KAPLAN READINESS ASSESSMENT C QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A |LATEST EXAM UPDATE 2026/2027..
*Core Domains*
*- Management of Care*
*- Safety and Infection Control*
*- Health Promotion and Maintenance*
*- Psychosocial Integrity*
*- Basic Care and Comfort*
*- Pharmacological and Parenteral Therapies*
*- Reduction of Risk Potential*
*- Physiological Adaptation*
*Introduction*
*The Kaplan Readiness Assessment C is designed to evaluate a nursing student’s preparedness for p
SECTION ONE: QUESTIONS 1–100
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. Which assessment finding should the nurse prioritize
during the initial shift assessment?
A. Patient's ability to demonstrate insulin administration.
B. Presence of ketones in the urine.
C. Patient's knowledge of carbohydrate counting.
D. Current fasting blood glucose level.
🟢B
🔴 RATIONALE: The presence of ketones in the urine indicates the breakdown of fats for energy, which is a precursor to diabetic
ketoacidosis (DKA), a life-threatening complication that requires immediate nursing intervention.
A client is receiving an intravenous infusion of potassium chloride. Which observation requires the nurse to stop the infusion
immediately?
A. The client reports mild burning at the IV site.
B. The heart rate is 88 beats per minute.
,C. The client reports a slight headache.
D. The serum potassium level is 4.2 mEq/L.
🟢A
🔴 RATIONALE: Potassium chloride is a vesicant and can cause severe tissue necrosis if infiltration occurs. Burning at the site is a
classic sign of irritation or infiltration, necessitating immediate cessation of the infusion.
Which action by a nurse demonstrates the best understanding of infection control standards when caring for a client with Clostridium
difficile?
A. Using alcohol-based hand sanitizer before entering the room.
B. Washing hands with soap and water after removing gloves.
C. Wearing a surgical mask when within 3 feet of the client.
D. Placing the client in a room with negative air pressure.
🟢B
🔴 RATIONALE: Alcohol-based sanitizers do not effectively kill C. difficile spores. Soap and water are required to mechanically remove
the spores from the skin.
A nurse is developing a plan of care for a client with dementia who is experiencing "sundowning." Which intervention should be
included?
A. Keep the room brightly lit during the evening hours.
B. Increase daytime physical activity.
C. Restrict fluid intake after 17:00.
D. Provide a complex, stimulating environment in the evening.
🟢B
🔴 RATIONALE: Increasing physical activity during the day helps the client expend energy and reduces restlessness, which can
decrease the severity of sundowning symptoms in the evening.
A client in the emergency department reports sudden, severe chest pain and shortness of breath. Which action is the nurse's priority?
A. Obtain a 12-lead electrocardiogram (ECG).
B. Administer oxygen via nasal cannula.
C. Assess the client’s vital signs.
D. Administer sublingual nitroglycerin.
🟢B
🔴 RATIONALE: The priority is to ensure adequate oxygenation. Airway and breathing always take precedence in the ABC (Airway,
Breathing, Circulation) framework.
, A nurse is providing discharge instructions to a client taking warfarin. Which statement by the client indicates an understanding of the
teaching?
A. "I will increase my intake of dark green leafy vegetables."
B. "I should use a soft-bristled toothbrush for oral hygiene."
C. "I can take aspirin for occasional headaches."
D. "I will stop taking the medication if I see bruising."
🟢B
🔴 RATIONALE: Warfarin increases the risk of bleeding. Using a soft-bristled toothbrush minimizes trauma to the gums and reduces
the risk of oral bleeding.
Which client should the nurse see first?
A. A client with a stage 1 pressure ulcer on the sacrum.
B. A client with an indwelling urinary catheter who has a temperature of 100.4°F (38°C).
C. A client who is postoperative day 2 and reporting pain of 6/10.
D. A client with a new prescription for a medication that requires clarification.
🟢B
🔴 RATIONALE: A client with an indwelling catheter and a fever may be developing a catheter-associated urinary tract infection
(CAUTI) or urosepsis, which is a priority for investigation over the other listed conditions.
A nurse is reviewing an arterial blood gas (ABG) report for a client with chronic obstructive pulmonary disease (COPD). Which finding is
expected?
A. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L.
B. pH 7.45, PaCO2 35 mmHg, HCO3 22 mEq/L.
C. pH 7.50, PaCO2 30 mmHg, HCO3 24 mEq/L.
D. pH 7.35, PaCO2 40 mmHg, HCO3 24 mEq/L.
🟢A
🔴 RATIONALE: Clients with COPD often retain CO2, leading to respiratory acidosis. A pH of 7.32 (acidic) and a PaCO2 of 50 mmHg
(elevated) are consistent with compensated or uncompensated respiratory acidosis.
When assessing a client for signs of hypovolemia, which finding is the most sensitive indicator?
A. Dry mucous membranes.
B. Decreased urine output.
C. Increased heart rate.
D. Poor skin turgor.
🟢C
Q&A |LATEST EXAM UPDATE 2026/2027..
*Core Domains*
*- Management of Care*
*- Safety and Infection Control*
*- Health Promotion and Maintenance*
*- Psychosocial Integrity*
*- Basic Care and Comfort*
*- Pharmacological and Parenteral Therapies*
*- Reduction of Risk Potential*
*- Physiological Adaptation*
*Introduction*
*The Kaplan Readiness Assessment C is designed to evaluate a nursing student’s preparedness for p
SECTION ONE: QUESTIONS 1–100
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. Which assessment finding should the nurse prioritize
during the initial shift assessment?
A. Patient's ability to demonstrate insulin administration.
B. Presence of ketones in the urine.
C. Patient's knowledge of carbohydrate counting.
D. Current fasting blood glucose level.
🟢B
🔴 RATIONALE: The presence of ketones in the urine indicates the breakdown of fats for energy, which is a precursor to diabetic
ketoacidosis (DKA), a life-threatening complication that requires immediate nursing intervention.
A client is receiving an intravenous infusion of potassium chloride. Which observation requires the nurse to stop the infusion
immediately?
A. The client reports mild burning at the IV site.
B. The heart rate is 88 beats per minute.
,C. The client reports a slight headache.
D. The serum potassium level is 4.2 mEq/L.
🟢A
🔴 RATIONALE: Potassium chloride is a vesicant and can cause severe tissue necrosis if infiltration occurs. Burning at the site is a
classic sign of irritation or infiltration, necessitating immediate cessation of the infusion.
Which action by a nurse demonstrates the best understanding of infection control standards when caring for a client with Clostridium
difficile?
A. Using alcohol-based hand sanitizer before entering the room.
B. Washing hands with soap and water after removing gloves.
C. Wearing a surgical mask when within 3 feet of the client.
D. Placing the client in a room with negative air pressure.
🟢B
🔴 RATIONALE: Alcohol-based sanitizers do not effectively kill C. difficile spores. Soap and water are required to mechanically remove
the spores from the skin.
A nurse is developing a plan of care for a client with dementia who is experiencing "sundowning." Which intervention should be
included?
A. Keep the room brightly lit during the evening hours.
B. Increase daytime physical activity.
C. Restrict fluid intake after 17:00.
D. Provide a complex, stimulating environment in the evening.
🟢B
🔴 RATIONALE: Increasing physical activity during the day helps the client expend energy and reduces restlessness, which can
decrease the severity of sundowning symptoms in the evening.
A client in the emergency department reports sudden, severe chest pain and shortness of breath. Which action is the nurse's priority?
A. Obtain a 12-lead electrocardiogram (ECG).
B. Administer oxygen via nasal cannula.
C. Assess the client’s vital signs.
D. Administer sublingual nitroglycerin.
🟢B
🔴 RATIONALE: The priority is to ensure adequate oxygenation. Airway and breathing always take precedence in the ABC (Airway,
Breathing, Circulation) framework.
, A nurse is providing discharge instructions to a client taking warfarin. Which statement by the client indicates an understanding of the
teaching?
A. "I will increase my intake of dark green leafy vegetables."
B. "I should use a soft-bristled toothbrush for oral hygiene."
C. "I can take aspirin for occasional headaches."
D. "I will stop taking the medication if I see bruising."
🟢B
🔴 RATIONALE: Warfarin increases the risk of bleeding. Using a soft-bristled toothbrush minimizes trauma to the gums and reduces
the risk of oral bleeding.
Which client should the nurse see first?
A. A client with a stage 1 pressure ulcer on the sacrum.
B. A client with an indwelling urinary catheter who has a temperature of 100.4°F (38°C).
C. A client who is postoperative day 2 and reporting pain of 6/10.
D. A client with a new prescription for a medication that requires clarification.
🟢B
🔴 RATIONALE: A client with an indwelling catheter and a fever may be developing a catheter-associated urinary tract infection
(CAUTI) or urosepsis, which is a priority for investigation over the other listed conditions.
A nurse is reviewing an arterial blood gas (ABG) report for a client with chronic obstructive pulmonary disease (COPD). Which finding is
expected?
A. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L.
B. pH 7.45, PaCO2 35 mmHg, HCO3 22 mEq/L.
C. pH 7.50, PaCO2 30 mmHg, HCO3 24 mEq/L.
D. pH 7.35, PaCO2 40 mmHg, HCO3 24 mEq/L.
🟢A
🔴 RATIONALE: Clients with COPD often retain CO2, leading to respiratory acidosis. A pH of 7.32 (acidic) and a PaCO2 of 50 mmHg
(elevated) are consistent with compensated or uncompensated respiratory acidosis.
When assessing a client for signs of hypovolemia, which finding is the most sensitive indicator?
A. Dry mucous membranes.
B. Decreased urine output.
C. Increased heart rate.
D. Poor skin turgor.
🟢C
