BSN Semester 5 Cumulative Final Exam Prep 2026/2027 UPDATE
1. A client with COPD is admitted with an ABG of pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these results?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal or
slightly high bicarbonate indicates the respiratory system is the cause.
2. The nurse is caring for a client in ventricular tachycardia who is conscious and
has a pulse. Which action is the priority?
A. Synchronized cardioversion
B. Cardiopulmonary resuscitation (CPR)
C. Immediate defibrillation
D. Administration of Epinephrine
Answer: A
Rationale: Synchronized cardioversion is indicated for stable clients with a pulse in
ventricular tachycardia. Defibrillation is for pulseless V-tach or V-fib.
,3. A nurse is assessing a client with Type 1 Diabetes who has Kussmaul
respirations and a fruity breath odor. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Hyperglycemic Hyperosmolar State (HHS)
D. Respiratory failure
Answer: A
Rationale: DKA is characterized by hyperglycemia, ketosis (fruity breath), and metabolic
acidosis, which triggers Kussmaul respirations to blow off CO2.
4. Which task is most appropriate for the RN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Performing an admission assessment
B. Measuring and recording intake and output
C. Feeding a client at risk for aspiration
D. Suctioning a stable tracheostomy
Answer: B
Rationale: UAPs can perform routine tasks such as measuring I&O. Assessment, suctioning,
and feeding high-risk patients require professional nursing judgment.
5. A client with liver cirrhosis has high ammonia levels. Which medication
should the nurse anticipate administering?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Vitamin K
Answer: C
Rationale: Lactulose promotes the excretion of ammonia through the stool, helping to
prevent or treat hepatic encephalopathy.
, 6. What is the primary goal of care for a client in the acute phase of a burn
injury?
A. Wound debridement
B. Fluid resuscitation
C. Emotional support
D. Physical therapy
Answer: B
Rationale: During the emergent/acute phase of a burn, preventing hypovolemic shock
through aggressive fluid resuscitation is the absolute priority.
7. A nurse is caring for a client with a Glascow Coma Scale (GCS) score of 7.
What is the priority nursing intervention?
A. Ensure airway patency
B. Monitor urine output
C. Check pupillary response
D. Perform ROM exercises
Answer: A
Rationale: A GCS score of 8 or less typically indicates a coma and the need for airway
protection (intubation).
8. Which laboratory value is most indicative of Acute Kidney Injury (AKI)?
A. Decreased Blood Urea Nitrogen (BUN)
B. Increased Serum Creatinine
C. Decreased Serum Potassium
D. Increased Serum Hemoglobin
Answer: B
Rationale: Serum creatinine is a more specific indicator of renal function than BUN.
Creatinine rises when the glomerular filtration rate (GFR) drops.
1. A client with COPD is admitted with an ABG of pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these results?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg with a normal or
slightly high bicarbonate indicates the respiratory system is the cause.
2. The nurse is caring for a client in ventricular tachycardia who is conscious and
has a pulse. Which action is the priority?
A. Synchronized cardioversion
B. Cardiopulmonary resuscitation (CPR)
C. Immediate defibrillation
D. Administration of Epinephrine
Answer: A
Rationale: Synchronized cardioversion is indicated for stable clients with a pulse in
ventricular tachycardia. Defibrillation is for pulseless V-tach or V-fib.
,3. A nurse is assessing a client with Type 1 Diabetes who has Kussmaul
respirations and a fruity breath odor. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Hypoglycemia
C. Hyperglycemic Hyperosmolar State (HHS)
D. Respiratory failure
Answer: A
Rationale: DKA is characterized by hyperglycemia, ketosis (fruity breath), and metabolic
acidosis, which triggers Kussmaul respirations to blow off CO2.
4. Which task is most appropriate for the RN to delegate to an Unlicensed
Assistive Personnel (UAP)?
A. Performing an admission assessment
B. Measuring and recording intake and output
C. Feeding a client at risk for aspiration
D. Suctioning a stable tracheostomy
Answer: B
Rationale: UAPs can perform routine tasks such as measuring I&O. Assessment, suctioning,
and feeding high-risk patients require professional nursing judgment.
5. A client with liver cirrhosis has high ammonia levels. Which medication
should the nurse anticipate administering?
A. Spironolactone
B. Propranolol
C. Lactulose
D. Vitamin K
Answer: C
Rationale: Lactulose promotes the excretion of ammonia through the stool, helping to
prevent or treat hepatic encephalopathy.
, 6. What is the primary goal of care for a client in the acute phase of a burn
injury?
A. Wound debridement
B. Fluid resuscitation
C. Emotional support
D. Physical therapy
Answer: B
Rationale: During the emergent/acute phase of a burn, preventing hypovolemic shock
through aggressive fluid resuscitation is the absolute priority.
7. A nurse is caring for a client with a Glascow Coma Scale (GCS) score of 7.
What is the priority nursing intervention?
A. Ensure airway patency
B. Monitor urine output
C. Check pupillary response
D. Perform ROM exercises
Answer: A
Rationale: A GCS score of 8 or less typically indicates a coma and the need for airway
protection (intubation).
8. Which laboratory value is most indicative of Acute Kidney Injury (AKI)?
A. Decreased Blood Urea Nitrogen (BUN)
B. Increased Serum Creatinine
C. Decreased Serum Potassium
D. Increased Serum Hemoglobin
Answer: B
Rationale: Serum creatinine is a more specific indicator of renal function than BUN.
Creatinine rises when the glomerular filtration rate (GFR) drops.
