Nursing Clinical Excellence: Med-Surg, Psych, OB, and Community
Health 2026/2027 UPDATE
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease
(COPD). Which oxygen delivery setting is most appropriate to prevent
suppression of the hypoxic drive?
A. 100% via non-rebreather mask
B. 2-3 L/min via nasal cannula
C. 8 L/min via simple face mask
D. 15 L/min via Venturi mask
Answer: B
Rationale: In COPD patients, high levels of oxygen can suppress the drive to breathe. Low-
flow oxygen (2-3 L/min) is typically used to maintain saturation between 88-92%.
2. A client is admitted to the psychiatric unit with a diagnosis of Major
Depressive Disorder. Which assessment finding is the priority?
A. Poor personal hygiene
B. Anhedonia and social withdrawal
C. Statements regarding hopelessness and a plan for self-harm
D. Weight loss of 5 pounds in two weeks
Answer: C
Rationale: Safety is the priority in psychiatric nursing. Hopelessness and a specific plan for
self-harm indicate a high risk for suicide requiring immediate intervention.
,3. During the active phase of labor, a nurse notes a late deceleration on the fetal
heart rate monitor. What is the priority nursing action?
A. Increase the IV pitocin rate
B. Administer an analgesic
C. Perform a vaginal exam
D. Position the mother on her left side
Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning the
mother to the left side improves blood flow to the placenta and fetus.
4. A community health nurse is conducting a screening for hypertension at a
local senior center. This is an example of which level of prevention?
A. Primary prevention
B. Quaternary prevention
C. Tertiary prevention
D. Secondary prevention
Answer: D
Rationale: Secondary prevention focuses on early detection and screening to limit the
impact of a disease.
5. Which electrolyte imbalance is a patient most at risk for when taking a loop
diuretic like Furosemide?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Loop diuretics are potassium-wasting, leading to an increased risk of
hypokalemia.
, 6. A client in the manic phase of Bipolar Disorder is pacing the hallways and
interrupting others. Which intervention is most therapeutic?
A. Encourage the client to join a group therapy session
B. Instruct the client to sit in a chair for 30 minutes
C. Place the client in a quiet room with low stimuli
D. Ask the client to explain their behavior
Answer: C
Rationale: Reducing environmental stimuli helps decrease the agitation and hyperactivity
associated with a manic episode.
7. A postpartum nurse is assessing a client 2 hours after delivery. The fundus is
boggy and displaced to the right. What is the nurse’s first action?
A. Assist the client to empty her bladder
B. Notify the healthcare provider
C. Massage the fundus until firm
D. Increase the IV oxytocin rate
Answer: A
Rationale: A fundus displaced to the right is usually caused by a full bladder, which
prevents the uterus from contracting. Emptying the bladder is the first step.
8. A nurse is educating a community group about primary prevention of skin
cancer. Which statement should be included?
A. Perform monthly self-skin checks
B. Visit a dermatologist annually for a mole check
C. Apply sunscreen with at least SPF 30 before sun exposure
D. Seek treatment for any changing lesions immediately
Answer: C
Rationale: Primary prevention involves actions taken to prevent the onset of disease, such
as using sunscreen to prevent DNA damage.
Health 2026/2027 UPDATE
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease
(COPD). Which oxygen delivery setting is most appropriate to prevent
suppression of the hypoxic drive?
A. 100% via non-rebreather mask
B. 2-3 L/min via nasal cannula
C. 8 L/min via simple face mask
D. 15 L/min via Venturi mask
Answer: B
Rationale: In COPD patients, high levels of oxygen can suppress the drive to breathe. Low-
flow oxygen (2-3 L/min) is typically used to maintain saturation between 88-92%.
2. A client is admitted to the psychiatric unit with a diagnosis of Major
Depressive Disorder. Which assessment finding is the priority?
A. Poor personal hygiene
B. Anhedonia and social withdrawal
C. Statements regarding hopelessness and a plan for self-harm
D. Weight loss of 5 pounds in two weeks
Answer: C
Rationale: Safety is the priority in psychiatric nursing. Hopelessness and a specific plan for
self-harm indicate a high risk for suicide requiring immediate intervention.
,3. During the active phase of labor, a nurse notes a late deceleration on the fetal
heart rate monitor. What is the priority nursing action?
A. Increase the IV pitocin rate
B. Administer an analgesic
C. Perform a vaginal exam
D. Position the mother on her left side
Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning the
mother to the left side improves blood flow to the placenta and fetus.
4. A community health nurse is conducting a screening for hypertension at a
local senior center. This is an example of which level of prevention?
A. Primary prevention
B. Quaternary prevention
C. Tertiary prevention
D. Secondary prevention
Answer: D
Rationale: Secondary prevention focuses on early detection and screening to limit the
impact of a disease.
5. Which electrolyte imbalance is a patient most at risk for when taking a loop
diuretic like Furosemide?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Loop diuretics are potassium-wasting, leading to an increased risk of
hypokalemia.
, 6. A client in the manic phase of Bipolar Disorder is pacing the hallways and
interrupting others. Which intervention is most therapeutic?
A. Encourage the client to join a group therapy session
B. Instruct the client to sit in a chair for 30 minutes
C. Place the client in a quiet room with low stimuli
D. Ask the client to explain their behavior
Answer: C
Rationale: Reducing environmental stimuli helps decrease the agitation and hyperactivity
associated with a manic episode.
7. A postpartum nurse is assessing a client 2 hours after delivery. The fundus is
boggy and displaced to the right. What is the nurse’s first action?
A. Assist the client to empty her bladder
B. Notify the healthcare provider
C. Massage the fundus until firm
D. Increase the IV oxytocin rate
Answer: A
Rationale: A fundus displaced to the right is usually caused by a full bladder, which
prevents the uterus from contracting. Emptying the bladder is the first step.
8. A nurse is educating a community group about primary prevention of skin
cancer. Which statement should be included?
A. Perform monthly self-skin checks
B. Visit a dermatologist annually for a mole check
C. Apply sunscreen with at least SPF 30 before sun exposure
D. Seek treatment for any changing lesions immediately
Answer: C
Rationale: Primary prevention involves actions taken to prevent the onset of disease, such
as using sunscreen to prevent DNA damage.
