing matters anymore; I
just want to stay in bed." Which of the following actions should the registered nurse take
first?
A. Reassure the assistive personnel that depressive clients often lack motivation in the morning
,B. Document the client's refusal in the electronic health record and reassess later in the shift
C. Personally assess the client for active suicidal ideation and implement safety
precautions
D. Instruct the assistive personnel to return to the room and encourage the client firmly to get up
Statements reflecting hopelessness and worthlessness are major warning signs of potential
self-harm in depressed clients. The registered nurse must conduct a direct assessment rather
than delegating or dismissing the remark. Safety is the top priority in psychiatric nursing.
4. A nurse is reviewing laboratory results for a client receiving intravenous heparin
therapy for deep vein thrombosis. Which of the following findings requires immediate
notification of the healthcare provider?
A. Activated partial thromboplastin time of 75 seconds
B. International Normalized Ratio of 1.1
C. Platelet count of 75,000/mcL
D. Hemoglobin level of 13.5 g/dL
Heparin-induced thrombocytopenia is a serious immune-mediated adverse effect characterized
by a significant drop in platelets, often defined as a count below 100,000/mcL or a 50%
reduction from baseline. This requires immediate cessation of heparin. An activated partial
thromboplastin time of 75 seconds is typically within the therapeutic range for heparin
therapy.
5. A community health nurse is planning an educational seminar regarding hypertension
management for a diverse adult population. Which of the following teaching strategies is
most effective for adult learners?
A. Distributing complex medical journals detailing the pathophysiology of vascular resistance
B. Utilizing interactive case studies and practical lifestyle modification examples
C. Providing a strict lecture format without allowing participant interruptions
D. Expecting participants to memorize normal blood pressure numerical thresholds
Adult learners learn best when education is practical, relevant to their daily lives, and
interactive. Case studies bridge the gap between theory and real-world application, whereas
lectures and rote memorization are less effective for behavior change.
6. A nurse is assessing a client who has returned to the post-anesthesia care unit following a
thyroidectomy. Which of the following assessment findings should be reported
immediately?
A. Mild drowsiness and soreness at the surgical incision site
B. Stridor and frequent clearing of the throat
C. Blood pressure of 120/80 mm Hg and heart rate of 78 beats/min
D. Pain rating of 4 out of 10 managed with prescribed analgesics
,Stridor indicates laryngeal edema or airway obstruction, which is a life-threatening
complication following a thyroidectomy due to the proximity of the surgical site to the trachea.
Mild pain, stable vitals, and normal post-operative drowsiness are expected findings.
7. A client with type 1 diabetes mellitus is found unconscious in their hospital room. A
point-of-care blood glucose test reveals a value of 45 mg/dL. Which of the following
interventions should the nurse perform first?
A. Administer subcutaneous regular insulin per sliding scale
B. Administer 50% dextrose in water intravenously as prescribed
C. Offer the client 4 ounces of regular orange juice orally
D. Document the blood glucose finding and recheck in 30 minutes
An unconscious client cannot safely swallow oral carbohydrates due to the immediate risk of
aspiration. Intravenous administration of concentrated dextrose is the required emergency
treatment for severe hypoglycemia when oral intake is impossible.
8. A charge nurse is making assignments for a medical-surgical unit. Which of the
following clients is most appropriate to assign to an experienced licensed practical nurse?
A. A newly admitted client experiencing acute chest pain of uncertain etiology
B. A client with chronic stable heart disease requiring scheduled oral medications and
routine dressing changes
C. A client scheduled for discharge teaching following complex abdominal surgery
D. A client exhibiting sudden neurological deficits indicative of a transient ischemic attack
Licensed practical nurses can care for stable clients with predictable outcomes. Unstable
clients, new admissions requiring comprehensive assessment, complex initial discharge
teaching, and acute neurological changes must be managed by the registered nurse.
9. A nurse is providing discharge instructions to a client prescribed warfarin therapy.
Which of the following statements by the client indicates a need for further instruction?
A. "I will use a soft-bristled toothbrush and an electric razor."
B. "I should maintain a consistent daily intake of green leafy vegetables containing vitamin K."
C. "I can take aspirin for occasional headaches without consulting my doctor."
D. "I will keep all scheduled appointments for blood testing."
Aspirin and other nonsteroidal anti-inflammatory drugs increase the risk of bleeding when
taken concurrently with anticoagulants like warfarin. Clients must consult their provider
before taking any over-the-counter medications. All other statements reflect correct safety
practices.
10. A nurse enters the room of a client who is receiving enteral nutrition via a nasogastric
tube and discovers the client coughing violently with respiratory distress. Which of the
following actions should the nurse take first?
, A. Immediately stop the enteral feeding infusion
B. Flush the nasogastric tube with 30 mL of sterile water
C. Increase the rate of the enteral feeding pump to complete the dose
D. Auscultate the client's abdomen for bowel sounds
Coughing and respiratory distress during enteral feeding strongly suggest tube displacement
or pulmonary aspiration of formula. Stopping the infusion immediately prevents further
aspiration. Assessing lung sounds and positioning the client follow this critical first step.
11. A nurse is assessing an infant during a routine well-child visit. Which of the following
developmental milestones is expected for a 6-month-old infant?
A. Walking independently while holding onto furniture
B. Rolling from back to abdomen
C. Speaking three-word sentences clearly
D. Showing stranger anxiety and sitting unsupported
By 6 months of age, most infants can sit unsupported and frequently exhibit stranger anxiety
as part of cognitive development. Walking independently occurs closer to 12 to 15 months, and
three-word sentences emerge in toddlerhood.
12. A nurse is caring for a client with severe burns covering 40% of their total body surface
area during the resuscitation phase. Which of the following laboratory values is
characteristic of this initial phase?
A. Serum potassium level of 2.8 mEq/L
B. Serum sodium level of 150 mEq/L
C. Serum potassium level of 5.8 mEq/L
D. Hematocrit level of 32%
Cellular destruction during severe burns releases large amounts of intracellular potassium
into the extracellular fluid, resulting in hyperkalemia during the emergent resuscitation
phase. Fluid shifts also cause hemoconcentration, elevating the hematocrit rather than
lowering it.
13. A nurse receives a telephone order from a healthcare provider for an urgent medication
adjustment. Which of the following actions is required to ensure safe transcription of the
order?
A. Write the order down, read it back to the provider, and obtain confirmation before
entering it into the system
B. Enter the order directly into the computer system without reading it back to save time in an
emergency
C. Ask another nurse to listen in on the telephone speakerphone without documenting verbal
confirmation
D. Wait until the provider arrives at the unit later in the shift to sign the order
