Comprehensive Nursing Final
Exam (SU 2026) Questions
and Correct Answers with
Rationale
Question 1
A nurse is assessing a client with suspected hypovolemic shock.
Which assessment finding should the nurse recognize as an early
indicator?
A. Bradycardia
B. Tachycardia
C. Hypertension
D. Bounding pulses
Answer: B. Tachycardia
Rationale: Tachycardia is an early compensatory response to
decreased circulating blood volume. The body increases heart
rate to maintain cardiac output. Bradycardia is a late, ominous
sign, while hypotension—not hypertension—develops as shock
progresses.
Question 2
,Which client should the nurse assess first?
A. A client with pneumonia who has an oxygen saturation of
88% on room air
B. A client requesting pain medication rated 8/10
C. A client awaiting discharge instructions
D. A client with diabetes requesting lunch
Answer: A. A client with pneumonia who has an oxygen
saturation of 88% on room air
Rationale: Airway and breathing take priority (ABCs). An
oxygen saturation of 88% indicates hypoxemia requiring
immediate assessment and intervention.
Question 3
A client with heart failure is prescribed furosemide. Which
electrolyte imbalance is the nurse most concerned about?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases
potassium excretion, placing the client at risk for hypokalemia,
which can cause muscle weakness and life-threatening
dysrhythmias.
,Question 4
Which laboratory value should the nurse report immediately?
A. Sodium 139 mEq/L
B. Potassium 2.7 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
Answer: B. Potassium 2.7 mEq/L
Rationale: A potassium level below 3.0 mEq/L significantly
increases the risk for cardiac dysrhythmias and requires prompt
intervention.
Question 5
A nurse is teaching a client taking warfarin. Which statement
indicates correct understanding?
A. "I'll stop eating green vegetables."
B. "I'll keep my intake of green vegetables consistent."
C. "I'll double my dose if I miss one."
D. "I'll take aspirin for headaches."
Answer: B. "I'll keep my intake of green vegetables
consistent."
, Rationale: Vitamin K intake should remain consistent to
maintain therapeutic anticoagulation. Aspirin increases bleeding
risk and should only be taken if approved by the provider.
Question 6
Which assessment finding is most consistent with left-sided
heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in both lungs
D. Ascites
Answer: C. Crackles in both lungs
Rationale: Left-sided heart failure causes pulmonary
congestion, resulting in crackles, dyspnea, orthopnea, and
pulmonary edema.
Question 7
A client suddenly develops chest pain, dyspnea, and anxiety
after surgery. Which complication is most likely?
A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Pleural effusion
Exam (SU 2026) Questions
and Correct Answers with
Rationale
Question 1
A nurse is assessing a client with suspected hypovolemic shock.
Which assessment finding should the nurse recognize as an early
indicator?
A. Bradycardia
B. Tachycardia
C. Hypertension
D. Bounding pulses
Answer: B. Tachycardia
Rationale: Tachycardia is an early compensatory response to
decreased circulating blood volume. The body increases heart
rate to maintain cardiac output. Bradycardia is a late, ominous
sign, while hypotension—not hypertension—develops as shock
progresses.
Question 2
,Which client should the nurse assess first?
A. A client with pneumonia who has an oxygen saturation of
88% on room air
B. A client requesting pain medication rated 8/10
C. A client awaiting discharge instructions
D. A client with diabetes requesting lunch
Answer: A. A client with pneumonia who has an oxygen
saturation of 88% on room air
Rationale: Airway and breathing take priority (ABCs). An
oxygen saturation of 88% indicates hypoxemia requiring
immediate assessment and intervention.
Question 3
A client with heart failure is prescribed furosemide. Which
electrolyte imbalance is the nurse most concerned about?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypercalcemia
Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases
potassium excretion, placing the client at risk for hypokalemia,
which can cause muscle weakness and life-threatening
dysrhythmias.
,Question 4
Which laboratory value should the nurse report immediately?
A. Sodium 139 mEq/L
B. Potassium 2.7 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
Answer: B. Potassium 2.7 mEq/L
Rationale: A potassium level below 3.0 mEq/L significantly
increases the risk for cardiac dysrhythmias and requires prompt
intervention.
Question 5
A nurse is teaching a client taking warfarin. Which statement
indicates correct understanding?
A. "I'll stop eating green vegetables."
B. "I'll keep my intake of green vegetables consistent."
C. "I'll double my dose if I miss one."
D. "I'll take aspirin for headaches."
Answer: B. "I'll keep my intake of green vegetables
consistent."
, Rationale: Vitamin K intake should remain consistent to
maintain therapeutic anticoagulation. Aspirin increases bleeding
risk and should only be taken if approved by the provider.
Question 6
Which assessment finding is most consistent with left-sided
heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in both lungs
D. Ascites
Answer: C. Crackles in both lungs
Rationale: Left-sided heart failure causes pulmonary
congestion, resulting in crackles, dyspnea, orthopnea, and
pulmonary edema.
Question 7
A client suddenly develops chest pain, dyspnea, and anxiety
after surgery. Which complication is most likely?
A. Pneumonia
B. Pulmonary embolism
C. Atelectasis
D. Pleural effusion
