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KAPLAN INTEGRATED TEST 4 — COMPREHENSIVE
PRACTICE EXAM 2026/2027 COMPLETE (100) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
KAPLAN
Prepare for the Kaplan Integrated Test 4 Exam with a focused study resource designed
to reinforce essential nursing concepts across multiple clinical areas. It supports
review of patient assessment, safety, prioritization, clinical judgment, nursing
interventions, and effective care planning. Use the material to strengthen knowledge,
identify areas for additional study, and build confidence before the exam. This
resource is best suited for nursing students and NCLEX candidates preparing for
comprehensive integrated assessments.
MULTIPLE CHOICE.
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-15)
1. A client is diagnosed with hypertension. The client says, "I have trouble
remembering to take my medications, but I am now only smoking 5
cigarettes a day instead of 2 packs." Which response by the nurse is best?
a) "Ask your spouse to help you remember the medications. The smoking
needs to be reduced even more."
b) "It is good that your smoking has decreased. Let's talk about ways to
remember the medication."
c) "You must take the medication, and the smoking habit needs to stop very
soon."
d) "It sounds like you are trying to adhere to the plan. Tell me about your
current diet."
Answer: b) "It is good that your smoking has decreased. Let's talk about
ways to remember the medication."
Rationale: This response uses therapeutic communication by acknowledging
the client's positive behavior change (reduced smoking) while collaboratively
addressing the medication adherence issue. Options a and c are judgmental
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and nontherapeutic; option d shifts focus away from the medication
adherence concern.
2. A client is diagnosed with myasthenia gravis. The client says, "I am tired
all the time and I don't want to live anymore. If I stop taking my
medication, I can stop breathing." Which is the nurse's best response?
a) Ask the client about feelings of hopelessness
b) Give the client information about a myasthenia gravis support group
c) Place the client on suicide watch
d) Teach the client about the new medication
Answer: a) Ask the client about feelings of hopelessness
Rationale: The client's statement about not wanting to live indicates potential
suicidal ideation. The priority is to assess the client's feelings of hopelessness
and explore the risk of self-harm. Placing on suicide watch may be needed
after assessment, but direct questioning is the first step.
3. The nurse suctions a client's tracheostomy. Which techniques does the
nurse use? (Select all that apply)
a) Routinely instills sterile normal saline before suctioning
b) Applies suction when inserting the catheter
c) Suctions the client every hour
d) Uses sterile technique when suctioning
e) Rotates the catheter when withdrawing
f) Uses intermittent suctioning
Answer: d, e, f — Uses sterile technique when suctioning; Rotates the
catheter when withdrawing; Uses intermittent suctioning
Rationale: Sterile technique is required for tracheostomy suctioning. The
catheter should be rotated during withdrawal to prevent trauma to the
tracheal mucosa. Intermittent suctioning is applied only during withdrawal,
not insertion. Routine instillation of saline is no longer recommended,
suctioning should be based on client need not a fixed schedule, and suction
should never be applied during catheter insertion.
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4. A client just had an upper GI X-ray procedure. Which information is
most important for the nurse to give the client?
a) Save stool specimen after 48 hours
b) Take a laxative after 72 hours if no stool
c) Clear liquid diet only for 24 hours then a regular diet
d) Drink large amounts of fluid for 72 hours
Answer: d) Drink large amounts of fluid for 72 hours
Rationale: After an upper GI X-ray using barium contrast, the client should
drink large amounts of fluid to help eliminate the barium and prevent
constipation or fecal impaction.
5. A client experiences anaphylactic shock caused by a reaction to a
medication. IV diphenhydramine is administered, and the client appears
to be recovering. Which vital sign is the most important for the nurse to
monitor for the next several hours?
a) Respirations
b) Blood pressure
c) Pulse
d) Temperature
Answer: a) Respirations
Rationale: In anaphylaxis, airway compromise and respiratory distress are
the greatest threats. Even after initial recovery, the client remains at risk for
recurrent respiratory symptoms or biphasic reactions. Respiratory status
must be monitored closely.
6. A client with acute pain has a prescription for morphine sulfate 8 mg IV
every 3-4 hours as needed for pain. The client asks the nurse for the
medication at bedtime. Prior to administering the pain medication, the
nurse takes which initial action?
a) Assumes the pain is physiological
b) Checks to see if the client has a history of addiction
c) Tries several other pain relief measures
d) Assesses location, character, and intensity of pain
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Answer: d) Assesses location, character, and intensity of pain
Rationale: The nurse must perform a comprehensive pain assessment
(location, character, intensity, duration, and aggravating/alleviating factors)
before administering any analgesic. This ensures appropriate medication
selection and dosing.
7. A client diagnosed with a necrotizing spider bite is to perform dressing
changes at home. Which client statement indicates to the nurse a correct
understanding of medical asepsis?
a) "I need to buy sterile gloves to redress this wound"
b) "I should wash my hands before redressing my wound"
c) "I need to keep the wound covered at all times"
d) "I will use an over-the-counter antimicrobial ointment"
Answer: b) "I should wash my hands before redressing my wound"
Rationale: Hand hygiene is the foundation of medical asepsis. Medical
asepsis (clean technique) does not require sterile gloves for a home dressing
change—clean gloves and handwashing are sufficient. Keeping the wound
covered and using ointment are also appropriate but do not specifically
demonstrate understanding of asepsis.
8. The nurse obtains a health history from an older adult client. Which
statement does the nurse expect the client to make?
a) "I get fewer urinary tract infections than I did before."
b) "My appetite is so much better than it used to be."
c) "I think that I am a little shorter than I used to be."
d) "I get so warm I need to wear lighter clothing."
Answer: c) "I think that I am a little shorter than I used to be."
Rationale: Age-related changes include loss of height due to vertebral
compression and postural changes. Older adults typically have decreased
appetite, increased susceptibility to UTIs, and decreased ability to regulate
temperature (feeling cold more often).
KAPLAN INTEGRATED TEST 4 — COMPREHENSIVE
PRACTICE EXAM 2026/2027 COMPLETE (100) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
KAPLAN
Prepare for the Kaplan Integrated Test 4 Exam with a focused study resource designed
to reinforce essential nursing concepts across multiple clinical areas. It supports
review of patient assessment, safety, prioritization, clinical judgment, nursing
interventions, and effective care planning. Use the material to strengthen knowledge,
identify areas for additional study, and build confidence before the exam. This
resource is best suited for nursing students and NCLEX candidates preparing for
comprehensive integrated assessments.
MULTIPLE CHOICE.
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-15)
1. A client is diagnosed with hypertension. The client says, "I have trouble
remembering to take my medications, but I am now only smoking 5
cigarettes a day instead of 2 packs." Which response by the nurse is best?
a) "Ask your spouse to help you remember the medications. The smoking
needs to be reduced even more."
b) "It is good that your smoking has decreased. Let's talk about ways to
remember the medication."
c) "You must take the medication, and the smoking habit needs to stop very
soon."
d) "It sounds like you are trying to adhere to the plan. Tell me about your
current diet."
Answer: b) "It is good that your smoking has decreased. Let's talk about
ways to remember the medication."
Rationale: This response uses therapeutic communication by acknowledging
the client's positive behavior change (reduced smoking) while collaboratively
addressing the medication adherence issue. Options a and c are judgmental
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and nontherapeutic; option d shifts focus away from the medication
adherence concern.
2. A client is diagnosed with myasthenia gravis. The client says, "I am tired
all the time and I don't want to live anymore. If I stop taking my
medication, I can stop breathing." Which is the nurse's best response?
a) Ask the client about feelings of hopelessness
b) Give the client information about a myasthenia gravis support group
c) Place the client on suicide watch
d) Teach the client about the new medication
Answer: a) Ask the client about feelings of hopelessness
Rationale: The client's statement about not wanting to live indicates potential
suicidal ideation. The priority is to assess the client's feelings of hopelessness
and explore the risk of self-harm. Placing on suicide watch may be needed
after assessment, but direct questioning is the first step.
3. The nurse suctions a client's tracheostomy. Which techniques does the
nurse use? (Select all that apply)
a) Routinely instills sterile normal saline before suctioning
b) Applies suction when inserting the catheter
c) Suctions the client every hour
d) Uses sterile technique when suctioning
e) Rotates the catheter when withdrawing
f) Uses intermittent suctioning
Answer: d, e, f — Uses sterile technique when suctioning; Rotates the
catheter when withdrawing; Uses intermittent suctioning
Rationale: Sterile technique is required for tracheostomy suctioning. The
catheter should be rotated during withdrawal to prevent trauma to the
tracheal mucosa. Intermittent suctioning is applied only during withdrawal,
not insertion. Routine instillation of saline is no longer recommended,
suctioning should be based on client need not a fixed schedule, and suction
should never be applied during catheter insertion.
, Page 3 of 39
4. A client just had an upper GI X-ray procedure. Which information is
most important for the nurse to give the client?
a) Save stool specimen after 48 hours
b) Take a laxative after 72 hours if no stool
c) Clear liquid diet only for 24 hours then a regular diet
d) Drink large amounts of fluid for 72 hours
Answer: d) Drink large amounts of fluid for 72 hours
Rationale: After an upper GI X-ray using barium contrast, the client should
drink large amounts of fluid to help eliminate the barium and prevent
constipation or fecal impaction.
5. A client experiences anaphylactic shock caused by a reaction to a
medication. IV diphenhydramine is administered, and the client appears
to be recovering. Which vital sign is the most important for the nurse to
monitor for the next several hours?
a) Respirations
b) Blood pressure
c) Pulse
d) Temperature
Answer: a) Respirations
Rationale: In anaphylaxis, airway compromise and respiratory distress are
the greatest threats. Even after initial recovery, the client remains at risk for
recurrent respiratory symptoms or biphasic reactions. Respiratory status
must be monitored closely.
6. A client with acute pain has a prescription for morphine sulfate 8 mg IV
every 3-4 hours as needed for pain. The client asks the nurse for the
medication at bedtime. Prior to administering the pain medication, the
nurse takes which initial action?
a) Assumes the pain is physiological
b) Checks to see if the client has a history of addiction
c) Tries several other pain relief measures
d) Assesses location, character, and intensity of pain
, Page 4 of 39
Answer: d) Assesses location, character, and intensity of pain
Rationale: The nurse must perform a comprehensive pain assessment
(location, character, intensity, duration, and aggravating/alleviating factors)
before administering any analgesic. This ensures appropriate medication
selection and dosing.
7. A client diagnosed with a necrotizing spider bite is to perform dressing
changes at home. Which client statement indicates to the nurse a correct
understanding of medical asepsis?
a) "I need to buy sterile gloves to redress this wound"
b) "I should wash my hands before redressing my wound"
c) "I need to keep the wound covered at all times"
d) "I will use an over-the-counter antimicrobial ointment"
Answer: b) "I should wash my hands before redressing my wound"
Rationale: Hand hygiene is the foundation of medical asepsis. Medical
asepsis (clean technique) does not require sterile gloves for a home dressing
change—clean gloves and handwashing are sufficient. Keeping the wound
covered and using ointment are also appropriate but do not specifically
demonstrate understanding of asepsis.
8. The nurse obtains a health history from an older adult client. Which
statement does the nurse expect the client to make?
a) "I get fewer urinary tract infections than I did before."
b) "My appetite is so much better than it used to be."
c) "I think that I am a little shorter than I used to be."
d) "I get so warm I need to wear lighter clothing."
Answer: c) "I think that I am a little shorter than I used to be."
Rationale: Age-related changes include loss of height due to vertebral
compression and postural changes. Older adults typically have decreased
appetite, increased susceptibility to UTIs, and decreased ability to regulate
temperature (feeling cold more often).
