BSN Senior Nursing Comprehensive
Examination Practice Questions & [Verified
Answers], Plus Explained Rationales|2026
Latest Update| Instant Download PDF
1. A nurse is caring for a client with septic shock who has received an
initial fluid bolus. Which finding requires the nurse's immediate
attention?
A. Temperature of 38.3°C (100.9°F)
B. Heart rate of 108 beats/min
C. Blood pressure of 82/48 mmHg
D. White blood cell count of 15,000/mm³
Answer: C. Blood pressure of 82/48 mmHg
Rationale: Persistent hypotension after initial fluid resuscitation
indicates inadequate tissue perfusion and possible septic shock
requiring rapid intervention, such as vasopressor therapy and
continued hemodynamic support.
2. A client with heart failure is receiving IV furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Sodium
B. Potassium
C. Hemoglobin
D. Platelet count
1|Page
,Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that promotes potassium
excretion. Hypokalemia can cause muscle weakness and potentially
life-threatening cardiac dysrhythmias.
3. A client with chronic obstructive pulmonary disease is receiving
oxygen therapy. Which oxygen saturation is generally an appropriate
target for a client at risk for chronic carbon dioxide retention?
A. 70%–75%
B. 80%–85%
C. 88%–92%
D. 98%–100%
Answer: C. 88%–92%
Rationale: For many clients with COPD who are at risk for hypercapnic
respiratory failure, controlled oxygen therapy targeting
approximately 88%–92% helps provide adequate oxygenation while
reducing the risk of excessive oxygen administration.
4. A client develops sudden facial drooping, slurred speech, and
weakness of the right arm. What is the nurse's priority action?
A. Give the client oral fluids
B. Place the client in Trendelenburg position
C. Determine the time symptoms began
D. Administer an oral antihypertensive
Answer: C. Determine the time symptoms began
2|Page
,Rationale: Establishing the last-known-well time is critical in
suspected acute ischemic stroke because eligibility for time-sensitive
reperfusion therapies depends partly on symptom onset.
5. A client receiving digoxin has an apical pulse of 54 beats/min. What
should the nurse do?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Give the medication with an antacid
D. Administer an additional dose
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia and other dysrhythmias. An
adult apical pulse below 60 beats/min generally warrants withholding
the dose and further evaluation.
6. A client with diabetic ketoacidosis is receiving IV regular insulin.
Which laboratory value requires particularly close monitoring?
A. Potassium
B. Calcium
C. Hemoglobin
D. Platelet count
Answer: A. Potassium
Rationale: Insulin drives potassium into cells and can rapidly lower
serum potassium during treatment of diabetic ketoacidosis. Severe
hypokalemia can cause dangerous cardiac dysrhythmias.
3|Page
, 7. A client with increased intracranial pressure is being assessed.
Which finding is most concerning?
A. Mild headache
B. Restlessness
C. Decreasing level of consciousness
D. Photophobia
Answer: C. Decreasing level of consciousness
Rationale: A declining level of consciousness is an important indicator
of worsening cerebral dysfunction and may signal increasing
intracranial pressure or impending neurologic deterioration.
8. A nurse is caring for a client who has a chest tube connected to a
drainage system. Which finding requires immediate intervention?
A. Tidaling in the water-seal chamber
B. Small amount of serous drainage
C. Continuous vigorous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C. Continuous vigorous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber usually
indicates an air leak in the system or from the client. The nurse should
assess the tubing and connections promptly.
9. A client with a suspected pulmonary embolism suddenly develops
dyspnea and chest pain. What is the priority nursing action?
A. Encourage ambulation
B. Apply oxygen and assess respiratory status
4|Page
Examination Practice Questions & [Verified
Answers], Plus Explained Rationales|2026
Latest Update| Instant Download PDF
1. A nurse is caring for a client with septic shock who has received an
initial fluid bolus. Which finding requires the nurse's immediate
attention?
A. Temperature of 38.3°C (100.9°F)
B. Heart rate of 108 beats/min
C. Blood pressure of 82/48 mmHg
D. White blood cell count of 15,000/mm³
Answer: C. Blood pressure of 82/48 mmHg
Rationale: Persistent hypotension after initial fluid resuscitation
indicates inadequate tissue perfusion and possible septic shock
requiring rapid intervention, such as vasopressor therapy and
continued hemodynamic support.
2. A client with heart failure is receiving IV furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Sodium
B. Potassium
C. Hemoglobin
D. Platelet count
1|Page
,Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that promotes potassium
excretion. Hypokalemia can cause muscle weakness and potentially
life-threatening cardiac dysrhythmias.
3. A client with chronic obstructive pulmonary disease is receiving
oxygen therapy. Which oxygen saturation is generally an appropriate
target for a client at risk for chronic carbon dioxide retention?
A. 70%–75%
B. 80%–85%
C. 88%–92%
D. 98%–100%
Answer: C. 88%–92%
Rationale: For many clients with COPD who are at risk for hypercapnic
respiratory failure, controlled oxygen therapy targeting
approximately 88%–92% helps provide adequate oxygenation while
reducing the risk of excessive oxygen administration.
4. A client develops sudden facial drooping, slurred speech, and
weakness of the right arm. What is the nurse's priority action?
A. Give the client oral fluids
B. Place the client in Trendelenburg position
C. Determine the time symptoms began
D. Administer an oral antihypertensive
Answer: C. Determine the time symptoms began
2|Page
,Rationale: Establishing the last-known-well time is critical in
suspected acute ischemic stroke because eligibility for time-sensitive
reperfusion therapies depends partly on symptom onset.
5. A client receiving digoxin has an apical pulse of 54 beats/min. What
should the nurse do?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Give the medication with an antacid
D. Administer an additional dose
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia and other dysrhythmias. An
adult apical pulse below 60 beats/min generally warrants withholding
the dose and further evaluation.
6. A client with diabetic ketoacidosis is receiving IV regular insulin.
Which laboratory value requires particularly close monitoring?
A. Potassium
B. Calcium
C. Hemoglobin
D. Platelet count
Answer: A. Potassium
Rationale: Insulin drives potassium into cells and can rapidly lower
serum potassium during treatment of diabetic ketoacidosis. Severe
hypokalemia can cause dangerous cardiac dysrhythmias.
3|Page
, 7. A client with increased intracranial pressure is being assessed.
Which finding is most concerning?
A. Mild headache
B. Restlessness
C. Decreasing level of consciousness
D. Photophobia
Answer: C. Decreasing level of consciousness
Rationale: A declining level of consciousness is an important indicator
of worsening cerebral dysfunction and may signal increasing
intracranial pressure or impending neurologic deterioration.
8. A nurse is caring for a client who has a chest tube connected to a
drainage system. Which finding requires immediate intervention?
A. Tidaling in the water-seal chamber
B. Small amount of serous drainage
C. Continuous vigorous bubbling in the water-seal chamber
D. Mild discomfort at the insertion site
Answer: C. Continuous vigorous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber usually
indicates an air leak in the system or from the client. The nurse should
assess the tubing and connections promptly.
9. A client with a suspected pulmonary embolism suddenly develops
dyspnea and chest pain. What is the priority nursing action?
A. Encourage ambulation
B. Apply oxygen and assess respiratory status
4|Page
