KAPLAN INTEGRATED D QUESTIONS
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains:
• Comprehensive Nursing Process and Clinical Judgment
• Integrated Pathophysiology and Pharmacology
• Medical-Surgical Nursing Across the Lifespan
• Pediatric and Maternal-Newborn Nursing
• Psychiatric-Mental Health Nursing
• Community Health and Population-Based Care
• Leadership, Management, and Delegation
• Legal, Ethical, and Professional Nursing Standards
• Emergency and Critical Care Nursing
• Health Promotion and Disease Prevention
Introduction
This Integrated D examination is designed to evaluate the nursing
candidate's ability to synthesize and apply knowledge across multiple
content areas in complex, real-world clinical scenarios. The exam assesses
higher-order critical thinking, clinical reasoning, and decision-making
skills essential for safe and effective nursing practice. Questions integrate
pharmacology, pathophysiology, nursing interventions, and professional
standards to reflect the multifaceted nature of patient care. The structure
includes multiple-choice and scenario-based questions that require the
candidate to prioritize actions, identify complications, and implement
evidence-based interventions. Emphasis is placed on holistic patient
,assessment, interdisciplinary collaboration, and culturally competent care
across the lifespan. Candidates are expected to demonstrate integration of
theoretical knowledge with clinical application, preparing them for the
demands of professional nursing practice in diverse healthcare settings.
SECTION ONE: QUESTIONS 1-75
Question 1
The nurse is caring for a patient with diabetic ketoacidosis (DKA) who is
receiving an insulin infusion. Which assessment finding indicates that
the treatment is effective?
A. Serum glucose level decreasing
B. Urine output increasing
C. Serum potassium level rising
D. Serum pH returning to normal
D. Serum pH returning to normal
RATIONALE: The primary goal in treating DKA is to correct acidosis.
A return of serum pH to normal is the most definitive indicator of
effective treatment. While decreasing glucose, increasing urine output,
and potassium shifts are important, they are secondary to acid-base
balance.
Question 2
The nurse is caring for a patient with a chest tube following a
pneumothorax. The nurse notes continuous bubbling in the water seal
chamber. Which action should the nurse take first?
A. Clamp the chest tube
B. Notify the healthcare provider
C. Assess the chest tube system for an air leak
D. Document the finding as normal
C. Assess the chest tube system for an air leak
, RATIONALE: Continuous bubbling in the water seal chamber
indicates an air leak. The nurse should first assess the system for a leak
by checking all connections, then notify the healthcare provider if the
leak persists. Clamping the tube is not recommended as it can cause a
tension pneumothorax.
Question 3
The nurse is preparing to administer a blood transfusion to a patient.
Which action is most important to ensure patient safety?
A. Verify the blood product with another licensed nurse
B. Administer the blood through a 22-gauge IV catheter
C. Prime the tubing with dextrose solution
D. Transfuse the blood within 6 hours
A. Verify the blood product with another licensed nurse
RATIONALE: Verifying blood compatibility with another licensed
nurse is a critical safety step in the blood transfusion process to ensure
the correct blood product is given to the correct patient.
Question 4
The nurse is assessing a patient who has just undergone a
thyroidectomy. Which finding would indicate a life-threatening
complication?
A. Hoarseness
B. Difficulty swallowing
C. Laryngeal stridor
D. Neck pain
C. Laryngeal stridor
RATIONALE: Laryngeal stridor is a sign of laryngeal edema or
tracheal compression, which can lead to airway obstruction. This is a
life-threatening emergency following thyroidectomy. Hoarseness and
difficulty swallowing may occur but are not immediately life-
threatening.
, Question 5
The nurse is providing education to a patient prescribed an
anticoagulant. Which statement by the patient indicates a need for
further teaching?
A. "I will use a soft toothbrush."
B. "I will use an electric razor."
C. "I will avoid contact sports."
D. "I will take aspirin for pain relief."
D. "I will take aspirin for pain relief."
RATIONALE: Patients on anticoagulants should avoid aspirin and
other NSAIDs because they increase the risk of bleeding.
Acetaminophen is a safer alternative for pain relief.
Question 6
The nurse is caring for a patient with a new diagnosis of heart failure.
Which dietary instruction is most important?
A. Increase fluid intake
B. Decrease sodium intake
C. Increase potassium intake
D. Decrease protein intake
B. Decrease sodium intake
RATIONALE: Sodium restriction is a cornerstone of heart failure
management because sodium contributes to fluid retention, which
worsens heart failure symptoms. Fluid restriction may also be
recommended, but sodium restriction is the priority dietary
intervention.
Question 7
The nurse is assessing a patient who is receiving a continuous heparin
infusion. The aPTT level is 110 seconds (normal range 25-35 seconds).
Which action should the nurse take?
A. Increase the infusion rate
B. Decrease the infusion rate
AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains:
• Comprehensive Nursing Process and Clinical Judgment
• Integrated Pathophysiology and Pharmacology
• Medical-Surgical Nursing Across the Lifespan
• Pediatric and Maternal-Newborn Nursing
• Psychiatric-Mental Health Nursing
• Community Health and Population-Based Care
• Leadership, Management, and Delegation
• Legal, Ethical, and Professional Nursing Standards
• Emergency and Critical Care Nursing
• Health Promotion and Disease Prevention
Introduction
This Integrated D examination is designed to evaluate the nursing
candidate's ability to synthesize and apply knowledge across multiple
content areas in complex, real-world clinical scenarios. The exam assesses
higher-order critical thinking, clinical reasoning, and decision-making
skills essential for safe and effective nursing practice. Questions integrate
pharmacology, pathophysiology, nursing interventions, and professional
standards to reflect the multifaceted nature of patient care. The structure
includes multiple-choice and scenario-based questions that require the
candidate to prioritize actions, identify complications, and implement
evidence-based interventions. Emphasis is placed on holistic patient
,assessment, interdisciplinary collaboration, and culturally competent care
across the lifespan. Candidates are expected to demonstrate integration of
theoretical knowledge with clinical application, preparing them for the
demands of professional nursing practice in diverse healthcare settings.
SECTION ONE: QUESTIONS 1-75
Question 1
The nurse is caring for a patient with diabetic ketoacidosis (DKA) who is
receiving an insulin infusion. Which assessment finding indicates that
the treatment is effective?
A. Serum glucose level decreasing
B. Urine output increasing
C. Serum potassium level rising
D. Serum pH returning to normal
D. Serum pH returning to normal
RATIONALE: The primary goal in treating DKA is to correct acidosis.
A return of serum pH to normal is the most definitive indicator of
effective treatment. While decreasing glucose, increasing urine output,
and potassium shifts are important, they are secondary to acid-base
balance.
Question 2
The nurse is caring for a patient with a chest tube following a
pneumothorax. The nurse notes continuous bubbling in the water seal
chamber. Which action should the nurse take first?
A. Clamp the chest tube
B. Notify the healthcare provider
C. Assess the chest tube system for an air leak
D. Document the finding as normal
C. Assess the chest tube system for an air leak
, RATIONALE: Continuous bubbling in the water seal chamber
indicates an air leak. The nurse should first assess the system for a leak
by checking all connections, then notify the healthcare provider if the
leak persists. Clamping the tube is not recommended as it can cause a
tension pneumothorax.
Question 3
The nurse is preparing to administer a blood transfusion to a patient.
Which action is most important to ensure patient safety?
A. Verify the blood product with another licensed nurse
B. Administer the blood through a 22-gauge IV catheter
C. Prime the tubing with dextrose solution
D. Transfuse the blood within 6 hours
A. Verify the blood product with another licensed nurse
RATIONALE: Verifying blood compatibility with another licensed
nurse is a critical safety step in the blood transfusion process to ensure
the correct blood product is given to the correct patient.
Question 4
The nurse is assessing a patient who has just undergone a
thyroidectomy. Which finding would indicate a life-threatening
complication?
A. Hoarseness
B. Difficulty swallowing
C. Laryngeal stridor
D. Neck pain
C. Laryngeal stridor
RATIONALE: Laryngeal stridor is a sign of laryngeal edema or
tracheal compression, which can lead to airway obstruction. This is a
life-threatening emergency following thyroidectomy. Hoarseness and
difficulty swallowing may occur but are not immediately life-
threatening.
, Question 5
The nurse is providing education to a patient prescribed an
anticoagulant. Which statement by the patient indicates a need for
further teaching?
A. "I will use a soft toothbrush."
B. "I will use an electric razor."
C. "I will avoid contact sports."
D. "I will take aspirin for pain relief."
D. "I will take aspirin for pain relief."
RATIONALE: Patients on anticoagulants should avoid aspirin and
other NSAIDs because they increase the risk of bleeding.
Acetaminophen is a safer alternative for pain relief.
Question 6
The nurse is caring for a patient with a new diagnosis of heart failure.
Which dietary instruction is most important?
A. Increase fluid intake
B. Decrease sodium intake
C. Increase potassium intake
D. Decrease protein intake
B. Decrease sodium intake
RATIONALE: Sodium restriction is a cornerstone of heart failure
management because sodium contributes to fluid retention, which
worsens heart failure symptoms. Fluid restriction may also be
recommended, but sodium restriction is the priority dietary
intervention.
Question 7
The nurse is assessing a patient who is receiving a continuous heparin
infusion. The aPTT level is 110 seconds (normal range 25-35 seconds).
Which action should the nurse take?
A. Increase the infusion rate
B. Decrease the infusion rate
