SCFHS-STYLE CLINICAL MIDTERM EXAM - CLINICAL
HEALTH-SCIENCE COMPETENCY EXAMINATION | ALL
PRACTICE Q&A 2026/2027 | A+ GRADED |
COMPREHENSIVE EXAM GUIDE 2026&2027
1. A 56-year-old patient arrives in the emergency department with crushing substernal
chest pain that began 30 minutes ago. The patient is pale and diaphoretic. Which action
should the nurse prioritize?
A. Obtain a complete dietary history
B. Obtain a 12-lead ECG promptly
C. Encourage the patient to ambulate
D. Schedule an outpatient stress test
Answer: B
A 12-lead ECG should be obtained promptly in a patient with suspected acute coronary
syndrome because early identification of ischemic changes guides urgent treatment decisions.
2. A postoperative patient suddenly develops shortness of breath, pleuritic chest pain,
tachycardia, and oxygen saturation of 86%. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary edema
C. Pulmonary embolism
D. Fluid overload
Answer: C
The sudden onset of hypoxemia, tachycardia, dyspnea, and pleuritic chest pain is highly
concerning for pulmonary embolism and requires immediate assessment and intervention.
3. A patient with diabetes mellitus is awake, confused, diaphoretic, and has a blood glucose
level of 48 mg/dL. What is the most appropriate immediate intervention?
A. Administer rapid-acting carbohydrate
B. Administer long-acting insulin
C. Restrict oral intake
D. Encourage exercise
Answer: A
A conscious patient with symptomatic hypoglycemia should receive a rapidly absorbed
carbohydrate to raise blood glucose promptly.
,4. A patient receiving an intravenous medication develops wheezing, facial swelling,
hypotension, and generalized urticaria. Which medication should the clinician anticipate
administering first?
A. Furosemide
B. Diphenhydramine only
C. Acetaminophen
D. Epinephrine
Answer: D
The combination of airway symptoms, hypotension, and urticaria indicates anaphylaxis.
Intramuscular epinephrine is the priority treatment because it rapidly addresses airway
edema, bronchospasm, and cardiovascular compromise.
5. A patient with chronic kidney disease has a potassium level of 6.8 mmol/L and peaked T
waves on the ECG. Which intervention is the priority?
A. Encourage potassium-rich foods
B. Initiate treatment to stabilize the cardiac membrane
C. Administer oral iron
D. Increase dietary sodium
Answer: B
Severe hyperkalemia with ECG changes can cause life-threatening dysrhythmias. Immediate
therapy to stabilize the cardiac membrane, typically intravenous calcium, is prioritized.
6. A patient with suspected bacterial meningitis is admitted before antimicrobial therapy is
started. Which infection-control precaution is most appropriate initially?
A. Contact precautions only
B. Airborne precautions only
C. Droplet precautions
D. Protective isolation
Answer: C
Suspected bacterial meningitis requires droplet precautions because respiratory droplets can
transmit the causative organisms during close contact.
7. A patient receiving a blood transfusion develops chills, fever, and flank pain 15 minutes
after the transfusion begins. What should the nurse do first?
A. Stop the transfusion
B. Increase the transfusion rate
C. Administer the next scheduled medication
D. Reassess the patient in 30 minutes
Answer: A
,The transfusion should be stopped immediately when an acute transfusion reaction is
suspected. The intravenous line is generally maintained with compatible fluid according to
institutional protocol while the patient is assessed.
8. A patient with heart failure reports a 2-kg weight gain over the past two days. What does
this finding most likely indicate?
A. Improved nutritional status
B. Increased muscle mass
C. Dehydration
D. Fluid retention
Answer: D
Rapid weight gain over a short period in a patient with heart failure commonly reflects fluid
accumulation and may indicate worsening volume overload.
9. A patient with chronic obstructive pulmonary disease is receiving supplemental oxygen.
Which assessment finding requires the most immediate attention?
A. Mild chronic cough
B. New onset of increasing somnolence
C. Barrel-shaped chest
D. Prolonged expiration
Answer: B
New somnolence can indicate worsening carbon dioxide retention or respiratory failure and
requires prompt assessment of ventilation and oxygenation.
10. A patient with a suspected stroke suddenly develops facial drooping and unilateral
weakness. Which information is most important to establish immediately?
A. The patient's preferred diet
B. The patient's last bowel movement
C. The exact time the symptoms began
D. The patient's usual sleep schedule
Answer: C
The exact time of symptom onset is critical in acute stroke evaluation because eligibility for
time-sensitive reperfusion therapies depends partly on when symptoms began or when the
patient was last known well.
11. A nurse is preparing to administer medication to a patient. Which action best supports
medication safety?
A. Verify the medication against the prescription and patient identifiers
B. Rely on the patient's room number
, C. Ask another patient to confirm the medication
D. Skip verification when the medication is familiar
Answer: A
Medication safety requires systematic verification of the medication, prescription, patient
identity, dose, route, timing, and other applicable rights before administration.
12. A patient reports sudden severe abdominal pain with a rigid, board-like abdomen.
Which condition should the nurse consider most urgently?
A. Mild gastroesophageal reflux
B. Functional constipation
C. Acute peritonitis
D. Chronic gastritis
Answer: C
A rigid abdomen with severe acute pain is a potential sign of peritoneal irritation and requires
urgent evaluation for conditions such as perforation or intra-abdominal infection.
13. A patient becomes dizzy when standing after several days of poor oral intake. Which
assessment finding would support orthostatic hypotension?
A. Increased blood pressure after standing
B. Significant blood pressure decrease with position change
C. Increased oxygen saturation
D. Reduced respiratory rate after standing
Answer: B
Orthostatic hypotension is characterized by a clinically significant fall in blood pressure
associated with changing position, often accompanied by dizziness or weakness.
14. A patient with asthma develops severe wheezing and difficulty speaking in complete
sentences. Which medication would the nurse expect to administer for rapid
bronchodilation?
A. Albuterol
B. Warfarin
C. Furosemide
D. Metformin
Answer: A
Albuterol is a short-acting beta2-adrenergic agonist that provides rapid bronchodilation
during acute bronchospasm.
HEALTH-SCIENCE COMPETENCY EXAMINATION | ALL
PRACTICE Q&A 2026/2027 | A+ GRADED |
COMPREHENSIVE EXAM GUIDE 2026&2027
1. A 56-year-old patient arrives in the emergency department with crushing substernal
chest pain that began 30 minutes ago. The patient is pale and diaphoretic. Which action
should the nurse prioritize?
A. Obtain a complete dietary history
B. Obtain a 12-lead ECG promptly
C. Encourage the patient to ambulate
D. Schedule an outpatient stress test
Answer: B
A 12-lead ECG should be obtained promptly in a patient with suspected acute coronary
syndrome because early identification of ischemic changes guides urgent treatment decisions.
2. A postoperative patient suddenly develops shortness of breath, pleuritic chest pain,
tachycardia, and oxygen saturation of 86%. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary edema
C. Pulmonary embolism
D. Fluid overload
Answer: C
The sudden onset of hypoxemia, tachycardia, dyspnea, and pleuritic chest pain is highly
concerning for pulmonary embolism and requires immediate assessment and intervention.
3. A patient with diabetes mellitus is awake, confused, diaphoretic, and has a blood glucose
level of 48 mg/dL. What is the most appropriate immediate intervention?
A. Administer rapid-acting carbohydrate
B. Administer long-acting insulin
C. Restrict oral intake
D. Encourage exercise
Answer: A
A conscious patient with symptomatic hypoglycemia should receive a rapidly absorbed
carbohydrate to raise blood glucose promptly.
,4. A patient receiving an intravenous medication develops wheezing, facial swelling,
hypotension, and generalized urticaria. Which medication should the clinician anticipate
administering first?
A. Furosemide
B. Diphenhydramine only
C. Acetaminophen
D. Epinephrine
Answer: D
The combination of airway symptoms, hypotension, and urticaria indicates anaphylaxis.
Intramuscular epinephrine is the priority treatment because it rapidly addresses airway
edema, bronchospasm, and cardiovascular compromise.
5. A patient with chronic kidney disease has a potassium level of 6.8 mmol/L and peaked T
waves on the ECG. Which intervention is the priority?
A. Encourage potassium-rich foods
B. Initiate treatment to stabilize the cardiac membrane
C. Administer oral iron
D. Increase dietary sodium
Answer: B
Severe hyperkalemia with ECG changes can cause life-threatening dysrhythmias. Immediate
therapy to stabilize the cardiac membrane, typically intravenous calcium, is prioritized.
6. A patient with suspected bacterial meningitis is admitted before antimicrobial therapy is
started. Which infection-control precaution is most appropriate initially?
A. Contact precautions only
B. Airborne precautions only
C. Droplet precautions
D. Protective isolation
Answer: C
Suspected bacterial meningitis requires droplet precautions because respiratory droplets can
transmit the causative organisms during close contact.
7. A patient receiving a blood transfusion develops chills, fever, and flank pain 15 minutes
after the transfusion begins. What should the nurse do first?
A. Stop the transfusion
B. Increase the transfusion rate
C. Administer the next scheduled medication
D. Reassess the patient in 30 minutes
Answer: A
,The transfusion should be stopped immediately when an acute transfusion reaction is
suspected. The intravenous line is generally maintained with compatible fluid according to
institutional protocol while the patient is assessed.
8. A patient with heart failure reports a 2-kg weight gain over the past two days. What does
this finding most likely indicate?
A. Improved nutritional status
B. Increased muscle mass
C. Dehydration
D. Fluid retention
Answer: D
Rapid weight gain over a short period in a patient with heart failure commonly reflects fluid
accumulation and may indicate worsening volume overload.
9. A patient with chronic obstructive pulmonary disease is receiving supplemental oxygen.
Which assessment finding requires the most immediate attention?
A. Mild chronic cough
B. New onset of increasing somnolence
C. Barrel-shaped chest
D. Prolonged expiration
Answer: B
New somnolence can indicate worsening carbon dioxide retention or respiratory failure and
requires prompt assessment of ventilation and oxygenation.
10. A patient with a suspected stroke suddenly develops facial drooping and unilateral
weakness. Which information is most important to establish immediately?
A. The patient's preferred diet
B. The patient's last bowel movement
C. The exact time the symptoms began
D. The patient's usual sleep schedule
Answer: C
The exact time of symptom onset is critical in acute stroke evaluation because eligibility for
time-sensitive reperfusion therapies depends partly on when symptoms began or when the
patient was last known well.
11. A nurse is preparing to administer medication to a patient. Which action best supports
medication safety?
A. Verify the medication against the prescription and patient identifiers
B. Rely on the patient's room number
, C. Ask another patient to confirm the medication
D. Skip verification when the medication is familiar
Answer: A
Medication safety requires systematic verification of the medication, prescription, patient
identity, dose, route, timing, and other applicable rights before administration.
12. A patient reports sudden severe abdominal pain with a rigid, board-like abdomen.
Which condition should the nurse consider most urgently?
A. Mild gastroesophageal reflux
B. Functional constipation
C. Acute peritonitis
D. Chronic gastritis
Answer: C
A rigid abdomen with severe acute pain is a potential sign of peritoneal irritation and requires
urgent evaluation for conditions such as perforation or intra-abdominal infection.
13. A patient becomes dizzy when standing after several days of poor oral intake. Which
assessment finding would support orthostatic hypotension?
A. Increased blood pressure after standing
B. Significant blood pressure decrease with position change
C. Increased oxygen saturation
D. Reduced respiratory rate after standing
Answer: B
Orthostatic hypotension is characterized by a clinically significant fall in blood pressure
associated with changing position, often accompanied by dizziness or weakness.
14. A patient with asthma develops severe wheezing and difficulty speaking in complete
sentences. Which medication would the nurse expect to administer for rapid
bronchodilation?
A. Albuterol
B. Warfarin
C. Furosemide
D. Metformin
Answer: A
Albuterol is a short-acting beta2-adrenergic agonist that provides rapid bronchodilation
during acute bronchospasm.
