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KAPLAN FUNDAMENTALS INTEGRATED
EXAM Comprehensive Practice Questions
Advanced/Hard Difficulty Level Target
Audience: Nursing Students/Professionals
Question 1
A nurse is preparing to administer a medication to a client via the intramuscular (IM) route.
Which of the following actions is correct when performing a Z-track injection?
A. Use a 20-gauge, 1-inch needle for a deltoid injection.
B. Massage the injection site after needle removal to promote absorption.
C. Displace the skin laterally approximately 1 inch before inserting the needle.
D. Administer the medication at a 45-degree angle.
Correct Answer: C
Explanation: The Z-track method involves displacing the skin laterally (approximately 1 inch)
before inserting the needle. This creates a zigzag path that prevents medication from leaking
back into subcutaneous tissue. The site should not be massaged after injection. A 90-degree
angle is used for IM injections.
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Question 2
A nurse is preparing to insert a nasogastric (NG) tube for a client who is unable to swallow.
Which action should the nurse take to confirm proper placement of the tube before initiating
enteral feedings?
A. Aspirate gastric contents and check the pH.
B. Auscultate over the epigastric area while injecting air.
C. Obtain a chest x-ray.
D. Place the end of the tube in water and observe for bubbles.
Correct Answer: C
Explanation: A chest x-ray is the gold standard for confirming NG tube placement before
initiating feedings. While aspirating gastric contents (A) and auscultating (B) are methods used
to check placement, they are less reliable than x-ray confirmation.
Question 3
The practical nurse is reinforcing teaching with a client prescribed warfarin. Which statement
indicates understanding?
A. "I will use a soft toothbrush and an electric razor."
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B. "I can take ibuprofen for headaches."
C. "I will eat more green leafy vegetables daily."
D. "I will stop taking the medication if I feel dizzy."
Correct Answer: A
Explanation: Warfarin increases bleeding risk, so clients should use soft toothbrushes and
electric razors to prevent injury. Ibuprofen increases bleeding risk with warfarin. Green leafy
vegetables are high in vitamin K, which decreases warfarin's effectiveness. Clients should never
stop medications abruptly without provider guidance.
Question 4
A client who is receiving total parenteral nutrition (TPN) through a central line develops
symptoms of an air embolism. What is the priority action?
A. Place the client in Trendelenburg position on the left side.
B. Clamp the central line.
C. Administer oxygen.
D. Notify the provider.
Correct Answer: A
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Explanation: The priority action for an air embolism is to place the client in Trendelenburg
position on the left side (Durant's position) to trap air in the right atrium and prevent it from
traveling to the lungs. Clamping the line and administering oxygen are important but come after
positioning.
Question 5
A nurse is caring for a client in restraints. Which of the following actions is a violation of client
rights?
A. Applying restraints with a quick-release knot.
B. Documenting the client's behavior every 15 minutes.
C. Leaving the client in restraints for 6 hours without reassessment.
D. Providing range-of-motion exercises every 2 hours.
Correct Answer: C
Explanation: Restraints require frequent reassessment (at least every 2 hours for adults).
Leaving a client in restraints for 6 hours without assessment violates both legal and ethical
standards. Quick-release knots (A), ongoing documentation (B), and range-of-motion exercises
(D) are all appropriate actions.
KAPLAN FUNDAMENTALS INTEGRATED
EXAM Comprehensive Practice Questions
Advanced/Hard Difficulty Level Target
Audience: Nursing Students/Professionals
Question 1
A nurse is preparing to administer a medication to a client via the intramuscular (IM) route.
Which of the following actions is correct when performing a Z-track injection?
A. Use a 20-gauge, 1-inch needle for a deltoid injection.
B. Massage the injection site after needle removal to promote absorption.
C. Displace the skin laterally approximately 1 inch before inserting the needle.
D. Administer the medication at a 45-degree angle.
Correct Answer: C
Explanation: The Z-track method involves displacing the skin laterally (approximately 1 inch)
before inserting the needle. This creates a zigzag path that prevents medication from leaking
back into subcutaneous tissue. The site should not be massaged after injection. A 90-degree
angle is used for IM injections.
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Question 2
A nurse is preparing to insert a nasogastric (NG) tube for a client who is unable to swallow.
Which action should the nurse take to confirm proper placement of the tube before initiating
enteral feedings?
A. Aspirate gastric contents and check the pH.
B. Auscultate over the epigastric area while injecting air.
C. Obtain a chest x-ray.
D. Place the end of the tube in water and observe for bubbles.
Correct Answer: C
Explanation: A chest x-ray is the gold standard for confirming NG tube placement before
initiating feedings. While aspirating gastric contents (A) and auscultating (B) are methods used
to check placement, they are less reliable than x-ray confirmation.
Question 3
The practical nurse is reinforcing teaching with a client prescribed warfarin. Which statement
indicates understanding?
A. "I will use a soft toothbrush and an electric razor."
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B. "I can take ibuprofen for headaches."
C. "I will eat more green leafy vegetables daily."
D. "I will stop taking the medication if I feel dizzy."
Correct Answer: A
Explanation: Warfarin increases bleeding risk, so clients should use soft toothbrushes and
electric razors to prevent injury. Ibuprofen increases bleeding risk with warfarin. Green leafy
vegetables are high in vitamin K, which decreases warfarin's effectiveness. Clients should never
stop medications abruptly without provider guidance.
Question 4
A client who is receiving total parenteral nutrition (TPN) through a central line develops
symptoms of an air embolism. What is the priority action?
A. Place the client in Trendelenburg position on the left side.
B. Clamp the central line.
C. Administer oxygen.
D. Notify the provider.
Correct Answer: A
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Explanation: The priority action for an air embolism is to place the client in Trendelenburg
position on the left side (Durant's position) to trap air in the right atrium and prevent it from
traveling to the lungs. Clamping the line and administering oxygen are important but come after
positioning.
Question 5
A nurse is caring for a client in restraints. Which of the following actions is a violation of client
rights?
A. Applying restraints with a quick-release knot.
B. Documenting the client's behavior every 15 minutes.
C. Leaving the client in restraints for 6 hours without reassessment.
D. Providing range-of-motion exercises every 2 hours.
Correct Answer: C
Explanation: Restraints require frequent reassessment (at least every 2 hours for adults).
Leaving a client in restraints for 6 hours without assessment violates both legal and ethical
standards. Quick-release knots (A), ongoing documentation (B), and range-of-motion exercises
(D) are all appropriate actions.
