KAPLAN DIAGNOSTIC COMPLETE
EXAM PREPARATION QUESTIONS AND
ANSWERS
1. A nurse is caring for a client with a history of heart failure who is receiving Digoxin. Which
of the following laboratory results should the nurse prioritize reporting to the healthcare
provider?
A. Serum Digoxin level of 1.2 ng/mL
B. Serum Sodium level of 136 mEq/L
C. Serum Potassium level of 3.2 mEq/L
D. Serum Creatinine level of 1.0 mg/dL
Answer: C
Conceptual Explanation: Hypokalemia (potassium less than 3.5 mEq/L) significantly
increases the risk of digoxin toxicity even if the digoxin level is within the therapeutic
range.
2. A client is admitted to the emergency department with a suspected tension
pneumothorax. Which clinical finding should the nurse expect to observe?
A. Tracheal deviation toward the affected side
,B. Increased breath sounds on the affected side
C. Tracheal deviation toward the unaffected side
D. Flattened neck veins
Answer: C
Conceptual Explanation: In a tension pneumothorax, air accumulation shifts the
mediastinum and trachea toward the opposite (unaffected) side, often accompanied by
distended neck veins.
3. The nurse is assigned to four clients. Which client should the nurse assess first?
A. A client with COPD and an oxygen saturation of 89% on 2L NC
B. A client with a new onset of atrial fibrillation with a heart rate of 115 bpm
C. A client 2 hours post-thyroidectomy reporting tingling around the mouth
D. A client scheduled for surgery in 1 hour who is crying
C. A client 2 hours post-thyroidectomy reporting tingling around the mouth
Answer: C
Conceptual Explanation: Tingling around the mouth (circumoral paresthesia) post-
thyroidectomy indicates hypocalcemia, which can lead to laryngospasm and airway
obstruction, making it the highest priority.
, 4. Which task is most appropriate for the nurse to delegate to an unlicensed assistive
personnel (UAP)?
A. Obtaining a clean-catch urine specimen from a mobile client
B. Feeding a client with dysphagia for the first time post-stroke
C. Changing the dressing of a stage II pressure ulcer
D. Teaching a client how to use an incentive spirometer
Answer: A
Conceptual Explanation: UAPs can perform routine tasks such as specimen collection for
stable clients. Nursing assessment, dressing changes (sterile or medicated), and teaching
are responsibilities of the licensed nurse.
5. A client with Type 1 Diabetes Mellitus presents with Kussmaul respirations and a fruity
breath odor. The nurse anticipates which of the following arterial blood gas results?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.45, PaCO2 35, HCO3 24
C. pH 7.32, PaCO2 50, HCO3 28
D. pH 7.30, PaCO2 40, HCO3 18
Answer: D
Conceptual Explanation: The description indicates Diabetic Ketoacidosis (DKA), which
manifests as metabolic acidosis (low pH and low bicarbonate).
EXAM PREPARATION QUESTIONS AND
ANSWERS
1. A nurse is caring for a client with a history of heart failure who is receiving Digoxin. Which
of the following laboratory results should the nurse prioritize reporting to the healthcare
provider?
A. Serum Digoxin level of 1.2 ng/mL
B. Serum Sodium level of 136 mEq/L
C. Serum Potassium level of 3.2 mEq/L
D. Serum Creatinine level of 1.0 mg/dL
Answer: C
Conceptual Explanation: Hypokalemia (potassium less than 3.5 mEq/L) significantly
increases the risk of digoxin toxicity even if the digoxin level is within the therapeutic
range.
2. A client is admitted to the emergency department with a suspected tension
pneumothorax. Which clinical finding should the nurse expect to observe?
A. Tracheal deviation toward the affected side
,B. Increased breath sounds on the affected side
C. Tracheal deviation toward the unaffected side
D. Flattened neck veins
Answer: C
Conceptual Explanation: In a tension pneumothorax, air accumulation shifts the
mediastinum and trachea toward the opposite (unaffected) side, often accompanied by
distended neck veins.
3. The nurse is assigned to four clients. Which client should the nurse assess first?
A. A client with COPD and an oxygen saturation of 89% on 2L NC
B. A client with a new onset of atrial fibrillation with a heart rate of 115 bpm
C. A client 2 hours post-thyroidectomy reporting tingling around the mouth
D. A client scheduled for surgery in 1 hour who is crying
C. A client 2 hours post-thyroidectomy reporting tingling around the mouth
Answer: C
Conceptual Explanation: Tingling around the mouth (circumoral paresthesia) post-
thyroidectomy indicates hypocalcemia, which can lead to laryngospasm and airway
obstruction, making it the highest priority.
, 4. Which task is most appropriate for the nurse to delegate to an unlicensed assistive
personnel (UAP)?
A. Obtaining a clean-catch urine specimen from a mobile client
B. Feeding a client with dysphagia for the first time post-stroke
C. Changing the dressing of a stage II pressure ulcer
D. Teaching a client how to use an incentive spirometer
Answer: A
Conceptual Explanation: UAPs can perform routine tasks such as specimen collection for
stable clients. Nursing assessment, dressing changes (sterile or medicated), and teaching
are responsibilities of the licensed nurse.
5. A client with Type 1 Diabetes Mellitus presents with Kussmaul respirations and a fruity
breath odor. The nurse anticipates which of the following arterial blood gas results?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.45, PaCO2 35, HCO3 24
C. pH 7.32, PaCO2 50, HCO3 28
D. pH 7.30, PaCO2 40, HCO3 18
Answer: D
Conceptual Explanation: The description indicates Diabetic Ketoacidosis (DKA), which
manifests as metabolic acidosis (low pH and low bicarbonate).
