AND CORRECT ANSWERS (VERIFIED ANSWERS)
Q&A 2026/2027 INSTANT DOWNLOAD PDF
1. A nurse is caring for a client with pneumonia. Which
assessment finding requires immediate intervention?
A. Temperature of 38°C (100.4°F)
B. Productive cough with yellow sputum
C. Oxygen saturation of 86%
D. Fatigue and weakness
Correct Answer: C. Oxygen saturation of 86%
Rationale: Low oxygen saturation indicates impaired
oxygenation and requires immediate intervention to prevent
respiratory compromise.
2. Which nursing intervention is most effective in preventing
postoperative atelectasis?
A. Limiting fluid intake
B. Encouraging incentive spirometer use
C. Maintaining bed rest
D. Administering antibiotics routinely
Correct Answer: B. Encouraging incentive spirometer use
,Rationale: Incentive spirometry promotes lung expansion and
prevents alveolar collapse after surgery.
3. A client with heart failure reports sudden weight gain. What
does this finding indicate?
A. Improved cardiac function
B. Fluid retention
C. Decreased appetite
D. Medication effectiveness
Correct Answer: B. Fluid retention
Rationale: Rapid weight gain is a common indicator of fluid
overload in heart failure.
4. Which assessment finding is expected in a client with left-
sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary crackles
D. Enlarged liver
Correct Answer: C. Pulmonary crackles
Rationale: Left-sided heart failure causes fluid accumulation in
the lungs, producing crackles.
,5. The nurse is caring for a client receiving oxygen therapy.
Which safety measure is priority?
A. Apply petroleum-based products to lips
B. Keep oxygen away from flames
C. Increase oxygen flow without an order
D. Store oxygen tanks horizontally
Correct Answer: B. Keep oxygen away from flames
Rationale: Oxygen supports combustion and increases fire risk.
6. Which finding indicates a client may be experiencing
hypoglycemia?
A. Increased thirst
B. Fruity breath odor
C. Sweating and shakiness
D. Warm dry skin
Correct Answer: C. Sweating and shakiness
Rationale: Adrenergic symptoms such as sweating, tremors,
and shakiness commonly occur with low blood glucose.
7. A nurse is teaching a client with diabetes about foot care.
Which statement indicates understanding?
A. “I will walk barefoot at home.”
B. “I will inspect my feet every day.”
, C. “I will soak my feet in hot water daily.”
D. “I will trim my nails deeply at the corners.”
Correct Answer: B. “I will inspect my feet every day.”
Rationale: Daily inspection helps identify injuries early and
prevents complications.
8. Which laboratory value should the nurse monitor for a
client taking warfarin?
A. Hemoglobin A1C
B. INR
C. Serum sodium
D. Creatinine kinase
Correct Answer: B. INR
Rationale: INR measures the effectiveness and safety of
warfarin therapy.
9. A client receiving anticoagulant therapy reports bleeding
gums. What should the nurse do first?
A. Document the finding
B. Notify the provider
C. Give aspirin
D. Encourage flossing
Correct Answer: B. Notify the provider