**THE RN CLINICAL MASTERY EXAM: 2026
COMPREHENSIVE PREDICTOR**
---
**Question 1**
A patient with heart failure is receiving furosemide 40 mg IV push. Which finding indicates the
medication is having the desired effect?
A) Increased blood pressure
B) Decreased jugular venous distension
C) Heart rate increases from 80 to 100 bpm
D) Crackles increase in lung fields
---
💫RATIONALE✔️✔️: Furosemide reduces preload, decreasing jugular venous distension and pulmonary
congestion; improved cardiac output may increase BP but the direct effect is reduced volume overload.
💫ANSWER✔️✔️: B) Decreased jugular venous distension
---
**Question 2**
A nurse is providing discharge teaching to a patient with a new prescription for enoxaparin. Which
statement by the patient indicates correct understanding?
A) "I will need to have my blood tested every week."
B) "I will inject the medication into my abdomen."
C) "I can take ibuprofen if I have a headache."
D) "I will stop the medication if I see bruising."
---
💫RATIONALE✔️✔️: Enoxaparin is given subcutaneously in the abdomen; it does not require routine
monitoring (unlike warfarin), but NSAIDs increase bleeding risk.
,💫ANSWER✔️✔️: B) "I will inject the medication into my abdomen."
---
**Question 3**
A patient with a new diagnosis of type 2 diabetes mellitus has an HbA1c of 10.2%. The nurse
understands that this indicates:
A) Excellent glucose control over the past 3 months
B) Average blood glucose of approximately 250 mg/dL
C) The patient has been taking metformin correctly
D) The patient is in diabetic ketoacidosis
---
💫RATIONALE✔️✔️: HbA1c of 10.2% correlates with an average glucose of approximately 250-260 mg/dL
and indicates poor glycemic control over 3 months.
💫ANSWER✔️✔️: B) Average blood glucose of approximately 250 mg/dL
---
**Question 4**
A nurse is caring for a patient with a chest tube after a lobectomy. The chest tube becomes
disconnected from the drainage system. What should the nurse do first?
A) Clamp the chest tube near the insertion site
B) Submerge the end of the tube in sterile water
C) Notify the healthcare provider immediately
D) Reconnect the tube to a new drainage system
---
💫RATIONALE✔️✔️: Submerging the open end in sterile water creates a water seal, preventing air from
entering the pleural space while a new system is obtained.
💫ANSWER✔️✔️: B) Submerge the end of the tube in sterile water
, ---
**Question 5**
A patient with a history of depression is prescribed phenelzine, a monoamine oxidase inhibitor. Which
food should the patient avoid?
A) Fresh apples
B) Aged cheddar cheese
C) Broiled chicken
D) White rice
---
💫RATIONALE✔️✔️: Aged cheeses contain tyramine, which can cause hypertensive crisis in patients taking
MAOIs due to inhibition of tyramine metabolism.
💫ANSWER✔️✔️: B) Aged cheddar cheese
---
**Question 6**
A nurse is assessing a patient who is 6 hours post-transurethral resection of the prostate. The nurse
notes bright red urine with large clots and the patient reports severe bladder spasms. What is the
priority action?
A) Increase the continuous bladder irrigation rate
B) Administer an antispasmodic medication
C) Notify the healthcare provider immediately
D) Encourage oral fluids to flush the bladder
---
💫RATIONALE✔️✔️: Bright red urine with large clots post-TURP indicates hemorrhage; the provider must
be notified immediately for possible intervention.
💫ANSWER✔️✔️: C) Notify the healthcare provider immediately
---
COMPREHENSIVE PREDICTOR**
---
**Question 1**
A patient with heart failure is receiving furosemide 40 mg IV push. Which finding indicates the
medication is having the desired effect?
A) Increased blood pressure
B) Decreased jugular venous distension
C) Heart rate increases from 80 to 100 bpm
D) Crackles increase in lung fields
---
💫RATIONALE✔️✔️: Furosemide reduces preload, decreasing jugular venous distension and pulmonary
congestion; improved cardiac output may increase BP but the direct effect is reduced volume overload.
💫ANSWER✔️✔️: B) Decreased jugular venous distension
---
**Question 2**
A nurse is providing discharge teaching to a patient with a new prescription for enoxaparin. Which
statement by the patient indicates correct understanding?
A) "I will need to have my blood tested every week."
B) "I will inject the medication into my abdomen."
C) "I can take ibuprofen if I have a headache."
D) "I will stop the medication if I see bruising."
---
💫RATIONALE✔️✔️: Enoxaparin is given subcutaneously in the abdomen; it does not require routine
monitoring (unlike warfarin), but NSAIDs increase bleeding risk.
,💫ANSWER✔️✔️: B) "I will inject the medication into my abdomen."
---
**Question 3**
A patient with a new diagnosis of type 2 diabetes mellitus has an HbA1c of 10.2%. The nurse
understands that this indicates:
A) Excellent glucose control over the past 3 months
B) Average blood glucose of approximately 250 mg/dL
C) The patient has been taking metformin correctly
D) The patient is in diabetic ketoacidosis
---
💫RATIONALE✔️✔️: HbA1c of 10.2% correlates with an average glucose of approximately 250-260 mg/dL
and indicates poor glycemic control over 3 months.
💫ANSWER✔️✔️: B) Average blood glucose of approximately 250 mg/dL
---
**Question 4**
A nurse is caring for a patient with a chest tube after a lobectomy. The chest tube becomes
disconnected from the drainage system. What should the nurse do first?
A) Clamp the chest tube near the insertion site
B) Submerge the end of the tube in sterile water
C) Notify the healthcare provider immediately
D) Reconnect the tube to a new drainage system
---
💫RATIONALE✔️✔️: Submerging the open end in sterile water creates a water seal, preventing air from
entering the pleural space while a new system is obtained.
💫ANSWER✔️✔️: B) Submerge the end of the tube in sterile water
, ---
**Question 5**
A patient with a history of depression is prescribed phenelzine, a monoamine oxidase inhibitor. Which
food should the patient avoid?
A) Fresh apples
B) Aged cheddar cheese
C) Broiled chicken
D) White rice
---
💫RATIONALE✔️✔️: Aged cheeses contain tyramine, which can cause hypertensive crisis in patients taking
MAOIs due to inhibition of tyramine metabolism.
💫ANSWER✔️✔️: B) Aged cheddar cheese
---
**Question 6**
A nurse is assessing a patient who is 6 hours post-transurethral resection of the prostate. The nurse
notes bright red urine with large clots and the patient reports severe bladder spasms. What is the
priority action?
A) Increase the continuous bladder irrigation rate
B) Administer an antispasmodic medication
C) Notify the healthcare provider immediately
D) Encourage oral fluids to flush the bladder
---
💫RATIONALE✔️✔️: Bright red urine with large clots post-TURP indicates hemorrhage; the provider must
be notified immediately for possible intervention.
💫ANSWER✔️✔️: C) Notify the healthcare provider immediately
---
