(Professional Role & Transition)
Objective Assessment
(4 Full Exams Set)
Actual Questions with Verified Answers
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➢500+ OA Exam Questions w/ Answers
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➢ HESI-style/NCLEX-style multiple-choice and
alternate-format clinical judgment questions
,Table of Contents
D455 EXAM SET 1 ........................................................................ 2
D455 EXAM SET 2 .................................................................... 124
D455 EXAM SET 3 .................................................................... 211
D455 EXAM SET 4 .................................................................... 290
D455 EXAM SET 1
QUESTION 1
While changing a client's postoperative dressing, the nurse observes purulent
drainage at the wound. Before reporting this to the healthcare provider, the nurse
should note which of the client's laboratory results?
a. Creatinine level
b. Platelet count
c. Hematocrit
d. White blood cell (WBC) count
CORRECT ANSWER:
D
RATIONALE:
• Option A is INCORRECT. Creatinine measures kidney function. While important
for overall health assessment, it does not directly indicate the presence or
severity of a wound infection.
• Option B is INCORRECT. Platelet count is relevant for bleeding risk and clotting
ability. Thrombocytopenia may increase bleeding from the wound but does not
indicate infection.
, • Option C is INCORRECT. Hematocrit measures the proportion of red blood cells
in blood. It may be low if there is significant blood loss but does not reflect
infection status.
• Option D is CORRECT. Purulent drainage indicates infection. The WBC count
is the primary laboratory indicator of the body's immune and inflammatory
response to infection. An elevated WBC count (leukocytosis) with a left shift
(increased neutrophils and bands) confirms the presence of bacterial infection
and helps the healthcare provider determine the severity and guide antibiotic
therapy. The nurse should review this value before contacting the provider to
provide a complete clinical picture.
NURSING CONCEPT: Perioperative Care – Wound Infection / Laboratory Values /
Clinical Judgment
QUESTION 2 (Case Study – Part 1)
CASE STUDY CONTEXT:
The client is in the hospital after her house collapsed during a hurricane. She has
been in the intensive care unit for 2 weeks and moved today to the surgical floor
to continue monitoring her respiratory function and to complete intravenous
antibiotic administration.
Click to highlight the aspects of the assessment that require urgent attention:
The client's pain is 2/10. The client requests sleeping medication for the night. She
states she has horrible thoughts and memories about the house collapsing all the time,
and that it is keeping her from falling asleep. She states, "I used to be so happy before
all of this happened. Now I can't seem to get out of this funk I am in." The client would
also prefer to be in a quieter area of the unit as she is currently by the nurses station
and hears talking and alarms constantly.
URGENT ATTENTION ITEMS (Select All That Apply):
✓ She states she has horrible thoughts and memories about the house collapsing all the
time.
✓ It is keeping her from falling asleep.
✓ Prefers to be in a quieter area of the unit.
RATIONALE:
• "Horrible thoughts and memories about the house collapsing all the time"
indicates intrusive memories, a hallmark symptom of Acute Stress Disorder
, (ASD) or Post-Traumatic Stress Disorder (PTSD). This requires immediate
psychological assessment and intervention.
• Sleep deprivation exacerbates mental health crises, impairs healing, reduces
coping capacity, and increases the risk of delirium. Addressing sleep is a priority.
• Environmental modification (moving to a quieter area) is a non-
pharmacological intervention that demonstrates the client's ability to identify
triggers and advocate for her needs. It also reduces sensory overload, which can
worsen anxiety and flashbacks.
• Pain rated 2/10 is manageable and not urgent. The request for sleep medication
is appropriate but secondary to addressing the underlying psychological distress.
NURSING CONCEPT: Mental Health – Trauma and Stressor-Related Disorders /
Priority Setting
QUESTION 3 (Case Study – Part 2)
After listening to the client's symptoms, the nurse realizes that she likely has
________________ related to ________________.
CORRECT ANSWER:
• Acute Stress Disorder
• Traumatic Stress exposure
RATIONALE:
• The client experienced a life-threatening traumatic event (house collapse during
a hurricane) and is now displaying symptoms consistent with Acute Stress
Disorder (ASD): intrusive memories, negative mood states, sleep disturbance,
and marked distress.
• ASD is diagnosed when symptoms occur between 3 days and 1 month after
trauma exposure. This client is within that timeframe (2 weeks post-trauma).
• The etiology is explicitly "traumatic stress exposure"—the direct experience of
actual or threatened death, serious injury, or sexual violence.
• If symptoms persist beyond 1 month, the diagnosis would be reconsidered as
Post-Traumatic Stress Disorder (PTSD).
NURSING CONCEPT: Mental Health – Acute Stress Disorder / Diagnostic Criteria