2026-Style Prac ce Exam
,1. A nurse is caring for a client who reports dizziness when standing. Which ac on should the
nurse take first?
A. Encourage the client to ambulate independently
B. Assist the client back to bed or a seated posi on
C. Restrict the client's oral fluid intake
D. Administer an an hypertensive medica on
Answer: B
Ra onale: The priority is preven ng injury from a fall. The nurse should immediately assist the
client to a safe posi on before further assessment.
2. Which finding should a prac cal nurse report immediately for a client receiving a blood
transfusion?
A. Temperature of 37.2°C (99°F)
B. Mild thirst
C. Chills and low back pain
D. Heart rate of 82/min
Answer: C
Ra onale: Chills and low back pain can indicate an acute hemoly c transfusion reac on. The
transfusion should be stopped immediately and the provider no fied according to facility
protocol.
3. A client with diabetes mellitus is awake, swea ng, and trembling. The client's blood glucose
is 54 mg/dL. Which ac on should the nurse take?
A. Give 15 g of rapid-ac ng carbohydrate
B. Administer regular insulin
C. Give a high-protein meal
D. Restrict oral intake
Answer: A
Ra onale: A conscious client with symptoma c hypoglycemia should receive approximately 15 g
of rapid-ac ng carbohydrate, followed by reassessment of blood glucose.
,4. Which assessment finding is most concerning in a client with pneumonia?
A. Produc ve cough
B. Temperature of 38.2°C (100.8°F)
C. Respiratory rate of 30/min
D. Crackles in the lower lobes
Answer: C
Ra onale: Tachypnea can indicate worsening respiratory distress and impaired oxygena on.
Airway and breathing take priority.
5. A nurse is teaching a client about incen ve spirometry. Which instruc on is appropriate?
A. Exhale forcefully into the device
B. Inhale slowly and deeply through the mouthpiece
C. Use the device only when shortness of breath occurs
D. Breathe rapidly through the mouthpiece
Answer: B
Ra onale: Incen ve spirometry promotes lung expansion by encouraging slow, deep inhala on
and helps prevent atelectasis.
6. A client receiving furosemide is at greatest risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C
Ra onale: Furosemide is a loop diure c that increases urinary potassium excre on, placing the
client at risk for hypokalemia.
7. Which finding indicates that a client may be experiencing fluid volume overload?
A. Flat neck veins
B. Weight loss
, C. Bilateral crackles
D. Dry mucous membranes
Answer: C
Ra onale: Pulmonary crackles can result from fluid accumula on in the lungs and are a
common manifesta on of fluid volume excess.
8. A client is receiving digoxin. Which finding should cause the nurse to withhold the
medica on and no fy the provider?
A. Apical pulse of 54/min
B. Respiratory rate of 18/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 37°C (98.6°F)
Answer: A
Ra onale: Digoxin can cause bradycardia. The medica on is generally withheld when the adult
apical pulse is below the prescribed safety threshold, commonly 60/min.
9. Which statement by a client taking warfarin indicates correct understanding?
A. “I should completely avoid foods containing vitamin K.”
B. “I should keep my vitamin K intake consistent.”
C. “I can double my dose if I miss one.”
D. “I don't need blood tests while taking this medica on.”
Answer: B
Ra onale: Clients taking warfarin should maintain a consistent intake of vitamin K rather than
elimina ng it completely. INR monitoring is also necessary.
10. Which laboratory value is most important for monitoring a client receiving heparin?
A. INR
B. aPTT
C. HbA1c
D. Serum calcium