P
PRRE
EMM II U
UMM SS TT U
UDDY
Y M
MAA TT E
ERR II A
A LL SS S
STTU
UDDY
Y C
COOL
LLLE
ECCT
T II O
ONN :: 2
2002
2 55
ATI RN EXIT TEST BANK – QUESTIONS WITH
RATIONALIZED ANSWERS () 100%
GUARANTEE PASS.
WHAT'S INSIDE:
Latest 2025/2026 Questions
Verified Correct Answers Highlighted for Easy Learning
Detailed Explanations & Rationales for Better Understanding
Proven to Boost Grades and Exam Confidence
Covers All Essential Topics and Core Concepts
Perfect for Quick Revision and Last-Minute Review
Question 1
A 72-year-old female with a history of chronic heart failure (EF 30%), atrial fibrillation on warfarin, and chronic
kidney disease stage 4 presents to the emergency department with sudden onset dyspnea, orthopnea, and a blood
pressure of 88/52 mmHg. Physical exam reveals jugular venous distention, bibasilar crackles, and a new holosystolic
murmur at the apex. Laboratory studies show INR 3.5, BUN 68 mg/dL, creatinine 3.2 mg/dL, and serum potassium
5.8 mEq/L. Which nursing intervention should be implemented first?
A. Administer intravenous furosemide 40 mg over 30 minutes
B. Prepare the patient for emergent cardioversion
C. Hold warfarin and give vitamin K 10 mg IV
D. Place the patient in a semi‑Fowler position and monitor oxygen saturation
Correct Answer
Place the patient in a semi‑Fowler position and monitor oxygen saturation
Rationale:
Stabilizing airway and breathing takes priority; positioning improves ventilation and oxygenation while the nurse assesses for further
interventions. Medication adjustments and cardioversion are secondary until the patient is hemodynamically stable.
,Question 2
A 45-year-old man with newly diagnosed HIV infection (CD4 count 150 cells/µL) is admitted for treatment of
Pneumocystis jirovecii pneumonia. He is started on trimethoprim‑sulfamethoxazole, prednisone, and supplemental
oxygen. The nurse notes a rash on his trunk, fever of 38.9°C, and a sudden drop in blood pressure to 92/58 mmHg.
Which action should the nurse take first?
A. Discontinue trimethoprim‑sulfamethoxazole and notify the provider
B. Administer an additional dose of prednisone
C. Increase the oxygen flow rate to 6 L/min
D. Obtain a stat blood culture
Correct Answer
Discontinue trimethoprim‑sulfamethoxazole and notify the provider
Rationale:
The presentation suggests a severe drug reaction (possible Stevens‑Johnson syndrome) requiring immediate cessation of the
offending drug and provider notification before other measures are taken.
Question 3
A 29-year-old pregnant woman at 34 weeks gestation presents with a 3‑day history of severe headache, visual
disturbances, and blood pressure of 168/106 mmHg. Laboratory results reveal proteinuria 2+ and platelet count of
90,000/µL. Which nursing intervention is the highest priority?
A. Administer magnesium sulfate per protocol
B. Prepare the patient for emergent cesarean delivery
C. Place the patient on strict bed rest in a left lateral position
D. Obtain a fetal non‑stress test
Correct Answer
Administer magnesium sulfate per protocol
Rationale:
Magnesium sulfate prevents seizures in severe preeclampsia/eclampsia; seizure prophylaxis is the immediate priority before delivery
planning or other assessments.
,Question 4
A 62-year-old male undergoing laparoscopic cholecystectomy develops a sudden drop in end‑tidal CO₂ from 38
mmHg to 22 mmHg, tachycardia, and hypotension. The anesthesiologist suspects a CO₂ embolism. What is the most
appropriate nursing action?
A. Increase the fresh gas flow rate
B. Notify the surgeon and prepare for immediate conversion to open surgery
C. Place the patient in the left lateral decubitus (Durant) position and administer 100% oxygen
D. Administer IV epinephrine 0.1 mg
Correct Answer
Place the patient in the left lateral decubitus (Durant) position and administer 100%
oxygen
Rationale:
The Durant maneuver traps the embolus in the right atrium, reducing obstruction, while 100% O₂ improves oxygenation; these steps
precede pharmacologic interventions.
Question 5
A 54-year-old woman with a recent diagnosis of multiple sclerosis is prescribed interferon beta‑1a subcutaneously.
She reports flu‑like symptoms, fatigue, and injection‑site erythema after each dose. Which teaching point should the
nurse emphasize to improve adherence?
A. Rotate injection sites and apply a cool compress after injection
B. Increase the dose gradually over two weeks
C. Take acetaminophen 30 minutes before the injection
D. Inject the medication into the gluteal muscle
Correct Answer
Rotate injection sites and apply a cool compress after injection
Rationale:
Site rotation and cool compresses reduce local reactions and systemic flu‑like symptoms, enhancing tolerability and adherence; dose
adjustments or muscle injections are not recommended.
, Question 6
A 38-year-old male with severe burns covering 45% TBSA is admitted to the ICU. On day 3, his temperature rises to
39.5°C, white blood cell count is 18,000/µL, and cultures are pending. Which intervention should the nurse
implement first?
A. Begin broad‑spectrum intravenous antibiotics per protocol
B. Increase fluid resuscitation to 150% of the Parkland calculation
C. Apply silver‑sulfadiazine dressing to the burn wounds
D. Obtain a surgical consult for early excision
Correct Answer
Begin broad‑spectrum intravenous antibiotics per protocol
Rationale:
Burn patients are at high risk for sepsis; early empiric antibiotics are critical while awaiting culture results, outweighing dressing
changes or fluid adjustments.
Question 7
A 23-year-old college student presents to the urgent care clinic with a 2‑day history of sore throat, fever, and a
sandpaper‑like rash on the trunk. A rapid strep test is negative, but a throat culture later grows group A
Streptococcus. Which complication is the nurse most likely to educate the patient about if untreated?
A. Acute rheumatic fever
B. Post‑streptococcal glomerulonephritis
C. Toxic shock syndrome
D. Scarlet fever
Correct Answer
Acute rheumatic fever
Rationale:
Untreated group A Streptococcus pharyngitis can lead to rheumatic fever, an immune‑mediated sequela affecting heart valves;
education focuses on this serious long‑term risk.
PRRE
EMM II U
UMM SS TT U
UDDY
Y M
MAA TT E
ERR II A
A LL SS S
STTU
UDDY
Y C
COOL
LLLE
ECCT
T II O
ONN :: 2
2002
2 55
ATI RN EXIT TEST BANK – QUESTIONS WITH
RATIONALIZED ANSWERS () 100%
GUARANTEE PASS.
WHAT'S INSIDE:
Latest 2025/2026 Questions
Verified Correct Answers Highlighted for Easy Learning
Detailed Explanations & Rationales for Better Understanding
Proven to Boost Grades and Exam Confidence
Covers All Essential Topics and Core Concepts
Perfect for Quick Revision and Last-Minute Review
Question 1
A 72-year-old female with a history of chronic heart failure (EF 30%), atrial fibrillation on warfarin, and chronic
kidney disease stage 4 presents to the emergency department with sudden onset dyspnea, orthopnea, and a blood
pressure of 88/52 mmHg. Physical exam reveals jugular venous distention, bibasilar crackles, and a new holosystolic
murmur at the apex. Laboratory studies show INR 3.5, BUN 68 mg/dL, creatinine 3.2 mg/dL, and serum potassium
5.8 mEq/L. Which nursing intervention should be implemented first?
A. Administer intravenous furosemide 40 mg over 30 minutes
B. Prepare the patient for emergent cardioversion
C. Hold warfarin and give vitamin K 10 mg IV
D. Place the patient in a semi‑Fowler position and monitor oxygen saturation
Correct Answer
Place the patient in a semi‑Fowler position and monitor oxygen saturation
Rationale:
Stabilizing airway and breathing takes priority; positioning improves ventilation and oxygenation while the nurse assesses for further
interventions. Medication adjustments and cardioversion are secondary until the patient is hemodynamically stable.
,Question 2
A 45-year-old man with newly diagnosed HIV infection (CD4 count 150 cells/µL) is admitted for treatment of
Pneumocystis jirovecii pneumonia. He is started on trimethoprim‑sulfamethoxazole, prednisone, and supplemental
oxygen. The nurse notes a rash on his trunk, fever of 38.9°C, and a sudden drop in blood pressure to 92/58 mmHg.
Which action should the nurse take first?
A. Discontinue trimethoprim‑sulfamethoxazole and notify the provider
B. Administer an additional dose of prednisone
C. Increase the oxygen flow rate to 6 L/min
D. Obtain a stat blood culture
Correct Answer
Discontinue trimethoprim‑sulfamethoxazole and notify the provider
Rationale:
The presentation suggests a severe drug reaction (possible Stevens‑Johnson syndrome) requiring immediate cessation of the
offending drug and provider notification before other measures are taken.
Question 3
A 29-year-old pregnant woman at 34 weeks gestation presents with a 3‑day history of severe headache, visual
disturbances, and blood pressure of 168/106 mmHg. Laboratory results reveal proteinuria 2+ and platelet count of
90,000/µL. Which nursing intervention is the highest priority?
A. Administer magnesium sulfate per protocol
B. Prepare the patient for emergent cesarean delivery
C. Place the patient on strict bed rest in a left lateral position
D. Obtain a fetal non‑stress test
Correct Answer
Administer magnesium sulfate per protocol
Rationale:
Magnesium sulfate prevents seizures in severe preeclampsia/eclampsia; seizure prophylaxis is the immediate priority before delivery
planning or other assessments.
,Question 4
A 62-year-old male undergoing laparoscopic cholecystectomy develops a sudden drop in end‑tidal CO₂ from 38
mmHg to 22 mmHg, tachycardia, and hypotension. The anesthesiologist suspects a CO₂ embolism. What is the most
appropriate nursing action?
A. Increase the fresh gas flow rate
B. Notify the surgeon and prepare for immediate conversion to open surgery
C. Place the patient in the left lateral decubitus (Durant) position and administer 100% oxygen
D. Administer IV epinephrine 0.1 mg
Correct Answer
Place the patient in the left lateral decubitus (Durant) position and administer 100%
oxygen
Rationale:
The Durant maneuver traps the embolus in the right atrium, reducing obstruction, while 100% O₂ improves oxygenation; these steps
precede pharmacologic interventions.
Question 5
A 54-year-old woman with a recent diagnosis of multiple sclerosis is prescribed interferon beta‑1a subcutaneously.
She reports flu‑like symptoms, fatigue, and injection‑site erythema after each dose. Which teaching point should the
nurse emphasize to improve adherence?
A. Rotate injection sites and apply a cool compress after injection
B. Increase the dose gradually over two weeks
C. Take acetaminophen 30 minutes before the injection
D. Inject the medication into the gluteal muscle
Correct Answer
Rotate injection sites and apply a cool compress after injection
Rationale:
Site rotation and cool compresses reduce local reactions and systemic flu‑like symptoms, enhancing tolerability and adherence; dose
adjustments or muscle injections are not recommended.
, Question 6
A 38-year-old male with severe burns covering 45% TBSA is admitted to the ICU. On day 3, his temperature rises to
39.5°C, white blood cell count is 18,000/µL, and cultures are pending. Which intervention should the nurse
implement first?
A. Begin broad‑spectrum intravenous antibiotics per protocol
B. Increase fluid resuscitation to 150% of the Parkland calculation
C. Apply silver‑sulfadiazine dressing to the burn wounds
D. Obtain a surgical consult for early excision
Correct Answer
Begin broad‑spectrum intravenous antibiotics per protocol
Rationale:
Burn patients are at high risk for sepsis; early empiric antibiotics are critical while awaiting culture results, outweighing dressing
changes or fluid adjustments.
Question 7
A 23-year-old college student presents to the urgent care clinic with a 2‑day history of sore throat, fever, and a
sandpaper‑like rash on the trunk. A rapid strep test is negative, but a throat culture later grows group A
Streptococcus. Which complication is the nurse most likely to educate the patient about if untreated?
A. Acute rheumatic fever
B. Post‑streptococcal glomerulonephritis
C. Toxic shock syndrome
D. Scarlet fever
Correct Answer
Acute rheumatic fever
Rationale:
Untreated group A Streptococcus pharyngitis can lead to rheumatic fever, an immune‑mediated sequela affecting heart valves;
education focuses on this serious long‑term risk.
