KAPLAN FINAL EXIT EXAM Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf
                  &am
Domains*
- Management of Care and Prioritization
- Safety and Infection Control
- Pharmacology and Parenteral Therapies
- Health Promotion and Maintenance
- Physiological Integrity and Adaptation
- Ethical and Legal Professional Standards
- Maternal-Child and Pediatric Nursing
- Mental Health and Psychiatric Nursing
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This comprehensive assessment evaluates nursing students' readiness for professional practice and licensure examination. The exam measures critical competencies including clinical judgment, safe medication
administration, patient prioritization, and evidence-based decision-making across diverse healthcare scenarios. Questions are presented in multiple-choice and scenario-based formats that emphasize real-world
application of nursing knowledge. Candidates will demonstrate mastery of the nursing process, regulatory compliance, ethical standards, and collaborative care principles essential for safe, effective nursing practice in
contemporary healthcare settings.
SECTION ONE: Questions 1–100
Question 1
A nurse is caring for a client with septic shock who has a blood pressure of 82/40 mmHg, heart rate of 128 bpm, and oxygen saturation of 88% on room air. Which intervention should the nurse implement first?
A. Administer IV antibiotics as prescribed
B. Insert a large-bore IV catheter
C. Apply oxygen via nasal cannula
D. Administer IV bolus of normal saline
🟢 C. Apply oxygen via nasal cannula
🔴 RATIONALE: Airway, breathing, and circulation (ABC) priority dictates that oxygenation is the immediate priority. The client's oxygen saturation of 88% indicates hypoxemia requiring immediate oxygen therapy before
fluid resuscitation or antibiotics.
Question 2
Which action by a nurse demonstrates proper understanding of confidentiality under HIPAA regulations?
A. Discussing client information in the elevator with another nurse
B. Sharing client passwords with a covering colleague during vacation
C. Reviewing client records only for patients under their direct care
D. Leaving a computer screen displaying lab results unattended
🟢 C. Reviewing client records only for patients under their direct care
🔴 RATIONALE: HIPAA requires that healthcare providers access only patient information necessary for their direct care role. Accessing records without a treatment need violates patient confidentiality.
,Question 3
A client prescribed warfarin for atrial fibrillation asks about dietary restrictions. Which food should the nurse advise the client to consume consistently rather than avoid?
A. Spinach
B. Chicken breast
C. White rice
D. Apples
🟢 A. Spinach
🔴 RATIONALE: Spinach is high in vitamin K, which antagonizes warfarin. The client should consume vitamin K-rich foods consistently rather than avoiding them, as sudden changes in intake affect INR stability.
Question 4
During a shift report, the nurse receives information about four clients. Which client should the nurse assess first?
A. Client with type 2 diabetes whose blood glucose is 180 mg/dL
B. Client post-op day 1 after cholecystectomy with pain score of 6
C. Client with COPD who has sudden onset of dyspnea and oxygen saturation of 89%
D. Client with hypertension requesting refilling of antihypertensive medication
🟢 C. Client with COPD who has sudden onset of dyspnea and oxygen saturation of 89%
🔴 RATIONALE: Sudden dyspnea with hypoxemia indicates potential respiratory compromise requiring immediate assessment. This client has the highest risk for deterioration compared to the others.
Question 5
A nurse is teaching a client about insulin administration. Which statement by the client indicates understanding of rotation of injection sites?
A. "I will use the same arm for all injections to keep track."
B. "I will rotate injection sites within the same area to prevent lipodystrophy."
C. "I will inject into areas with muscle for faster absorption."
D. "I will inject into scar tissue for better absorption."
🟢 B. "I will rotate injection sites within the same area to prevent lipodystrophy."
🔴 RATIONALE: Rotating sites within the same anatomical area ensures consistent absorption while preventing lipodystrophy (fatty lumps) from repeated injections in the same spot.
Question 6
Which finding in a client receiving IV magnesium sulfate for preeclampsia requires immediate intervention?
A. Blood pressure of 150/94 mmHg
B. Deep tendon reflexes of 2+
C. Urine output of 25 mL/hr
D. Respiratory rate of 10 breaths/min
🟢 D. Respiratory rate of 10 breaths/min
🔴 RATIONALE: Magnesium sulfate toxicity causes respiratory depression. A respiratory rate below 12 breaths/min indicates toxicity requiring immediate discontinuation of the infusion and administration of calcium
gluconate.
Question 7
A nurse is preparing to delegate tasks to a licensed practical nurse (LPN). Which task is appropriate to delegate?
, A. Initial assessment of a newly admitted client
B. Teaching a client about new medications
C. Administering oral medications to a stable client
D. Developing a nursing care plan
🟢 C. Administering oral medications to a stable client
🔴 RATIONALE: LPNs can administer oral medications to stable clients. Assessment, teaching, and care plan development require RN-level judgment and scope of practice.
Question 8
A client with chest pain is admitted to the emergency department. Which medication should the nurse administer first?
A. Aspirin 325 mg chewed
B. Morphine sulfate 4 mg IV
C. Nitroglycerin 0.4 mg sublingual
D. Oxygen via nasal cannula
🟢 D. Oxygen via nasal cannula
🔴 RATIONALE: Following ABC priority, oxygen is administered first to ensure adequate tissue oxygenation. Aspirin, nitroglycerin, and morphine follow after oxygenation is established.
Question 9
Which laboratory value requires immediate notification of the healthcare provider?
A. Potassium 3.8 mEq/L
B. Sodium 140 mEq/L
C. Platelet count 45,000/mm³
D. Hemoglobin 13.5 g/dL
🟢 C. Platelet count 45,000/mm³
🔴 RATIONALE: A platelet count below 50,000/mm³ indicates severe thrombocytopenia with high bleeding risk requiring immediate intervention. Normal platelet count is 150,000-400,000/mm³.
Question 10
A nurse is caring for a client with a central venous catheter. Which action is most important to prevent catheter-related bloodstream infection?
A. Change the dressing every 7 days
B. Use sterile technique during dressing changes
C. Flush the catheter with normal saline daily
D. Keep the catheter hub capped when not in use
🟢 B. Use sterile technique during dressing changes
🔴 RATIONALE: Sterile technique during dressing changes is critical for preventing catheter-related bloodstream infections. This is a primary infection control measure in central line maintenance.
Question 11
A client with heart failure reports increased shortness of breath and weight gain of 3 pounds in 2 days. Which assessment finding should the nurse prioritize?
A. Crackles in bilateral lung bases
B. Pedal edema 2+
C. Jugular vein distention
D. Heart rate of 92 bpm
                  &am
Domains*
- Management of Care and Prioritization
- Safety and Infection Control
- Pharmacology and Parenteral Therapies
- Health Promotion and Maintenance
- Physiological Integrity and Adaptation
- Ethical and Legal Professional Standards
- Maternal-Child and Pediatric Nursing
- Mental Health and Psychiatric Nursing
                 &nb
This comprehensive assessment evaluates nursing students' readiness for professional practice and licensure examination. The exam measures critical competencies including clinical judgment, safe medication
administration, patient prioritization, and evidence-based decision-making across diverse healthcare scenarios. Questions are presented in multiple-choice and scenario-based formats that emphasize real-world
application of nursing knowledge. Candidates will demonstrate mastery of the nursing process, regulatory compliance, ethical standards, and collaborative care principles essential for safe, effective nursing practice in
contemporary healthcare settings.
SECTION ONE: Questions 1–100
Question 1
A nurse is caring for a client with septic shock who has a blood pressure of 82/40 mmHg, heart rate of 128 bpm, and oxygen saturation of 88% on room air. Which intervention should the nurse implement first?
A. Administer IV antibiotics as prescribed
B. Insert a large-bore IV catheter
C. Apply oxygen via nasal cannula
D. Administer IV bolus of normal saline
🟢 C. Apply oxygen via nasal cannula
🔴 RATIONALE: Airway, breathing, and circulation (ABC) priority dictates that oxygenation is the immediate priority. The client's oxygen saturation of 88% indicates hypoxemia requiring immediate oxygen therapy before
fluid resuscitation or antibiotics.
Question 2
Which action by a nurse demonstrates proper understanding of confidentiality under HIPAA regulations?
A. Discussing client information in the elevator with another nurse
B. Sharing client passwords with a covering colleague during vacation
C. Reviewing client records only for patients under their direct care
D. Leaving a computer screen displaying lab results unattended
🟢 C. Reviewing client records only for patients under their direct care
🔴 RATIONALE: HIPAA requires that healthcare providers access only patient information necessary for their direct care role. Accessing records without a treatment need violates patient confidentiality.
,Question 3
A client prescribed warfarin for atrial fibrillation asks about dietary restrictions. Which food should the nurse advise the client to consume consistently rather than avoid?
A. Spinach
B. Chicken breast
C. White rice
D. Apples
🟢 A. Spinach
🔴 RATIONALE: Spinach is high in vitamin K, which antagonizes warfarin. The client should consume vitamin K-rich foods consistently rather than avoiding them, as sudden changes in intake affect INR stability.
Question 4
During a shift report, the nurse receives information about four clients. Which client should the nurse assess first?
A. Client with type 2 diabetes whose blood glucose is 180 mg/dL
B. Client post-op day 1 after cholecystectomy with pain score of 6
C. Client with COPD who has sudden onset of dyspnea and oxygen saturation of 89%
D. Client with hypertension requesting refilling of antihypertensive medication
🟢 C. Client with COPD who has sudden onset of dyspnea and oxygen saturation of 89%
🔴 RATIONALE: Sudden dyspnea with hypoxemia indicates potential respiratory compromise requiring immediate assessment. This client has the highest risk for deterioration compared to the others.
Question 5
A nurse is teaching a client about insulin administration. Which statement by the client indicates understanding of rotation of injection sites?
A. "I will use the same arm for all injections to keep track."
B. "I will rotate injection sites within the same area to prevent lipodystrophy."
C. "I will inject into areas with muscle for faster absorption."
D. "I will inject into scar tissue for better absorption."
🟢 B. "I will rotate injection sites within the same area to prevent lipodystrophy."
🔴 RATIONALE: Rotating sites within the same anatomical area ensures consistent absorption while preventing lipodystrophy (fatty lumps) from repeated injections in the same spot.
Question 6
Which finding in a client receiving IV magnesium sulfate for preeclampsia requires immediate intervention?
A. Blood pressure of 150/94 mmHg
B. Deep tendon reflexes of 2+
C. Urine output of 25 mL/hr
D. Respiratory rate of 10 breaths/min
🟢 D. Respiratory rate of 10 breaths/min
🔴 RATIONALE: Magnesium sulfate toxicity causes respiratory depression. A respiratory rate below 12 breaths/min indicates toxicity requiring immediate discontinuation of the infusion and administration of calcium
gluconate.
Question 7
A nurse is preparing to delegate tasks to a licensed practical nurse (LPN). Which task is appropriate to delegate?
, A. Initial assessment of a newly admitted client
B. Teaching a client about new medications
C. Administering oral medications to a stable client
D. Developing a nursing care plan
🟢 C. Administering oral medications to a stable client
🔴 RATIONALE: LPNs can administer oral medications to stable clients. Assessment, teaching, and care plan development require RN-level judgment and scope of practice.
Question 8
A client with chest pain is admitted to the emergency department. Which medication should the nurse administer first?
A. Aspirin 325 mg chewed
B. Morphine sulfate 4 mg IV
C. Nitroglycerin 0.4 mg sublingual
D. Oxygen via nasal cannula
🟢 D. Oxygen via nasal cannula
🔴 RATIONALE: Following ABC priority, oxygen is administered first to ensure adequate tissue oxygenation. Aspirin, nitroglycerin, and morphine follow after oxygenation is established.
Question 9
Which laboratory value requires immediate notification of the healthcare provider?
A. Potassium 3.8 mEq/L
B. Sodium 140 mEq/L
C. Platelet count 45,000/mm³
D. Hemoglobin 13.5 g/dL
🟢 C. Platelet count 45,000/mm³
🔴 RATIONALE: A platelet count below 50,000/mm³ indicates severe thrombocytopenia with high bleeding risk requiring immediate intervention. Normal platelet count is 150,000-400,000/mm³.
Question 10
A nurse is caring for a client with a central venous catheter. Which action is most important to prevent catheter-related bloodstream infection?
A. Change the dressing every 7 days
B. Use sterile technique during dressing changes
C. Flush the catheter with normal saline daily
D. Keep the catheter hub capped when not in use
🟢 B. Use sterile technique during dressing changes
🔴 RATIONALE: Sterile technique during dressing changes is critical for preventing catheter-related bloodstream infections. This is a primary infection control measure in central line maintenance.
Question 11
A client with heart failure reports increased shortness of breath and weight gain of 3 pounds in 2 days. Which assessment finding should the nurse prioritize?
A. Crackles in bilateral lung bases
B. Pedal edema 2+
C. Jugular vein distention
D. Heart rate of 92 bpm
