BSN Advanced Nursing Fundamentals Exam 5 Practice
Questions 2026/2027 UPDATED ACTUAL Questions and
CORRECT Answers
1. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 50 mm Hg,
and HCO3 24 mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: The pH is low (acidosis) and the PaCO2 is high, which indicates a respiratory
cause. The HCO3 is normal, suggesting no compensation yet.
2. Which clinical manifestation should a nurse expect to see in a patient with a
serum potassium level of 2.8 mEq/L?
A. Peaked T waves on EKG
B. Muscle weakness and leg cramps
C. Hyperactive bowel sounds
D. Elevated blood pressure
Answer: B
Rationale: Hypokalemia (low potassium) commonly causes muscle weakness, leg cramps,
and flattened T waves or U waves on an EKG.
,3. A nurse is monitoring a patient receiving a blood transfusion. Within 15
minutes, the patient reports back pain and dyspnea. What is the priority action?
A. Slow the infusion rate
B. Notify the healthcare provider
C. Check the patient’s temperature
D. Stop the infusion immediately
Answer: D
Rationale: Back pain and dyspnea are signs of a hemolytic reaction. The priority is to stop
the infusion to prevent further exposure to the incompatible blood.
4. Which laboratory value is the most reliable indicator of a patient’s long-term
nutritional status?
A. Transferrin
B. Prealbumin
C. Serum Albumin
D. Total protein
Answer: C
Rationale: Albumin reflects nutritional status over the previous few weeks due to its
longer half-life, whereas prealbumin reflects more acute changes.
5. A nurse is caring for a patient with a stage 3 pressure injury. How should the
nurse describe this wound in the documentation?
A. Non-blanchable erythema of intact skin
B. Full-thickness skin loss with visible subcutaneous fat
C. Partial-thickness skin loss involving the dermis
D. Full-thickness skin loss with exposed bone or muscle
Answer: B
Rationale: Stage 3 pressure injuries involve full-thickness skin loss where subcutaneous
fat may be visible, but bone, tendon, or muscle are not yet exposed.
, 6. The nurse is preparing to administer an intramuscular (IM) injection using the
Z-track method. What is the primary purpose of this technique?
A. To prevent medication from leaking into subcutaneous tissue
B. To decrease the pain of the injection
C. To ensure the medication reaches the bone
D. To increase the speed of absorption
Answer: A
Rationale: The Z-track method creates a zigzag path that seals the medication in the
muscle and prevents it from tracking back into the subcutaneous layer.
7. When assessing a patient with fluid volume deficit, which finding should the
nurse anticipate?
A. Increased urine specific gravity
B. Bradycardia
C. Distended neck veins
D. Crackles in the lungs
Answer: A
Rationale: In fluid volume deficit, the kidneys conserve water, leading to concentrated
urine and an increased specific gravity (above 1.030).
8. A nurse is caring for a patient who is post-operative day 1. The patient refuses
to use the incentive spirometer. Which complication is the patient at greatest
risk for?
A. Pulmonary embolism
B. Deep vein thrombosis
C. Atelectasis
D. Hypovolemia
Answer: C
Questions 2026/2027 UPDATED ACTUAL Questions and
CORRECT Answers
1. A patient’s arterial blood gas (ABG) results are: pH 7.31, PaCO2 50 mm Hg,
and HCO3 24 mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: The pH is low (acidosis) and the PaCO2 is high, which indicates a respiratory
cause. The HCO3 is normal, suggesting no compensation yet.
2. Which clinical manifestation should a nurse expect to see in a patient with a
serum potassium level of 2.8 mEq/L?
A. Peaked T waves on EKG
B. Muscle weakness and leg cramps
C. Hyperactive bowel sounds
D. Elevated blood pressure
Answer: B
Rationale: Hypokalemia (low potassium) commonly causes muscle weakness, leg cramps,
and flattened T waves or U waves on an EKG.
,3. A nurse is monitoring a patient receiving a blood transfusion. Within 15
minutes, the patient reports back pain and dyspnea. What is the priority action?
A. Slow the infusion rate
B. Notify the healthcare provider
C. Check the patient’s temperature
D. Stop the infusion immediately
Answer: D
Rationale: Back pain and dyspnea are signs of a hemolytic reaction. The priority is to stop
the infusion to prevent further exposure to the incompatible blood.
4. Which laboratory value is the most reliable indicator of a patient’s long-term
nutritional status?
A. Transferrin
B. Prealbumin
C. Serum Albumin
D. Total protein
Answer: C
Rationale: Albumin reflects nutritional status over the previous few weeks due to its
longer half-life, whereas prealbumin reflects more acute changes.
5. A nurse is caring for a patient with a stage 3 pressure injury. How should the
nurse describe this wound in the documentation?
A. Non-blanchable erythema of intact skin
B. Full-thickness skin loss with visible subcutaneous fat
C. Partial-thickness skin loss involving the dermis
D. Full-thickness skin loss with exposed bone or muscle
Answer: B
Rationale: Stage 3 pressure injuries involve full-thickness skin loss where subcutaneous
fat may be visible, but bone, tendon, or muscle are not yet exposed.
, 6. The nurse is preparing to administer an intramuscular (IM) injection using the
Z-track method. What is the primary purpose of this technique?
A. To prevent medication from leaking into subcutaneous tissue
B. To decrease the pain of the injection
C. To ensure the medication reaches the bone
D. To increase the speed of absorption
Answer: A
Rationale: The Z-track method creates a zigzag path that seals the medication in the
muscle and prevents it from tracking back into the subcutaneous layer.
7. When assessing a patient with fluid volume deficit, which finding should the
nurse anticipate?
A. Increased urine specific gravity
B. Bradycardia
C. Distended neck veins
D. Crackles in the lungs
Answer: A
Rationale: In fluid volume deficit, the kidneys conserve water, leading to concentrated
urine and an increased specific gravity (above 1.030).
8. A nurse is caring for a patient who is post-operative day 1. The patient refuses
to use the incentive spirometer. Which complication is the patient at greatest
risk for?
A. Pulmonary embolism
B. Deep vein thrombosis
C. Atelectasis
D. Hypovolemia
Answer: C
