EXAM STUDY GUIDE 2026 – COMPLETE
CONCEPT REVIEW & PRACTICE MATERIALS
(LATEST EDITION)
Pharmacology & Parenteral Therapies
1. A client taking warfarin has an INR of 5.8. The nurse should prepare to administer which
antidote?
a) Protamine sulfate
b) Vitamin K ✓
c) Naloxone
d) Flumazenil
2. Before administering intravenous (IV) dopamine, the nurse's priority assessment is:
a) Lung sounds
b) Blood pressure ✓
c) Level of consciousness
d) Urine output
3. A client with myasthenia gravis is experiencing increased muscle weakness 1 hour after
taking pyridostigmine. The nurse should suspect:
a) A therapeutic response
b) Cholinergic crisis ✓
c) Myasthenic crisis
d) An allergic reaction
4. The nurse administers propranolol to a client. Which finding requires immediate
intervention?
a) Heart rate of 58 bpm
b) Blood pressure of 110/70 mmHg
c) Wheezing and shortness of breath ✓
d) Report of mild fatigue
5. A client is receiving a first dose of IV vancomycin. The nurse should monitor most closely
for:
, a) Red man syndrome ✓
b) Blue-green discoloration of urine
c) Crystal formation in the IV tubing
d) Ototoxicity (this is important but not the most immediate concern with the first dose)
Management of Care & Safety
6. A nurse discovers a fire in a client's room. What is the nurse's first action?
a) Activate the fire alarm. ✓
b) Use the fire extinguisher.
c) Remove the client from the room.
d) Close all doors on the unit.
7. A client with tuberculosis on airborne precautions must go to radiology. The nurse
should ensure the client:
a) Is escorted via the shortest route while wearing a simple mask.
b) Wears a surgical mask during transport. ✓
c) Is transported only after all other clients have cleared the hallway.
d) Remains in isolation and the procedure is performed at the bedside.
8. A nurse is delegating tasks for a stable group of clients. Which task is appropriate to
assign to an unlicensed assistive personnel (UAP)?
a) Assess a surgical incision for signs of infection.
b) Feed a client who has recently had a stroke.
c) Obtain a blood glucose reading for a diabetic client. ✓
d) Evaluate the effectiveness of pain medication.
9. A client is refusing a scheduled blood transfusion for religious reasons. The nurse's best
action is to:
a) Inform the client of the risks of refusal and document.
b) Notify the healthcare provider and the risk manager.
c) Ensure the refusal is informed, document it, and uphold the client's right. ✓
d) Ask the family to persuade the client to accept the transfusion.
10. During a code, the nurse's primary role when not assigned a specific task is to:
a) Document events as they occur. ✓
b) Give family members updates in the hallway.
c) Restock supplies after the code is over.
d) Perform chest compressions to relieve the primary compressor.
Reduction of Risk Potential
, 11. A client 2 days post-hip arthroplasty suddenly reports chest pain and shortness of
breath. The nurse's priority action is to:
a) Administer PRN opioid pain medication.
b) Apply oxygen and call for assistance. ✓
c) Perform a full respiratory assessment.
d) Encourage coughing and deep breathing.
12. A client with a left-sided chest tube has continuous bubbling in the water-seal chamber.
The nurse should:
a) Clamp the tube immediately.
b) This is an expected finding.
c) Check for an air leak in the system. ✓
d) Increase the suction pressure.
13. Before administering digoxin, the nurse assesses the apical pulse and finds it to be 52
beats/min. The nurse should:
a) Administer the drug as it is within the normal range.
b) Withhold the drug and notify the provider. ✓
c) Administer the drug and recheck the pulse in 1 hour.
d) Check the radial pulse for confirmation.
14. A client has a serum potassium level of 6.2 mEq/L. The nurse should anticipate
administering:
a) Potassium chloride IV.
b) Sodium polystyrene sulfonate (Kayexalate). ✓
c) Spironolactone.
d) Furosemide (Lasix).
15. Which client is at highest risk for developing a pressure injury?
a) A 25-year-old with a fractured arm.
b) A 40-year-old who is mildly obese.
c) An 80-year-old who is incontinent and bedridden. ✓
d) A 60-year-old ambulatory diabetic.
Health Promotion & Maintenance
16. The nurse is teaching a mother about introducing solid foods to her 5-month-old infant.
Which instruction is correct?
a) Start with finely chopped table foods.
b) Begin with rice cereal mixed with formula. ✓
, c) Introduce egg whites to assess for allergy.
d) Add honey to cereal for sweetness.
17. A 65-year-old client asks about recommended health screenings. The nurse should
recommend:
a) Colonoscopy every 10 years until age 75. ✓
b) Annual mammogram starting at age 40 for all.
c) Bone density scan annually.
d) No further screenings are routinely needed.
18. During a well-child visit, the parent of a 4-year-old expresses concern about bedwetting.
The nurse's best response is:
a) "This is a sign of behavioral problems; consider discipline."
b) "Nighttime bladder control is normal until age 5 or 6." ✓
c) "You should limit fluids after 12 PM."
d) "Your child needs to see a urologist immediately."
19. The school nurse is teaching a class on helmet safety. Which statement by a student
indicates understanding?
a) "I only need a helmet for long bike rides."
b) "My skateboard helmet is also fine for football."
c) "I should wear a helmet every time I ride my bike." ✓
d) "Helmets aren't cool, so I won't wear one."
20. A pregnant client at 28 weeks gestation is concerned about heartburn. The nurse should
advise:
a) Lie down for 30 minutes after meals.
b) Eat large, less frequent meals.
c) Drink milk with meals and at bedtime.
d) Eat small, frequent meals and avoid greasy foods. ✓
Psychosocial Integrity
21. A client says, "I'm just a burden to everyone since I got sick." The nurse's therapeutic
response is:
a) "That's not true. Your family loves you."
b) "Tell me more about feeling like a burden." ✓
c) "You shouldn't think that way."
d) "Let's talk about something more positive."