Exam Nursing Competency 2026/2027 |
Practice Questions & Answers with
Detailed Rationales | Comprehensive
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(GRADED A+)
Question 1
A nurse is caring for a client with heart failure who reports
increasing shortness of breath and weight gain of 3 lb (1.4 kg) in
24 hours. Which action should the nurse take first?
A. Encourage increased oral fluids
B. Assess lung sounds and oxygen saturation
C. Restrict all physical activity
D. Obtain a dietary history
Answer: B. Assess lung sounds and oxygen saturation
Rationale: Assessment is the priority. Increasing dyspnea and
rapid weight gain may indicate fluid overload and worsening
heart failure. The nurse should first assess respiratory status
and oxygenation before implementing additional interventions.
Question 2
,Which client should the nurse assess first during a change-of-
shift report?
A. Client with diabetes whose blood glucose is 180 mg/dL
B. Client awaiting discharge instructions
C. Client reporting sudden chest pain and diaphoresis
D. Client requesting pain medication rated 4/10
Answer: C. Client reporting sudden chest pain and diaphoresis
Rationale: Sudden chest pain accompanied by diaphoresis may
indicate myocardial ischemia or infarction and requires
immediate assessment according to priority-setting principles.
Question 3
A nurse is teaching infection prevention to a newly admitted
client. Which statement by the client indicates understanding?
A. "Hand hygiene is only necessary before meals."
B. "I should wash my hands before and after touching wounds."
C. "Gloves replace the need for hand hygiene."
D. "Alcohol-based sanitizer is ineffective."
Answer: B. "I should wash my hands before and after
touching wounds."
Rationale: Proper hand hygiene before and after wound contact
reduces transmission of microorganisms and is a key infection-
control measure.
,Question 4
Which laboratory value should the nurse report immediately?
A. Potassium 6.2 mEq/L
B. Sodium 138 mEq/L
C. Hemoglobin 13.8 g/dL
D. Platelets 250,000/mm³
Answer: A. Potassium 6.2 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias and requires prompt intervention.
Question 5
A nurse delegates ambulation of a stable postoperative client to
an assistive personnel (AP). Which action remains the nurse’s
responsibility?
A. Transporting the client
B. Reporting vital signs
C. Evaluating the client's tolerance to activity
D. Assisting with hygiene
Answer: C. Evaluating the client's tolerance to activity
Rationale: Assessment and evaluation cannot be delegated. The
nurse must determine the client’s response to ambulation and
modify the plan of care accordingly.
, Question 6
A client receiving opioid medication becomes difficult to arouse
and has a respiratory rate of 8 breaths/min. Which medication
should the nurse anticipate administering?
A. Flumazenil
B. Epinephrine
C. Naloxone
D. Atropine
Answer: C. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse
respiratory depression caused by opioid overdose.
Question 7
Which finding indicates effective teaching regarding
hypertension management?
A. "I will stop my medication when I feel better."
B. "I will take my medication as prescribed even when I feel
well."
C. "I only need blood pressure checks when symptoms occur."
D. "Reducing exercise helps lower blood pressure."
Answer: B. "I will take my medication as prescribed even
when I feel well."