Comprehensive Final Exam
100 Verified Questions &Answers with Detailed Rationales
2026/2027/2028 Testing Cycle |Modules 1-12
Joyce University
SECTION 1: VITAL SIGNS, IV THERAPY & MEDICATION ADMINISTRATION (20
Questions)
Q1: A nurse is preparing to measure orthostatic vital signs on a patient who reports dizziness
when standing. Which sequence should the nurse follow?
A. Standing, sitting, lying
B. Lying, sitting, standing
C. Sitting, lying, standing
D. Standing, lying, sitting
Answer: B
Rationale: Orthostatic vital signs are measured with the patient lying down first, then sitting, then
standing. This sequence allows the nurse to detect drops in blood pressure and increases in heart
rate upon position changes.
Q2: A nurse is assessing a patient and notes a pulse deficit. Which action should the nurse take?
A. Document the finding as normal
B. Reassess the radial pulse only
C. Notify the provider immediately
D. Compare the apical and radial pulses simultaneously
Answer: D
,Rationale: A pulse deficit is the difference between the apical and radial pulse rates. It is detected
by having two nurses simultaneously count the apical and radial pulses. A pulse deficit may
indicate atrial fibrillation or other arrhythmias.
Q3: A nurse is calculating the mean arterial pressure (MAP) for a patient with a blood pressure
of 120/80 mmHg. What is the MAP?
A. 80 mmHg
B. 93 mmHg
C. 100 mmHg
D. 120 mmHg
Answer: B
Rationale: MAP = (Systolic + 2 × Diastolic) ÷ 3 = (120 + 160) ÷ 3 = 280 ÷ 3 = 93.3 ≈ 93 mmHg.
A MAP of at least 60 mmHg is needed to perfuse vital organs.
Q4: A nurse is assessing a patient's IV site and notes coolness, pallor, and swelling around the
insertion site. Which complication should the nurse suspect?
A. Phlebitis
B. Infiltration
C. Extravasation
D. Infection
Answer: B
Rationale: Infiltration occurs when IV fluid enters the surrounding tissue instead of the vein,
causing coolness, pallor, swelling, and discomfort. Phlebitis presents with redness, warmth, and
tenderness along the vein.
Q5: A nurse is caring for a patient receiving a blood transfusion. Which action should the nurse
take during the first 15 minutes?
A. Stay with the patient and monitor for reactions
B. Leave the room to complete other tasks
C. Increase the infusion rate to complete the transfusion faster
D. Administer the blood without a filter
Answer: A
,Rationale: The nurse must stay with the patient during the first 15 minutes of a blood transfusion
because most acute transfusion reactions occur during this time. Vital signs are taken before, 15
minutes after starting, and at the end of the transfusion.
Q6: A nurse is preparing to administer insulin. Which action is correct?
A. Administer insulin intramuscularly
B. Use a tuberculin syringe
C. Verify the dose with a second nurse
D. Administer insulin with meals
Answer: C
Rationale: Insulin is a high-alert medication requiring a second nurse to verify the dose and type
before administration. Insulin is administered subcutaneously, not intramuscularly, and uses an
insulin syringe.
Q7: A nurse is caring for a patient receiving heparin. Which laboratory value should the nurse
monitor?
A. INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
Warfarin therapy is monitored using the INR.
Q8: A nurse is administering digoxin to a patient. Which action should the nurse take before
administration?
A. Check the apical pulse for 1 full minute
B. Check the radial pulse for 15 seconds
C. Administer the medication with food
D. Check the blood pressure
Answer: A
Rationale: Digoxin slows the heart rate. The nurse must check the apical pulse for 1 full minute
and hold the medication if the pulse is below 60 beats/min in adults.
, Q9: A nurse is caring for a patient who develops crackles, jugular venous distention, and edema
after receiving IV fluids. Which complication should the nurse suspect?
A. Fluid overload
B. Dehydration
C. Infiltration
D. Phlebitis
Answer: A
Rationale: Fluid overload (hypervolemia) presents with crackles, JVD, edema, weight gain, and
hypertension. The nurse should slow the IV rate and notify the provider.
Q10: A nurse is preparing to administer a medication via a central venous catheter. Which action
is correct?
A. Use clean technique
B. Verify catheter placement with a chest X-ray
C. Administer the medication rapidly
D. Use a smaller syringe for all medications
Answer: B
Rationale: Central venous catheter placement must be verified with a chest X-ray before use to
ensure the tip is in the superior vena cava and not in the heart or pleural space.
Q11: Which of the following are signs of phlebitis at an IV site? (Select all that apply.)
A. Redness along the vein
B. Warmth at the site
C. Coolness and pallor
D. Tenderness along the vein
E. Swelling at the site
Answer: A, B, D, E
Rationale: Phlebitis presents with redness, warmth, tenderness, and swelling along the vein.
Coolness and pallor indicate infiltration.