Progressive Care RN A v1 Test | 165 Questions with 100%
Correct Answers | Verified | Updated 2025/2026
Question 1
A nurse is assessing a client admitted with acute decompensated heart
failure. Which of the following findings would indicate worsening pulmonary
edema?
A) Peripheral edema and weight gain.
B) Dry, non-productive cough.
C) Increased heart rate with strong peripheral pulses.
D) Pink, frothy sputum and crackles throughout lung fields.
E) Decreased respiratory rate and improved SpO2.
Correct Answer: D) Pink, frothy sputum and crackles throughout lung
fields.
Rationale: Pink, frothy sputum is a classic sign of severe pulmonary
edema, indicating fluid extravasation into the alveoli, often
accompanied by widespread crackles, severe dyspnea, and hypoxia.
Question 2
A client with a history of hypertension and diabetes is admitted with acute
pancreatitis. The nurse should monitor for which of the following
complications?
A) Right upper quadrant pain radiating to the shoulder.
B) Hyperglycemia and hypocalcemia.
C) Hypokalemia and metabolic alkalosis.
D) Jaundice with dark urine.
E) Left lower quadrant tenderness.
Correct Answer: B) Hyperglycemia and hypocalcemia.
Rationale: Acute pancreatitis can cause pancreatic beta-cell
dysfunction, leading to hyperglycemia. Damaged pancreatic tissue
can release lipase, which consumes calcium in fat necrosis, leading
to hypocalcemia.
,Question 3
A nurse is caring for a client with an acute ST-segment elevation myocardial
infarction (STEMI). The client has a new prescription for metoprolol. The
nurse should withhold the medication and notify the provider if the client
exhibits which of the following?
A) Heart rate of 80/min.
B) Blood pressure of 130/80 mmHg.
C) New onset of wheezing.
D) Mild peripheral edema.
E) Chest pain rated 4/10.
Correct Answer: C) New onset of wheezing.
Rationale: Metoprolol is a beta-blocker. New onset wheezing could
indicate bronchospasm, especially in clients with reactive airway
disease (asthma, COPD), which is a contraindication or requires
caution with beta-blockers.
Question 4
A client is admitted to the progressive care unit following a cerebral
aneurysm rupture and subarachnoid hemorrhage. The nurse should prioritize
monitoring for which of the following?
A) Gradual decrease in blood pressure.
B) Stable neurological assessment findings.
C) Signs of re-bleeding or vasospasm.
D) Increased urine output.
E) Peripheral edema.
Correct Answer: C) Signs of re-bleeding or vasospasm.
Rationale: Re-bleeding (re-rupture) and cerebral vasospasm
(narrowing of cerebral blood vessels, typically 3-14 days post-SAH)
are critical and potentially devastating complications following SAH,
requiring vigilant neurological monitoring.
,Question 5
A nurse is assessing a client who is diagnosed with acute kidney injury (AKI)
in the oliguric phase. Which of the following findings should the nurse
expect?
A) Polyuria and hypovolemia.
B) Decreased urine output and hyperkalemia.
C) Normal electrolyte levels.
D) Hypotension and tachycardia.
E) Improved glomerular filtration rate (GFR).
Correct Answer: B) Decreased urine output and hyperkalemia.
Rationale: The oliguric phase of AKI is characterized by a significant
reduction in urine output, leading to fluid retention and
accumulation of electrolytes that are normally excreted by the
kidneys, such as potassium (hyperkalemia).
Question 6
A client with Type 2 Diabetes Mellitus is admitted with hyperglycemic
hyperosmolar state (HHS). The nurse should prioritize which of the following
interventions?
A) Administering a large bolus of regular insulin.
B) Aggressive intravenous fluid resuscitation.
C) Initiating a potassium chloride infusion.
D) Preparing for emergency dialysis.
E) Administering oral glucose.
Correct Answer: B) Aggressive intravenous fluid resuscitation.
Rationale: HHS is characterized by profound dehydration and
hyperosmolarity. Aggressive fluid resuscitation is the primary and
most critical initial treatment to restore circulating volume and
lower blood glucose.
Question 7
A nurse is caring for a client with a history of atrial fibrillation who is taking
, warfarin. Which of the following lab values should the nurse monitor to
ensure the therapeutic effect of warfarin?
A) Activated Partial Thromboplastin Time (aPTT)
B) Platelet count
C) International Normalized Ratio (INR)
D) Fibrinogen levels
E) D-dimer
Correct Answer: C) International Normalized Ratio (INR)
Rationale: Warfarin's therapeutic effect is monitored by the PT, which
is standardized to the INR (typically 2.0-3.0 for atrial fibrillation),
ensuring consistent anticoagulation.
Question 8
A client is admitted with new onset gastrointestinal bleeding. The nurse
notes the client is hypotensive and tachycardic. Which of the following is the
most appropriate initial nursing action?
A) Administer a proton pump inhibitor (PPI).
B) Obtain a stool sample for occult blood.
C) Insert a nasogastric tube.
D) Establish IV access and administer prescribed intravenous fluids.
E) Prepare for endoscopy.
Correct Answer: D) Establish IV access and administer prescribed
intravenous fluids.
Rationale: Hypotension and tachycardia in a client with GI bleeding
indicate hypovolemic shock. The immediate priority is to restore
circulating volume with IV fluids to stabilize hemodynamics.
Question 9
A nurse is caring for a client with a new colostomy. The client asks, "When
should I empty my colostomy pouch?" The nurse should instruct the client to
empty the pouch when it is approximately:
A) One-quarter to one-half full.
Correct Answers | Verified | Updated 2025/2026
Question 1
A nurse is assessing a client admitted with acute decompensated heart
failure. Which of the following findings would indicate worsening pulmonary
edema?
A) Peripheral edema and weight gain.
B) Dry, non-productive cough.
C) Increased heart rate with strong peripheral pulses.
D) Pink, frothy sputum and crackles throughout lung fields.
E) Decreased respiratory rate and improved SpO2.
Correct Answer: D) Pink, frothy sputum and crackles throughout lung
fields.
Rationale: Pink, frothy sputum is a classic sign of severe pulmonary
edema, indicating fluid extravasation into the alveoli, often
accompanied by widespread crackles, severe dyspnea, and hypoxia.
Question 2
A client with a history of hypertension and diabetes is admitted with acute
pancreatitis. The nurse should monitor for which of the following
complications?
A) Right upper quadrant pain radiating to the shoulder.
B) Hyperglycemia and hypocalcemia.
C) Hypokalemia and metabolic alkalosis.
D) Jaundice with dark urine.
E) Left lower quadrant tenderness.
Correct Answer: B) Hyperglycemia and hypocalcemia.
Rationale: Acute pancreatitis can cause pancreatic beta-cell
dysfunction, leading to hyperglycemia. Damaged pancreatic tissue
can release lipase, which consumes calcium in fat necrosis, leading
to hypocalcemia.
,Question 3
A nurse is caring for a client with an acute ST-segment elevation myocardial
infarction (STEMI). The client has a new prescription for metoprolol. The
nurse should withhold the medication and notify the provider if the client
exhibits which of the following?
A) Heart rate of 80/min.
B) Blood pressure of 130/80 mmHg.
C) New onset of wheezing.
D) Mild peripheral edema.
E) Chest pain rated 4/10.
Correct Answer: C) New onset of wheezing.
Rationale: Metoprolol is a beta-blocker. New onset wheezing could
indicate bronchospasm, especially in clients with reactive airway
disease (asthma, COPD), which is a contraindication or requires
caution with beta-blockers.
Question 4
A client is admitted to the progressive care unit following a cerebral
aneurysm rupture and subarachnoid hemorrhage. The nurse should prioritize
monitoring for which of the following?
A) Gradual decrease in blood pressure.
B) Stable neurological assessment findings.
C) Signs of re-bleeding or vasospasm.
D) Increased urine output.
E) Peripheral edema.
Correct Answer: C) Signs of re-bleeding or vasospasm.
Rationale: Re-bleeding (re-rupture) and cerebral vasospasm
(narrowing of cerebral blood vessels, typically 3-14 days post-SAH)
are critical and potentially devastating complications following SAH,
requiring vigilant neurological monitoring.
,Question 5
A nurse is assessing a client who is diagnosed with acute kidney injury (AKI)
in the oliguric phase. Which of the following findings should the nurse
expect?
A) Polyuria and hypovolemia.
B) Decreased urine output and hyperkalemia.
C) Normal electrolyte levels.
D) Hypotension and tachycardia.
E) Improved glomerular filtration rate (GFR).
Correct Answer: B) Decreased urine output and hyperkalemia.
Rationale: The oliguric phase of AKI is characterized by a significant
reduction in urine output, leading to fluid retention and
accumulation of electrolytes that are normally excreted by the
kidneys, such as potassium (hyperkalemia).
Question 6
A client with Type 2 Diabetes Mellitus is admitted with hyperglycemic
hyperosmolar state (HHS). The nurse should prioritize which of the following
interventions?
A) Administering a large bolus of regular insulin.
B) Aggressive intravenous fluid resuscitation.
C) Initiating a potassium chloride infusion.
D) Preparing for emergency dialysis.
E) Administering oral glucose.
Correct Answer: B) Aggressive intravenous fluid resuscitation.
Rationale: HHS is characterized by profound dehydration and
hyperosmolarity. Aggressive fluid resuscitation is the primary and
most critical initial treatment to restore circulating volume and
lower blood glucose.
Question 7
A nurse is caring for a client with a history of atrial fibrillation who is taking
, warfarin. Which of the following lab values should the nurse monitor to
ensure the therapeutic effect of warfarin?
A) Activated Partial Thromboplastin Time (aPTT)
B) Platelet count
C) International Normalized Ratio (INR)
D) Fibrinogen levels
E) D-dimer
Correct Answer: C) International Normalized Ratio (INR)
Rationale: Warfarin's therapeutic effect is monitored by the PT, which
is standardized to the INR (typically 2.0-3.0 for atrial fibrillation),
ensuring consistent anticoagulation.
Question 8
A client is admitted with new onset gastrointestinal bleeding. The nurse
notes the client is hypotensive and tachycardic. Which of the following is the
most appropriate initial nursing action?
A) Administer a proton pump inhibitor (PPI).
B) Obtain a stool sample for occult blood.
C) Insert a nasogastric tube.
D) Establish IV access and administer prescribed intravenous fluids.
E) Prepare for endoscopy.
Correct Answer: D) Establish IV access and administer prescribed
intravenous fluids.
Rationale: Hypotension and tachycardia in a client with GI bleeding
indicate hypovolemic shock. The immediate priority is to restore
circulating volume with IV fluids to stabilize hemodynamics.
Question 9
A nurse is caring for a client with a new colostomy. The client asks, "When
should I empty my colostomy pouch?" The nurse should instruct the client to
empty the pouch when it is approximately:
A) One-quarter to one-half full.
