Chamberlain
University Nursing
Comprehensive
Exam 2026 — Practice Questions
Format: 10 multiple-choice questions | Bolded correct answers | Detailed rationales
Question 1
A nurse is preparing to administer a blood transfusion to a client who has anemia.
Which of the following actions should the nurse take first?
A. Obtain the client's vital signs
B. Prime the IV tubing with normal saline
C. Verify the client's identity using two identifiers
D. Document the transfusion in the electronic medical record
Rationale: The first action is verifying the client's identity using two identifiers to ensure
the correct blood product is administered to the correct client. This is a critical safety
step before initiating the transfusion .
,Question 2
A client who is postoperative day one following a total hip arthroplasty reports sudden
chest pain and shortness of breath. Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Incisional pain
D. Pneumonia
Rationale: Sudden chest pain and shortness of breath in a postoperative client,
especially following orthopedic surgery, are classic signs of a pulmonary embolism. This
is a life-threatening complication requiring immediate intervention .
Question 3
A nurse is assessing a client who has a sodium level of 155 mEq/L. Which finding should
the nurse expect?
A. Muscle cramps
B. Hypotension
C. Edema
D. Thirst
Rationale: A sodium level of 155 mEq/L indicates hypernatremia. Thirst is an early and
primary sign of hypernatremia as the body attempts to increase water intake to dilute
the elevated serum sodium concentration .
,Question 4
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. The client
asks, "Why do I need to take insulin injections?" Which response is most appropriate?
A. "Your body is resistant to the insulin your pancreas produces."
B. "Your pancreas is not producing enough insulin."
C. "Your body produces too much glucose."
D. "Your immune system destroys the cells that produce insulin."
Rationale: Type 1 diabetes is an autoimmune condition in which the immune system
attacks and destroys the beta cells in the pancreas, leading to absolute insulin
deficiency. Therefore, exogenous insulin is required .
Question 5
A nurse is performing a physical assessment on a client who has heart failure. Which
finding is an early indicator of fluid volume overload?
A. Peripheral edema
B. Jugular venous distention
C. Weight gain
D. Crackles in the lungs
Rationale: Weight gain is an early indicator of fluid volume overload, often occurring
before other signs such as dyspnea or edema. Daily weights are a sensitive measure for
detecting fluid retention .
, Question 6
A nurse is providing discharge teaching to a client who has a prescription for warfarin.
Which client statement indicates an understanding of the teaching?
A. "I will eat more leafy green vegetables."
B. "I will take ibuprofen for my headaches."
C. "I will report any unusual bruising or bleeding."
D. "I will take my warfarin with a glass of milk."
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. The client
should be taught to report any signs of bleeding, such as unusual bruising, bleeding
gums, or blood in the stool .
Question 7
A nurse is caring for a client who has a chest tube following a pneumothorax. Which
action is most important for the nurse to take?
A. Clamp the chest tube when moving the client
B. Ensure the drainage system is below the client's chest level
C. Strip the chest tube every 4 hours
D. Maintain the client in a supine position
Rationale: Keeping the drainage system below chest level prevents fluid from flowing
back into the pleural space, which could cause infection or compromise lung expansion .
University Nursing
Comprehensive
Exam 2026 — Practice Questions
Format: 10 multiple-choice questions | Bolded correct answers | Detailed rationales
Question 1
A nurse is preparing to administer a blood transfusion to a client who has anemia.
Which of the following actions should the nurse take first?
A. Obtain the client's vital signs
B. Prime the IV tubing with normal saline
C. Verify the client's identity using two identifiers
D. Document the transfusion in the electronic medical record
Rationale: The first action is verifying the client's identity using two identifiers to ensure
the correct blood product is administered to the correct client. This is a critical safety
step before initiating the transfusion .
,Question 2
A client who is postoperative day one following a total hip arthroplasty reports sudden
chest pain and shortness of breath. Which complication should the nurse suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Incisional pain
D. Pneumonia
Rationale: Sudden chest pain and shortness of breath in a postoperative client,
especially following orthopedic surgery, are classic signs of a pulmonary embolism. This
is a life-threatening complication requiring immediate intervention .
Question 3
A nurse is assessing a client who has a sodium level of 155 mEq/L. Which finding should
the nurse expect?
A. Muscle cramps
B. Hypotension
C. Edema
D. Thirst
Rationale: A sodium level of 155 mEq/L indicates hypernatremia. Thirst is an early and
primary sign of hypernatremia as the body attempts to increase water intake to dilute
the elevated serum sodium concentration .
,Question 4
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. The client
asks, "Why do I need to take insulin injections?" Which response is most appropriate?
A. "Your body is resistant to the insulin your pancreas produces."
B. "Your pancreas is not producing enough insulin."
C. "Your body produces too much glucose."
D. "Your immune system destroys the cells that produce insulin."
Rationale: Type 1 diabetes is an autoimmune condition in which the immune system
attacks and destroys the beta cells in the pancreas, leading to absolute insulin
deficiency. Therefore, exogenous insulin is required .
Question 5
A nurse is performing a physical assessment on a client who has heart failure. Which
finding is an early indicator of fluid volume overload?
A. Peripheral edema
B. Jugular venous distention
C. Weight gain
D. Crackles in the lungs
Rationale: Weight gain is an early indicator of fluid volume overload, often occurring
before other signs such as dyspnea or edema. Daily weights are a sensitive measure for
detecting fluid retention .
, Question 6
A nurse is providing discharge teaching to a client who has a prescription for warfarin.
Which client statement indicates an understanding of the teaching?
A. "I will eat more leafy green vegetables."
B. "I will take ibuprofen for my headaches."
C. "I will report any unusual bruising or bleeding."
D. "I will take my warfarin with a glass of milk."
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. The client
should be taught to report any signs of bleeding, such as unusual bruising, bleeding
gums, or blood in the stool .
Question 7
A nurse is caring for a client who has a chest tube following a pneumothorax. Which
action is most important for the nurse to take?
A. Clamp the chest tube when moving the client
B. Ensure the drainage system is below the client's chest level
C. Strip the chest tube every 4 hours
D. Maintain the client in a supine position
Rationale: Keeping the drainage system below chest level prevents fluid from flowing
back into the pleural space, which could cause infection or compromise lung expansion .
