Comprehensive
Nursing Care & Clinical
Proficiency
Examination 2026/2027
**Question 1**
The nurse is caring for a client with diabetic ketoacidosis (DKA). Which assessment finding indicates the
client is responding to treatment?
A. Serum glucose has decreased from 350 mg/dL to 300 mg/dL
B. Serum potassium is 5.0 mEq/L
C. Arterial blood gas shows pH 7.32
D. The client's level of consciousness is improving
,💫RATIONALE✔️✔️: Improvement in level of consciousness indicates that cerebral edema and
metabolic acidosis are resolving, which is a critical indicator of treatment effectiveness. While
decreasing glucose and improving pH are important, clinical improvement in neurological status is the
most significant indicator of response to therapy.
💫ANSWER✔️✔️: D. The client's level of consciousness is improving
---
**Question 2**
The nurse is providing discharge teaching to a client with a new diagnosis of gout. Which dietary
instruction should the nurse include?
A. "Increase your intake of organ meats and shellfish."
B. "Limit your intake of purine-rich foods like red meat and beer."
C. "Avoid all dairy products to prevent flare-ups."
D. "You should eat a high-protein, high-fat diet."
💫RATIONALE✔️✔️: Gout is caused by elevated uric acid levels, which can be exacerbated by purine-
rich foods. Clients should limit intake of red meat, organ meats, shellfish, and alcoholic beverages,
especially beer. Low-fat dairy products may actually help lower uric acid levels.
💫ANSWER✔️✔️: B. "Limit your intake of purine-rich foods like red meat and beer."
---
**Question 3**
,The nurse is assessing a client who is 2 hours post-cardiac catheterization via the femoral artery. Which
finding should be reported to the healthcare provider immediately?
A. A small amount of serosanguineous drainage at the insertion site
B. The client reports a pain level of 3 out of 10 at the insertion site
C. The client's pulse distal to the insertion site is absent
D. The client is able to move their toes
💫RATIONALE✔️✔️: Absence of a distal pulse is a sign of arterial occlusion or compromise, which is a
serious complication of cardiac catheterization. This requires immediate intervention to prevent tissue
ischemia and potential loss of the limb. The other findings are expected or within normal limits.
💫ANSWER✔️✔️: C. The client's pulse distal to the insertion site is absent
---
**Question 4**
A client with a history of schizophrenia is experiencing acute psychosis. The client is pacing and talking
rapidly. Which nursing intervention is the priority?
A. Place the client in seclusion
B. Provide a quiet, low-stimulation environment
C. Administer a PRN dose of haloperidol
D. Ask the client to sit down and calm down
, 💫RATIONALE✔️✔️: A quiet, low-stimulation environment is the priority intervention to reduce
agitation and prevent escalation. This can help the client regain control. Seclusion and medication are
used only if less restrictive measures fail and the client is a danger to themselves or others.
💫ANSWER✔️✔️: B. Provide a quiet, low-stimulation environment
---
**Question 5**
The nurse is preparing to administer a blood transfusion to a client. Which action is most important to
prevent a transfusion reaction?
A. Verify the client's identity with two unique identifiers
B. Infuse the blood over 4 hours
C. Administer an antihistamine before the transfusion
D. Warm the blood to room temperature before infusion
💫RATIONALE✔️✔️: Proper identification of the client and the blood product is the most critical step
to prevent a transfusion reaction. The nurse must verify the client's identity using two identifiers (e.g.,
name and date of birth) and match it to the blood product label.
💫ANSWER✔️✔️: A. Verify the client's identity with two unique identifiers
---
**Question 6**
Nursing Care & Clinical
Proficiency
Examination 2026/2027
**Question 1**
The nurse is caring for a client with diabetic ketoacidosis (DKA). Which assessment finding indicates the
client is responding to treatment?
A. Serum glucose has decreased from 350 mg/dL to 300 mg/dL
B. Serum potassium is 5.0 mEq/L
C. Arterial blood gas shows pH 7.32
D. The client's level of consciousness is improving
,💫RATIONALE✔️✔️: Improvement in level of consciousness indicates that cerebral edema and
metabolic acidosis are resolving, which is a critical indicator of treatment effectiveness. While
decreasing glucose and improving pH are important, clinical improvement in neurological status is the
most significant indicator of response to therapy.
💫ANSWER✔️✔️: D. The client's level of consciousness is improving
---
**Question 2**
The nurse is providing discharge teaching to a client with a new diagnosis of gout. Which dietary
instruction should the nurse include?
A. "Increase your intake of organ meats and shellfish."
B. "Limit your intake of purine-rich foods like red meat and beer."
C. "Avoid all dairy products to prevent flare-ups."
D. "You should eat a high-protein, high-fat diet."
💫RATIONALE✔️✔️: Gout is caused by elevated uric acid levels, which can be exacerbated by purine-
rich foods. Clients should limit intake of red meat, organ meats, shellfish, and alcoholic beverages,
especially beer. Low-fat dairy products may actually help lower uric acid levels.
💫ANSWER✔️✔️: B. "Limit your intake of purine-rich foods like red meat and beer."
---
**Question 3**
,The nurse is assessing a client who is 2 hours post-cardiac catheterization via the femoral artery. Which
finding should be reported to the healthcare provider immediately?
A. A small amount of serosanguineous drainage at the insertion site
B. The client reports a pain level of 3 out of 10 at the insertion site
C. The client's pulse distal to the insertion site is absent
D. The client is able to move their toes
💫RATIONALE✔️✔️: Absence of a distal pulse is a sign of arterial occlusion or compromise, which is a
serious complication of cardiac catheterization. This requires immediate intervention to prevent tissue
ischemia and potential loss of the limb. The other findings are expected or within normal limits.
💫ANSWER✔️✔️: C. The client's pulse distal to the insertion site is absent
---
**Question 4**
A client with a history of schizophrenia is experiencing acute psychosis. The client is pacing and talking
rapidly. Which nursing intervention is the priority?
A. Place the client in seclusion
B. Provide a quiet, low-stimulation environment
C. Administer a PRN dose of haloperidol
D. Ask the client to sit down and calm down
, 💫RATIONALE✔️✔️: A quiet, low-stimulation environment is the priority intervention to reduce
agitation and prevent escalation. This can help the client regain control. Seclusion and medication are
used only if less restrictive measures fail and the client is a danger to themselves or others.
💫ANSWER✔️✔️: B. Provide a quiet, low-stimulation environment
---
**Question 5**
The nurse is preparing to administer a blood transfusion to a client. Which action is most important to
prevent a transfusion reaction?
A. Verify the client's identity with two unique identifiers
B. Infuse the blood over 4 hours
C. Administer an antihistamine before the transfusion
D. Warm the blood to room temperature before infusion
💫RATIONALE✔️✔️: Proper identification of the client and the blood product is the most critical step
to prevent a transfusion reaction. The nurse must verify the client's identity using two identifiers (e.g.,
name and date of birth) and match it to the blood product label.
💫ANSWER✔️✔️: A. Verify the client's identity with two unique identifiers
---
**Question 6**
