* Comprehensive
Nursing Synthesis &
Clinical Application
Examination 2026/2027
**Question 1**
The nurse is caring for a client with acute coronary syndrome. Which laboratory value is most specific
for diagnosing myocardial infarction?
A. Creatine kinase (CK-MB)
B. Troponin
C. Lactate dehydrogenase (LDH)
D. Myoglobin
,💫RATIONALE✔️✔️: Troponin is the most specific and sensitive cardiac biomarker for myocardial
infarction. It rises within 3-4 hours of myocardial injury and remains elevated for up to 14 days. CK-MB
and myoglobin are less specific, and LDH is an older, less specific marker.
💫ANSWER✔️✔️: B. Troponin
---
**Question 2**
A client is prescribed furosemide (Lasix) for the treatment of heart failure. Which assessment finding
indicates the medication is effective?
A. Decreased peripheral edema and weight loss
B. Increased blood pressure and heart rate
C. Crackles in the lung bases
D. Jugular vein distention
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that removes excess fluid from the body.
Effectiveness is indicated by decreased peripheral edema, weight loss, decreased dyspnea, and clear
lung sounds. Increased blood pressure and crackles would indicate worsening heart failure.
💫ANSWER✔️✔️: A. Decreased peripheral edema and weight loss
---
,**Question 3**
The nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD). The
client spends hours each day washing their hands. Which nursing intervention is most therapeutic?
A. Tell the client to stop washing their hands
B. Allow the client time for the ritual, then redirect to other activities
C. Sit with the client and talk about their feelings during the ritual
D. Remove the client from the room to prevent the ritual
💫RATIONALE✔️✔️: Clients with OCD use rituals to reduce anxiety. Initially, it is therapeutic to allow
the ritual and then gradually redirect to other activities. Confronting or forcing the client to stop can
increase anxiety. Talking during the ritual may be distracting, but the priority is to support the client
without reinforcing the behavior.
💫ANSWER✔️✔️: B. Allow the client time for the ritual, then redirect to other activities
---
**Question 4**
The nurse is caring for a client with a chest tube connected to a water-seal drainage system. Which
finding indicates a tension pneumothorax?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling in the water seal chamber
C. Tidaling with respirations
, D. Tracheal deviation to the unaffected side
💫RATIONALE✔️✔️: Tension pneumothorax is a life-threatening condition in which air accumulates
in the pleural space and shifts the mediastinum to the unaffected side. Tracheal deviation to the
unaffected side is a classic sign. Continuous bubbling indicates an air leak, and tidaling indicates a patent
chest tube.
💫ANSWER✔️✔️: D. Tracheal deviation to the unaffected side
---
**Question 5**
The nurse is providing education to a client with a new diagnosis of diabetes insipidus. Which instruction
is most important?
A. "Monitor your blood glucose levels regularly."
B. "You will need to restrict your fluid intake."
C. "Drink adequate fluids to prevent dehydration."
D. "This condition is caused by insulin deficiency."
💫RATIONALE✔️✔️: Diabetes insipidus is characterized by a deficiency of antidiuretic hormone
(ADH), leading to excessive urination (polyuria) and thirst (polydipsia). The client must drink adequate
fluids to prevent dehydration. It is not related to insulin or blood glucose.
💫ANSWER✔️✔️: C. "Drink adequate fluids to prevent dehydration."
---
Nursing Synthesis &
Clinical Application
Examination 2026/2027
**Question 1**
The nurse is caring for a client with acute coronary syndrome. Which laboratory value is most specific
for diagnosing myocardial infarction?
A. Creatine kinase (CK-MB)
B. Troponin
C. Lactate dehydrogenase (LDH)
D. Myoglobin
,💫RATIONALE✔️✔️: Troponin is the most specific and sensitive cardiac biomarker for myocardial
infarction. It rises within 3-4 hours of myocardial injury and remains elevated for up to 14 days. CK-MB
and myoglobin are less specific, and LDH is an older, less specific marker.
💫ANSWER✔️✔️: B. Troponin
---
**Question 2**
A client is prescribed furosemide (Lasix) for the treatment of heart failure. Which assessment finding
indicates the medication is effective?
A. Decreased peripheral edema and weight loss
B. Increased blood pressure and heart rate
C. Crackles in the lung bases
D. Jugular vein distention
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that removes excess fluid from the body.
Effectiveness is indicated by decreased peripheral edema, weight loss, decreased dyspnea, and clear
lung sounds. Increased blood pressure and crackles would indicate worsening heart failure.
💫ANSWER✔️✔️: A. Decreased peripheral edema and weight loss
---
,**Question 3**
The nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD). The
client spends hours each day washing their hands. Which nursing intervention is most therapeutic?
A. Tell the client to stop washing their hands
B. Allow the client time for the ritual, then redirect to other activities
C. Sit with the client and talk about their feelings during the ritual
D. Remove the client from the room to prevent the ritual
💫RATIONALE✔️✔️: Clients with OCD use rituals to reduce anxiety. Initially, it is therapeutic to allow
the ritual and then gradually redirect to other activities. Confronting or forcing the client to stop can
increase anxiety. Talking during the ritual may be distracting, but the priority is to support the client
without reinforcing the behavior.
💫ANSWER✔️✔️: B. Allow the client time for the ritual, then redirect to other activities
---
**Question 4**
The nurse is caring for a client with a chest tube connected to a water-seal drainage system. Which
finding indicates a tension pneumothorax?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling in the water seal chamber
C. Tidaling with respirations
, D. Tracheal deviation to the unaffected side
💫RATIONALE✔️✔️: Tension pneumothorax is a life-threatening condition in which air accumulates
in the pleural space and shifts the mediastinum to the unaffected side. Tracheal deviation to the
unaffected side is a classic sign. Continuous bubbling indicates an air leak, and tidaling indicates a patent
chest tube.
💫ANSWER✔️✔️: D. Tracheal deviation to the unaffected side
---
**Question 5**
The nurse is providing education to a client with a new diagnosis of diabetes insipidus. Which instruction
is most important?
A. "Monitor your blood glucose levels regularly."
B. "You will need to restrict your fluid intake."
C. "Drink adequate fluids to prevent dehydration."
D. "This condition is caused by insulin deficiency."
💫RATIONALE✔️✔️: Diabetes insipidus is characterized by a deficiency of antidiuretic hormone
(ADH), leading to excessive urination (polyuria) and thirst (polydipsia). The client must drink adequate
fluids to prevent dehydration. It is not related to insulin or blood glucose.
💫ANSWER✔️✔️: C. "Drink adequate fluids to prevent dehydration."
---
