NUR 283 COMPREHENSIVE
EXAMINATION 2026 QUESTIONS AND
ANSWERS
1. A nurse is caring for an infant with suspected Tetralogy of Fallot. Which clinical
manifestation should the nurse anticipate observing during a hypercyanotic spell?
A. Bradypnea and lethargy
B. Bounding peripheral pulses and hypertension
C. Knee-chest positioning and intense cyanosis
D. Increased urine output and peripheral edema
Answer: C
Conceptual Explanation: Hypercyanotic or ‘tet’ spells are characterized by sudden
cyanosis and hypoxia, where the infant often instinctively assumes a knee-chest position to
increase systemic vascular resistance and improve pulmonary blood flow.
2. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following provider
orders should the nurse implement first?
A. Administer 10 units of regular insulin IV bolus
B. Obtain a 12-lead electrocardiogram (ECG)
,C. Start an infusion of 0.9% Normal Saline at 1,000 mL/hr
D. Administer potassium chloride 20 mEq IVPB over 2 hours
Answer: C
Conceptual Explanation: The priority in DKA is fluid resuscitation to restore circulatory
volume and perfusion before correcting hyperglycemia or electrolyte imbalances.
3. A nurse is assessing a client receiving Magnesium Sulfate for preeclampsia. Which finding is
the most sensitive indicator of magnesium toxicity?
A. Increased blood pressure and headache
B. Respiratory rate of 14 breaths per minute
C. Urine output of 40 mL per hour
D. Absence of patellar deep tendon reflexes
Answer: D
Conceptual Explanation: Loss of deep tendon reflexes (DTRs) is an early and sensitive
sign of magnesium toxicity, occurring before respiratory depression or cardiac arrest.
4. A client with a C6 spinal cord injury reports a sudden, severe headache and is found to be
diaphoretic above the level of the injury. What is the priority nursing action?
A. Administer prescribed PRN hydralazine
B. Elevate the head of the bed to 90 degrees
C. Perform a digital rectal exam to check for fecal impaction
, D. Assess the client’s bladder for distension
Answer: B
Conceptual Explanation: These are classic signs of autonomic dysreflexia. The immediate
priority is to elevate the head of the bed to lower intracranial pressure and reduce blood
pressure through orthostatic effects.
5. A toddler is hospitalized with laryngotracheobronchitis (croup). Which assessment finding
requires immediate intervention?
A. Barking cough and hoarseness
B. Inspiratory stridor at rest
C. Intermittent crying and agitation
D. Pulse oximetry reading of 94% on room air
Answer: B
Conceptual Explanation: Stridor at rest indicates significant airway narrowing and
impending respiratory distress, requiring immediate medical intervention such as racemic
epinephrine.
6. Which laboratory value is most critical for a nurse to monitor in a client diagnosed with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Serum Potassium
B. Serum Calcium
EXAMINATION 2026 QUESTIONS AND
ANSWERS
1. A nurse is caring for an infant with suspected Tetralogy of Fallot. Which clinical
manifestation should the nurse anticipate observing during a hypercyanotic spell?
A. Bradypnea and lethargy
B. Bounding peripheral pulses and hypertension
C. Knee-chest positioning and intense cyanosis
D. Increased urine output and peripheral edema
Answer: C
Conceptual Explanation: Hypercyanotic or ‘tet’ spells are characterized by sudden
cyanosis and hypoxia, where the infant often instinctively assumes a knee-chest position to
increase systemic vascular resistance and improve pulmonary blood flow.
2. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following provider
orders should the nurse implement first?
A. Administer 10 units of regular insulin IV bolus
B. Obtain a 12-lead electrocardiogram (ECG)
,C. Start an infusion of 0.9% Normal Saline at 1,000 mL/hr
D. Administer potassium chloride 20 mEq IVPB over 2 hours
Answer: C
Conceptual Explanation: The priority in DKA is fluid resuscitation to restore circulatory
volume and perfusion before correcting hyperglycemia or electrolyte imbalances.
3. A nurse is assessing a client receiving Magnesium Sulfate for preeclampsia. Which finding is
the most sensitive indicator of magnesium toxicity?
A. Increased blood pressure and headache
B. Respiratory rate of 14 breaths per minute
C. Urine output of 40 mL per hour
D. Absence of patellar deep tendon reflexes
Answer: D
Conceptual Explanation: Loss of deep tendon reflexes (DTRs) is an early and sensitive
sign of magnesium toxicity, occurring before respiratory depression or cardiac arrest.
4. A client with a C6 spinal cord injury reports a sudden, severe headache and is found to be
diaphoretic above the level of the injury. What is the priority nursing action?
A. Administer prescribed PRN hydralazine
B. Elevate the head of the bed to 90 degrees
C. Perform a digital rectal exam to check for fecal impaction
, D. Assess the client’s bladder for distension
Answer: B
Conceptual Explanation: These are classic signs of autonomic dysreflexia. The immediate
priority is to elevate the head of the bed to lower intracranial pressure and reduce blood
pressure through orthostatic effects.
5. A toddler is hospitalized with laryngotracheobronchitis (croup). Which assessment finding
requires immediate intervention?
A. Barking cough and hoarseness
B. Inspiratory stridor at rest
C. Intermittent crying and agitation
D. Pulse oximetry reading of 94% on room air
Answer: B
Conceptual Explanation: Stridor at rest indicates significant airway narrowing and
impending respiratory distress, requiring immediate medical intervention such as racemic
epinephrine.
6. Which laboratory value is most critical for a nurse to monitor in a client diagnosed with
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A. Serum Potassium
B. Serum Calcium
