**THE NURSING JUDGMENT ACCELERATOR: 2026
COMPREHENSIVE EXAM DRILL**
Question 1
A nurse is caring for a client with diabetic ketoacidosis (DKA). Which finding indicates that treatment is
effective?
A) Serum potassium level of 5.5 mEq/L
B) Blood glucose level decreasing from 600 to 250 mg/dL
C) Deep tendon reflexes absent
D) Anion gap increasing from 12 to 20
---
💫RATIONALE✔️✔️: A decreasing blood glucose level indicates that insulin therapy is shifting glucose into
cells and stopping ketogenesis.
💫ANSWER✔️✔️: B) Blood glucose level decreasing from 600 to 250 mg/dL
Question 2
A patient with a history of seizures is admitted with status epilepticus. The nurse administers lorazepam
IV push. Which finding indicates a therapeutic response?
A) Respiratory rate decreases from 20 to 12 breaths/min
B) Seizure activity stops within 1-2 minutes
C) Blood pressure increases from 110/70 to 140/90 mmHg
D) Pupils become dilated and nonreactive
---
💫RATIONALE✔️✔️: Lorazepam is a first-line benzodiazepine for status epilepticus; cessation of seizure
activity is the desired therapeutic outcome.
💫ANSWER✔️✔️: B) Seizure activity stops within 1-2 minutes
Question 3
,A nurse is preparing a patient for a cardiac catheterization via the femoral artery. Which action is most
important before the procedure?
A) Shave the groin area completely
B) Verify that the patient has signed the consent form
C) Administer a clear liquid breakfast
D) Instruct the patient to void immediately after the procedure
---
💫RATIONALE✔️✔️: Informed consent must be obtained and verified before any invasive procedure; the
nurse ensures the signed form is present.
💫ANSWER✔️✔️: B) Verify that the patient has signed the consent form
Question 4
A client with chronic obstructive pulmonary disease (COPD) has a pulse oximetry reading of 88% on 2
L/min oxygen via nasal cannula. The patient is alert and talking. What should the nurse do first?
A) Increase oxygen to 4 L/min via nasal cannula
B) Apply a non-rebreather mask at 10 L/min
C) Document the finding as expected for COPD
D) Assess the patient's level of consciousness and work of breathing
---
💫RATIONALE✔️✔️: COPD patients often have chronic hypoxemia; the nurse must assess the whole
clinical picture (LOC, breathing effort) before changing oxygen.
💫ANSWER✔️✔️: D) Assess the patient's level of consciousness and work of breathing
Question 5
A nurse is administering an intramuscular injection of vitamin K to a newborn. Which site is preferred?
A) Deltoid muscle
B) Dorsogluteal muscle
C) Ventrogluteal muscle
D) Vastus lateralis muscle
---
, 💫RATIONALE✔️✔️: The vastus lateralis is the preferred IM site for newborns because it is large,
accessible, and away from major nerves and vessels.
💫ANSWER✔️✔️: D) Vastus lateralis muscle
Question 6
A patient with cirrhosis develops asterixis. The nurse understands this finding indicates:
A) Portal hypertension
B) Hepatic encephalopathy
C) Esophageal varices
D) Coagulopathy
---
💫RATIONALE✔️✔️: Asterixis (liver flap) is a flapping tremor of the hands and is a classic sign of hepatic
encephalopathy due to ammonia accumulation.
💫ANSWER✔️✔️: B) Hepatic encephalopathy
Question 7
A nurse is caring for a patient with a new diagnosis of Addison's disease. Which finding requires
immediate intervention?
A) Blood pressure 90/60 mmHg and heart rate 110 bpm
B) Serum sodium 134 mEq/L and potassium 5.1 mEq/L
C) Skin hyperpigmentation on the knuckles and elbows
D) Fasting blood glucose 95 mg/dL
---
💫RATIONALE✔️✔️: Hypotension with tachycardia indicates possible adrenal crisis (hypovolemia, shock),
requiring immediate IV fluids and hydrocortisone.
💫ANSWER✔️✔️: A) Blood pressure 90/60 mmHg and heart rate 110 bpm
Question 8
A school nurse is teaching a class on prevention of head lice. Which statement indicates a need for
further teaching?
COMPREHENSIVE EXAM DRILL**
Question 1
A nurse is caring for a client with diabetic ketoacidosis (DKA). Which finding indicates that treatment is
effective?
A) Serum potassium level of 5.5 mEq/L
B) Blood glucose level decreasing from 600 to 250 mg/dL
C) Deep tendon reflexes absent
D) Anion gap increasing from 12 to 20
---
💫RATIONALE✔️✔️: A decreasing blood glucose level indicates that insulin therapy is shifting glucose into
cells and stopping ketogenesis.
💫ANSWER✔️✔️: B) Blood glucose level decreasing from 600 to 250 mg/dL
Question 2
A patient with a history of seizures is admitted with status epilepticus. The nurse administers lorazepam
IV push. Which finding indicates a therapeutic response?
A) Respiratory rate decreases from 20 to 12 breaths/min
B) Seizure activity stops within 1-2 minutes
C) Blood pressure increases from 110/70 to 140/90 mmHg
D) Pupils become dilated and nonreactive
---
💫RATIONALE✔️✔️: Lorazepam is a first-line benzodiazepine for status epilepticus; cessation of seizure
activity is the desired therapeutic outcome.
💫ANSWER✔️✔️: B) Seizure activity stops within 1-2 minutes
Question 3
,A nurse is preparing a patient for a cardiac catheterization via the femoral artery. Which action is most
important before the procedure?
A) Shave the groin area completely
B) Verify that the patient has signed the consent form
C) Administer a clear liquid breakfast
D) Instruct the patient to void immediately after the procedure
---
💫RATIONALE✔️✔️: Informed consent must be obtained and verified before any invasive procedure; the
nurse ensures the signed form is present.
💫ANSWER✔️✔️: B) Verify that the patient has signed the consent form
Question 4
A client with chronic obstructive pulmonary disease (COPD) has a pulse oximetry reading of 88% on 2
L/min oxygen via nasal cannula. The patient is alert and talking. What should the nurse do first?
A) Increase oxygen to 4 L/min via nasal cannula
B) Apply a non-rebreather mask at 10 L/min
C) Document the finding as expected for COPD
D) Assess the patient's level of consciousness and work of breathing
---
💫RATIONALE✔️✔️: COPD patients often have chronic hypoxemia; the nurse must assess the whole
clinical picture (LOC, breathing effort) before changing oxygen.
💫ANSWER✔️✔️: D) Assess the patient's level of consciousness and work of breathing
Question 5
A nurse is administering an intramuscular injection of vitamin K to a newborn. Which site is preferred?
A) Deltoid muscle
B) Dorsogluteal muscle
C) Ventrogluteal muscle
D) Vastus lateralis muscle
---
, 💫RATIONALE✔️✔️: The vastus lateralis is the preferred IM site for newborns because it is large,
accessible, and away from major nerves and vessels.
💫ANSWER✔️✔️: D) Vastus lateralis muscle
Question 6
A patient with cirrhosis develops asterixis. The nurse understands this finding indicates:
A) Portal hypertension
B) Hepatic encephalopathy
C) Esophageal varices
D) Coagulopathy
---
💫RATIONALE✔️✔️: Asterixis (liver flap) is a flapping tremor of the hands and is a classic sign of hepatic
encephalopathy due to ammonia accumulation.
💫ANSWER✔️✔️: B) Hepatic encephalopathy
Question 7
A nurse is caring for a patient with a new diagnosis of Addison's disease. Which finding requires
immediate intervention?
A) Blood pressure 90/60 mmHg and heart rate 110 bpm
B) Serum sodium 134 mEq/L and potassium 5.1 mEq/L
C) Skin hyperpigmentation on the knuckles and elbows
D) Fasting blood glucose 95 mg/dL
---
💫RATIONALE✔️✔️: Hypotension with tachycardia indicates possible adrenal crisis (hypovolemia, shock),
requiring immediate IV fluids and hydrocortisone.
💫ANSWER✔️✔️: A) Blood pressure 90/60 mmHg and heart rate 110 bpm
Question 8
A school nurse is teaching a class on prevention of head lice. Which statement indicates a need for
further teaching?
