NUR 2811 Nursing Capstone Exam The Definitive Study and Exam Prep Guide: Comprehensive Topic Review, Realistic Practice Questions, Complete Test Bank Mastery, and Advanced Preparation Manual

1. A nurse is caring for multiple clients on a medical-surgical unit. Which client is at the highest risk for developing a nosocomial infection? A. Client with alcohol use disorder admitted for detoxification B. Client with Type 1 diabetes mellitus and peripheral neuropathy C. Client recovering from a laparoscopic cholecystectomy D. Client with full-thickness burns, NG tube, and Foley catheter Correct Answer: D. Client with full-thickness burns, NG tube, and Foley catheter Rationale: Patients with extensive burns have a severely compromised skin barrier, making them highly susceptible to infection. Invasive devices such as an NG tube and Foley catheter further increase infection risk. 2. Which client should the nurse prioritize for transfer from ICU to a stepdown neurological unit? A. Client with acute head injury and seizures B. Client with ischemic stroke 4 days ago and mild confusion C. Client 1-day post-transsphenoidal craniotomy with CSF leak D. Client with bacterial meningitis and Glasgow Coma Scale of 7 Correct Answer: B. Client with ischemic stroke 4 days ago and mild confusion Rationale: The most stable client is the one who is several days post-stroke and only mildly confused. The other clients are unstable due to CSF leak, decreased level of consciousness, or active neurological compromise. 3. After shift report, which client should the nurse assess first? A. Ventilated client requiring sputum culture collection B. COPD client with oxygen saturation of 90% from previous shift C. Pneumonia client awaiting IV antibiotics D. Asthma client reporting shortness of breath after bronchodilator use Correct Answer: D. Asthma client reporting shortness of breath after bronchodilator use Rationale: Shortness of breath after bronchodilator use suggests worsening bronchospasm or treatment failure. This is an airway priority. 4. Which postoperative client should the nurse assess first? A. Client scheduled for laparoscopic cholecystectomy B. Multiple trauma client from motor vehicle collision C. Client scheduled for thyroidectomy D. Client awaiting discharge after appendectomy Correct Answer: B. Multiple trauma client from motor vehicle collision Rationale: Trauma patients are the most unstable and require immediate assessment due to risk of internal injuries, hemorrhage, and airway compromise. 5. During disaster triage, which client can be safely discharged first? A. 24-hour post-hysterectomy client B. 5-day post-total hip replacement client C. 12-hour pyelonephritis admission D. 5-day stage III pressure ulcer patient Correct Answer: B. 5-day post-total hip replacement client Rationale: This client is the most stable and least dependent on acute care services compared with infection or surgical complications. 6. Which client requires immediate assessment after shift change? A. BP 90/60 with hot, dry skin B. Sleeping client with stable vital signs C. Fruity breath, polydipsia, and polyphagia D. Irritable client with tremors Correct Answer: C. Fruity breath, polydipsia, and polyphagia Rationale: Fruity breath with polydipsia and polyphagia suggests diabetic ketoacidosis, which is a medical emergency. 7. Which client should the nurse assess first? A. Headache rated 3/10 B. Watery diarrhea with abdominal pain C. Oxygen saturation 94% D. Nausea after contrast dye Correct Answer: B. Watery diarrhea with abdominal pain Rationale: Frequent diarrhea increases the risk for dehydration and electrolyte imbalance, which can become life-threatening. 8. Which finding should be immediately reported in a COPD patient without pneumococcal vaccination? A. BP 152/84 B. RR 27/min C. HR 92 bpm D. Temperature 38.4°C Correct Answer: D. Temperature 38.4°C Rationale: Fever suggests infection, which is particularly dangerous in COPD patients at risk for respiratory complications. 9. A postoperative patient has RR 38/min and oxygen saturation 90% on 6 L/min oxygen. What is the priority action? A. Increase nasal cannula to 10 L/min B. Encourage incentive spirometry C. Administer morphine D. Switch to non-rebreather mask and notify provider Correct Answer: D. Switch to non-rebreather mask and notify provider Rationale: The patient is in acute respiratory distress and needs immediate highconcentration oxygen, along with provider notification. 10. Which obstetric message should the nurse prioritize? A. Headache and blurred vision at 34 weeks B. Supine dizziness at 22 weeks C. No fetal movement at 15 weeks D. Vaginal discharge at 12 weeks Correct Answer: A. Headache and blurred vision at 34 weeks Rationale: These are signs of preeclampsia, a life-threatening pregnancy complication. 11 rural hospital client should be seen first? A. Post-tonsillectomy child B. Postpartum breastfeeding pain C. Leg cast pain after analgesia D. Liver biopsy pain 2 hours post-procedure Correct Answer: C. Leg cast pain after analgesia Rationale: after immobilization may indicate compartment syndrome, a n surgical Severe pai emergency. QUESTION 12 Which post-report client requires immediate attention? A. Femur fracture in cast B. Mild headache C. 5-hour post-laryngectomy client D. 1-day post-lobectomy client Correct Answer: C. 5-hour post-laryngectomy client Rationale: Airway obstruction risk is highest after laryngectomy; this is an ABC priority. QUESTION 13 Which emergency department client is priority? A. Nosebleed in elderly patient B. Vomiting for 3 hours C. Child with arm pain D. Fever in toddler Correct Answer: A. Nosebleed in elderly patient Rationale: Uncontrolled bleeding poses immediate circulation risk. 14 client is most at risk during Legionnaires’ disease outbreak? A. End-stage renal disease patient B. Alzheimer’s patient C. Stroke patient D. Hip fracture patient Correct Answer: A. End-stage renal disease patient Rationale: Immunocompromised patients are at highest risk for severe infection. QUESTION 15 Which task can be delegated to a UAP for pain management? A. Sitz bath preparation B. Pain assessment during ambulation C. Deep breathing coaching D. Evaluating pain relief Correct Answer: A. Sitz bath preparation Rationale: UAPs perform non-assessment, non-evaluation tasks only. QUESTION 16 Which task is appropriate for an LPN in opioid overdose? A. Calling physician B. Giving Narcan and evaluating response C. Monitoring respiratory status D. Applying oxygen Correct Answer: D. Applying oxygen Rationale: LPNs can implement interventions but not evaluate or independently assess outcomes. 17 oral cancer care task is appropriate for LPN? A. Assess oral hygiene B. Teach brushing techniques C. Administer sucralfate D. Recommend saliva substitutes Correct Answer: C. Administer sucralfate Rationale: LPNs can administer medications but not teach or assess. QUESTION 18 Which task is appropriate for LPN in HIV hospice care? A. Nutritional assessment B. Patient teaching C. Collecting medication response data D. Hygiene assistance Correct Answer: C. Collecting medication response data Rationale: LPNs collect data but do not perform initial assessment or teaching. QUESTION 19 Which action is appropriate for UAP in fluid deficit care? A. IV fluid administration B. Offering oral fluids C. Care plan development D. Teaching family Correct Answer: B. Offering oral fluids Rationale: UAPs assist with basic care activities only. 20 actions can LPN perform in oral care plan? (Select all that apply) A. Encourage saline rinses B. Observe mucosa C. Provide oral care D. Refer dietary consult Correct Answer: A, B, C Rationale: LPNs can perform care and observation but cannot initiate referrals.