RN Exit-Style Practice Exam with
correct answers and rationale
updated 2026 graded A+ new!!
1. A client receiving a blood transfusion develops chills, fever, and low back pain. What should the
nurse do first?
A. Slow the transfusion rate
B. Stop the transfusion
C. Administer acetaminophen
D. Notify the blood bank
Answer: B. Stop the transfusion
Rationale: Signs suggest an acute transfusion reaction; the first action is to stop the transfusion
immediately.
2. The nurse is preparing to administer digoxin. Which finding requires the nurse to hold the
medication?
A. Blood pressure 138/82 mmHg
B. Respiratory rate 18/min
C. Apical pulse 54/min
D. Potassium 4.2 mEq/L
Answer: C. Apical pulse 54/min
Rationale: Digoxin should generally be held if the adult apical pulse is below 60/min.
3. A client with diabetic ketoacidosis is admitted. Which prescription should the nurse expect first?
A. IV regular insulin bolus
B. IV 0.9% normal saline
,C. Subcutaneous NPH insulin
D. Oral potassium replacement
Answer: B. IV 0.9% normal saline
Rationale: Fluid resuscitation is the first priority in DKA to restore circulating volume.
4. A client with SIADH has a sodium level of 124 mEq/L. Which intervention is appropriate?
A. Encourage oral fluids
B. Administer hypotonic IV fluids
C. Institute fluid restriction
D. Provide a high-potassium diet
Answer: C. Institute fluid restriction
Rationale: SIADH causes water retention and dilutional hyponatremia, treated with fluid restriction.
5. Which ECG change is most concerning in a client with hyperkalemia?
A. Flattened T waves
B. Peaked T waves
C. ST depression
D. U waves
Answer: B. Peaked T waves
Rationale: Hyperkalemia commonly causes tall, peaked T waves and can lead to fatal dysrhythmias.
6. A client is diagnosed with bacterial meningitis. Which isolation precaution is required?
A. Contact
B. Airborne
C. Droplet
D. Protective
Answer: C. Droplet
, Rationale: Bacterial meningitis requires droplet precautions until appropriate antibiotic therapy has
been given.
7. A client arrives with stroke symptoms that began 2 hours ago. Which question is most important?
A. “Do you take aspirin?”
B. “Have you had any recent surgery or bleeding?”
C. “Do you smoke cigarettes?”
D. “Do you have a family history of stroke?”
Answer: B. “Have you had any recent surgery or bleeding?”
Rationale: Thrombolytic therapy eligibility requires assessment for bleeding risks and
contraindications.
8. A client reports crushing chest pain. Which action should the nurse prioritize?
A. Obtain a 12-lead ECG
B. Encourage deep breathing
C. Offer a meal tray
D. Place the client in Trendelenburg position
Answer: A. Obtain a 12-lead ECG
Rationale: A 12-lead ECG should be obtained quickly to evaluate for myocardial infarction.
9. A client with COPD is receiving oxygen. Which oxygen saturation goal is typically appropriate?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
Answer: C. 88–92%
Rationale: COPD clients are often maintained at 88–92% to avoid excessive oxygen administration.
10. Which method confirms correct placement of a newly inserted nasogastric tube?
correct answers and rationale
updated 2026 graded A+ new!!
1. A client receiving a blood transfusion develops chills, fever, and low back pain. What should the
nurse do first?
A. Slow the transfusion rate
B. Stop the transfusion
C. Administer acetaminophen
D. Notify the blood bank
Answer: B. Stop the transfusion
Rationale: Signs suggest an acute transfusion reaction; the first action is to stop the transfusion
immediately.
2. The nurse is preparing to administer digoxin. Which finding requires the nurse to hold the
medication?
A. Blood pressure 138/82 mmHg
B. Respiratory rate 18/min
C. Apical pulse 54/min
D. Potassium 4.2 mEq/L
Answer: C. Apical pulse 54/min
Rationale: Digoxin should generally be held if the adult apical pulse is below 60/min.
3. A client with diabetic ketoacidosis is admitted. Which prescription should the nurse expect first?
A. IV regular insulin bolus
B. IV 0.9% normal saline
,C. Subcutaneous NPH insulin
D. Oral potassium replacement
Answer: B. IV 0.9% normal saline
Rationale: Fluid resuscitation is the first priority in DKA to restore circulating volume.
4. A client with SIADH has a sodium level of 124 mEq/L. Which intervention is appropriate?
A. Encourage oral fluids
B. Administer hypotonic IV fluids
C. Institute fluid restriction
D. Provide a high-potassium diet
Answer: C. Institute fluid restriction
Rationale: SIADH causes water retention and dilutional hyponatremia, treated with fluid restriction.
5. Which ECG change is most concerning in a client with hyperkalemia?
A. Flattened T waves
B. Peaked T waves
C. ST depression
D. U waves
Answer: B. Peaked T waves
Rationale: Hyperkalemia commonly causes tall, peaked T waves and can lead to fatal dysrhythmias.
6. A client is diagnosed with bacterial meningitis. Which isolation precaution is required?
A. Contact
B. Airborne
C. Droplet
D. Protective
Answer: C. Droplet
, Rationale: Bacterial meningitis requires droplet precautions until appropriate antibiotic therapy has
been given.
7. A client arrives with stroke symptoms that began 2 hours ago. Which question is most important?
A. “Do you take aspirin?”
B. “Have you had any recent surgery or bleeding?”
C. “Do you smoke cigarettes?”
D. “Do you have a family history of stroke?”
Answer: B. “Have you had any recent surgery or bleeding?”
Rationale: Thrombolytic therapy eligibility requires assessment for bleeding risks and
contraindications.
8. A client reports crushing chest pain. Which action should the nurse prioritize?
A. Obtain a 12-lead ECG
B. Encourage deep breathing
C. Offer a meal tray
D. Place the client in Trendelenburg position
Answer: A. Obtain a 12-lead ECG
Rationale: A 12-lead ECG should be obtained quickly to evaluate for myocardial infarction.
9. A client with COPD is receiving oxygen. Which oxygen saturation goal is typically appropriate?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
Answer: C. 88–92%
Rationale: COPD clients are often maintained at 88–92% to avoid excessive oxygen administration.
10. Which method confirms correct placement of a newly inserted nasogastric tube?
