NURSE PRACTITIONERS IN PRIMARY CARE I
PAPER FOUR 2026 TEST SOLUTIONS GRADED
A+
◉ After receiving change of shift report about the following four
clients, which client should the nurse assess first?
a. 48 y/o admitted with a history of a-fib complaining of palpitations
and shortness of breath
b. 52 y/o being discharged to home after cardiac catheterization
c. 67 y/o admitted for heart failure who is 30 minutes behind in
getting morning medications
d. 78 y/o admitted with chest pain who just returned from x-ray
Answer: a
◉ After assessing a client who is receiving amiodarone (Cordarone)
intravenous infusion for unstable ventricular tachycardia, the nurse
documents the findings and compares these with the previous
assessment findings. Based on the assessments, which action should
the nurse take?
a. Stop the infusion and flush the IV
b. Ask the client to cough and deep breathe
,c. Administer IV normal saline
d. Slow the amiodarone infusion rate Answer: d
◉ Which nursing action is essential for the client experiencing
severe pitting edema secondary to heart failure?
a. Place in Sim's position for meals
b. Maintain strict bed rest
c. Turn the client frequently to prevent skin breakdown
d. Administer oxygen at 6 L/min via nasal cannula Answer: c
◉ When admitting a client with a non-ST segment elevation
myocardial infarction (NSTEMI) to the intensive care unit, which
nursing intervention takes priority?
a. Obtain STAT ABGs
b. Obtain UA/C&S
c. Assess the peripheral pulses
d. Assess the cardiac rhythm Answer: d
◉ A nurse is evaluating a client's response to cardioversion. Which
of the following observations would be of highest priority to the
nurse?
, a. Blood pressure
b. Level of consciousness
c. Oxygen flow rate
d. Status of airway Answer: d
◉ A client is admitted to the hospital with heart failure. The client
complains for shortness of breath and the nurse notes the heart rate
has increased from 86 bpm to 110 bpm. The nurse also notes the
respiratory effort increases with position changes. Which condition
is this client experiencing?
a. Activity intolerance
b. Impaired mobility
c. Atrial fibrillation
d. Anxiety Answer: a
◉ A 68 y/o female who presents with complaints of indigestion and
nausea is concerning for which of the following diseases? (Select all
that apply)
a. Unstable angina (UA)
b. Gastroesophageal reflux disease (GERD)
PAPER FOUR 2026 TEST SOLUTIONS GRADED
A+
◉ After receiving change of shift report about the following four
clients, which client should the nurse assess first?
a. 48 y/o admitted with a history of a-fib complaining of palpitations
and shortness of breath
b. 52 y/o being discharged to home after cardiac catheterization
c. 67 y/o admitted for heart failure who is 30 minutes behind in
getting morning medications
d. 78 y/o admitted with chest pain who just returned from x-ray
Answer: a
◉ After assessing a client who is receiving amiodarone (Cordarone)
intravenous infusion for unstable ventricular tachycardia, the nurse
documents the findings and compares these with the previous
assessment findings. Based on the assessments, which action should
the nurse take?
a. Stop the infusion and flush the IV
b. Ask the client to cough and deep breathe
,c. Administer IV normal saline
d. Slow the amiodarone infusion rate Answer: d
◉ Which nursing action is essential for the client experiencing
severe pitting edema secondary to heart failure?
a. Place in Sim's position for meals
b. Maintain strict bed rest
c. Turn the client frequently to prevent skin breakdown
d. Administer oxygen at 6 L/min via nasal cannula Answer: c
◉ When admitting a client with a non-ST segment elevation
myocardial infarction (NSTEMI) to the intensive care unit, which
nursing intervention takes priority?
a. Obtain STAT ABGs
b. Obtain UA/C&S
c. Assess the peripheral pulses
d. Assess the cardiac rhythm Answer: d
◉ A nurse is evaluating a client's response to cardioversion. Which
of the following observations would be of highest priority to the
nurse?
, a. Blood pressure
b. Level of consciousness
c. Oxygen flow rate
d. Status of airway Answer: d
◉ A client is admitted to the hospital with heart failure. The client
complains for shortness of breath and the nurse notes the heart rate
has increased from 86 bpm to 110 bpm. The nurse also notes the
respiratory effort increases with position changes. Which condition
is this client experiencing?
a. Activity intolerance
b. Impaired mobility
c. Atrial fibrillation
d. Anxiety Answer: a
◉ A 68 y/o female who presents with complaints of indigestion and
nausea is concerning for which of the following diseases? (Select all
that apply)
a. Unstable angina (UA)
b. Gastroesophageal reflux disease (GERD)
