ADN Final Exam Version 1 | Comprehensive All Units | 2026/2027
Update | Galen College of Nursing
1. A nurse is caring for a client with a serum potassium level of 2.8 mEq/L.
Which clinical manifestation should the nurse prioritize?
A. Hyperactive bowel sounds
B. Irregular heart rhythm
C. Increased muscle tone
D. Elevated blood pressure
Answer: B
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause significant cardiac
dysrhythmias and EKG changes, making cardiac monitoring a priority.
2. When administering Digoxin to a client with heart failure, which action is
most critical for the nurse to perform first?
A. Monitor the client’s intake and output
B. Check the client’s respiratory rate
C. Review the most recent serum sodium level
D. Assess the apical pulse for one full minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The apical pulse must be
checked for 60 seconds, and the drug held if the rate is below 60 bpm in adults.
,3. A client is prescribed Warfarin for atrial fibrillation. Which laboratory value
will the nurse monitor to evaluate the effectiveness of the therapy?
A. International Normalized Ratio (INR)
B. Platelet count
C. Activated Partial Thromboplastin Time (aPTT)
D. Hemoglobin and Hematocrit
Answer: A
Rationale: INR is the standard lab test used to monitor the therapeutic effect of Warfarin
(Coumadin). aPTT is used for Heparin.
4. Which of the following findings is most indicative of a tension
pneumothorax?
A. Productive cough with rust-colored sputum
B. Bilateral breath sounds with crackles
C. Tracheal deviation toward the unaffected side
D. Flattened neck veins
Answer: C
Rationale: Tension pneumothorax causes a shift in the mediastinum, resulting in tracheal
deviation to the opposite (unaffected) side, decreased breath sounds on the affected side,
and distended neck veins.
5. The nurse is preparing to delegate tasks to an Unlicensed Assistive Personnel
(UAP). Which task is appropriate for delegation?
A. Instructing a client on the use of an incentive spirometer
B. Assessing a client’s surgical incision site
C. Administering a PRN oral analgesic
D. Assisting a stable client with ambulation
Answer: D
, Rationale: UAPs can perform tasks that are routine, non-invasive, and do not require
clinical judgment or assessment, such as assisting a stable client with walking.
6. A nurse notes a client’s arterial blood gas (ABG) results: pH 7.30, PaCO2 52
mmHg, HCO3 24 mEq/L. How should the nurse interpret these results?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is normal, this is uncompensated respiratory acidosis.
7. A client in the third trimester of pregnancy reports painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio Placentae
B. Placenta Previa
C. Ectopic Pregnancy
D. Spontaneous Abortion
Answer: B
Rationale: Painless, bright red vaginal bleeding in the second or third trimester is the
hallmark sign of placenta previa. Abruptio placentae usually involves painful bleeding.
8. Which assessment finding should the nurse expect in a client diagnosed with
Cushing’s Syndrome?
A. Buffalo hump and moon face
B. Hyperpigmentation of the skin
C. Weight loss and hypotension
D. Hyperkalemia and hypoglycemia
Answer: A
Update | Galen College of Nursing
1. A nurse is caring for a client with a serum potassium level of 2.8 mEq/L.
Which clinical manifestation should the nurse prioritize?
A. Hyperactive bowel sounds
B. Irregular heart rhythm
C. Increased muscle tone
D. Elevated blood pressure
Answer: B
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause significant cardiac
dysrhythmias and EKG changes, making cardiac monitoring a priority.
2. When administering Digoxin to a client with heart failure, which action is
most critical for the nurse to perform first?
A. Monitor the client’s intake and output
B. Check the client’s respiratory rate
C. Review the most recent serum sodium level
D. Assess the apical pulse for one full minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The apical pulse must be
checked for 60 seconds, and the drug held if the rate is below 60 bpm in adults.
,3. A client is prescribed Warfarin for atrial fibrillation. Which laboratory value
will the nurse monitor to evaluate the effectiveness of the therapy?
A. International Normalized Ratio (INR)
B. Platelet count
C. Activated Partial Thromboplastin Time (aPTT)
D. Hemoglobin and Hematocrit
Answer: A
Rationale: INR is the standard lab test used to monitor the therapeutic effect of Warfarin
(Coumadin). aPTT is used for Heparin.
4. Which of the following findings is most indicative of a tension
pneumothorax?
A. Productive cough with rust-colored sputum
B. Bilateral breath sounds with crackles
C. Tracheal deviation toward the unaffected side
D. Flattened neck veins
Answer: C
Rationale: Tension pneumothorax causes a shift in the mediastinum, resulting in tracheal
deviation to the opposite (unaffected) side, decreased breath sounds on the affected side,
and distended neck veins.
5. The nurse is preparing to delegate tasks to an Unlicensed Assistive Personnel
(UAP). Which task is appropriate for delegation?
A. Instructing a client on the use of an incentive spirometer
B. Assessing a client’s surgical incision site
C. Administering a PRN oral analgesic
D. Assisting a stable client with ambulation
Answer: D
, Rationale: UAPs can perform tasks that are routine, non-invasive, and do not require
clinical judgment or assessment, such as assisting a stable client with walking.
6. A nurse notes a client’s arterial blood gas (ABG) results: pH 7.30, PaCO2 52
mmHg, HCO3 24 mEq/L. How should the nurse interpret these results?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Rationale: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg indicates a
respiratory cause. Since the HCO3 is normal, this is uncompensated respiratory acidosis.
7. A client in the third trimester of pregnancy reports painless, bright red vaginal
bleeding. Which condition should the nurse suspect?
A. Abruptio Placentae
B. Placenta Previa
C. Ectopic Pregnancy
D. Spontaneous Abortion
Answer: B
Rationale: Painless, bright red vaginal bleeding in the second or third trimester is the
hallmark sign of placenta previa. Abruptio placentae usually involves painful bleeding.
8. Which assessment finding should the nurse expect in a client diagnosed with
Cushing’s Syndrome?
A. Buffalo hump and moon face
B. Hyperpigmentation of the skin
C. Weight loss and hypotension
D. Hyperkalemia and hypoglycemia
Answer: A
