Progressive Care RN “A” Exam Questions PRACTICE
QUESTIONS PLUS RATIONALES 2026 |INSTANT
DOWNOAD PDF
1. A 65-year-old patient with a history of atrial fibrillation
presents with shortness of breath and palpitations. Which
intervention is the priority?
A. Administer IV antibiotics
B. Apply oxygen via nasal cannula
C. Obtain an ECG and assess heart rate and rhythm
D. Start a blood transfusion
Correct Answer: C – Assessing the heart rate and rhythm is the
priority to identify the arrhythmia and guide treatment for
atrial fibrillation.
2. A patient with acute decompensated heart failure has a BP
of 85/50 mmHg. Which action should the nurse take first?
A. Administer IV furosemide
B. Elevate the legs and monitor vitals
C. Initiate fluid resuscitation with normal saline
D. Call the rapid response team
Correct Answer: D – Hypotension in acute decompensated heart
failure may indicate cardiogenic shock; rapid intervention is
necessary.
3. A post-MI patient develops sudden chest pain and dyspnea.
The ECG shows ST-segment elevation. What is the priority
,action?
A. Prepare for thrombolytic therapy
B. Place the patient in Trendelenburg position
C. Administer subcutaneous heparin
D. Encourage the patient to ambulate
Correct Answer: A – ST-elevation myocardial infarction requires
urgent reperfusion therapy such as thrombolytics or PCI.
4. A patient with COPD on 2 L O₂ develops confusion and CO₂
retention. Which is the best nursing action?
A. Increase O₂ to 6 L/min
B. Encourage deep breathing and pursed-lip breathing
C. Reduce oxygen to maintain SaO₂ 88–92%
D. Administer sedatives to calm the patient
Correct Answer: C – In COPD patients with CO₂ retention, high
O₂ can suppress respiratory drive; oxygen should be titrated to
safe levels.
5. Which lab result indicates the patient on heparin therapy is
within therapeutic range?
A. INR 1.0
B. aPTT 60–80 seconds
C. Platelets 50,000/mm³
D. Hematocrit 40%
Correct Answer: B – aPTT 1.5–2.5 times normal (usually 60–80
seconds) indicates therapeutic heparin anticoagulation.
6. A patient with diabetic ketoacidosis presents with K⁺ of 6.0
mEq/L. What is the priority?
,A. Administer IV insulin carefully
B. Give oral potassium supplement
C. Start a fluid bolus only
D. Administer bicarbonate immediately
Correct Answer: A – Insulin shifts potassium into cells,
correcting hyperkalemia; close monitoring is needed during DKA
management.
7. A patient develops sudden onset hemiplegia and slurred
speech. Which intervention should the nurse implement first?
A. Administer tissue plasminogen activator (tPA) if within the
window
B. Encourage ambulation
C. Administer antihypertensive medications immediately
D. Call for a blood transfusion
Correct Answer: A – Early recognition of acute ischemic stroke
and tPA administration within the window is critical for
reducing neurological damage.
8. A patient on IV dopamine develops palpitations and chest
pain. What is the nurse’s priority?
A. Slow the infusion
B. Assess vital signs and cardiac rhythm
C. Stop all IV medications
D. Encourage deep breathing exercises
Correct Answer: B – Dopamine can cause tachyarrhythmias;
assessing cardiac status guides urgent intervention.
, 9. Which finding in a patient with sepsis indicates worsening
condition?
A. HR 95 bpm, BP 120/80 mmHg
B. Urine output 20 mL/hr
C. Temp 37.5°C, RR 18
D. Alert and oriented
Correct Answer: B – Low urine output (<0.5 mL/kg/hr) indicates
poor perfusion and worsening sepsis.
10. A patient with pulmonary embolism has sudden
hypotension and dyspnea. What is the priority intervention?
A. Place patient in high Fowler’s position
B. Administer IV fluids cautiously and notify the provider
C. Apply heating pad to chest
D. Encourage coughing and deep breathing
Correct Answer: B – Hypotension indicates possible massive PE;
fluids and rapid notification for thrombolytic therapy are
priority.
11. A patient with chronic kidney disease presents with K⁺ 6.8
mEq/L. Which intervention is highest priority?
A. Administer Kayexalate
B. Monitor vital signs every 4 hours
C. Encourage high-potassium diet
D. Restrict fluid intake
Correct Answer: A – Hyperkalemia >6.5 is life-threatening;
urgent interventions like potassium-binding agents or dialysis
are needed.
QUESTIONS PLUS RATIONALES 2026 |INSTANT
DOWNOAD PDF
1. A 65-year-old patient with a history of atrial fibrillation
presents with shortness of breath and palpitations. Which
intervention is the priority?
A. Administer IV antibiotics
B. Apply oxygen via nasal cannula
C. Obtain an ECG and assess heart rate and rhythm
D. Start a blood transfusion
Correct Answer: C – Assessing the heart rate and rhythm is the
priority to identify the arrhythmia and guide treatment for
atrial fibrillation.
2. A patient with acute decompensated heart failure has a BP
of 85/50 mmHg. Which action should the nurse take first?
A. Administer IV furosemide
B. Elevate the legs and monitor vitals
C. Initiate fluid resuscitation with normal saline
D. Call the rapid response team
Correct Answer: D – Hypotension in acute decompensated heart
failure may indicate cardiogenic shock; rapid intervention is
necessary.
3. A post-MI patient develops sudden chest pain and dyspnea.
The ECG shows ST-segment elevation. What is the priority
,action?
A. Prepare for thrombolytic therapy
B. Place the patient in Trendelenburg position
C. Administer subcutaneous heparin
D. Encourage the patient to ambulate
Correct Answer: A – ST-elevation myocardial infarction requires
urgent reperfusion therapy such as thrombolytics or PCI.
4. A patient with COPD on 2 L O₂ develops confusion and CO₂
retention. Which is the best nursing action?
A. Increase O₂ to 6 L/min
B. Encourage deep breathing and pursed-lip breathing
C. Reduce oxygen to maintain SaO₂ 88–92%
D. Administer sedatives to calm the patient
Correct Answer: C – In COPD patients with CO₂ retention, high
O₂ can suppress respiratory drive; oxygen should be titrated to
safe levels.
5. Which lab result indicates the patient on heparin therapy is
within therapeutic range?
A. INR 1.0
B. aPTT 60–80 seconds
C. Platelets 50,000/mm³
D. Hematocrit 40%
Correct Answer: B – aPTT 1.5–2.5 times normal (usually 60–80
seconds) indicates therapeutic heparin anticoagulation.
6. A patient with diabetic ketoacidosis presents with K⁺ of 6.0
mEq/L. What is the priority?
,A. Administer IV insulin carefully
B. Give oral potassium supplement
C. Start a fluid bolus only
D. Administer bicarbonate immediately
Correct Answer: A – Insulin shifts potassium into cells,
correcting hyperkalemia; close monitoring is needed during DKA
management.
7. A patient develops sudden onset hemiplegia and slurred
speech. Which intervention should the nurse implement first?
A. Administer tissue plasminogen activator (tPA) if within the
window
B. Encourage ambulation
C. Administer antihypertensive medications immediately
D. Call for a blood transfusion
Correct Answer: A – Early recognition of acute ischemic stroke
and tPA administration within the window is critical for
reducing neurological damage.
8. A patient on IV dopamine develops palpitations and chest
pain. What is the nurse’s priority?
A. Slow the infusion
B. Assess vital signs and cardiac rhythm
C. Stop all IV medications
D. Encourage deep breathing exercises
Correct Answer: B – Dopamine can cause tachyarrhythmias;
assessing cardiac status guides urgent intervention.
, 9. Which finding in a patient with sepsis indicates worsening
condition?
A. HR 95 bpm, BP 120/80 mmHg
B. Urine output 20 mL/hr
C. Temp 37.5°C, RR 18
D. Alert and oriented
Correct Answer: B – Low urine output (<0.5 mL/kg/hr) indicates
poor perfusion and worsening sepsis.
10. A patient with pulmonary embolism has sudden
hypotension and dyspnea. What is the priority intervention?
A. Place patient in high Fowler’s position
B. Administer IV fluids cautiously and notify the provider
C. Apply heating pad to chest
D. Encourage coughing and deep breathing
Correct Answer: B – Hypotension indicates possible massive PE;
fluids and rapid notification for thrombolytic therapy are
priority.
11. A patient with chronic kidney disease presents with K⁺ 6.8
mEq/L. Which intervention is highest priority?
A. Administer Kayexalate
B. Monitor vital signs every 4 hours
C. Encourage high-potassium diet
D. Restrict fluid intake
Correct Answer: A – Hyperkalemia >6.5 is life-threatening;
urgent interventions like potassium-binding agents or dialysis
are needed.
