ADULT HEALTH NURSING
COMPREHENSIVE PRACTICE
EXAM
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
, Adult Health Nursing Comprehensive Practice Exam 2026–
2027
Original Questions & Rationales
Instructions: Choose the best answer for each question. Each item includes the correct answer, a detailed rationale,
and an analysis of why the remaining options are incorrect.
—
UNIT 1: Cardiovascular Nursing
Question 1
A nurse is caring for a client admitted with acute decompensated heart failure. The client is receiving
furosemide IV. Which assessment finding requires immediate notification of the healthcare provider?
A. Urine output of 1,200 mL over 4 hours
B. Serum potassium of 3.1 mEq/L
C. Weight loss of 0.5 kg in 24 hours
D. Blood pressure of 118/72 mm Hg
Correct Answer: B
Detailed Rationale: Loop diuretics such as furosemide cause significant potassium excretion. A serum
potassium of 3.1 mEq/L indicates hypokalemia, which places the client at risk for life-threatening dysrhythmias
(especially ventricular dysrhythmias and digoxin toxicity if concurrently prescribed). The nurse must notify the
provider for potassium replacement and rhythm monitoring.
Why the Other Options Are Incorrect:
- A: Urine output of 1,200 mL over 4 hours (300 mL/hr) demonstrates effective diuresis, which is the
therapeutic goal.
- C: A 0.5 kg weight loss in 24 hours is expected and appropriate with diuretic therapy (goal is often 0.5–1
kg/day).
- D: BP of 118/72 mm Hg is within normal limits and not immediately concerning.
—
Question 2
A client is scheduled for a cardiac catheterization via the femoral artery. Which pre-procedure instruction is
most important for the nurse to provide?
A. "You may eat a light breakfast before the procedure."
B. "You will need to remain flat for several hours after the procedure."
C. "You should stop taking your metformin 24 hours before the procedure."
D. "You will receive general anesthesia during the procedure."
Correct Answer: B
Detailed Rationale: After femoral artery catheterization, the client must remain flat and keep the affected
extremity straight for several hours (typically 4–6 hours) to prevent bleeding, hematoma formation, and
pseudoaneurysm at the puncture site. This is a critical post-procedure safety instruction that should be
explained pre-procedure so the client understands what to expect.
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
,Why the Other Options Are Incorrect:
- A: Clients are typically NPO 6–8 hours before cardiac catheterization to reduce the risk of aspiration and
vomiting during the procedure.
- C: Metformin is typically held 48 hours before and after procedures involving iodinated contrast due to the
risk of contrast-induced nephropathy and lactic acidosis; the timing stated is incorrect, and this is not the
most important instruction.
- D: Cardiac catheterization uses local anesthesia with conscious sedation, not general anesthesia.
—
Question 3
A nurse is teaching a client about lifestyle modifications to manage hypertension. Which statement by the client
indicates a need for further teaching?
A. "I will limit my sodium intake to less than 1,500 mg per day."
B. "I will try to exercise for at least 30 minutes most days of the week."
C. "I can continue to drink alcohol as long as I limit it to 3 drinks per day."
D. "I will monitor my blood pressure at home and keep a log."
Correct Answer: C
Detailed Rationale: For clients with hypertension, alcohol intake should be limited to no more than 2 standard
drinks per day for men and 1 standard drink per day for women. Stating "3 drinks per day" exceeds
recommended limits and indicates the client needs further education. Excessive alcohol consumption raises
blood pressure and reduces the effectiveness of antihypertensive therapy.
Why the Other Options Are Incorrect:
- A: Limiting sodium to less than 1,500 mg/day is a recommended DASH-style approach for hypertension
management.
- B: At least 30 minutes of moderate aerobic activity most days is consistent with AHA/ACC guidelines.
- D: Home BP monitoring and logging is an appropriate self-management strategy.
—
Question 4
A client with atrial fibrillation is prescribed warfarin. The client's INR is 5.8. Which action should the nurse take
first?
A. Administer the next scheduled dose of warfarin
B. Prepare to administer vitamin K (phytonadione)
C. Encourage the client to increase intake of green leafy vegetables
D. Document the finding and reassess in 24 hours
Correct Answer: B
Detailed Rationale: An INR of 5.8 is critically elevated (therapeutic range for atrial fibrillation is typically 2.0–
3.0), placing the client at high risk for hemorrhage. The nurse should hold the warfarin dose and prepare to
administer vitamin K (phytonadione), the antidote for warfarin, as prescribed. The provider must be notified
immediately.
Why the Other Options Are Incorrect:
- A: Administering more warfarin would further increase bleeding risk.
- C: Increasing vitamin K–rich foods (green leafy vegetables) can interfere with warfarin, but this is not the
immediate action for a critically elevated INR; IV vitamin K is required.
- D: Simply documenting and reassessing in 24 hours would delay necessary treatment and endanger the
client.
—
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
, Question 5
A nurse is assessing a client with suspected infective endocarditis. Which clinical manifestation is most
consistent with this diagnosis?
A. Janeway lesions on the palms and soles
B. Pitting edema of the lower extremities
C. Jugular venous distention
D. Crackles in the lung bases
Correct Answer: A
Detailed Rationale: Janeway lesions are small, painless, erythematous macules on the palms and soles
caused by septic emboli, a classic peripheral manifestation of infective endocarditis. Other classic findings
include Osler nodes, Roth spots, splinter hemorrhages, and a new or changed murmur.
Why the Other Options Are Incorrect:
- B: Pitting edema is more consistent with heart failure, venous insufficiency, or renal disease.
- C: Jugular venous distention indicates right-sided heart failure or fluid overload.
- D: Crackles in the lung bases suggest pulmonary congestion or pneumonia.
—
UNIT 2: Respiratory Nursing
Question 6
A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 86% on room air. The
healthcare provider prescribes oxygen therapy. Which oxygen delivery method and flow rate is most
appropriate?
A. Nasal cannula at 1–2 L/min
B. Simple face mask at 8 L/min
C. Non-rebreather mask at 12 L/min
D. Venturi mask at 40%
Correct Answer: A
Detailed Rationale: Clients with COPD often have chronic hypercapnia and rely on hypoxic drive to stimulate
breathing. Therefore, oxygen should be titrated carefully, typically starting at 1–2 L/min via nasal cannula, with a
target SpO₂ of 88–92%. This low-flow approach minimizes the risk of oxygen-induced hypercapnia and
respiratory depression.
Why the Other Options Are Incorrect:
- B: 8 L/min via simple face mask delivers a high FiO₂ that could suppress the hypoxic drive in a COPD
client.
- C: A non-rebreather at 12 L/min is for emergencies (e.g., severe hypoxemia, trauma) and is too high for
routine COPD management.
- D: Venturi mask at 40% provides a precise but relatively high FiO₂ that may exceed the target range for
COPD clients.
—
Question 7
A nurse is caring for a client with a chest tube following a thoracotomy. Which finding requires immediate
intervention?
A. Continuous bubbling in the water-seal chamber
B. Intermittent bubbling in the suction control chamber
C. Tidaling in the water-seal chamber with respiration
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
COMPREHENSIVE PRACTICE
EXAM
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
, Adult Health Nursing Comprehensive Practice Exam 2026–
2027
Original Questions & Rationales
Instructions: Choose the best answer for each question. Each item includes the correct answer, a detailed rationale,
and an analysis of why the remaining options are incorrect.
—
UNIT 1: Cardiovascular Nursing
Question 1
A nurse is caring for a client admitted with acute decompensated heart failure. The client is receiving
furosemide IV. Which assessment finding requires immediate notification of the healthcare provider?
A. Urine output of 1,200 mL over 4 hours
B. Serum potassium of 3.1 mEq/L
C. Weight loss of 0.5 kg in 24 hours
D. Blood pressure of 118/72 mm Hg
Correct Answer: B
Detailed Rationale: Loop diuretics such as furosemide cause significant potassium excretion. A serum
potassium of 3.1 mEq/L indicates hypokalemia, which places the client at risk for life-threatening dysrhythmias
(especially ventricular dysrhythmias and digoxin toxicity if concurrently prescribed). The nurse must notify the
provider for potassium replacement and rhythm monitoring.
Why the Other Options Are Incorrect:
- A: Urine output of 1,200 mL over 4 hours (300 mL/hr) demonstrates effective diuresis, which is the
therapeutic goal.
- C: A 0.5 kg weight loss in 24 hours is expected and appropriate with diuretic therapy (goal is often 0.5–1
kg/day).
- D: BP of 118/72 mm Hg is within normal limits and not immediately concerning.
—
Question 2
A client is scheduled for a cardiac catheterization via the femoral artery. Which pre-procedure instruction is
most important for the nurse to provide?
A. "You may eat a light breakfast before the procedure."
B. "You will need to remain flat for several hours after the procedure."
C. "You should stop taking your metformin 24 hours before the procedure."
D. "You will receive general anesthesia during the procedure."
Correct Answer: B
Detailed Rationale: After femoral artery catheterization, the client must remain flat and keep the affected
extremity straight for several hours (typically 4–6 hours) to prevent bleeding, hematoma formation, and
pseudoaneurysm at the puncture site. This is a critical post-procedure safety instruction that should be
explained pre-procedure so the client understands what to expect.
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
,Why the Other Options Are Incorrect:
- A: Clients are typically NPO 6–8 hours before cardiac catheterization to reduce the risk of aspiration and
vomiting during the procedure.
- C: Metformin is typically held 48 hours before and after procedures involving iodinated contrast due to the
risk of contrast-induced nephropathy and lactic acidosis; the timing stated is incorrect, and this is not the
most important instruction.
- D: Cardiac catheterization uses local anesthesia with conscious sedation, not general anesthesia.
—
Question 3
A nurse is teaching a client about lifestyle modifications to manage hypertension. Which statement by the client
indicates a need for further teaching?
A. "I will limit my sodium intake to less than 1,500 mg per day."
B. "I will try to exercise for at least 30 minutes most days of the week."
C. "I can continue to drink alcohol as long as I limit it to 3 drinks per day."
D. "I will monitor my blood pressure at home and keep a log."
Correct Answer: C
Detailed Rationale: For clients with hypertension, alcohol intake should be limited to no more than 2 standard
drinks per day for men and 1 standard drink per day for women. Stating "3 drinks per day" exceeds
recommended limits and indicates the client needs further education. Excessive alcohol consumption raises
blood pressure and reduces the effectiveness of antihypertensive therapy.
Why the Other Options Are Incorrect:
- A: Limiting sodium to less than 1,500 mg/day is a recommended DASH-style approach for hypertension
management.
- B: At least 30 minutes of moderate aerobic activity most days is consistent with AHA/ACC guidelines.
- D: Home BP monitoring and logging is an appropriate self-management strategy.
—
Question 4
A client with atrial fibrillation is prescribed warfarin. The client's INR is 5.8. Which action should the nurse take
first?
A. Administer the next scheduled dose of warfarin
B. Prepare to administer vitamin K (phytonadione)
C. Encourage the client to increase intake of green leafy vegetables
D. Document the finding and reassess in 24 hours
Correct Answer: B
Detailed Rationale: An INR of 5.8 is critically elevated (therapeutic range for atrial fibrillation is typically 2.0–
3.0), placing the client at high risk for hemorrhage. The nurse should hold the warfarin dose and prepare to
administer vitamin K (phytonadione), the antidote for warfarin, as prescribed. The provider must be notified
immediately.
Why the Other Options Are Incorrect:
- A: Administering more warfarin would further increase bleeding risk.
- C: Increasing vitamin K–rich foods (green leafy vegetables) can interfere with warfarin, but this is not the
immediate action for a critically elevated INR; IV vitamin K is required.
- D: Simply documenting and reassessing in 24 hours would delay necessary treatment and endanger the
client.
—
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
, Question 5
A nurse is assessing a client with suspected infective endocarditis. Which clinical manifestation is most
consistent with this diagnosis?
A. Janeway lesions on the palms and soles
B. Pitting edema of the lower extremities
C. Jugular venous distention
D. Crackles in the lung bases
Correct Answer: A
Detailed Rationale: Janeway lesions are small, painless, erythematous macules on the palms and soles
caused by septic emboli, a classic peripheral manifestation of infective endocarditis. Other classic findings
include Osler nodes, Roth spots, splinter hemorrhages, and a new or changed murmur.
Why the Other Options Are Incorrect:
- B: Pitting edema is more consistent with heart failure, venous insufficiency, or renal disease.
- C: Jugular venous distention indicates right-sided heart failure or fluid overload.
- D: Crackles in the lung bases suggest pulmonary congestion or pneumonia.
—
UNIT 2: Respiratory Nursing
Question 6
A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 86% on room air. The
healthcare provider prescribes oxygen therapy. Which oxygen delivery method and flow rate is most
appropriate?
A. Nasal cannula at 1–2 L/min
B. Simple face mask at 8 L/min
C. Non-rebreather mask at 12 L/min
D. Venturi mask at 40%
Correct Answer: A
Detailed Rationale: Clients with COPD often have chronic hypercapnia and rely on hypoxic drive to stimulate
breathing. Therefore, oxygen should be titrated carefully, typically starting at 1–2 L/min via nasal cannula, with a
target SpO₂ of 88–92%. This low-flow approach minimizes the risk of oxygen-induced hypercapnia and
respiratory depression.
Why the Other Options Are Incorrect:
- B: 8 L/min via simple face mask delivers a high FiO₂ that could suppress the hypoxic drive in a COPD
client.
- C: A non-rebreather at 12 L/min is for emergencies (e.g., severe hypoxemia, trauma) and is too high for
routine COPD management.
- D: Venturi mask at 40% provides a precise but relatively high FiO₂ that may exceed the target range for
COPD clients.
—
Question 7
A nurse is caring for a client with a chest tube following a thoracotomy. Which finding requires immediate
intervention?
A. Continuous bubbling in the water-seal chamber
B. Intermittent bubbling in the suction control chamber
C. Tidaling in the water-seal chamber with respiration
Adult Health Nursing Comprehensive Practice Exam 2026–2027 | Practice Resource
