3 FINAL EXAM STUDY GUIDE 2025/2026 ACCURATE
QUESTIONS AND VERIFIED CORRECT SOLUTIONS WITH
RATIONALES || 100% GUARANTEED PASS
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1. Infectious Disease
An RN is supervising an unlicensed assistive personnel (UAP) at a nursing
home. The UAP states that they have viral conjunctivitis and will be glad
when the shift is over. Which is the most immediate instruction the RN
should provide to the UAP?
"Make sure not to share towels or makeup."
"Wear dark glasses if the light bothers you."
"Cold compresses applied for 10 minutes, 4 to 5 times a day, may help with
the pain."
"You will need to go home and not return to work until your medical doctor
has cleared you to return to work." - ANSWER ✓ 1) This is a true statement,
but not the most important.
2) This is a true statement, but not the most important.
3) This is a true statement, but not the most important.
*4) Viral conjunctivitis is very contagious. The UAP should stay home and
not return for 7 days or when a medical doctor allows. There is too high of a
risk to spread this to the residents.
2. Infectious Disease
A 52-year-old patient has repeatedly visited a clinic, reporting multiple
generalized signs and symptoms. The patient's laboratory test results reveal a
positive HBsAg. What would this laboratory test result indicate to the RN?
The patient has active hepatitis B.
, The patient has immunity to hepatitis B.
The patient has had the hepatitis vaccine.
The patient has not been exposed to hepatitis B. - ANSWER ✓ *1) HBsAg
is the hepatitis B surface antigen and is a marker of active infection. An
elevated level would demonstrate active hepatitis B.
2) HBsAg does not demonstrate immunity.
3) See 1).
4) This is not possible, since the patient has active hepatitis B.
3. Neurological Dysfunction
A pediatric patient with epilepsy weighs 60 lb. The health care provider
orders lamotrigine (Lamictal) 300 mg 2 times a day. The RN reads the drug
dosage requirements and finds that the safe dose is a maximum of 15
mg/kg/day. What is the appropriate action for the RN to take?
Collaborate with the health care provider regarding the order.
Assess the vital signs prior to administering the medication.
Review the complete blood count for evidence of anemia.
Administer the medication as prescribed. - ANSWER ✓ *1) Convert lb to kg
60 lb/2.2 = 27.3 kg weight of the patient
Find safe dose for that patient based on weight: 15mg/27.3 kg/day = 409.5
mg/day
Health care provider orders 500 mg twice a day. 300 x 2 = 600 mg per day
600 mg/day would be OVER the maximum safe dose of 409.5 mg/day.
4. Neurological Dysfunction
Which changes in vital signs indicate increased intracranial pressure (ICP) in
a comatose patient?
Decreased respiratory rate with increased pulse rate
, Increased pulse rate with increased temperature
Decreased systolic blood pressure with increased pulse rate
Increased systolic blood pressure with decreased pulse rate - ANSWER ✓ 1)
Both pulse and respiratory rates decrease in Cushing's triad, indicating
increased ICP.
2) Pulse rate decreases when ICP increases.
3) Systolic pressure with bradycardia indicates increased ICP.
*4) Cushing's response (reflex) is seen as an increased blood pressure with a
reflexive decrease in pulse in response to decreased blood flow from
cerebral edema.
5. Neurological Dysfunction
A school-aged child falls 2 feet off of playground equipment and hits their
head on the ground. The child's level of consciousness is assessed as awake
and alert. A minor bump on the head is treated with an ice pack. Which
instruction should the school RN provide to the parents of the child?
(Select all that apply.)
Keep the child on bed rest for 24 hours.
Check the child's pupils every hour for 24 hours.
Take the child to the emergency department (ED) immediately.
Wake the child up at least once during the night to assess level of
consciousness.
Assess the child's level of consciousness every 1 to 2 hours for 24 hours,
while awake. - ANSWER ✓ 1) Bed rest is not necessary for a minor head
injury of this type.
2) Pupil check is not a skill that lay persons would carry out. Pupillary
dilation is a late sign of progressing brain injury.
3) A head injury of minor severity does not necessitate a trip to the
emergency department (ED).
, *4) Level of consciousness needs to be checked during the night in order to
assess for progressing brain injury.
*5) Level of consciousness is the best and earliest sign of progressing brain
injury.
6. Neurological Dysfunction
An adult patient with cerebral subdural hematoma is experiencing increased
intracranial pressure (ICP). Which nursing interventions would be a priority?
Hold the administration of stool softeners and monitor bowel sounds.
Lower head of bed from 30 degrees to a flat position.
Ensure midline head position, utilizing a cervical collar.
Change body position every 1 hour instead of every 2 hours. - ANSWER ✓
1) Constipation can occur without stool softeners and increase intrathoracic
pressure, which increases intracranial pressure.
2) Changing the head of bed to a flat position would decrease venous
drainage and potentially increase intracranial pressure.
*3) This intervention will promote venous drainage and help decrease
intracranial pressure.
4) Body position changes can increase intracranial pressure. An increased
frequency in position change can increase this risk.
7. Musculoskeletal Dysfunction
An RN is caring for a patient in skeletal traction. What is the standard of
care when providing care to a patient requiring skeletal traction?
Removing weights from the traction only in life-threatening conditions
Assessing neurovascular status every 8 hours
Cleaning pin sites with soap and water
Encouraging patient movement, using elbows and heel of unaffected leg -
ANSWER ✓ *1) Weights should not be removed unless it is a life-
threatening emergency.