CPNRE EVALUATION EXAM 2026 QUESTIONS AND
ANSWERS GRADED A+
✔✔A client has been taking antidepressant medication for 1 week and tells the nurse
that is not helping. The most accurate response by the nurse would be:
A) The medication will have to be switched to another type of antidepressant
B) Therapeutic effects usually begin after 2-6 weeks
C) They client must not be taking their medication
D) None of the above - ✔✔B) Therapeutic effects usually begin after 2-6 weeks
✔✔A patient about to receive his morning dose of digoxin (Lanoxin) has an apical pulse
of 70. What should the nurse do?
A) Administer the dose
B) Withhold the dose and notify the physician
C) Notify the physician and monitor the patient's vital signs
D) Recheck the pulse, making sure to count for 1 full minute - ✔✔A) Administer the
dose
✔✔Which of the following will give the patient a healthy supplement of potassium while
taking a potassium losing (non K sparing) diuretic?
A) a glass of milk
B) a bottle of "Honey Brown" ale
C) oranges and bananas
D) a glass of cranberry juice - ✔✔C) oranges and bananas
✔✔A male client is asking the nurse a question regarding the Mantoux test for
tuberculosis. The nurse should base her response on the fact that the:
A) Area of redness is measured in 3 days and determines whether tuberculosis is
present.
B) Skin test doesn't differentiate between active and dormant tuberculosis infection.
C) Presence of a wheal at the injection site in 2 days indicates active tuberculosis.
D) Test stimulates a reddened response in some clients and requires a second test in 3
months. - ✔✔B) Skin test doesn't differentiate between active and dormant tuberculosis
infection.
✔✔The nurse is teaching a male client with chronic bronchitis about breathing
exercises. Which of the following should the nurse include in the teaching?
A) Make inhalation longer than exhalation.
B) Exhale through an open mouth.
C) Use diaphragmatic breathing.
,D) Use chest breathing. - ✔✔C) Use diaphragmatic breathing.
Response Feedback:
In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to
strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than
inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis
should exhale through pursed lips to prolong exhalation, keep the bronchioles from
collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing —
increases lung expansion.
✔✔A female client must take streptomycin for tuberculosis. Before therapy begins, the
nurse should instruct the client to notify the physician if which health concern occurs?
A) Impaired color discrimination
B) Increased urinary frequency
C) Decreased hearing acuity
D) Increased appetite - ✔✔C) Decreased hearing acuity
Response Feedback:
Decreased hearing acuity indicates ototoxicity, a serious adverse effect of streptomycin
therapy. The client should notify the physician immediately if it occurs so that
streptomycin can be discontinued and an alternative drug can be prescribed. The other
options aren't associated with streptomycin. Impaired color discrimination indicates color
blindness; increased urinary frequency and increased appetite accompany diabetes
mellitus.
✔✔The nurse assesses a male client's respiratory status. Which observation indicates
that the client is experiencing difficulty breathing?
A) Diaphragmatic breathing
B) Use of accessory muscles
C) Pursed-lip breathing
D) Controlled breathing - ✔✔B) Use of accessory muscles
Response Feedback:
The use of accessory muscles for respiration indicates the client is having difficulty
breathing. Diaphragmatic and pursed-lip breathing are two controlled breathing
techniques that help the client conserve energy.
✔✔A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophyllin)
(400 mg in 500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The
nurse calls the physician who instructs the nurse to change the dosage to 0.45
mg/kg/hour. The nurse should:
A) Question the order because it's too low.
B) Question the order because it's too high.
,C) Set the pump at 45 ml/hour.
D) Stop the infusion and have the laboratory repeat the theophylline measurement. -
✔✔A) Question the order because it's too low.
Response Feedback:
A therapeutic theophylline level is 10 to 20 mcg/ml. The client is currently receiving 0.5
mg/kg/hour of aminophylline. Because the client's theophylline level is sub-therapeutic,
reducing the dose (which is what the physician's order would do) would be
inappropriate. Therefore, the nurse should question the order.
✔✔A male client admitted to an acute care facility with pneumonia is receiving
supplemental oxygen, 2 L/minute via nasal cannula. The client's history includes chronic
obstructive pulmonary disease (COPD) and coronary artery disease. Because of these
history findings, the nurse closely monitors the oxygen flow and the client's respiratory
status. Which complication may arise if the client receives a high oxygen concentration?
A) Apnea
B) Anginal pain
C) Respiratory alkalosis
D) Metabolic acidosis - ✔✔A) Apnea
Response Feedback:
Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen
administration may lead to apnea by removing that stimulus. Anginal pain results from a
reduced myocardial oxygen supply. A client with COPD may have anginal pain from
generalized vasoconstriction secondary to hypoxia; however, administering oxygen at
any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis
results from alveolar hyperventilation, not excessive oxygen administration. In a client
with COPD, high oxygen concentrations decrease the ventilatory drive, leading to
respiratory acidosis, not alkalosis. High oxygen concentrations don't cause metabolic
acidosis.
✔✔A black client with asthma seeks emergency care for acute respiratory distress.
Because of this client's dark skin, the nurse should assess for cyanosis by inspecting
the:
A) Lips.
B) Mucous membranes.
C) Nail beds.
D) Earlobes. - ✔✔B) Mucous membranes.
Response Feedback:
Skin color doesn't affect the mucous membranes. The lips, nail beds, and earlobes are
less reliable indicators of cyanosis because they're affected by skin color.
, ✔✔The nurse in charge is teaching a client with emphysema how to perform pursed-lip
breathing. The client asks the nurse to explain the purpose of this breathing technique.
Which explanation should the nurse provide?
A) It helps prevent early airway collapse.
B) It increases inspiratory muscle strength.
C) It decreases use of accessory breathing muscles.
D) It prolongs the inspiratory phase of respiration. - ✔✔A) It helps prevent early airway
collapse.
Response Feedback:
Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps
the client control respiration during periods of excitement, anxiety, exercise, and
respiratory distress. To increase inspiratory muscle strength and endurance, the client
may need to learn inspiratory resistive breathing. To decrease accessory muscle use
and thus reduce the work of breathing, the client may need to learn diaphragmatic
(abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-
expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as
1:4.)
✔✔A nurse is preparing to obtain a sputum specimen from a male client. Which of the
following nursing actions will facilitate obtaining the specimen?
A) Limiting fluid
B) Having the client take deep breaths
C) Asking the client to spit into the collection container
D) Asking the client to obtain the specimen after eating - ✔✔B) Having the client take
deep breaths
Response Feedback:
To obtain a sputum specimen, the client should rinse the mouth to reduce
contamination, breathe deeply, and then cough into a sputum specimen container. The
client should be encouraged to cough and not spit so as to obtain sputum. Sputum can
be thinned by fluids or by a respiratory treatment such as inhalation of nebulized saline
or water. The optimal time to obtain a specimen is on arising in the morning.
✔✔A male adult client is suspected of having a pulmonary embolus. A nurse assesses
the client, knowing that which of the following is a common clinical manifestation of
pulmonary embolism?
A) Dyspnea
B) Bradypnea
C) Bradycardia
D) Decreased respirations - ✔✔A) Dyspnea
Response Feedback:
ANSWERS GRADED A+
✔✔A client has been taking antidepressant medication for 1 week and tells the nurse
that is not helping. The most accurate response by the nurse would be:
A) The medication will have to be switched to another type of antidepressant
B) Therapeutic effects usually begin after 2-6 weeks
C) They client must not be taking their medication
D) None of the above - ✔✔B) Therapeutic effects usually begin after 2-6 weeks
✔✔A patient about to receive his morning dose of digoxin (Lanoxin) has an apical pulse
of 70. What should the nurse do?
A) Administer the dose
B) Withhold the dose and notify the physician
C) Notify the physician and monitor the patient's vital signs
D) Recheck the pulse, making sure to count for 1 full minute - ✔✔A) Administer the
dose
✔✔Which of the following will give the patient a healthy supplement of potassium while
taking a potassium losing (non K sparing) diuretic?
A) a glass of milk
B) a bottle of "Honey Brown" ale
C) oranges and bananas
D) a glass of cranberry juice - ✔✔C) oranges and bananas
✔✔A male client is asking the nurse a question regarding the Mantoux test for
tuberculosis. The nurse should base her response on the fact that the:
A) Area of redness is measured in 3 days and determines whether tuberculosis is
present.
B) Skin test doesn't differentiate between active and dormant tuberculosis infection.
C) Presence of a wheal at the injection site in 2 days indicates active tuberculosis.
D) Test stimulates a reddened response in some clients and requires a second test in 3
months. - ✔✔B) Skin test doesn't differentiate between active and dormant tuberculosis
infection.
✔✔The nurse is teaching a male client with chronic bronchitis about breathing
exercises. Which of the following should the nurse include in the teaching?
A) Make inhalation longer than exhalation.
B) Exhale through an open mouth.
C) Use diaphragmatic breathing.
,D) Use chest breathing. - ✔✔C) Use diaphragmatic breathing.
Response Feedback:
In chronic bronchitis the diaphragm is flat and weak. Diaphragmatic breathing helps to
strengthen the diaphragm and maximizes ventilation. Exhalation should be longer than
inhalation to prevent collapse of the bronchioles. The client with chronic bronchitis
should exhale through pursed lips to prolong exhalation, keep the bronchioles from
collapsing, and prevent air trapping. Diaphragmatic breathing — not chest breathing —
increases lung expansion.
✔✔A female client must take streptomycin for tuberculosis. Before therapy begins, the
nurse should instruct the client to notify the physician if which health concern occurs?
A) Impaired color discrimination
B) Increased urinary frequency
C) Decreased hearing acuity
D) Increased appetite - ✔✔C) Decreased hearing acuity
Response Feedback:
Decreased hearing acuity indicates ototoxicity, a serious adverse effect of streptomycin
therapy. The client should notify the physician immediately if it occurs so that
streptomycin can be discontinued and an alternative drug can be prescribed. The other
options aren't associated with streptomycin. Impaired color discrimination indicates color
blindness; increased urinary frequency and increased appetite accompany diabetes
mellitus.
✔✔The nurse assesses a male client's respiratory status. Which observation indicates
that the client is experiencing difficulty breathing?
A) Diaphragmatic breathing
B) Use of accessory muscles
C) Pursed-lip breathing
D) Controlled breathing - ✔✔B) Use of accessory muscles
Response Feedback:
The use of accessory muscles for respiration indicates the client is having difficulty
breathing. Diaphragmatic and pursed-lip breathing are two controlled breathing
techniques that help the client conserve energy.
✔✔A male client who weighs 175 lb (79.4 kg) is receiving aminophylline (Aminophyllin)
(400 mg in 500 ml) at 50 ml/hour. The theophylline level is reported as 6 mcg/ml. The
nurse calls the physician who instructs the nurse to change the dosage to 0.45
mg/kg/hour. The nurse should:
A) Question the order because it's too low.
B) Question the order because it's too high.
,C) Set the pump at 45 ml/hour.
D) Stop the infusion and have the laboratory repeat the theophylline measurement. -
✔✔A) Question the order because it's too low.
Response Feedback:
A therapeutic theophylline level is 10 to 20 mcg/ml. The client is currently receiving 0.5
mg/kg/hour of aminophylline. Because the client's theophylline level is sub-therapeutic,
reducing the dose (which is what the physician's order would do) would be
inappropriate. Therefore, the nurse should question the order.
✔✔A male client admitted to an acute care facility with pneumonia is receiving
supplemental oxygen, 2 L/minute via nasal cannula. The client's history includes chronic
obstructive pulmonary disease (COPD) and coronary artery disease. Because of these
history findings, the nurse closely monitors the oxygen flow and the client's respiratory
status. Which complication may arise if the client receives a high oxygen concentration?
A) Apnea
B) Anginal pain
C) Respiratory alkalosis
D) Metabolic acidosis - ✔✔A) Apnea
Response Feedback:
Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen
administration may lead to apnea by removing that stimulus. Anginal pain results from a
reduced myocardial oxygen supply. A client with COPD may have anginal pain from
generalized vasoconstriction secondary to hypoxia; however, administering oxygen at
any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis
results from alveolar hyperventilation, not excessive oxygen administration. In a client
with COPD, high oxygen concentrations decrease the ventilatory drive, leading to
respiratory acidosis, not alkalosis. High oxygen concentrations don't cause metabolic
acidosis.
✔✔A black client with asthma seeks emergency care for acute respiratory distress.
Because of this client's dark skin, the nurse should assess for cyanosis by inspecting
the:
A) Lips.
B) Mucous membranes.
C) Nail beds.
D) Earlobes. - ✔✔B) Mucous membranes.
Response Feedback:
Skin color doesn't affect the mucous membranes. The lips, nail beds, and earlobes are
less reliable indicators of cyanosis because they're affected by skin color.
, ✔✔The nurse in charge is teaching a client with emphysema how to perform pursed-lip
breathing. The client asks the nurse to explain the purpose of this breathing technique.
Which explanation should the nurse provide?
A) It helps prevent early airway collapse.
B) It increases inspiratory muscle strength.
C) It decreases use of accessory breathing muscles.
D) It prolongs the inspiratory phase of respiration. - ✔✔A) It helps prevent early airway
collapse.
Response Feedback:
Pursed-lip breathing helps prevent early airway collapse. Learning this technique helps
the client control respiration during periods of excitement, anxiety, exercise, and
respiratory distress. To increase inspiratory muscle strength and endurance, the client
may need to learn inspiratory resistive breathing. To decrease accessory muscle use
and thus reduce the work of breathing, the client may need to learn diaphragmatic
(abdominal) breathing. In pursed-lip breathing, the client mimics a normal inspiratory-
expiratory (I:E) ratio of 1:2. (A client with emphysema may have an I:E ratio as high as
1:4.)
✔✔A nurse is preparing to obtain a sputum specimen from a male client. Which of the
following nursing actions will facilitate obtaining the specimen?
A) Limiting fluid
B) Having the client take deep breaths
C) Asking the client to spit into the collection container
D) Asking the client to obtain the specimen after eating - ✔✔B) Having the client take
deep breaths
Response Feedback:
To obtain a sputum specimen, the client should rinse the mouth to reduce
contamination, breathe deeply, and then cough into a sputum specimen container. The
client should be encouraged to cough and not spit so as to obtain sputum. Sputum can
be thinned by fluids or by a respiratory treatment such as inhalation of nebulized saline
or water. The optimal time to obtain a specimen is on arising in the morning.
✔✔A male adult client is suspected of having a pulmonary embolus. A nurse assesses
the client, knowing that which of the following is a common clinical manifestation of
pulmonary embolism?
A) Dyspnea
B) Bradypnea
C) Bradycardia
D) Decreased respirations - ✔✔A) Dyspnea
Response Feedback:
