AAPC CPC FINAL 2026/2027 | AAPC CPC Final Exam Study Guide,
Certified Professional Coder Exam Prep, CPC Certification Review,
ICD-10-CM, CPT, HCPCS Level II, Medical Coding Guidelines,
Evaluation & Management, Surgery, Medicine, Anesthesia, Radiology,
Practice Questions, Answers & Rationales
Question 1: A patient is admitted with a suspected stroke and the provider
orders warfarin to be held pending laboratory results. Which laboratory value is
most critical for the nurse to review before administering warfarin?
A. Serum potassium
B. International Normalized Ratio (INR)
C. Serum creatinine
D. Hemoglobin and hematocrit
CORRECT ANSWER: B. International Normalized Ratio (INR)
Rationale: Warfarin is an anticoagulant that requires careful monitoring of the
International Normalized Ratio (INR) to ensure therapeutic effectiveness while
minimizing bleeding risk. The INR reflects the extrinsic pathway of coagulation
and is the standard test for warfarin therapy monitoring. A therapeutic INR
typically ranges from 2.0 to 3.0 for most indications. Administering warfarin
without knowing the INR could lead to excessive anticoagulation and hemorrhage
or inadequate anticoagulation and clot formation.
Question 2: A nurse is assessing a patient who experienced a stroke and has
dysphagia. Which assessment findings would indicate possible aspiration?
(Select all that apply. Choose the BEST combination.)
A. Coughing during meals
B. Hoarseness after swallowing
C. Clear lung sounds bilaterally
D. Regurgitation into the mouth
CORRECT ANSWER: A, B, and D. Coughing, hoarseness, and regurgitation are all
indicators of aspiration risk.
Rationale: Dysphagia following stroke significantly increases aspiration risk.
Coughing during or after swallowing indicates that food or liquid has entered the
airway. Hoarseness suggests laryngeal irritation or involvement. Regurgitation
,into the mouth indicates that swallowed material is refluxing back, creating
aspiration risk. Clear lung sounds would be a normal finding, not an indicator of
aspiration.
Question 3: A nurse is preparing to administer a secondary intravenous
antibiotic infusion to a patient with a positive Group B Streptococcus (GBS)
status. Place the following steps in the correct order.
A. Verify the provider's order, check allergy status, confirm patient identity,
explain the procedure, assess the IV site, check the rights of medication
administration
B. Check allergy status, verify the provider's order, assess the IV site, confirm
patient identity, explain the procedure, check the rights of medication
administration
C. Confirm patient identity, verify the provider's order, check allergy status, assess
the IV site, explain the procedure, check the rights of medication administration
D. Assess the IV site, verify the provider's order, check allergy status, confirm
patient identity, explain the procedure, check the rights of medication
administration
CORRECT ANSWER: A. Verify the provider's order, check allergy status, confirm
patient identity, explain the procedure, assess the IV site, check the rights of
medication administration
Rationale: Safe medication administration follows a systematic sequence. The
nurse must first verify the order to ensure it is complete and appropriate.
Checking allergy status prevents allergic reactions. Confirming patient identity
with two identifiers ensures the right patient. Explaining the procedure promotes
patient cooperation and informed consent. Assessing the IV site ensures the
access is patent and suitable. Finally, reviewing the rights of medication
administration provides a final safety check.
Question 4: A patient in active labor with a positive GBS status and ruptured
membranes has a temperature of 100.8°F. What is the priority nursing action?
A. Document the temperature and reassess in one hour
B. Report the temperature to the primary healthcare provider immediately
,C. Administer acetaminophen as ordered and continue monitoring
D. Increase the intravenous fluid rate to promote cooling
CORRECT ANSWER: B. Report the temperature to the primary healthcare
provider immediately
Rationale: A temperature of 100.8°F in a laboring patient with ruptured
membranes and positive GBS status is concerning for intrapartum infection
(chorioamnionitis). Maternal fever during labor increases the risk of neonatal
sepsis, pneumonia, and meningitis. The provider must be notified promptly to
initiate antibiotic therapy and consider delivery timing. Simply documenting or
treating the fever without notifying the provider delays critical intervention.
Question 5: A nurse is assessing a patient using the Glasgow Coma Scale. Which
components are included in this assessment tool?
A. Eye opening, verbal response, and motor response
B. Pupillary response, blood pressure, and respiratory rate
C. Level of consciousness, memory, and cranial nerve function
D. Sensory perception, gait, and deep tendon reflexes
CORRECT ANSWER: A. Eye opening, verbal response, and motor response
Rationale: The Glasgow Coma Scale (GCS) is a standardized tool for assessing level
of consciousness. It evaluates three components: eye opening (scored 1-4), verbal
response (scored 1-5), and motor response (scored 1-6). The total score ranges
from 3 to 15, with lower scores indicating more severe neurological impairment.
Pupillary response, vital signs, memory, and cranial nerve function are assessed
separately as part of a comprehensive neurological examination.
Question 6: A nurse is assessing a patient who had a stroke. Which assessment
findings would indicate potential neurologic compromise? (Select all that apply.
Choose the BEST combination.)
A. Unequal pupils
B. Decreasing level of consciousness
C. Bilateral equal grip strength
D. Stable gait with assistance
, CORRECT ANSWER: A and B. Unequal pupils and decreasing level of
consciousness indicate neurologic compromise.
Rationale: Unequal pupils (anisocoria) can indicate increased intracranial pressure
or herniation, both of which are neurological emergencies. A decreasing level of
consciousness is one of the earliest and most sensitive indicators of neurological
deterioration. Bilateral equal grip strength and a stable gait would be reassuring
findings, not indicators of compromise.
Question 7: A patient is admitted with an acute myocardial infarction and
develops ventricular fibrillation. What is the priority nursing intervention?
A. Administer epinephrine intravenously
B. Begin chest compressions and defibrillate
C. Obtain a 12-lead electrocardiogram
D. Administer amiodarone intravenously
CORRECT ANSWER: B. Begin chest compressions and defibrillate
Rationale: Ventricular fibrillation is a lethal cardiac rhythm that results in
ineffective circulation. Immediate defibrillation is the definitive treatment, as it
can restore a perfusing rhythm. High-quality chest compressions must be
performed while the defibrillator is being prepared. Epinephrine and amiodarone
are adjunct medications used during advanced cardiac life support but are
secondary to prompt defibrillation and CPR.
Question 8: A post-operative patient who underwent an abdominal
hysterectomy is exhibiting signs of opioid intoxication. Which assessment
finding is most concerning?
A. Respiratory rate of 8 breaths per minute
B. Blood pressure of 110/70 mm Hg
C. Pain score of 3 out of 10
D. Heart rate of 88 beats per minute
CORRECT ANSWER: A. Respiratory rate of 8 breaths per minute
Rationale: Opioid intoxication causes central nervous system depression, with
respiratory depression being the most life-threatening effect. A respiratory rate of
8 breaths per minute is dangerously low and indicates inadequate ventilation,
Certified Professional Coder Exam Prep, CPC Certification Review,
ICD-10-CM, CPT, HCPCS Level II, Medical Coding Guidelines,
Evaluation & Management, Surgery, Medicine, Anesthesia, Radiology,
Practice Questions, Answers & Rationales
Question 1: A patient is admitted with a suspected stroke and the provider
orders warfarin to be held pending laboratory results. Which laboratory value is
most critical for the nurse to review before administering warfarin?
A. Serum potassium
B. International Normalized Ratio (INR)
C. Serum creatinine
D. Hemoglobin and hematocrit
CORRECT ANSWER: B. International Normalized Ratio (INR)
Rationale: Warfarin is an anticoagulant that requires careful monitoring of the
International Normalized Ratio (INR) to ensure therapeutic effectiveness while
minimizing bleeding risk. The INR reflects the extrinsic pathway of coagulation
and is the standard test for warfarin therapy monitoring. A therapeutic INR
typically ranges from 2.0 to 3.0 for most indications. Administering warfarin
without knowing the INR could lead to excessive anticoagulation and hemorrhage
or inadequate anticoagulation and clot formation.
Question 2: A nurse is assessing a patient who experienced a stroke and has
dysphagia. Which assessment findings would indicate possible aspiration?
(Select all that apply. Choose the BEST combination.)
A. Coughing during meals
B. Hoarseness after swallowing
C. Clear lung sounds bilaterally
D. Regurgitation into the mouth
CORRECT ANSWER: A, B, and D. Coughing, hoarseness, and regurgitation are all
indicators of aspiration risk.
Rationale: Dysphagia following stroke significantly increases aspiration risk.
Coughing during or after swallowing indicates that food or liquid has entered the
airway. Hoarseness suggests laryngeal irritation or involvement. Regurgitation
,into the mouth indicates that swallowed material is refluxing back, creating
aspiration risk. Clear lung sounds would be a normal finding, not an indicator of
aspiration.
Question 3: A nurse is preparing to administer a secondary intravenous
antibiotic infusion to a patient with a positive Group B Streptococcus (GBS)
status. Place the following steps in the correct order.
A. Verify the provider's order, check allergy status, confirm patient identity,
explain the procedure, assess the IV site, check the rights of medication
administration
B. Check allergy status, verify the provider's order, assess the IV site, confirm
patient identity, explain the procedure, check the rights of medication
administration
C. Confirm patient identity, verify the provider's order, check allergy status, assess
the IV site, explain the procedure, check the rights of medication administration
D. Assess the IV site, verify the provider's order, check allergy status, confirm
patient identity, explain the procedure, check the rights of medication
administration
CORRECT ANSWER: A. Verify the provider's order, check allergy status, confirm
patient identity, explain the procedure, assess the IV site, check the rights of
medication administration
Rationale: Safe medication administration follows a systematic sequence. The
nurse must first verify the order to ensure it is complete and appropriate.
Checking allergy status prevents allergic reactions. Confirming patient identity
with two identifiers ensures the right patient. Explaining the procedure promotes
patient cooperation and informed consent. Assessing the IV site ensures the
access is patent and suitable. Finally, reviewing the rights of medication
administration provides a final safety check.
Question 4: A patient in active labor with a positive GBS status and ruptured
membranes has a temperature of 100.8°F. What is the priority nursing action?
A. Document the temperature and reassess in one hour
B. Report the temperature to the primary healthcare provider immediately
,C. Administer acetaminophen as ordered and continue monitoring
D. Increase the intravenous fluid rate to promote cooling
CORRECT ANSWER: B. Report the temperature to the primary healthcare
provider immediately
Rationale: A temperature of 100.8°F in a laboring patient with ruptured
membranes and positive GBS status is concerning for intrapartum infection
(chorioamnionitis). Maternal fever during labor increases the risk of neonatal
sepsis, pneumonia, and meningitis. The provider must be notified promptly to
initiate antibiotic therapy and consider delivery timing. Simply documenting or
treating the fever without notifying the provider delays critical intervention.
Question 5: A nurse is assessing a patient using the Glasgow Coma Scale. Which
components are included in this assessment tool?
A. Eye opening, verbal response, and motor response
B. Pupillary response, blood pressure, and respiratory rate
C. Level of consciousness, memory, and cranial nerve function
D. Sensory perception, gait, and deep tendon reflexes
CORRECT ANSWER: A. Eye opening, verbal response, and motor response
Rationale: The Glasgow Coma Scale (GCS) is a standardized tool for assessing level
of consciousness. It evaluates three components: eye opening (scored 1-4), verbal
response (scored 1-5), and motor response (scored 1-6). The total score ranges
from 3 to 15, with lower scores indicating more severe neurological impairment.
Pupillary response, vital signs, memory, and cranial nerve function are assessed
separately as part of a comprehensive neurological examination.
Question 6: A nurse is assessing a patient who had a stroke. Which assessment
findings would indicate potential neurologic compromise? (Select all that apply.
Choose the BEST combination.)
A. Unequal pupils
B. Decreasing level of consciousness
C. Bilateral equal grip strength
D. Stable gait with assistance
, CORRECT ANSWER: A and B. Unequal pupils and decreasing level of
consciousness indicate neurologic compromise.
Rationale: Unequal pupils (anisocoria) can indicate increased intracranial pressure
or herniation, both of which are neurological emergencies. A decreasing level of
consciousness is one of the earliest and most sensitive indicators of neurological
deterioration. Bilateral equal grip strength and a stable gait would be reassuring
findings, not indicators of compromise.
Question 7: A patient is admitted with an acute myocardial infarction and
develops ventricular fibrillation. What is the priority nursing intervention?
A. Administer epinephrine intravenously
B. Begin chest compressions and defibrillate
C. Obtain a 12-lead electrocardiogram
D. Administer amiodarone intravenously
CORRECT ANSWER: B. Begin chest compressions and defibrillate
Rationale: Ventricular fibrillation is a lethal cardiac rhythm that results in
ineffective circulation. Immediate defibrillation is the definitive treatment, as it
can restore a perfusing rhythm. High-quality chest compressions must be
performed while the defibrillator is being prepared. Epinephrine and amiodarone
are adjunct medications used during advanced cardiac life support but are
secondary to prompt defibrillation and CPR.
Question 8: A post-operative patient who underwent an abdominal
hysterectomy is exhibiting signs of opioid intoxication. Which assessment
finding is most concerning?
A. Respiratory rate of 8 breaths per minute
B. Blood pressure of 110/70 mm Hg
C. Pain score of 3 out of 10
D. Heart rate of 88 beats per minute
CORRECT ANSWER: A. Respiratory rate of 8 breaths per minute
Rationale: Opioid intoxication causes central nervous system depression, with
respiratory depression being the most life-threatening effect. A respiratory rate of
8 breaths per minute is dangerously low and indicates inadequate ventilation,
