Q&A Latest Update 2025/2026
| 100% PASS
1. A client with COPD is experiencing increased dyspnea. What is the priority
nursing action?
Administer prescribed bronchodilator
//Bronchodilators help open airways, which is essential during episodes of
increased dyspnea in COPD patients.
2. Which lab value should the nurse monitor when a client is on warfarin?
INR
//INR (International Normalized Ratio) measures warfarin effectiveness and
bleeding risk.
3. A client with heart failure is prescribed furosemide. What should the nurse
monitor closely?
Potassium levels
//Furosemide is a loop diuretic that can cause potassium depletion,
increasing the risk of arrhythmias.
,4. A patient with diabetes reports blurred vision and headaches. What is the
nurse’s best first action?
Check blood glucose level
//These symptoms may indicate hyperglycemia or hypoglycemia; glucose
levels must be assessed first.
5. Which oxygen delivery device delivers the most precise concentration of
oxygen?
Venturi mask
//The Venturi mask allows precise oxygen delivery by controlling the flow of
oxygen and entrained air.
6. Which nursing diagnosis is appropriate for a patient with pneumonia?
Impaired gas exchange
//Pneumonia affects alveolar function and impairs oxygen and carbon
dioxide exchange.
7. A client receiving digoxin reports nausea and blurred vision. What should
the nurse do?
Check digoxin level
//Nausea and blurred vision are signs of digoxin toxicity, and levels must be
evaluated immediately.
8. The nurse notes crackles in both lungs in a patient with heart failure. What
is the likely cause?
Pulmonary edema
//Crackles suggest fluid accumulation in the alveoli due to left-sided heart
failure.
,9. What is the priority teaching for a patient starting lisinopril?
Change positions slowly
//Lisinopril can cause orthostatic hypotension, so patients should change
positions cautiously.
10.A nurse is caring for a post-op patient who is drowsy and has a RR of 8.
What medication likely caused this?
Morphine
//Morphine is an opioid that can cause respiratory depression, especially
post-operatively.
11.A client has a stage II pressure ulcer. Which dressing is most appropriate?
Hydrocolloid dressing
//Hydrocolloid dressings provide a moist environment that promotes
healing in stage II ulcers.
12.Which finding requires immediate intervention in a patient receiving
heparin?
Bloody urine
//Bloody urine may indicate internal bleeding, a serious adverse effect of
heparin therapy.
13.A patient on metoprolol reports dizziness and fatigue. What is the best
action?
Check blood pressure and heart rate
//Beta-blockers lower BP and HR, which can cause dizziness and fatigue if
levels drop too low.
, 14.A nurse is teaching a patient about nitroglycerin. Which statement indicates
correct understanding?
"I should sit down before taking this medication."
//Nitroglycerin can cause a rapid drop in BP, so sitting or lying down
prevents injury from falls.
15.What action should a nurse take if a chest tube becomes disconnected?
Place the tube in sterile water
//Placing the tube in sterile water maintains the water seal and prevents air
from entering the chest.
16.What lab value should the nurse monitor in a client taking enoxaparin?
Platelet count
//Enoxaparin can cause thrombocytopenia, so monitoring platelet levels is
crucial.
17.Which symptom is most indicative of hypoglycemia?
Diaphoresis
//Sweating is a common early symptom of low blood sugar levels.
18.A nurse is reviewing discharge instructions for a patient with a new
ileostomy. What should be included?
"Empty the pouch when it is one-third full."
//Frequent emptying prevents leakage and skin irritation around the stoma.
19.What assessment finding indicates effectiveness of albuterol?
Clear lung sounds
//Albuterol is a bronchodilator; clearer lung sounds indicate improved
airway patency.