COMPREHENSIVE REVIEW EXAM QUESTIONS
WITH CORRECT ANSWERS 2026-2027
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perfo
rm asSa priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours -SCORRECT ANSWER -
A. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-
converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypote
nsion. Therefore the nurse would check the client's blood pressure immediately before administering eac
h dose. Checking the client's peripheral pulses, the results of the most recent potassium level, and the int
ake and output for the previous 24 hours are not specifically associated with this mediation.
ASclient is scheduled to undergo an upper gastrointestinal (GI) series, and the licensed practical nurse rein
forces instructions to the client about the test. Which statement by the client indicates a need for further
instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the tes
t can be constipating." - CORRECT ANSWER -
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by
means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which
is administered in a flavored milkshake. Films are taken at intervals duringSthe test, which takes about 30
minutes. No special preparation is necessary before a GI series, except that NPO status must be maintain
ed for 8 hours before the test. After an upper GI series, the client is prescribed a laxative to hasten elimin
ation of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to f
ecal impaction.
,A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed me
dication is higher than the normal dose. The nurse calls the physician's answering service and is told that
the physician is off for the night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication butSconsult the physician when he becomes available -SCORRECT ANSWER -
B. Ask the answering service to contact the on-call physician
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a physician's p
rescription may be in error is responsible for clarifying the prescription before carrying it out. Therefore t
he nurse would not administer the medication; instead, the nurse would withhold the medication until th
e dose can be clarified. The nurse would not wait until the next morning to obtain clarification. It is prema
ture to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (
MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of pre
mature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines t
hat the PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. ContinuingSto monitor the client's cardiac statusS
D. Informing the client that PVCs are expected after an MI - CORRECT ANSWER -
B. Asking the ED physician to check the client
Rationale: PVCs are a resultSof increased irritability of ventricular cells. Peripheral pulses may be absent or
diminished with the PVCs themselves because the decreased stroke volume of the premature beats may
in turn decrease peripheral perfusion. Because other rhythms also cause widened QRS complexes, it is es
sential that the nurse determine whether the premature beats are resulting in perfusion of the extremitie
s. This is done by palpating the carotid, brachial, or femoral artery while observing the monitor for widen
ed complexes or by auscultating for apical heart sounds. In the situation of acute MI, PVCs may be consid
ered warning dysrhythmias, possibly heralding the onset of ventricular tachycardia or ventricular fibrillati
on. Therefore the nurse would not tell the client that the PVCs are expected. Although the nurse will conti
nue to monitor the client and document the findings, these are not the most appropriate actions of those
provided. The most appropriate action would be to askSthe ED physician to check the client.
,NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive t
herapy (ECT) at 1 p.m. On the morningSof the procedure, the nurse checks the client's record and notes th
at the client routinely takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT - CORRECT ANSWER -
A. Administer the antihypertensive with a small sip of water
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours before treatm
ent to helpSprevent aspiration. Exceptions include clients who routinely receive cardiacSmedications, antih
ypertensive agents, or histamine (H2) blockers, which should be administered several hours before treat
ment with a small sip of water. Withholding the antihypertensive and administeringSit at bedtime and wit
hholding the antihypertensive and resuming administration on the day after the ECT are incorrect actions
, because antihypertensives must be administered on time; otherwise, the risk for rebound hypertension
exists. The nurse would not administer a medication by way of a route that has not been prescribed.
ASclient who recently underwent coronary artery bypass graft surgery comes to the physician's office for a
follow-
up visit. On assessment, the client tells the nurse that he is feeling depressed. Which response by the nur
se is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over thisSdepression."
D. "Every client who has this surgery feels the same way for about a month." -SCORRECT ANSWER -
A. "Tell me more about what you're feeling."
Rationale: When a client expresses feelings of depression, it is extremely important for the nurse to furth
er explore these feelings with the client. In stating, "This is a normal response after this type of surgery" t
he nurse provides false reassurance and avoids addressing the client's feelings. "It will take time, but, I pr
omise you, you will get over the depression" is also a false reassurance, and it does not encourage the ex
pression of feelings. "Every client who has thisSsurgery feels the same way for about a month" is a general
ization that avoids the client's feelings.
, ASclient in labor experiences spontaneous rupture of the membranes. The nurse immediately counts the f
etal heart rate (FHR) for 1 full minute and then checks the amniotic fluid. The nurse notes that the fluid is
yellow and has a strong odor. Which of the following actions should be the nurse's priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
D. Continuing to monitor the client and the FHR -SCORRECT ANSWER -A. Contacting the physician
Rationale: The FHR is assessed for at least 1 minute when the membranes rupture. The nurse also checks
the quantity, color, and odor of the amniotic fluid. The fluid should be clear (often with bits of vernix) and
have a mild odor. Fluid with a foul or strong odor, cloudy appearance, or yellow coloration suggests chorio
amnionitis and warrants notifying the physician. A large amount of vernix in the fluid suggests that the fet
us is preterm. Greenish, meconium-
stained fluid may be seen in cases of postterm gestation or placental insufficiency. Checking the fluid for p
rotein is not associated with the data in the question. Although the nurse would continue to monitor the
client and the FHR and would document the findings, contacting the physician is the priority.
A nurse helps provide an educational session to community members about cancer of the cervix. The nur
se informs the group members that an early sign of this type of cancer is:
A. Dark, foul-smelling vaginal drainage
B. Abdominal pain
C. Constant, profuse bleeding
D. Irregular vaginal bleedingSor spotting - CORRECT ANSWER -D. Irregular vaginal bleeding or spotting
Rationale: Early cancer of the cervix is usually asymptomatic. The two chief symptoms are leukorrhea (va
ginal discharge) and irregular vaginal bleedingSor spotting. The vaginal discharge increases gradually in a
mount and becomes watery and finally dark and foul smelling because of necrosis and infection of the tu
mor mass. As the disease progresses, the bleeding may become constant and increase in amount.
A survivor of sexual assault being treated in the emergency department says to the nurse, "I'm really worr
ied that I've got HIV now." What is the appropriate response by the nurse?
A. "HIV is rarely an issue in survivors of sexual assault."
B. "Every survivor of sexual assault is concerned about HIV."
WITH CORRECT ANSWERS 2026-2027
Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perfo
rm asSa priority before administering the medication?
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours -SCORRECT ANSWER -
A. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-
converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypote
nsion. Therefore the nurse would check the client's blood pressure immediately before administering eac
h dose. Checking the client's peripheral pulses, the results of the most recent potassium level, and the int
ake and output for the previous 24 hours are not specifically associated with this mediation.
ASclient is scheduled to undergo an upper gastrointestinal (GI) series, and the licensed practical nurse rein
forces instructions to the client about the test. Which statement by the client indicates a need for further
instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink for the tes
t can be constipating." - CORRECT ANSWER -
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema on the mor
ning of the test."
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by
means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which
is administered in a flavored milkshake. Films are taken at intervals duringSthe test, which takes about 30
minutes. No special preparation is necessary before a GI series, except that NPO status must be maintain
ed for 8 hours before the test. After an upper GI series, the client is prescribed a laxative to hasten elimin
ation of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to f
ecal impaction.
,A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed me
dication is higher than the normal dose. The nurse calls the physician's answering service and is told that
the physician is off for the night and will be available in the morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication butSconsult the physician when he becomes available -SCORRECT ANSWER -
B. Ask the answering service to contact the on-call physician
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a physician's p
rescription may be in error is responsible for clarifying the prescription before carrying it out. Therefore t
he nurse would not administer the medication; instead, the nurse would withhold the medication until th
e dose can be clarified. The nurse would not wait until the next morning to obtain clarification. It is prema
ture to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (
MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of pre
mature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines t
hat the PVCs are not resulting in perfusion. The appropriate action by the nurse is:
A. Documenting the findings
B. Asking the ED physician to check the client
C. ContinuingSto monitor the client's cardiac statusS
D. Informing the client that PVCs are expected after an MI - CORRECT ANSWER -
B. Asking the ED physician to check the client
Rationale: PVCs are a resultSof increased irritability of ventricular cells. Peripheral pulses may be absent or
diminished with the PVCs themselves because the decreased stroke volume of the premature beats may
in turn decrease peripheral perfusion. Because other rhythms also cause widened QRS complexes, it is es
sential that the nurse determine whether the premature beats are resulting in perfusion of the extremitie
s. This is done by palpating the carotid, brachial, or femoral artery while observing the monitor for widen
ed complexes or by auscultating for apical heart sounds. In the situation of acute MI, PVCs may be consid
ered warning dysrhythmias, possibly heralding the onset of ventricular tachycardia or ventricular fibrillati
on. Therefore the nurse would not tell the client that the PVCs are expected. Although the nurse will conti
nue to monitor the client and document the findings, these are not the most appropriate actions of those
provided. The most appropriate action would be to askSthe ED physician to check the client.
,NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive t
herapy (ECT) at 1 p.m. On the morningSof the procedure, the nurse checks the client's record and notes th
at the client routinely takes an oral antihypertensive medication each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT - CORRECT ANSWER -
A. Administer the antihypertensive with a small sip of water
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours before treatm
ent to helpSprevent aspiration. Exceptions include clients who routinely receive cardiacSmedications, antih
ypertensive agents, or histamine (H2) blockers, which should be administered several hours before treat
ment with a small sip of water. Withholding the antihypertensive and administeringSit at bedtime and wit
hholding the antihypertensive and resuming administration on the day after the ECT are incorrect actions
, because antihypertensives must be administered on time; otherwise, the risk for rebound hypertension
exists. The nurse would not administer a medication by way of a route that has not been prescribed.
ASclient who recently underwent coronary artery bypass graft surgery comes to the physician's office for a
follow-
up visit. On assessment, the client tells the nurse that he is feeling depressed. Which response by the nur
se is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over thisSdepression."
D. "Every client who has this surgery feels the same way for about a month." -SCORRECT ANSWER -
A. "Tell me more about what you're feeling."
Rationale: When a client expresses feelings of depression, it is extremely important for the nurse to furth
er explore these feelings with the client. In stating, "This is a normal response after this type of surgery" t
he nurse provides false reassurance and avoids addressing the client's feelings. "It will take time, but, I pr
omise you, you will get over the depression" is also a false reassurance, and it does not encourage the ex
pression of feelings. "Every client who has thisSsurgery feels the same way for about a month" is a general
ization that avoids the client's feelings.
, ASclient in labor experiences spontaneous rupture of the membranes. The nurse immediately counts the f
etal heart rate (FHR) for 1 full minute and then checks the amniotic fluid. The nurse notes that the fluid is
yellow and has a strong odor. Which of the following actions should be the nurse's priority?
A. Contacting the physician
B. Documenting the findings
C. Checking the fluid for protein
D. Continuing to monitor the client and the FHR -SCORRECT ANSWER -A. Contacting the physician
Rationale: The FHR is assessed for at least 1 minute when the membranes rupture. The nurse also checks
the quantity, color, and odor of the amniotic fluid. The fluid should be clear (often with bits of vernix) and
have a mild odor. Fluid with a foul or strong odor, cloudy appearance, or yellow coloration suggests chorio
amnionitis and warrants notifying the physician. A large amount of vernix in the fluid suggests that the fet
us is preterm. Greenish, meconium-
stained fluid may be seen in cases of postterm gestation or placental insufficiency. Checking the fluid for p
rotein is not associated with the data in the question. Although the nurse would continue to monitor the
client and the FHR and would document the findings, contacting the physician is the priority.
A nurse helps provide an educational session to community members about cancer of the cervix. The nur
se informs the group members that an early sign of this type of cancer is:
A. Dark, foul-smelling vaginal drainage
B. Abdominal pain
C. Constant, profuse bleeding
D. Irregular vaginal bleedingSor spotting - CORRECT ANSWER -D. Irregular vaginal bleeding or spotting
Rationale: Early cancer of the cervix is usually asymptomatic. The two chief symptoms are leukorrhea (va
ginal discharge) and irregular vaginal bleedingSor spotting. The vaginal discharge increases gradually in a
mount and becomes watery and finally dark and foul smelling because of necrosis and infection of the tu
mor mass. As the disease progresses, the bleeding may become constant and increase in amount.
A survivor of sexual assault being treated in the emergency department says to the nurse, "I'm really worr
ied that I've got HIV now." What is the appropriate response by the nurse?
A. "HIV is rarely an issue in survivors of sexual assault."
B. "Every survivor of sexual assault is concerned about HIV."
