[D439 FOUNDATIONS OF NURSING EXAM] – EXAM-STYLE QUESTIONS AND
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
1. A nurse is preparing to administer a medication that requires a therapeutic
drug level to be drawn. Which action by the nurse demonstrates the best
understanding of the pre-analytical phase of laboratory testing?
A. Ensuring the patient is adequately hydrated prior to the venipuncture.
B. Verifying the correct tourniquet application time during the blood draw.
C. Confirming the patient's identity and verifying the provider's order for the test.
D. Collecting the blood sample at the specific time relative to the last
administered dose.
Correct Answer: D. Collecting the blood sample at the specific time relative to the
last administered dose.
Rationale: The pre-analytical phase includes all steps taken before the sample is
analyzed, and timing of collection is a critical variable. For therapeutic drug
monitoring, drawing a peak or trough level at the prescribed time is essential to
ensure accurate interpretation. Option A relates to patient preparation but is not
specific to drug level accuracy. Option B is a component of the analytical process.
Option C is a critical safety step for patient identification but is not specific to the
accuracy of the drug level itself.**
2. A client with a history of chronic obstructive pulmonary disease is receiving
oxygen at 2 L/min via nasal cannula. The nurse assesses the client and notes a
,respiratory rate of 10 breaths per minute and a decreased level of
consciousness. Which of the following is the nurse's priority action?
A. Increase the oxygen flow rate to 4 L/min.
B. Perform nasotracheal suctioning.
C. Discontinue the oxygen therapy.
D. Prepare for immediate intubation.
Correct Answer: C. Discontinue the oxygen therapy.
Rationale: In clients with COPD, the respiratory drive can be dependent on hypoxic
stimulation. High-flow oxygen can eliminate this drive, leading to hypoventilation
and respiratory acidosis. The priority is to reduce the oxygen flow. Option A would
worsen the condition. Option B is not indicated. Option D may be necessary if the
patient does not improve, but the first action is to remove the stimulus.**
3. A nurse is caring for a patient who is post-operative day one from a right
total knee arthroplasty. The patient rates their pain as 8/10 and is asking for
their prescribed PRN opioid. The nurse notes that the patient is also receiving
scheduled acetaminophen. What is the most important assessment prior to
administering the PRN opioid?
A. The patient's last bowel movement.
B. The patient's current respiratory rate.
C. The patient's allergy history.
D. The patient's pain level.
Correct Answer: B. The patient's current respiratory rate.
Rationale: Respiratory depression is the most significant and life-threatening
adverse effect of opioid analgesics. Assessing the respiratory rate before
,administration is a standard of care to ensure the medication is safe to give. While
assessing bowel function (A) and allergies (C) are important, they are not the most
immediate safety concern. Pain level (D) is what prompted the request, but it is not
the priority safety assessment.**
4. A nurse is reviewing the laboratory results of a client with chronic kidney
disease. The nurse notes a serum potassium level of 6.2 mEq/L. Which of the
following electrocardiogram changes should the nurse expect to observe?
A. Flattened T waves.
B. Prolonged PR interval.
C. Peaked T waves.
D. Prominent U waves.
Correct Answer: C. Peaked T waves.
Rationale: Hyperkalemia, or elevated serum potassium, classically presents with
tall, peaked, or "tented" T waves on an electrocardiogram. This is a hallmark sign.
Flattened T waves (A) and prominent U waves (D) are associated with hypokalemia.
A prolonged PR interval (B) can occur in hyperkalemia but is not the most
characteristic early finding; peaked T waves are typically the first sign.**
5. A nurse is providing discharge teaching to a patient who has a new
prescription for warfarin. Which statement made by the client indicates a need
for further teaching?
A. "I should take this medication at the same time every day."
B. "I will need to have my blood drawn regularly to check my levels."
C. "I can continue to eat my normal diet of leafy green vegetables."
D. "I should contact my provider if I notice any unusual bruising."
, Correct Answer: C. "I can continue to eat my normal diet of leafy green
vegetables."
Rationale: Warfarin's anticoagulant effect is antagonized by vitamin K, which is
abundant in leafy green vegetables. A consistent intake of vitamin K is crucial for
maintaining a stable INR. A statement about continuing a "normal diet" of leafy
greens indicates the client does not understand the need for dietary consistency or
possibly moderation. Options A, B, and D demonstrate correct understanding of
warfarin therapy.**
6. A patient with a suspected pulmonary embolism is receiving a continuous
heparin infusion. The nurse is reviewing the patient's lab results and notes a
PTT of 95 seconds. The baseline PTT is 25 seconds. What is the most
appropriate nursing action?
A. Continue the infusion as ordered.
B. Notify the provider to increase the infusion rate.
C. Obtain an order for a stat platelet count.
D. Hold the infusion and notify the provider.
Correct Answer: D. Hold the infusion and notify the provider.
Rationale: The therapeutic goal for a patient on a heparin infusion is typically a
PTT 1.5 to 2.5 times the baseline, which in this case would be 37.5 to 62.5 seconds.
A PTT of 95 seconds is significantly above the therapeutic range and indicates a
high risk of bleeding. The nurse should hold the infusion and notify the provider for
a dose adjustment. Option A is unsafe. Option B would worsen the situation. Option
C is indicated for Heparin-Induced Thrombocytopenia, which is not diagnosed by a
single PTT result.**
ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
1. A nurse is preparing to administer a medication that requires a therapeutic
drug level to be drawn. Which action by the nurse demonstrates the best
understanding of the pre-analytical phase of laboratory testing?
A. Ensuring the patient is adequately hydrated prior to the venipuncture.
B. Verifying the correct tourniquet application time during the blood draw.
C. Confirming the patient's identity and verifying the provider's order for the test.
D. Collecting the blood sample at the specific time relative to the last
administered dose.
Correct Answer: D. Collecting the blood sample at the specific time relative to the
last administered dose.
Rationale: The pre-analytical phase includes all steps taken before the sample is
analyzed, and timing of collection is a critical variable. For therapeutic drug
monitoring, drawing a peak or trough level at the prescribed time is essential to
ensure accurate interpretation. Option A relates to patient preparation but is not
specific to drug level accuracy. Option B is a component of the analytical process.
Option C is a critical safety step for patient identification but is not specific to the
accuracy of the drug level itself.**
2. A client with a history of chronic obstructive pulmonary disease is receiving
oxygen at 2 L/min via nasal cannula. The nurse assesses the client and notes a
,respiratory rate of 10 breaths per minute and a decreased level of
consciousness. Which of the following is the nurse's priority action?
A. Increase the oxygen flow rate to 4 L/min.
B. Perform nasotracheal suctioning.
C. Discontinue the oxygen therapy.
D. Prepare for immediate intubation.
Correct Answer: C. Discontinue the oxygen therapy.
Rationale: In clients with COPD, the respiratory drive can be dependent on hypoxic
stimulation. High-flow oxygen can eliminate this drive, leading to hypoventilation
and respiratory acidosis. The priority is to reduce the oxygen flow. Option A would
worsen the condition. Option B is not indicated. Option D may be necessary if the
patient does not improve, but the first action is to remove the stimulus.**
3. A nurse is caring for a patient who is post-operative day one from a right
total knee arthroplasty. The patient rates their pain as 8/10 and is asking for
their prescribed PRN opioid. The nurse notes that the patient is also receiving
scheduled acetaminophen. What is the most important assessment prior to
administering the PRN opioid?
A. The patient's last bowel movement.
B. The patient's current respiratory rate.
C. The patient's allergy history.
D. The patient's pain level.
Correct Answer: B. The patient's current respiratory rate.
Rationale: Respiratory depression is the most significant and life-threatening
adverse effect of opioid analgesics. Assessing the respiratory rate before
,administration is a standard of care to ensure the medication is safe to give. While
assessing bowel function (A) and allergies (C) are important, they are not the most
immediate safety concern. Pain level (D) is what prompted the request, but it is not
the priority safety assessment.**
4. A nurse is reviewing the laboratory results of a client with chronic kidney
disease. The nurse notes a serum potassium level of 6.2 mEq/L. Which of the
following electrocardiogram changes should the nurse expect to observe?
A. Flattened T waves.
B. Prolonged PR interval.
C. Peaked T waves.
D. Prominent U waves.
Correct Answer: C. Peaked T waves.
Rationale: Hyperkalemia, or elevated serum potassium, classically presents with
tall, peaked, or "tented" T waves on an electrocardiogram. This is a hallmark sign.
Flattened T waves (A) and prominent U waves (D) are associated with hypokalemia.
A prolonged PR interval (B) can occur in hyperkalemia but is not the most
characteristic early finding; peaked T waves are typically the first sign.**
5. A nurse is providing discharge teaching to a patient who has a new
prescription for warfarin. Which statement made by the client indicates a need
for further teaching?
A. "I should take this medication at the same time every day."
B. "I will need to have my blood drawn regularly to check my levels."
C. "I can continue to eat my normal diet of leafy green vegetables."
D. "I should contact my provider if I notice any unusual bruising."
, Correct Answer: C. "I can continue to eat my normal diet of leafy green
vegetables."
Rationale: Warfarin's anticoagulant effect is antagonized by vitamin K, which is
abundant in leafy green vegetables. A consistent intake of vitamin K is crucial for
maintaining a stable INR. A statement about continuing a "normal diet" of leafy
greens indicates the client does not understand the need for dietary consistency or
possibly moderation. Options A, B, and D demonstrate correct understanding of
warfarin therapy.**
6. A patient with a suspected pulmonary embolism is receiving a continuous
heparin infusion. The nurse is reviewing the patient's lab results and notes a
PTT of 95 seconds. The baseline PTT is 25 seconds. What is the most
appropriate nursing action?
A. Continue the infusion as ordered.
B. Notify the provider to increase the infusion rate.
C. Obtain an order for a stat platelet count.
D. Hold the infusion and notify the provider.
Correct Answer: D. Hold the infusion and notify the provider.
Rationale: The therapeutic goal for a patient on a heparin infusion is typically a
PTT 1.5 to 2.5 times the baseline, which in this case would be 37.5 to 62.5 seconds.
A PTT of 95 seconds is significantly above the therapeutic range and indicates a
high risk of bleeding. The nurse should hold the infusion and notify the provider for
a dose adjustment. Option A is unsafe. Option B would worsen the situation. Option
C is indicated for Heparin-Induced Thrombocytopenia, which is not diagnosed by a
single PTT result.**
