NR COPREHENSIVE EXIT
EXAM 2026
**Question 1**
The nurse is caring for a client with acute myocardial infarction (MI). Which laboratory value is most
specific for diagnosing MI?
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 with chronic obstructive pulmonary disease (COPD) who is receiving
oxygen therapy. Which oxygen delivery method is most appropriate for this client?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 2-4 L/min
C. Simple face mask at 8 L/min
D. Venturi mask at 40% FiO2
,💫RATIONALE✔️✔️: Clients with COPD require controlled oxygen therapy to maintain oxygen
saturation at 88-92% and avoid suppression of the hypoxic drive. A nasal cannula at 2-4 L/min or a
Venturi mask with precise FiO2 delivery is appropriate. High-flow oxygen can lead to respiratory
depression.
💫ANSWER✔️✔️: B. Nasal cannula at 2-4 L/min
---
**Question 4**
The nurse is caring for a client with a chest tube connected to a water-seal drainage system. Which
finding indicates the chest tube is functioning correctly?
A. Continuous bubbling in the water seal chamber
B. Tidaling (fluctuation) in the water seal chamber with respirations
C. A sudden increase in drainage of 100 mL in one hour
D. The client reports sharp chest pain
💫RATIONALE✔️✔️: Tidaling (fluctuation) in the water seal chamber with respirations indicates that
the chest tube is patent and functioning correctly. Continuous bubbling indicates an air leak. A sudden
increase in drainage could indicate hemorrhage and should be reported.
💫ANSWER✔️✔️: B. Tidaling (fluctuation) in the water seal chamber with respirations
---
, **Question 5**
The nurse is assessing a client with a diagnosis of diabetes insipidus. Which finding is most consistent
with this condition?
A. Serum sodium of 155 mEq/L and urine specific gravity of 1.002
B. Serum sodium of 120 mEq/L and urine specific gravity of 1.035
C. Serum potassium of 5.5 mEq/L and urine output of 40 mL/hour
D. Serum calcium of 10.5 mg/dL and urine specific gravity of 1.010
💫RATIONALE✔️✔️: Diabetes insipidus is characterized by a deficiency of antidiuretic hormone
(ADH), leading to excessive water loss. Findings include hypernatremia (elevated serum sodium) and
dilute urine (low specific gravity). A serum sodium of 155 mEq/L and urine specific gravity of 1.002 are
consistent with this condition.
💫ANSWER✔️✔️: A. Serum sodium of 155 mEq/L and urine specific gravity of 1.002
---
**Question 6**
The nurse is providing education to a client with a new diagnosis of heart failure. Which symptom
should the client report to the healthcare provider immediately?
A. Weight gain of 2 pounds in one day
B. Mild shortness of breath with activity
C. Occasional cough in the morning
EXAM 2026
**Question 1**
The nurse is caring for a client with acute myocardial infarction (MI). Which laboratory value is most
specific for diagnosing MI?
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 with chronic obstructive pulmonary disease (COPD) who is receiving
oxygen therapy. Which oxygen delivery method is most appropriate for this client?
A. Non-rebreather mask at 15 L/min
B. Nasal cannula at 2-4 L/min
C. Simple face mask at 8 L/min
D. Venturi mask at 40% FiO2
,💫RATIONALE✔️✔️: Clients with COPD require controlled oxygen therapy to maintain oxygen
saturation at 88-92% and avoid suppression of the hypoxic drive. A nasal cannula at 2-4 L/min or a
Venturi mask with precise FiO2 delivery is appropriate. High-flow oxygen can lead to respiratory
depression.
💫ANSWER✔️✔️: B. Nasal cannula at 2-4 L/min
---
**Question 4**
The nurse is caring for a client with a chest tube connected to a water-seal drainage system. Which
finding indicates the chest tube is functioning correctly?
A. Continuous bubbling in the water seal chamber
B. Tidaling (fluctuation) in the water seal chamber with respirations
C. A sudden increase in drainage of 100 mL in one hour
D. The client reports sharp chest pain
💫RATIONALE✔️✔️: Tidaling (fluctuation) in the water seal chamber with respirations indicates that
the chest tube is patent and functioning correctly. Continuous bubbling indicates an air leak. A sudden
increase in drainage could indicate hemorrhage and should be reported.
💫ANSWER✔️✔️: B. Tidaling (fluctuation) in the water seal chamber with respirations
---
, **Question 5**
The nurse is assessing a client with a diagnosis of diabetes insipidus. Which finding is most consistent
with this condition?
A. Serum sodium of 155 mEq/L and urine specific gravity of 1.002
B. Serum sodium of 120 mEq/L and urine specific gravity of 1.035
C. Serum potassium of 5.5 mEq/L and urine output of 40 mL/hour
D. Serum calcium of 10.5 mg/dL and urine specific gravity of 1.010
💫RATIONALE✔️✔️: Diabetes insipidus is characterized by a deficiency of antidiuretic hormone
(ADH), leading to excessive water loss. Findings include hypernatremia (elevated serum sodium) and
dilute urine (low specific gravity). A serum sodium of 155 mEq/L and urine specific gravity of 1.002 are
consistent with this condition.
💫ANSWER✔️✔️: A. Serum sodium of 155 mEq/L and urine specific gravity of 1.002
---
**Question 6**
The nurse is providing education to a client with a new diagnosis of heart failure. Which symptom
should the client report to the healthcare provider immediately?
A. Weight gain of 2 pounds in one day
B. Mild shortness of breath with activity
C. Occasional cough in the morning
