RN Comprehensive Predictor Proctored
Assessment | Advanced/Hard Difficulty
| Comprehensive Exam Bank | 100% Pass
Guaranteed | Graded A+
Question 1
A nurse in the emergency department is caring for a client who is experiencing
chest pain and diaphoresis. The client's ECG shows ST-segment elevation. Which
of the following actions should the nurse take first?
A. Administer sublingual nitroglycerin
B. Obtain cardiac enzyme levels
C. Administer oxygen
D. Notify the provider
Valid answer: C
Explanation: According to the ABC priority-setting framework, oxygen should
be administered first to ensure adequate oxygenation. While nitroglycerin,
cardiac enzymes, and provider notification are important, establishing a patent
airway and providing oxygen take priority.
Question 2
A nurse is caring for a client who has a new diagnosis of diabetes mellitus and is
being discharged. Which of the following instructions should the nurse include
regarding foot care?
A. Soak feet in hot water daily
B. Apply lotion between the toes
C. Trim toenails straight across
D. Use a heating pad to warm cold feet
Valid answer: C
pg. 1
,Explanation: Toenails should be trimmed straight across to prevent ingrown
toenails. Feet should not be soaked in hot water. Lotion should not be applied
between the toes as it can promote fungal growth. Heating pads should be
avoided due to the risk of burns from decreased sensation.
Question 3
A nurse is assessing a client who has a new prescription for haloperidol. Which
of the following findings should the nurse identify as an adverse effect that
requires immediate intervention?
A. Drowsiness
B. Dry mouth
C. Tardive dyskinesia
D. Orthostatic hypotension
Valid answer: C
Explanation: Tardive dyskinesia is a potentially irreversible adverse effect of
antipsychotic medications such as haloperidol and requires immediate
intervention. Drowsiness, dry mouth, and orthostatic hypotension are common
but less serious adverse effects.
Question 4
A nurse is caring for a client who is 1 day postoperative following a total knee
arthroplasty. Which of the following findings should the nurse report to the
provider?
A. Pain of 4 on a scale of 0 to 10
B. Temperature of 38.2°C (100.8°F)
C. Serosanguineous drainage on the dressing
D. Toes that are warm and pink
Valid answer: B
Explanation: A temperature of 38.2°C (100.8°F) on the first postoperative day
pg. 2
,may indicate infection and should be reported. Pain of 4, serosanguineous
drainage, and warm pink toes are expected findings.
Question 5
A nurse is providing teaching to a client who has a new prescription for lithium
carbonate. Which of the following instructions should the nurse include?
A. "Take the medication with meals to reduce gastrointestinal upset."
B. "Limit your fluid intake to 1 liter per day."
C. "Expect to feel better within 3 days."
D. "Use a salt substitute to season your food."
Valid answer: A
Explanation: Lithium should be taken with meals to reduce gastrointestinal
upset. Fluid intake should be maintained at 2-3 L/day to prevent toxicity.
Therapeutic effects take 1-3 weeks. Salt substitutes should be avoided as they
contain potassium and can affect lithium levels.
Question 6
A nurse is assessing a client who has a new diagnosis of heart failure. Which of
the following findings should the nurse expect?
A. Bounding peripheral pulses
B. Weight loss
C. Crackles in the lung bases
D. Decreased jugular venous pressure
Valid answer: C
Explanation: Crackles in the lung bases indicate pulmonary congestion and are
a sign of left-sided heart failure. Bounding pulses, weight loss, and decreased
jugular venous pressure are not expected findings in heart failure.
Question 7
A nurse is caring for a client who has a new prescription for enoxaparin. Which
pg. 3
, of the following actions should the nurse take?
A. Administer the medication intramuscularly
B. Rub the injection site after administration
C. Expel the air bubble from the prefilled syringe
D. Administer the medication subcutaneously in the abdomen
Valid answer: D
Explanation: Enoxaparin is administered subcutaneously in the abdomen. It
should not be given intramuscularly. The injection site should not be rubbed.
The air bubble should not be expelled from the prefilled syringe.
Question 8
A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should the nurse take first?
A. Verify the client's identity using two identifiers
B. Assess the client's baseline vital signs
C. Start the transfusion with 0.9% sodium chloride
D. Verify the blood product with another nurse
Valid answer: A
Explanation: Verification of the client's identity using two identifiers is the first
step in safe blood transfusion administration. Baseline vital signs, priming the
line, and verification with another nurse are also important but follow after
client identification.
Question 9
A nurse is providing discharge teaching to a client who has a new diagnosis of
chronic obstructive pulmonary disease (COPD). Which of the following
statements by the client indicates a need for further teaching?
A. "I should use pursed-lip breathing when I am short of breath."
B. "I should drink plenty of fluids to thin my secretions."
C. "I should use my oxygen at 4 L/min continuously."
pg. 4
Assessment | Advanced/Hard Difficulty
| Comprehensive Exam Bank | 100% Pass
Guaranteed | Graded A+
Question 1
A nurse in the emergency department is caring for a client who is experiencing
chest pain and diaphoresis. The client's ECG shows ST-segment elevation. Which
of the following actions should the nurse take first?
A. Administer sublingual nitroglycerin
B. Obtain cardiac enzyme levels
C. Administer oxygen
D. Notify the provider
Valid answer: C
Explanation: According to the ABC priority-setting framework, oxygen should
be administered first to ensure adequate oxygenation. While nitroglycerin,
cardiac enzymes, and provider notification are important, establishing a patent
airway and providing oxygen take priority.
Question 2
A nurse is caring for a client who has a new diagnosis of diabetes mellitus and is
being discharged. Which of the following instructions should the nurse include
regarding foot care?
A. Soak feet in hot water daily
B. Apply lotion between the toes
C. Trim toenails straight across
D. Use a heating pad to warm cold feet
Valid answer: C
pg. 1
,Explanation: Toenails should be trimmed straight across to prevent ingrown
toenails. Feet should not be soaked in hot water. Lotion should not be applied
between the toes as it can promote fungal growth. Heating pads should be
avoided due to the risk of burns from decreased sensation.
Question 3
A nurse is assessing a client who has a new prescription for haloperidol. Which
of the following findings should the nurse identify as an adverse effect that
requires immediate intervention?
A. Drowsiness
B. Dry mouth
C. Tardive dyskinesia
D. Orthostatic hypotension
Valid answer: C
Explanation: Tardive dyskinesia is a potentially irreversible adverse effect of
antipsychotic medications such as haloperidol and requires immediate
intervention. Drowsiness, dry mouth, and orthostatic hypotension are common
but less serious adverse effects.
Question 4
A nurse is caring for a client who is 1 day postoperative following a total knee
arthroplasty. Which of the following findings should the nurse report to the
provider?
A. Pain of 4 on a scale of 0 to 10
B. Temperature of 38.2°C (100.8°F)
C. Serosanguineous drainage on the dressing
D. Toes that are warm and pink
Valid answer: B
Explanation: A temperature of 38.2°C (100.8°F) on the first postoperative day
pg. 2
,may indicate infection and should be reported. Pain of 4, serosanguineous
drainage, and warm pink toes are expected findings.
Question 5
A nurse is providing teaching to a client who has a new prescription for lithium
carbonate. Which of the following instructions should the nurse include?
A. "Take the medication with meals to reduce gastrointestinal upset."
B. "Limit your fluid intake to 1 liter per day."
C. "Expect to feel better within 3 days."
D. "Use a salt substitute to season your food."
Valid answer: A
Explanation: Lithium should be taken with meals to reduce gastrointestinal
upset. Fluid intake should be maintained at 2-3 L/day to prevent toxicity.
Therapeutic effects take 1-3 weeks. Salt substitutes should be avoided as they
contain potassium and can affect lithium levels.
Question 6
A nurse is assessing a client who has a new diagnosis of heart failure. Which of
the following findings should the nurse expect?
A. Bounding peripheral pulses
B. Weight loss
C. Crackles in the lung bases
D. Decreased jugular venous pressure
Valid answer: C
Explanation: Crackles in the lung bases indicate pulmonary congestion and are
a sign of left-sided heart failure. Bounding pulses, weight loss, and decreased
jugular venous pressure are not expected findings in heart failure.
Question 7
A nurse is caring for a client who has a new prescription for enoxaparin. Which
pg. 3
, of the following actions should the nurse take?
A. Administer the medication intramuscularly
B. Rub the injection site after administration
C. Expel the air bubble from the prefilled syringe
D. Administer the medication subcutaneously in the abdomen
Valid answer: D
Explanation: Enoxaparin is administered subcutaneously in the abdomen. It
should not be given intramuscularly. The injection site should not be rubbed.
The air bubble should not be expelled from the prefilled syringe.
Question 8
A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should the nurse take first?
A. Verify the client's identity using two identifiers
B. Assess the client's baseline vital signs
C. Start the transfusion with 0.9% sodium chloride
D. Verify the blood product with another nurse
Valid answer: A
Explanation: Verification of the client's identity using two identifiers is the first
step in safe blood transfusion administration. Baseline vital signs, priming the
line, and verification with another nurse are also important but follow after
client identification.
Question 9
A nurse is providing discharge teaching to a client who has a new diagnosis of
chronic obstructive pulmonary disease (COPD). Which of the following
statements by the client indicates a need for further teaching?
A. "I should use pursed-lip breathing when I am short of breath."
B. "I should drink plenty of fluids to thin my secretions."
C. "I should use my oxygen at 4 L/min continuously."
pg. 4
