NR-600 NR600: Advanced Practice Nursing
Foundations – Theoretical Frameworks,
Evidence-Based Practice, and Role Development
1. Which action should a nurse prioritize when caring for a client
with a newly inserted central venous catheter (CVC)?
A. Monitor the insertion site for signs of infection
B. Assess the client's vital signs every 4 hours
C. Flush the catheter with saline every 12 hours
D. Verify the catheter placement with a chest X-ray
Rationale: Ensuring proper placement of a CVC is critical to prevent
complications such as pneumothorax or arterial puncture. A chest X-ray
confirms correct positioning.
2. A client is receiving total parenteral nutrition (TPN). Which
laboratory value indicates a potential complication?
A. Blood glucose level of 200 mg/dL
B. Hemoglobin of 14 g/dL
C. Serum albumin of 3.5 g/dL
D. White blood cell count of 7,000/mm³
Rationale: Hyperglycemia is a common complication of TPN due to the
high glucose content. Monitoring blood glucose levels is essential.
3. When preparing a client for a lumbar puncture, which nursing
intervention is most important?
,A. Instruct the client to remain still during the procedure
B. Encourage the client to drink fluids before the procedure
C. Administer a sedative as prescribed
D. Position the client in a supine position post-procedure
Rationale: Maintaining stillness during the procedure is crucial to obtain
accurate cerebrospinal fluid samples and prevent complications.
4. A nurse is caring for a client with a chest tube. Which finding
requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling in the suction control chamber
C. Fluctuation of the water level in the water seal chamber
D. Presence of tidaling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an
air leak, which requires prompt assessment and intervention.
5. A client with chronic kidney disease is prescribed erythropoiesis-
stimulating agent (ESA). Which laboratory value should the nurse
monitor?
A. Hemoglobin and hematocrit levels
B. Serum creatinine levels
C. Blood urea nitrogen (BUN) levels
D. Potassium levels
Rationale: ESAs stimulate red blood cell production, so monitoring
hemoglobin and hematocrit levels is essential to prevent hypertension
and thromboembolic events.
,6. A nurse is assessing a client with a suspected stroke. Which
assessment finding is most indicative of a stroke?
A. Facial drooping on one side
B. Bilateral leg weakness
C. Nausea and vomiting
D. Sudden onset of headache
Rationale: Facial drooping on one side is a classic sign of a stroke, often
associated with other symptoms like arm weakness and speech
difficulties.
7. A client is receiving warfarin therapy. Which laboratory test is most
important to monitor?
A. International Normalized Ratio (INR)
B. Platelet count
C. Partial thromboplastin time (PTT)
D. Prothrombin time (PT)
Rationale: The INR is used to monitor the effectiveness of warfarin
therapy and ensure the client remains within the therapeutic range.
8. A nurse is caring for a client with a nasogastric (NG) tube. Which
action is most important to prevent complications?
A. Verify tube placement before each use
B. Irrigate the tube with warm water every 4 hours
C. Administer medications through the tube without dilution
D. Change the NG tube every 72 hours
, Rationale: Verifying tube placement before each use ensures that the
tube is in the correct position, reducing the risk of aspiration and other
complications.
9. A client is receiving a blood transfusion and develops chills and
fever. What is the nurse's priority action?
A. Stop the transfusion immediately
B. Administer acetaminophen as prescribed
C. Notify the healthcare provider
D. Continue the transfusion at a slower rate
Rationale: Chills and fever during a transfusion may indicate a
transfusion reaction. Stopping the transfusion immediately is the
priority action.
10. A nurse is preparing a client for discharge after a myocardial
infarction. Which instruction should the nurse include?
A. Avoid lifting heavy objects for at least 6 weeks
B. Resume driving after 1 week
C. Limit walking to 10 minutes per day
D. Discontinue prescribed medications after 2 weeks
Rationale: Avoiding heavy lifting helps prevent strain on the heart
during the recovery period.
11. A nurse is assessing a client with heart failure. Which finding
indicates worsening fluid overload?
Foundations – Theoretical Frameworks,
Evidence-Based Practice, and Role Development
1. Which action should a nurse prioritize when caring for a client
with a newly inserted central venous catheter (CVC)?
A. Monitor the insertion site for signs of infection
B. Assess the client's vital signs every 4 hours
C. Flush the catheter with saline every 12 hours
D. Verify the catheter placement with a chest X-ray
Rationale: Ensuring proper placement of a CVC is critical to prevent
complications such as pneumothorax or arterial puncture. A chest X-ray
confirms correct positioning.
2. A client is receiving total parenteral nutrition (TPN). Which
laboratory value indicates a potential complication?
A. Blood glucose level of 200 mg/dL
B. Hemoglobin of 14 g/dL
C. Serum albumin of 3.5 g/dL
D. White blood cell count of 7,000/mm³
Rationale: Hyperglycemia is a common complication of TPN due to the
high glucose content. Monitoring blood glucose levels is essential.
3. When preparing a client for a lumbar puncture, which nursing
intervention is most important?
,A. Instruct the client to remain still during the procedure
B. Encourage the client to drink fluids before the procedure
C. Administer a sedative as prescribed
D. Position the client in a supine position post-procedure
Rationale: Maintaining stillness during the procedure is crucial to obtain
accurate cerebrospinal fluid samples and prevent complications.
4. A nurse is caring for a client with a chest tube. Which finding
requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling in the suction control chamber
C. Fluctuation of the water level in the water seal chamber
D. Presence of tidaling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an
air leak, which requires prompt assessment and intervention.
5. A client with chronic kidney disease is prescribed erythropoiesis-
stimulating agent (ESA). Which laboratory value should the nurse
monitor?
A. Hemoglobin and hematocrit levels
B. Serum creatinine levels
C. Blood urea nitrogen (BUN) levels
D. Potassium levels
Rationale: ESAs stimulate red blood cell production, so monitoring
hemoglobin and hematocrit levels is essential to prevent hypertension
and thromboembolic events.
,6. A nurse is assessing a client with a suspected stroke. Which
assessment finding is most indicative of a stroke?
A. Facial drooping on one side
B. Bilateral leg weakness
C. Nausea and vomiting
D. Sudden onset of headache
Rationale: Facial drooping on one side is a classic sign of a stroke, often
associated with other symptoms like arm weakness and speech
difficulties.
7. A client is receiving warfarin therapy. Which laboratory test is most
important to monitor?
A. International Normalized Ratio (INR)
B. Platelet count
C. Partial thromboplastin time (PTT)
D. Prothrombin time (PT)
Rationale: The INR is used to monitor the effectiveness of warfarin
therapy and ensure the client remains within the therapeutic range.
8. A nurse is caring for a client with a nasogastric (NG) tube. Which
action is most important to prevent complications?
A. Verify tube placement before each use
B. Irrigate the tube with warm water every 4 hours
C. Administer medications through the tube without dilution
D. Change the NG tube every 72 hours
, Rationale: Verifying tube placement before each use ensures that the
tube is in the correct position, reducing the risk of aspiration and other
complications.
9. A client is receiving a blood transfusion and develops chills and
fever. What is the nurse's priority action?
A. Stop the transfusion immediately
B. Administer acetaminophen as prescribed
C. Notify the healthcare provider
D. Continue the transfusion at a slower rate
Rationale: Chills and fever during a transfusion may indicate a
transfusion reaction. Stopping the transfusion immediately is the
priority action.
10. A nurse is preparing a client for discharge after a myocardial
infarction. Which instruction should the nurse include?
A. Avoid lifting heavy objects for at least 6 weeks
B. Resume driving after 1 week
C. Limit walking to 10 minutes per day
D. Discontinue prescribed medications after 2 weeks
Rationale: Avoiding heavy lifting helps prevent strain on the heart
during the recovery period.
11. A nurse is assessing a client with heart failure. Which finding
indicates worsening fluid overload?
