NR 509 COMPREHENSIVE TEST SCRIPT 2026
FULL QUESTIONS AND CORRECT ANSWERS
▶ A confused client is hospitalized for possible pneumonia and is admitted
from the emergency department with an indwelling catheter in place.
During interdisciplinary rounds the following day, what question by the
nurse takes priority?
A) "Can we discontinue the in-dwelling catheter?"
B) "Will the client be able to return home?"
C) "Should we get another chest x-ray today?"
D) "Do you want daily weights on this client?". Answer: A
An in-dwelling catheter dramatically increases the risks of urinary tract
infection and urosepsis. Nursing staff should ensure that catheters are left
in place only as long as they are medically needed. The nurse should
inquire about removing the catheter. All other questions might be
appropriate, but because of client safety, this question takes priority.
▶ The nurse is assessing a client who had a stroke in the right cerebral
hemisphere. Which neurologic deficit does the nurse assess for in this
client?
A) Agraphia
B) Aphasia
C) Impaired olfaction
D) Impaired proprioception. Answer: D
A stroke to the right cerebral hemisphere causes impaired visual and
spatial awareness. The client may present with impaired proprioception and
may be disoriented as to time and place. The right cerebral hemisphere
does not control speech, smell, or the client's ability to write.
▶ A client has newly diagnosed diabetes. To delay the onset of
microvascular and macrovascular complications in this client, the nurse
stresses that the client take which action?
A) Restrict fluid intake.
,B) Prevent ketosis.
C) Control hyperglycemia.
D) Prevent hypoglycemia.. Answer: C
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic
complications. Maintaining tight glycemic control will help delay the onset of
complications. Preventing hypoglycemia and ketosis, although important, is
not as important as maintaining daily glycemic control. Restricting fluid
intake is not part of the treatment plan for clients with diabetes.
▶ Which interventions are necessary to provide safe, quality care to a
patient receiving enteral tube feedings? SELECT ALL THAT APPLY!!
A) check the residual volume every 4-6 hours
B) use clean technique when changing the feeding system
C) keep the head of the beg elevated at least 30 degrees
D) change the feeding bag & tubing every 12 hours
E) allow closed system containers to hang for 24 hours. Answer: A,B,C,E
▶ A client with a pressure ulcer has the following laboratory values: white
blood count 8000/mm3, prealbumin 15.2 mg/dL, albumin 4.2 mg/dL, and
lymphocyte count 2000/mm3. Which action by the nurse is most
appropriate?
A) Request a dietary consult.
B) Assess the client's vital signs.
C) Document the findings.
D) Place the client in isolation.. Answer: A
Albumin, prealbumin, and lymphocyte counts all give information related to
nutritional status. The albumin and lymphocyte counts given are normal.
The white blood cell count is not directly related to nutritional status. The
prealbumin count is low and is a more specific indicator of nutritional status
than is the albumin count. This puts the client at risk for impaired wound
healing, so the nurse should request a dietary consult.
▶ A nurse is explaining to a student nurse about perfusion. The nurse
knows the student understands the concept of perfusion when the student
states, "Perfusion
,A) is a normal function of the body, and I don't have to be concerned about
it."
B) varies as a person ages, so I would expect changes in the body."
C) is monitored by the physician, and I just follow orders."
D) is monitored by vital signs and capillary refill.". Answer: D
The best method to monitor perfusion is to monitor vital signs and capillary
refill. This allows the nurse to know if perfusion is adequate to maintain vital
organs. The nurse does have to be concerned about perfusion. Perfusion is
not only monitored by the physician but the nurse too. Perfusion does not
always change as the person ages.
▶ The nurse is a assessing a client with hypertension. Which client
outcome is indicative of effective hypertension management?
A) No complaints of sexual dysfunction occur.
B) Pedal edema is not present in the lower legs.
C) No indication of renal impairment is present.
D) The blood pressure reading is 148/94 mm Hg.. Answer: C
One expected outcome for a client with hypertension is for the client to
have no evidence of target organ damage, such as renal or heart disease,
that can occur with poorly managed hypertension. Development of pedal
edema is not directly related to the management of hypertension. Side
effects of some hypertensive agents may interfere with sexual function, but
this does not relate to the effectiveness of treatment for hypertension. The
blood pressure reading is too high to demonstrate effective management.
▶ What statement indicates that the client understands teaching about
neutropenia?
A) "I will call my doctor if I have an increase in temperature."
B) "My grandchildren may get an infection from me."
C) "I need to use a soft toothbrush."
D) "I have to wear a mask at all times.". Answer: A
Bone marrow suppression leads to neutropenia and increases the client's
risk for infection. Decreased numbers of neutrophils and other white blood
cells can minimize the clinical manifestations of infection. For this reason,
the client may not develop a high temperature, even with severe infection,
, and any elevation of temperature should be reported immediately to the
health care provider. The client does not need to wear a mask or use a soft
toothbrush (although if the client has low platelets, he or she should use a
soft toothbrush to avoid causing trauma). The client is not contagious.
▶ A client has a small-bore nasoenteric feeding tube. The nurse assesses
the following vital signs: temperature, 100.2° F (37.8° C); pulse, 112
beats/min; respiratory rate, 22 breaths/min; and blood pressure, 106/62
mm Hg. Which action by the nurse takes priority?
A) Auscultate bowel sounds and slow the feeding down.
B) Remove the tube immediately and notify the heath care provider.
C) Auscultate lung sounds and obtain oxygen saturation.
D) Add blue dye to the feeding tube formula.. Answer: C
The client may have aspirated. The nurse should further assess the client's
respiratory and oxygenation status. The client may have another reason for
the abnormal vital signs, so the nurse should not pull out the tube before
performing other assessments. Adding blue dye to the tube feeding formula
is not recommended to check for aspiration. Slowing the feeding down will
not be helpful.
▶ A client is receiving a chemotherapeutic agent intravenously through a
peripheral line. What is the nurse's first action when the client reports
burning at the site?
A) Apply a cold compress.
B) Discontinue the infusion.
C) Slow the rate of infusion.
D) Check for a blood return.. Answer: B
Both irritants and vesicants can cause tissue damage. If the nurse suspects
extravasation, he or she should immediately stop the infusion. Even if the
IV has a good blood return, some of the chemotherapeutic agent can still
be leaking into the tissues. Slowing the rate of infusion is not sufficient to
prevent further leakage and damage. Applying a cold compress may or
may not be the correct action, depending on the specific agent. However,
the compress would be applied only after the infusion has been
discontinued.
FULL QUESTIONS AND CORRECT ANSWERS
▶ A confused client is hospitalized for possible pneumonia and is admitted
from the emergency department with an indwelling catheter in place.
During interdisciplinary rounds the following day, what question by the
nurse takes priority?
A) "Can we discontinue the in-dwelling catheter?"
B) "Will the client be able to return home?"
C) "Should we get another chest x-ray today?"
D) "Do you want daily weights on this client?". Answer: A
An in-dwelling catheter dramatically increases the risks of urinary tract
infection and urosepsis. Nursing staff should ensure that catheters are left
in place only as long as they are medically needed. The nurse should
inquire about removing the catheter. All other questions might be
appropriate, but because of client safety, this question takes priority.
▶ The nurse is assessing a client who had a stroke in the right cerebral
hemisphere. Which neurologic deficit does the nurse assess for in this
client?
A) Agraphia
B) Aphasia
C) Impaired olfaction
D) Impaired proprioception. Answer: D
A stroke to the right cerebral hemisphere causes impaired visual and
spatial awareness. The client may present with impaired proprioception and
may be disoriented as to time and place. The right cerebral hemisphere
does not control speech, smell, or the client's ability to write.
▶ A client has newly diagnosed diabetes. To delay the onset of
microvascular and macrovascular complications in this client, the nurse
stresses that the client take which action?
A) Restrict fluid intake.
,B) Prevent ketosis.
C) Control hyperglycemia.
D) Prevent hypoglycemia.. Answer: C
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic
complications. Maintaining tight glycemic control will help delay the onset of
complications. Preventing hypoglycemia and ketosis, although important, is
not as important as maintaining daily glycemic control. Restricting fluid
intake is not part of the treatment plan for clients with diabetes.
▶ Which interventions are necessary to provide safe, quality care to a
patient receiving enteral tube feedings? SELECT ALL THAT APPLY!!
A) check the residual volume every 4-6 hours
B) use clean technique when changing the feeding system
C) keep the head of the beg elevated at least 30 degrees
D) change the feeding bag & tubing every 12 hours
E) allow closed system containers to hang for 24 hours. Answer: A,B,C,E
▶ A client with a pressure ulcer has the following laboratory values: white
blood count 8000/mm3, prealbumin 15.2 mg/dL, albumin 4.2 mg/dL, and
lymphocyte count 2000/mm3. Which action by the nurse is most
appropriate?
A) Request a dietary consult.
B) Assess the client's vital signs.
C) Document the findings.
D) Place the client in isolation.. Answer: A
Albumin, prealbumin, and lymphocyte counts all give information related to
nutritional status. The albumin and lymphocyte counts given are normal.
The white blood cell count is not directly related to nutritional status. The
prealbumin count is low and is a more specific indicator of nutritional status
than is the albumin count. This puts the client at risk for impaired wound
healing, so the nurse should request a dietary consult.
▶ A nurse is explaining to a student nurse about perfusion. The nurse
knows the student understands the concept of perfusion when the student
states, "Perfusion
,A) is a normal function of the body, and I don't have to be concerned about
it."
B) varies as a person ages, so I would expect changes in the body."
C) is monitored by the physician, and I just follow orders."
D) is monitored by vital signs and capillary refill.". Answer: D
The best method to monitor perfusion is to monitor vital signs and capillary
refill. This allows the nurse to know if perfusion is adequate to maintain vital
organs. The nurse does have to be concerned about perfusion. Perfusion is
not only monitored by the physician but the nurse too. Perfusion does not
always change as the person ages.
▶ The nurse is a assessing a client with hypertension. Which client
outcome is indicative of effective hypertension management?
A) No complaints of sexual dysfunction occur.
B) Pedal edema is not present in the lower legs.
C) No indication of renal impairment is present.
D) The blood pressure reading is 148/94 mm Hg.. Answer: C
One expected outcome for a client with hypertension is for the client to
have no evidence of target organ damage, such as renal or heart disease,
that can occur with poorly managed hypertension. Development of pedal
edema is not directly related to the management of hypertension. Side
effects of some hypertensive agents may interfere with sexual function, but
this does not relate to the effectiveness of treatment for hypertension. The
blood pressure reading is too high to demonstrate effective management.
▶ What statement indicates that the client understands teaching about
neutropenia?
A) "I will call my doctor if I have an increase in temperature."
B) "My grandchildren may get an infection from me."
C) "I need to use a soft toothbrush."
D) "I have to wear a mask at all times.". Answer: A
Bone marrow suppression leads to neutropenia and increases the client's
risk for infection. Decreased numbers of neutrophils and other white blood
cells can minimize the clinical manifestations of infection. For this reason,
the client may not develop a high temperature, even with severe infection,
, and any elevation of temperature should be reported immediately to the
health care provider. The client does not need to wear a mask or use a soft
toothbrush (although if the client has low platelets, he or she should use a
soft toothbrush to avoid causing trauma). The client is not contagious.
▶ A client has a small-bore nasoenteric feeding tube. The nurse assesses
the following vital signs: temperature, 100.2° F (37.8° C); pulse, 112
beats/min; respiratory rate, 22 breaths/min; and blood pressure, 106/62
mm Hg. Which action by the nurse takes priority?
A) Auscultate bowel sounds and slow the feeding down.
B) Remove the tube immediately and notify the heath care provider.
C) Auscultate lung sounds and obtain oxygen saturation.
D) Add blue dye to the feeding tube formula.. Answer: C
The client may have aspirated. The nurse should further assess the client's
respiratory and oxygenation status. The client may have another reason for
the abnormal vital signs, so the nurse should not pull out the tube before
performing other assessments. Adding blue dye to the tube feeding formula
is not recommended to check for aspiration. Slowing the feeding down will
not be helpful.
▶ A client is receiving a chemotherapeutic agent intravenously through a
peripheral line. What is the nurse's first action when the client reports
burning at the site?
A) Apply a cold compress.
B) Discontinue the infusion.
C) Slow the rate of infusion.
D) Check for a blood return.. Answer: B
Both irritants and vesicants can cause tissue damage. If the nurse suspects
extravasation, he or she should immediately stop the infusion. Even if the
IV has a good blood return, some of the chemotherapeutic agent can still
be leaking into the tissues. Slowing the rate of infusion is not sufficient to
prevent further leakage and damage. Applying a cold compress may or
may not be the correct action, depending on the specific agent. However,
the compress would be applied only after the infusion has been
discontinued.
