KAPLAN INTEGRATED NURSING EXIT EXAM |
180 QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES | BRAND NEW 2025/2026
VERSION
Core Domains
1. Management of Care – Delegation, Prioritization, Collaboration, Case
Management, Client Rights, Advance Directives, Assignment, Supervision
2. Safety and Infection Control – Accident Prevention, Disaster Planning, Error
Prevention, Standard/Transmission Precautions, Restraints, Home Safety
3. Health Promotion and Maintenance – Ante/Intra/Postpartum Care, Developmental
Stages, Aging Process, Health Screening, Disease Prevention
4. Psychosocial Integrity – Coping Mechanisms, Grief and Loss, Mental Health
Disorders, Therapeutic Communication, Abuse/Neglect, Behavioral Interventions
5. Basic Care and Comfort – Hygiene, Mobility, Nutrition, Sleep/Rest, Pain
Management, Wound Care, Elimination, Assistive Devices
6. Pharmacological and Parenteral Therapies – Medication Administration, Dosage
Calculation, Adverse Effects, Interactions, Blood/Blood Products, IV Therapy
7. Reduction of Risk Potential – Diagnostic Tests, Vital Signs, Lab Values, Therapeutic
Procedures, Body System Changes, Unexpected Responses
8. Physiological Adaptation – Fluid/Electrolytes, Acid-Base Balance, Pathophysiology,
Medical Emergencies, Shock, Organ Failure, Perioperative Care
9. NGN – Clinical Judgment, Bow-Tie Case Studies, Extended Multiple Response
(SATA), Drag and Drop, Cloze (Dropdown), Unfolding Cases
10. NGN – Prioritization, Interprofessional Collaboration, Quality Improvement, Care
Coordination, Health Teaching, Transition of Care
Introduction
This comprehensive practice examination is meticulously designed for nursing
students preparing for the Kaplan Integrated Nursing Exit Examination. The
,assessment covers all essential domains required for successful program
completion and NCLEX-RN/PN readiness, including management of care, safety and
infection control, health promotion and maintenance, psychosocial integrity, basic
care and comfort, pharmacological therapies, reduction of risk potential, and
physiological adaptation. Through a combination of multiple-choice questions,
Select-All-That-Apply (SATA), and Next Generation NCLEX (NGN) style case studies,
candidates will demonstrate their understanding of integrated nursing concepts,
clinical judgment, and decision-making in complex patient scenarios. Each question
includes a detailed rationale explaining the correct answer and reinforcing key
concepts. The questions are structured to test not only recall of nursing principles but
also the ability to apply critical thinking to real-world clinical situations. Successful
completion of this examination demonstrates readiness for the official Kaplan
Integrated Nursing Exit Examination and the NCLEX licensure examination.
SECTION ONE: QUESTIONS 1-180
1. A nurse is caring for a client who has a new prescription for warfarin. Which of
the following statements by the client indicates an understanding of the
teaching?
A. "I will avoid leafy green vegetables."
B. "I will take ibuprofen for headaches."
C. "I will have my INR checked regularly."
D. Both A and C
D. Both A and C
RATIONALE: Clients on warfarin should avoid vitamin K-rich foods (leafy greens)
and have INR monitored regularly. Ibuprofen increases bleeding risk and should be
avoided.
2. A nurse is preparing to administer digoxin to a client. Which of the following
actions should the nurse take prior to administration?
,A. Check the client's apical pulse for 1 full minute
B. Assess the client's respiratory rate
C. Measure the client's blood pressure
D. Check the client's serum potassium level
A. Check the client's apical pulse for 1 full minute
RATIONALE: Digoxin should be withheld if the apical pulse is less than 60/min in
adults. The apical pulse should be assessed for 1 full minute before administration.
3. A nurse is providing teaching to a client who has a new prescription for
metformin. Which of the following adverse effects should the nurse instruct the
client to report to the provider?
A. Weight gain
B. Constipation
C. Lactic acidosis symptoms (muscle pain, weakness, difficulty breathing)
D. Insomnia
C. Lactic acidosis symptoms (muscle pain, weakness, difficulty breathing)
RATIONALE: Metformin can cause lactic acidosis, a rare but serious adverse
effect. Symptoms include muscle pain, weakness, difficulty breathing, abdominal
pain, and dizziness.
4. A nurse is caring for a client who has a prescription for heparin therapy. Which
of the following laboratory values should the nurse monitor to evaluate the
therapeutic effectiveness of the medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. International normalized ratio (INR)
D. Platelet count
A. Activated partial thromboplastin time (aPTT)
RATIONALE: Heparin therapy is monitored using aPTT, which should be 1.5 to 2.5
times the normal control value. PT and INR are used to monitor warfarin therapy.
, 5. A nurse is assessing a client who has a new diagnosis of myocardial infarction.
Which of the following pain characteristics is most consistent with this
condition?
A. Sharp, stabbing pain that worsens with deep inspiration
B. Crushing, substernal pain that radiates to the left arm
C. Burning epigastric pain
D. Pain that worsens with movement
B. Crushing, substernal pain that radiates to the left arm
RATIONALE: Myocardial infarction pain is often described as crushing substernal
pain radiating to the left arm. Sharp pain with inspiration suggests pleuritis.
6. A nurse is caring for a client who is postoperative and is experiencing nausea
and vomiting. The nurse should identify which of the following findings as
indications that the client has fluid volume deficit? (Select all that apply.)
A. Full bounding pulse
B. Cool extremities
C. Moist crackles in the lungs
D. Orthostatic hypotension
E. Flat neck veins
B. Cool extremities; D. Orthostatic hypotension; E. Flat neck veins
RATIONALE: Fluid volume deficit (hypovolemia) is indicated by cool extremities,
orthostatic hypotension, and flat neck veins. A full bounding pulse and moist
crackles in the lungs are signs of fluid volume excess.
7. A nurse is assessing a client who has a new diagnosis of hypothyroidism. Which
of the following skin findings should the nurse expect?
A. Dry, flaky skin
B. Moist, warm skin
C. Skin ulcers
D. Diaphoresis
180 QUESTIONS AND CORRECT ANSWERS
WITH RATIONALES | BRAND NEW 2025/2026
VERSION
Core Domains
1. Management of Care – Delegation, Prioritization, Collaboration, Case
Management, Client Rights, Advance Directives, Assignment, Supervision
2. Safety and Infection Control – Accident Prevention, Disaster Planning, Error
Prevention, Standard/Transmission Precautions, Restraints, Home Safety
3. Health Promotion and Maintenance – Ante/Intra/Postpartum Care, Developmental
Stages, Aging Process, Health Screening, Disease Prevention
4. Psychosocial Integrity – Coping Mechanisms, Grief and Loss, Mental Health
Disorders, Therapeutic Communication, Abuse/Neglect, Behavioral Interventions
5. Basic Care and Comfort – Hygiene, Mobility, Nutrition, Sleep/Rest, Pain
Management, Wound Care, Elimination, Assistive Devices
6. Pharmacological and Parenteral Therapies – Medication Administration, Dosage
Calculation, Adverse Effects, Interactions, Blood/Blood Products, IV Therapy
7. Reduction of Risk Potential – Diagnostic Tests, Vital Signs, Lab Values, Therapeutic
Procedures, Body System Changes, Unexpected Responses
8. Physiological Adaptation – Fluid/Electrolytes, Acid-Base Balance, Pathophysiology,
Medical Emergencies, Shock, Organ Failure, Perioperative Care
9. NGN – Clinical Judgment, Bow-Tie Case Studies, Extended Multiple Response
(SATA), Drag and Drop, Cloze (Dropdown), Unfolding Cases
10. NGN – Prioritization, Interprofessional Collaboration, Quality Improvement, Care
Coordination, Health Teaching, Transition of Care
Introduction
This comprehensive practice examination is meticulously designed for nursing
students preparing for the Kaplan Integrated Nursing Exit Examination. The
,assessment covers all essential domains required for successful program
completion and NCLEX-RN/PN readiness, including management of care, safety and
infection control, health promotion and maintenance, psychosocial integrity, basic
care and comfort, pharmacological therapies, reduction of risk potential, and
physiological adaptation. Through a combination of multiple-choice questions,
Select-All-That-Apply (SATA), and Next Generation NCLEX (NGN) style case studies,
candidates will demonstrate their understanding of integrated nursing concepts,
clinical judgment, and decision-making in complex patient scenarios. Each question
includes a detailed rationale explaining the correct answer and reinforcing key
concepts. The questions are structured to test not only recall of nursing principles but
also the ability to apply critical thinking to real-world clinical situations. Successful
completion of this examination demonstrates readiness for the official Kaplan
Integrated Nursing Exit Examination and the NCLEX licensure examination.
SECTION ONE: QUESTIONS 1-180
1. A nurse is caring for a client who has a new prescription for warfarin. Which of
the following statements by the client indicates an understanding of the
teaching?
A. "I will avoid leafy green vegetables."
B. "I will take ibuprofen for headaches."
C. "I will have my INR checked regularly."
D. Both A and C
D. Both A and C
RATIONALE: Clients on warfarin should avoid vitamin K-rich foods (leafy greens)
and have INR monitored regularly. Ibuprofen increases bleeding risk and should be
avoided.
2. A nurse is preparing to administer digoxin to a client. Which of the following
actions should the nurse take prior to administration?
,A. Check the client's apical pulse for 1 full minute
B. Assess the client's respiratory rate
C. Measure the client's blood pressure
D. Check the client's serum potassium level
A. Check the client's apical pulse for 1 full minute
RATIONALE: Digoxin should be withheld if the apical pulse is less than 60/min in
adults. The apical pulse should be assessed for 1 full minute before administration.
3. A nurse is providing teaching to a client who has a new prescription for
metformin. Which of the following adverse effects should the nurse instruct the
client to report to the provider?
A. Weight gain
B. Constipation
C. Lactic acidosis symptoms (muscle pain, weakness, difficulty breathing)
D. Insomnia
C. Lactic acidosis symptoms (muscle pain, weakness, difficulty breathing)
RATIONALE: Metformin can cause lactic acidosis, a rare but serious adverse
effect. Symptoms include muscle pain, weakness, difficulty breathing, abdominal
pain, and dizziness.
4. A nurse is caring for a client who has a prescription for heparin therapy. Which
of the following laboratory values should the nurse monitor to evaluate the
therapeutic effectiveness of the medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. International normalized ratio (INR)
D. Platelet count
A. Activated partial thromboplastin time (aPTT)
RATIONALE: Heparin therapy is monitored using aPTT, which should be 1.5 to 2.5
times the normal control value. PT and INR are used to monitor warfarin therapy.
, 5. A nurse is assessing a client who has a new diagnosis of myocardial infarction.
Which of the following pain characteristics is most consistent with this
condition?
A. Sharp, stabbing pain that worsens with deep inspiration
B. Crushing, substernal pain that radiates to the left arm
C. Burning epigastric pain
D. Pain that worsens with movement
B. Crushing, substernal pain that radiates to the left arm
RATIONALE: Myocardial infarction pain is often described as crushing substernal
pain radiating to the left arm. Sharp pain with inspiration suggests pleuritis.
6. A nurse is caring for a client who is postoperative and is experiencing nausea
and vomiting. The nurse should identify which of the following findings as
indications that the client has fluid volume deficit? (Select all that apply.)
A. Full bounding pulse
B. Cool extremities
C. Moist crackles in the lungs
D. Orthostatic hypotension
E. Flat neck veins
B. Cool extremities; D. Orthostatic hypotension; E. Flat neck veins
RATIONALE: Fluid volume deficit (hypovolemia) is indicated by cool extremities,
orthostatic hypotension, and flat neck veins. A full bounding pulse and moist
crackles in the lungs are signs of fluid volume excess.
7. A nurse is assessing a client who has a new diagnosis of hypothyroidism. Which
of the following skin findings should the nurse expect?
A. Dry, flaky skin
B. Moist, warm skin
C. Skin ulcers
D. Diaphoresis
