Test Bank Concepts for Nursing Practice
(4TH Ed) by Jean Giddens 2025_2026
1 — MCQ
A postoperative patient reports shortness of breath and has an oxygen saturation of 88% on
room air. Which action should the nurse perform first?
✅
A. Call the surgeon.
B. Increase the supplemental oxygen per protocol. [Green]
C. Obtain an arterial blood gas.
D. Encourage deep-breathing exercises.
Rationale: First, correct tissue oxygenation must be restored — increasing O₂ per protocol is
immediate. Diagnostic tests and provider notification follow stabilization.
Learning objective: Immediate response to hypoxemia.
Concept: Oxygenation / Safety
2 — MCQ
A patient with heart failure has sudden weight gain of 3 kg in 48 hours and dyspnea at rest.
Which lab/test result is highest priority to review?
✅
A. Serum sodium.
B. BNP level. [Green]
C. Hemoglobin.
D. Serum calcium.
Rationale: BNP correlates with ventricular stretch and fluid overload—useful for acute
decompensated HF assessment and prioritization.
Learning objective: Identify markers of volume overload.
Concept: Perfusion / Fluid & Electrolyte
3 — MCQ
,Which instruction to a client starting a new ACE inhibitor best prevents a common side effect?
✅
A. Take the medication with grapefruit juice.
B. Stop the drug if you develop a cough. [Green]
C. Check your pulse daily.
D. Avoid salt substitutes containing potassium.
Rationale: ACE inhibitors commonly cause a dry cough; if persistent, provider should evaluate
discontinuation or substitution.
Learning objective: Recognize common ACE inhibitor adverse effects.
Concept: Pharmacology
4 — MCQ
A nurse prepares to give digoxin to a patient. The apical pulse is 48 bpm. What should the
nurse do?
✅
A. Give the medication as scheduled.
B. Hold the medication and notify the provider. [Green]
C. Double-check the dose.
D. Give oral sugar to raise the pulse.
Rationale: Digoxin can cause bradycardia; hold for significant bradycardia and notify provider.
Learning objective: Safe medication administration.
Concept: Pharmacology / Safety
5 — MCQ
Which action best reduces the risk of catheter-associated urinary tract infections (CAUTI)?
✅
A. Instill antimicrobial solution daily.
B. Use an indwelling catheter only when necessary and remove ASAP. [Green]
C. Change the catheter every 72 hours.
D. Flush the catheter twice daily.
Rationale: Use-avoidance and early removal are primary prevention strategies for CAUTI per
evidence-based practice.
Learning objective: Infection prevention for urinary devices.
Concept: Infection Control / Safety
,6 — MCQ
A patient with COPD is scheduled for discharge. Which teaching point is highest priority?
✅
A. How to use the incentive spirometer.
B. Signs of exacerbation requiring prompt medical attention. [Green]
C. Nutritional choices for weight gain.
D. How to maintain household humidity.
Rationale: Recognizing early signs of exacerbation can prevent morbidity and admission; it’s
the priority for home safety.
Learning objective: Discharge planning and risk recognition.
Concept: Oxygenation / Health Promotion
7 — MCQ
Which assessment finding indicates a complication of peripheral IV therapy?
✅
A. Slight tenderness at insertion site.
B. Coolness and pallor of the limb distal to the site. [Green]
C. Slight bruising at the site.
D. Clear drainage on dressing.
Rationale: Coolness and pallor may indicate arterial compromise or infiltration causing impaired
perfusion—requires immediate action.
Learning objective: Recognize IV complications.
Concept: Tissue Integrity / Perfusion
8 — MCQ
✅
A patient receiving a blood transfusion develops itching and urticaria. The nurse should first:
A. Stop the transfusion and keep the IV line open with saline. [Green]
B. Administer epinephrine immediately.
C. Continue transfusion and document reaction.
D. Send the patient for allergy testing.
Rationale: For allergic transfusion reactions, stop the transfusion, maintain IV with saline, and
notify provider for further orders.
Learning objective: Manage transfusion reactions.
Concept: Safety / Immune Response
, 9 — MCQ
Which intervention most effectively prevents medication errors during shift change?
✅
A. Asking patients to remind staff of their meds.
B. Performing a bedside handoff with medication reconciliation. [Green]
C. Relying on electronic medication administration record alone.
D. Allowing the oncoming nurse to prepare meds later.
Rationale: Bedside handoff with reconciliation ensures accurate med information and reduces
errors at transitions.
Learning objective: Safe handoff practices.
Concept: Communication / Safety
10 — MCQ
A patient with diabetic ketoacidosis (DKA) is being treated. Which is the immediate nursing
priority?
✅
A. Administer scheduled insulin once labs arrive.
B. Rehydrate with IV fluids and monitor electrolytes. [Green]
C. Restrict carbohydrate intake.
D. Teach foot care.
Rationale: Fluid resuscitation and electrolyte monitoring are immediate priorities to correct
dehydration and prevent complications.
Learning objective: Acute metabolic crisis management.
Concept: Metabolism / Fluid & Electrolyte
11 — MCQ
Which statement about opioid analgesia is accurate?
✅
A. Respiratory depression is most likely when pain is well-controlled.
B. Stool softeners should be prescribed to prevent constipation. [Green]
C. Opioids do not cause tolerance with prolonged use.
D. Nausea indicates addiction.
Rationale: Opioid-induced constipation is common; preemptive bowel regimen is
recommended.
Learning objective: Anticipate opioid side effects.
Concept: Pharmacology / Safety
(4TH Ed) by Jean Giddens 2025_2026
1 — MCQ
A postoperative patient reports shortness of breath and has an oxygen saturation of 88% on
room air. Which action should the nurse perform first?
✅
A. Call the surgeon.
B. Increase the supplemental oxygen per protocol. [Green]
C. Obtain an arterial blood gas.
D. Encourage deep-breathing exercises.
Rationale: First, correct tissue oxygenation must be restored — increasing O₂ per protocol is
immediate. Diagnostic tests and provider notification follow stabilization.
Learning objective: Immediate response to hypoxemia.
Concept: Oxygenation / Safety
2 — MCQ
A patient with heart failure has sudden weight gain of 3 kg in 48 hours and dyspnea at rest.
Which lab/test result is highest priority to review?
✅
A. Serum sodium.
B. BNP level. [Green]
C. Hemoglobin.
D. Serum calcium.
Rationale: BNP correlates with ventricular stretch and fluid overload—useful for acute
decompensated HF assessment and prioritization.
Learning objective: Identify markers of volume overload.
Concept: Perfusion / Fluid & Electrolyte
3 — MCQ
,Which instruction to a client starting a new ACE inhibitor best prevents a common side effect?
✅
A. Take the medication with grapefruit juice.
B. Stop the drug if you develop a cough. [Green]
C. Check your pulse daily.
D. Avoid salt substitutes containing potassium.
Rationale: ACE inhibitors commonly cause a dry cough; if persistent, provider should evaluate
discontinuation or substitution.
Learning objective: Recognize common ACE inhibitor adverse effects.
Concept: Pharmacology
4 — MCQ
A nurse prepares to give digoxin to a patient. The apical pulse is 48 bpm. What should the
nurse do?
✅
A. Give the medication as scheduled.
B. Hold the medication and notify the provider. [Green]
C. Double-check the dose.
D. Give oral sugar to raise the pulse.
Rationale: Digoxin can cause bradycardia; hold for significant bradycardia and notify provider.
Learning objective: Safe medication administration.
Concept: Pharmacology / Safety
5 — MCQ
Which action best reduces the risk of catheter-associated urinary tract infections (CAUTI)?
✅
A. Instill antimicrobial solution daily.
B. Use an indwelling catheter only when necessary and remove ASAP. [Green]
C. Change the catheter every 72 hours.
D. Flush the catheter twice daily.
Rationale: Use-avoidance and early removal are primary prevention strategies for CAUTI per
evidence-based practice.
Learning objective: Infection prevention for urinary devices.
Concept: Infection Control / Safety
,6 — MCQ
A patient with COPD is scheduled for discharge. Which teaching point is highest priority?
✅
A. How to use the incentive spirometer.
B. Signs of exacerbation requiring prompt medical attention. [Green]
C. Nutritional choices for weight gain.
D. How to maintain household humidity.
Rationale: Recognizing early signs of exacerbation can prevent morbidity and admission; it’s
the priority for home safety.
Learning objective: Discharge planning and risk recognition.
Concept: Oxygenation / Health Promotion
7 — MCQ
Which assessment finding indicates a complication of peripheral IV therapy?
✅
A. Slight tenderness at insertion site.
B. Coolness and pallor of the limb distal to the site. [Green]
C. Slight bruising at the site.
D. Clear drainage on dressing.
Rationale: Coolness and pallor may indicate arterial compromise or infiltration causing impaired
perfusion—requires immediate action.
Learning objective: Recognize IV complications.
Concept: Tissue Integrity / Perfusion
8 — MCQ
✅
A patient receiving a blood transfusion develops itching and urticaria. The nurse should first:
A. Stop the transfusion and keep the IV line open with saline. [Green]
B. Administer epinephrine immediately.
C. Continue transfusion and document reaction.
D. Send the patient for allergy testing.
Rationale: For allergic transfusion reactions, stop the transfusion, maintain IV with saline, and
notify provider for further orders.
Learning objective: Manage transfusion reactions.
Concept: Safety / Immune Response
, 9 — MCQ
Which intervention most effectively prevents medication errors during shift change?
✅
A. Asking patients to remind staff of their meds.
B. Performing a bedside handoff with medication reconciliation. [Green]
C. Relying on electronic medication administration record alone.
D. Allowing the oncoming nurse to prepare meds later.
Rationale: Bedside handoff with reconciliation ensures accurate med information and reduces
errors at transitions.
Learning objective: Safe handoff practices.
Concept: Communication / Safety
10 — MCQ
A patient with diabetic ketoacidosis (DKA) is being treated. Which is the immediate nursing
priority?
✅
A. Administer scheduled insulin once labs arrive.
B. Rehydrate with IV fluids and monitor electrolytes. [Green]
C. Restrict carbohydrate intake.
D. Teach foot care.
Rationale: Fluid resuscitation and electrolyte monitoring are immediate priorities to correct
dehydration and prevent complications.
Learning objective: Acute metabolic crisis management.
Concept: Metabolism / Fluid & Electrolyte
11 — MCQ
Which statement about opioid analgesia is accurate?
✅
A. Respiratory depression is most likely when pain is well-controlled.
B. Stool softeners should be prescribed to prevent constipation. [Green]
C. Opioids do not cause tolerance with prolonged use.
D. Nausea indicates addiction.
Rationale: Opioid-induced constipation is common; preemptive bowel regimen is
recommended.
Learning objective: Anticipate opioid side effects.
Concept: Pharmacology / Safety
