NIH IPPCR COMPREHENSIVE TEST SCRIPT 2026
FULL QUESTIONS AND CORRECT ANSWERS
▶ A client is being treated for dehydration. Which statement made by the
client indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.. Answer: D
Because 1 L of water weighs 1 kg, change in body weight is a good
measure of excess fluid loss or fluid retention. Weight loss greater than 0.5
lb daily is indicative of excessive fluid loss. The other statements are not
indicative of practices that will prevent dehydration.
▶ The nurse notes that the handgrip of the client with hypokalemia has
diminished since the previous assessment one hour ago. Which
intervention by the nurse is the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider. Answer: A
In a client with hypokkalemia, progressive skeletal muscle weakness is
associated with increasing severity of hypokalemia. The most life-
threatening complication of hypokalemia is respiratory insufficiency. It is
imperative for the nurse to perform a respiratory assessment first to make
sure that the client is not in immediate jeopardy. Next, the nurse would call
the health care provider to obtain orders for potassium replacement.
▶ The physician orders Lasix (furosemide) 60 mg po every day for your
patient. On hand you have Lasix 40 mg. How many tablets will you give the
patient?
a. 3
b. 1
,c. 1 1/2
d. 2 1/5. Answer: C
60/40 (desired/have)
▶ A client has been taught to restrict dietary sodium. Which food selection
by the client indicates to the nurse that teaching has been effective?
a. a grilled cheese sandwich with tomato soup
b. Chinese take-out, including steamed rice
c. a chicken leg, one slice of bread with butter, and steamed carrots
d. slices of ham and cheese on whole grain crackers. Answer: C
Clients on restricted sodium diets generally should avoid processed,
smoked, and pickled foods and those with sauces and other condiments.
Foods lowest in sodium include fish, poultry, and fresh produce. The
chinese food likely would have soy sauce, the tomato soup is processed,
and the crackers are a snack food - a category of foods often high in
sodium.
▶ When a client is assessed, which behavior best indicates that he or she
is experiencing changes associated with acute pain?
a. inability to concentrate
b. expressed hopelessness
c. psychosocial withdrawal
d. anger and hostility. Answer: A
The characteristics most common to chronic pain are psychosocial
withdrawal, anger and hostility, depression, and hopelessness. The inability
to concentrate is associated much more with acute pain, before any
physiologic or behavioral adaptation has occurred.
▶ A nurse is caring for several clients at risk for overhydration. The nurse
assesses the older client with which finding first?
A) Has had diabetes mellitus for 12 years
B) Had abdominal surgery and has a nasogastric tube
C) Just received 3 units of packed red blood cells
D) Uses sodium-containing antacids frequently. Answer: C
,Blood replacement therapy involves intravenous fluid administration, which
inherently increases the risk for overhydration. The fact that the fluid
consists of packed red blood cells greatly increases the risk, because this
fluid increases the colloidal oncotic pressure of the blood, causing fluid to
move from interstitial and intracellular spaces into the plasma volume. An
older adult may not have sufficient cardiac or renal reserve to manage this
extra fluid.
▶ The client with a stroke was admitted to a medical-surgical unit. Which
tasks does the nurse delegate to the unlicensed assistive personnel?
A) Assess level of consciousness.
B) Evaluate the pulse oximetry reading.
C) Assist the client with meals.
D) Complete the nursing care plan.. Answer: C
The nurse needs to know the five rights of delegation: right task, right
circumstances, right person, right communication, and right supervision.
Unlicensed assistive personnel can help with feeding, but only the nurse
can care plan, assess the level of consciousness, and evaluate the
oxygenation of the client.
▶ Interrelated concepts to the professional nursing role a nurse manager
would consider when addressing concerns about the quality of patient
education include:
A) adherence.
B) developmental level.
C) motivation.
D) technology.. Answer: D
The interrelated concepts to the professional role of a nurse include health
promotion, leadership, technology/informatics, quality, collaboration, and
communication. Adherence, culture, developmental level, family dynamics,
and motivation are considered interrelated concepts to patient attributes
and preference.
, ▶ During orientation to an emergency department, the nurse educator
would be concerned if the new nurse listed which of the following as a risk
factor for impaired thermoregulation?
A) Temperature extremes
B) Occupational exposure
C) Impaired cognition
D) Physical agility. Answer: D
Physical agility is not a risk factor for impaired thermoregulation. The nurse
educator would use this information to plan additional teaching to include
medical conditions and gait disturbance as risk factors for hypothermia,
because their bodies have a reduced ability to generate heat. Impaired
cognition is a risk factor. Recreational or occupational exposure is a risk
factor. Temperature extremes are risk factors for impaired
thermoregulation.
▶ An older adult client is in physical restraints. Which intervention by the
nurse is the priority?
A) Assess the client hourly while keeping the restraints in place.
B) Assess the client once each shift, releasing the restraints for feeding.
C) Assess the client twice each shift while keeping the restraints in place.
D) Assess the client every 30 to 60 minutes, releasing restraints every 2
hours.. Answer: D
The application of restraints can have serious consequences. Thus, the
nurse should check the client every 30 to 60 minutes, releasing the
restraints every 2 hours for positioning and toileting. The other answers
would not be appropriate because the client would not be assessed
frequently enough, and circulation to the limbs could be compromised.
Assessing every hour and releasing the restraints every 2 hours is in
compliance with federal policy for monitoring clients in restraints.
▶ The nurse is assessing a client with a long-term history of arthritic pain.
Assessment reveals a heart rate of 115 beats/min and blood pressure of
170/80 mm Hg. Which intervention will the nurse carry out first?
A) Administer blood pressure medication.
B) Administer a drug to lower the heart rate.
C) Continue to assess for possible causes of elevated vital signs.
FULL QUESTIONS AND CORRECT ANSWERS
▶ A client is being treated for dehydration. Which statement made by the
client indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.. Answer: D
Because 1 L of water weighs 1 kg, change in body weight is a good
measure of excess fluid loss or fluid retention. Weight loss greater than 0.5
lb daily is indicative of excessive fluid loss. The other statements are not
indicative of practices that will prevent dehydration.
▶ The nurse notes that the handgrip of the client with hypokalemia has
diminished since the previous assessment one hour ago. Which
intervention by the nurse is the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider. Answer: A
In a client with hypokkalemia, progressive skeletal muscle weakness is
associated with increasing severity of hypokalemia. The most life-
threatening complication of hypokalemia is respiratory insufficiency. It is
imperative for the nurse to perform a respiratory assessment first to make
sure that the client is not in immediate jeopardy. Next, the nurse would call
the health care provider to obtain orders for potassium replacement.
▶ The physician orders Lasix (furosemide) 60 mg po every day for your
patient. On hand you have Lasix 40 mg. How many tablets will you give the
patient?
a. 3
b. 1
,c. 1 1/2
d. 2 1/5. Answer: C
60/40 (desired/have)
▶ A client has been taught to restrict dietary sodium. Which food selection
by the client indicates to the nurse that teaching has been effective?
a. a grilled cheese sandwich with tomato soup
b. Chinese take-out, including steamed rice
c. a chicken leg, one slice of bread with butter, and steamed carrots
d. slices of ham and cheese on whole grain crackers. Answer: C
Clients on restricted sodium diets generally should avoid processed,
smoked, and pickled foods and those with sauces and other condiments.
Foods lowest in sodium include fish, poultry, and fresh produce. The
chinese food likely would have soy sauce, the tomato soup is processed,
and the crackers are a snack food - a category of foods often high in
sodium.
▶ When a client is assessed, which behavior best indicates that he or she
is experiencing changes associated with acute pain?
a. inability to concentrate
b. expressed hopelessness
c. psychosocial withdrawal
d. anger and hostility. Answer: A
The characteristics most common to chronic pain are psychosocial
withdrawal, anger and hostility, depression, and hopelessness. The inability
to concentrate is associated much more with acute pain, before any
physiologic or behavioral adaptation has occurred.
▶ A nurse is caring for several clients at risk for overhydration. The nurse
assesses the older client with which finding first?
A) Has had diabetes mellitus for 12 years
B) Had abdominal surgery and has a nasogastric tube
C) Just received 3 units of packed red blood cells
D) Uses sodium-containing antacids frequently. Answer: C
,Blood replacement therapy involves intravenous fluid administration, which
inherently increases the risk for overhydration. The fact that the fluid
consists of packed red blood cells greatly increases the risk, because this
fluid increases the colloidal oncotic pressure of the blood, causing fluid to
move from interstitial and intracellular spaces into the plasma volume. An
older adult may not have sufficient cardiac or renal reserve to manage this
extra fluid.
▶ The client with a stroke was admitted to a medical-surgical unit. Which
tasks does the nurse delegate to the unlicensed assistive personnel?
A) Assess level of consciousness.
B) Evaluate the pulse oximetry reading.
C) Assist the client with meals.
D) Complete the nursing care plan.. Answer: C
The nurse needs to know the five rights of delegation: right task, right
circumstances, right person, right communication, and right supervision.
Unlicensed assistive personnel can help with feeding, but only the nurse
can care plan, assess the level of consciousness, and evaluate the
oxygenation of the client.
▶ Interrelated concepts to the professional nursing role a nurse manager
would consider when addressing concerns about the quality of patient
education include:
A) adherence.
B) developmental level.
C) motivation.
D) technology.. Answer: D
The interrelated concepts to the professional role of a nurse include health
promotion, leadership, technology/informatics, quality, collaboration, and
communication. Adherence, culture, developmental level, family dynamics,
and motivation are considered interrelated concepts to patient attributes
and preference.
, ▶ During orientation to an emergency department, the nurse educator
would be concerned if the new nurse listed which of the following as a risk
factor for impaired thermoregulation?
A) Temperature extremes
B) Occupational exposure
C) Impaired cognition
D) Physical agility. Answer: D
Physical agility is not a risk factor for impaired thermoregulation. The nurse
educator would use this information to plan additional teaching to include
medical conditions and gait disturbance as risk factors for hypothermia,
because their bodies have a reduced ability to generate heat. Impaired
cognition is a risk factor. Recreational or occupational exposure is a risk
factor. Temperature extremes are risk factors for impaired
thermoregulation.
▶ An older adult client is in physical restraints. Which intervention by the
nurse is the priority?
A) Assess the client hourly while keeping the restraints in place.
B) Assess the client once each shift, releasing the restraints for feeding.
C) Assess the client twice each shift while keeping the restraints in place.
D) Assess the client every 30 to 60 minutes, releasing restraints every 2
hours.. Answer: D
The application of restraints can have serious consequences. Thus, the
nurse should check the client every 30 to 60 minutes, releasing the
restraints every 2 hours for positioning and toileting. The other answers
would not be appropriate because the client would not be assessed
frequently enough, and circulation to the limbs could be compromised.
Assessing every hour and releasing the restraints every 2 hours is in
compliance with federal policy for monitoring clients in restraints.
▶ The nurse is assessing a client with a long-term history of arthritic pain.
Assessment reveals a heart rate of 115 beats/min and blood pressure of
170/80 mm Hg. Which intervention will the nurse carry out first?
A) Administer blood pressure medication.
B) Administer a drug to lower the heart rate.
C) Continue to assess for possible causes of elevated vital signs.
