NRNP 6540 FINAL 2026 COMPREHENSIVE
ASSESSMENT SCRIPT SOLVED QUESTIONS
ANSWERS UPDATED REVIEW SET
◉ The nurse teaches a patient with hypertension and osteoarthritis
about actions to prevent and control epistaxis. Which statement, if
made by the patient, indicates further teaching is required?
A. "I should avoid using ibuprofen for pain and discomfort."
B. "It is important for me to take my blood pressure medication
every day."
C. "I will sit down and pinch the tip of my nose for at least 10 to 15
minutes."
D. "If I get a nosebleed, I will lie down flat and raise my feet above
my heart."
Answer: D. "If I get a nosebleed, I will lie down flat and raise my feet
above my heart."
Rationale:
A simple measure to control epistaxis (or a nosebleed) is for the
patient to remain quiet in a sitting position. Another measure is to
apply direct pressure by pinching the entire soft lower portion of the
nose for 10 to 15 minutes. Aspirin and nonsteroidal
antiinflammatory drugs such as ibuprofen increase the bleeding
time and should be avoided. Elevated blood pressure makes
epistaxis more difficult to control. The patient should continue with
antihypertensive medications as prescribed
,◉ The patient has been diagnosed with head and neck cancer. Along
with the treatment for the cancer, what other treatment should the
nurse expect to teach the patient about?
A. Nasal packing
B. Epistaxis balloon
C. Gastrostomy tube
D. Peripheral skin care
Answer: C. Gastrostomy tube
Rationale:
Because 50% of patients with head and neck cancer are
malnourished before treatment begins, many patients need enteral
nutrition via a gastrostomy tube because the effects of treatment
make it difficult to take in enough nutrients orally, whether surgery,
chemotherapy, or radiation is used. Nasal packing could be used
with epistaxis or with nasal or sinus problems. Peripheral skin care
would not be expected because it is not related to head and neck
cancer.
◉ The patient has decided to use the voice rehabilitation that offers
the best speech quality even though it must be cleaned regularly.
The nurse knows that this is what kind of voice rehabilitation?
A. Electromyography
B. Intraoral electrolarynx
C. Neck type electrolarynx
,D. Transesophageal puncture
Answer: D. Transesophageal puncture
Rationale:
The transesophageal puncture provides a fistula between the
esophagus and trachea with a one-way valved prosthesis to prevent
aspiration from the esophagus to the trachea. Air moves from the
lungs and vibrates against the esophagus, and words are formed
with the tongue and lips as the air moves out the mouth. The
electromyography and both electrolarynx methods produce low-
pitched mechanical sounds.
◉ Which task can the registered nurse (RN) delegate to unlicensed
assistive personnel (UAP) in the care of a stable patient who has a
tracheostomy?
A. Assessing the need for suctioning
B. Suctioning the patient's oropharynx
C. Assessing the patient's swallowing ability
D. Maintaining appropriate cuff inflation pressure
Answer: B. Suctioning the patient's oropharynx
Rationale:
Providing the person has been trained in correct technique, the UAP
may suction the patient's oropharynx. Assessing the need for
suctioning should be performed by an RN or licensed practical
nurse. An RN should perform a swallowing assessment and maintain
cuff inflation pressure.
, ◉ A school nurse is providing information to high school students
about influenza prevention. What should the nurse emphasize in
teaching to prevent the transmission of the virus? (Select all that
apply.)
A. Cover the nose when coughing.
B. Obtain an influenza vaccination.
C. Stay at home when symptomatic.
D. Drink noncaffeinated fluids daily.
E. Obtain antibiotic therapy promptly.
Answer: A. Cover the nose when coughing.
B. Obtain an influenza vaccination.
C. Stay at home when symptomatic.
rationale:
Covering the nose and mouth when coughing is an effective way to
prevent the spread of the virus. Obtaining an influenza vaccination
helps prevent the flu. Staying at home helps prevent direct exposure
of others to the virus. Drinking fluids helps liquefy secretions but
does not prevent influenza. Antibiotic therapy is not used unless the
patient develops a secondary bacterial infection.
◉ The nurse is caring for a patient with a tracheostomy. What is the
priority nursing assessment for this patient?
A. Electrolyte levels and daily weights
ASSESSMENT SCRIPT SOLVED QUESTIONS
ANSWERS UPDATED REVIEW SET
◉ The nurse teaches a patient with hypertension and osteoarthritis
about actions to prevent and control epistaxis. Which statement, if
made by the patient, indicates further teaching is required?
A. "I should avoid using ibuprofen for pain and discomfort."
B. "It is important for me to take my blood pressure medication
every day."
C. "I will sit down and pinch the tip of my nose for at least 10 to 15
minutes."
D. "If I get a nosebleed, I will lie down flat and raise my feet above
my heart."
Answer: D. "If I get a nosebleed, I will lie down flat and raise my feet
above my heart."
Rationale:
A simple measure to control epistaxis (or a nosebleed) is for the
patient to remain quiet in a sitting position. Another measure is to
apply direct pressure by pinching the entire soft lower portion of the
nose for 10 to 15 minutes. Aspirin and nonsteroidal
antiinflammatory drugs such as ibuprofen increase the bleeding
time and should be avoided. Elevated blood pressure makes
epistaxis more difficult to control. The patient should continue with
antihypertensive medications as prescribed
,◉ The patient has been diagnosed with head and neck cancer. Along
with the treatment for the cancer, what other treatment should the
nurse expect to teach the patient about?
A. Nasal packing
B. Epistaxis balloon
C. Gastrostomy tube
D. Peripheral skin care
Answer: C. Gastrostomy tube
Rationale:
Because 50% of patients with head and neck cancer are
malnourished before treatment begins, many patients need enteral
nutrition via a gastrostomy tube because the effects of treatment
make it difficult to take in enough nutrients orally, whether surgery,
chemotherapy, or radiation is used. Nasal packing could be used
with epistaxis or with nasal or sinus problems. Peripheral skin care
would not be expected because it is not related to head and neck
cancer.
◉ The patient has decided to use the voice rehabilitation that offers
the best speech quality even though it must be cleaned regularly.
The nurse knows that this is what kind of voice rehabilitation?
A. Electromyography
B. Intraoral electrolarynx
C. Neck type electrolarynx
,D. Transesophageal puncture
Answer: D. Transesophageal puncture
Rationale:
The transesophageal puncture provides a fistula between the
esophagus and trachea with a one-way valved prosthesis to prevent
aspiration from the esophagus to the trachea. Air moves from the
lungs and vibrates against the esophagus, and words are formed
with the tongue and lips as the air moves out the mouth. The
electromyography and both electrolarynx methods produce low-
pitched mechanical sounds.
◉ Which task can the registered nurse (RN) delegate to unlicensed
assistive personnel (UAP) in the care of a stable patient who has a
tracheostomy?
A. Assessing the need for suctioning
B. Suctioning the patient's oropharynx
C. Assessing the patient's swallowing ability
D. Maintaining appropriate cuff inflation pressure
Answer: B. Suctioning the patient's oropharynx
Rationale:
Providing the person has been trained in correct technique, the UAP
may suction the patient's oropharynx. Assessing the need for
suctioning should be performed by an RN or licensed practical
nurse. An RN should perform a swallowing assessment and maintain
cuff inflation pressure.
, ◉ A school nurse is providing information to high school students
about influenza prevention. What should the nurse emphasize in
teaching to prevent the transmission of the virus? (Select all that
apply.)
A. Cover the nose when coughing.
B. Obtain an influenza vaccination.
C. Stay at home when symptomatic.
D. Drink noncaffeinated fluids daily.
E. Obtain antibiotic therapy promptly.
Answer: A. Cover the nose when coughing.
B. Obtain an influenza vaccination.
C. Stay at home when symptomatic.
rationale:
Covering the nose and mouth when coughing is an effective way to
prevent the spread of the virus. Obtaining an influenza vaccination
helps prevent the flu. Staying at home helps prevent direct exposure
of others to the virus. Drinking fluids helps liquefy secretions but
does not prevent influenza. Antibiotic therapy is not used unless the
patient develops a secondary bacterial infection.
◉ The nurse is caring for a patient with a tracheostomy. What is the
priority nursing assessment for this patient?
A. Electrolyte levels and daily weights
