NUR 2811 Nursing Capstone Exam All-Inclusive Certification Study Guide: Extensive Practice Questions, Complete Test Bank Review, Detailed Knowledge Assessment, and Final Exam Prep Manual

1. A client who had a cast applied to the right lower arm 48 hours ago presents with severe burning pain, paresthesia, and a cool, pale extremity. What complication should the nurse suspect? A. Fat embolism syndrome B. Compartment syndrome C. Deep vein thrombosis D. Cellulitis Correct Answer: B. Compartment syndrome Rationale: Compartment syndrome occurs when increased pressure within a closed muscle compartment compromises circulation and nerve function. Classic signs include severe pain, paresthesia, pallor, and coolness of the extremity. 2. The nurse is assessing a client’s urinary elimination pattern. Which questions are appropriate? (Select all that apply) A. “Do you frequently wake up at night to urinate?” B. “Does your bladder feel empty after voiding?” C. “Do you void at least every 8 hours?” D. “Has the appearance of your urine changed?” Correct Answer: A, B, D Rationale: Nocturia, incomplete bladder emptying, and changes in urine appearance are important indicators of urinary dysfunction. 3. Which dietary choice best supports healthy bowel elimination? A. White rice with fried chicken B. Grape and walnut chicken salad on whole wheat bread C. Processed cheese sandwich on white bread D. Bacon and egg breakfast platter Correct Answer: B. Grape and walnut chicken salad on whole wheat bread Rationale: High-fiber foods such as whole grains, fruits, and nuts promote healthy bowel movements by increasing stool bulk and improving motility. 4. Which technique is appropriate when performing ice massage for pain relief? A. Apply ice for 20–30 minutes continuously B. Use slow circular movements until numbness occurs C. Apply ice only to inflamed joints without movement D. Use intermittent heat and ice alternating every minute Correct Answer: B. Use slow circular movements until numbness occurs Rationale: Ice massage is applied using firm, circular movement until numbness develops, usually within 5–10 minutes. 5. What is the correct guideline when bathing a bedridden client? A. Keep windows open for fresh air B. Close doors and windows to prevent drafts C. Bathe only exposed areas of the body 6. Which clients are at increased risk for falls? (Select all that apply) A. 67-year-old with shuffling gait B. 72-year-old fully oriented client C. 48-year-old receiving opioids and sedatives D. 58-year-old legally blind client Correct Answer: A, C, D Rationale: Fall risk increases with gait disturbances, sedative use, and sensory impairment. Orientation alone does not increase fall risk. 7. A client receiving propranolol develops expiratory wheezes. What does this indicate? A. Expected therapeutic effect B. Hypoglycemia C. Bronchospasm (adverse effect) D. Fluid overload Correct Answer: C. Bronchospasm (adverse effect) Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction. Wheezing indicates airway narrowing and requires immediate intervention. 8. Which finding best indicates successful pain management using nonpharmacological interventions? A. Blood pressure remains elevated B. Client reports “I feel more comfortable” C. Client sleeps for 8 hours D. Pain score remains 10/10 Correct Answer: B. Client reports “I feel more comfortable” Rationale: Pain is subjective, so the client’s self-report is the most reliable indicator of effectiveness. 9. Which client has the highest risk for skin breakdown? A. 34-year-old wheelchair-bound client B. 25-year-old athlete C. 40-year-old ambulatory client D. 60-year-old walking independently Correct Answer: A. 34-year-old wheelchair-bound client Rationale: Immobility is a major risk factor for pressure injuries because of prolonged pressure and reduced circulation. 10. Which client is most at risk for impaired skin integrity? A. Diaphoretic patient B. Hydrated patient C. Active patient D. Young adult Correct Answer: A. Diaphoretic patient Rationale: Excessive moisture from sweating leads to skin maceration and breakdown. Question 11: What is the priority assessment for a client in skeletal traction? A. Pain level B. Pin site infection C. Nutrition status D. Family support Correct Answer: B. Pin site infection Rationale: Infection at pin sites is a serious complication of skeletal traction and requires immediate assessment. Question 12: Which side effect should the nurse monitor in a client taking alprazolam? A. Hypertension B. Excessive sedation C. Tachycardia D. Hyperactivity Correct Answer: B. Excessive sedation Rationale: Alprazolam is a benzodiazepine that causes CNS depression, leading to sedation and respiratory depression. Question 13: What is the priority nursing response when an adolescent reports poor sleep habits? A. Ignore the behavior B. Provide sleep hygiene education C. Prescribe sleep medication D. Refer immediately to psychiatry Correct Answer: B. Provide sleep hygiene education Rationale: Education is the first-line intervention for lifestyle-related sleep disturbances. Question 14: Which blood product is indicated for severe anemia? A. Fresh frozen plasma B. Platelets C. Packed red blood cells D. Albumin Correct Answer: C. Packed red blood cells Rationale: PRBCs increase oxygen-carrying capacity in anemia. Question 15: Which medication is routinely prescribed with opioids? A. Antihypertensives B. Stool softeners C. Antivirals D. Diuretics Correct Answer: B. Stool softeners Rationale: Opioids cause constipation by slowing GI motility. Question 16: Which antidote is used for benzodiazepine overdose? A. Naloxone B. Flumazenil C. Atropine D. Protamine sulfate Correct Answer: B. Flumazenil Rationale: Flumazenil reverses benzodiazepine sedation effects. Question 17: What is the correct action when infusing IV piggyback antibiotics? A. Hang antibiotic lower than primary IV B. Disconnect primary IV C. Hang antibiotic higher than primary IV D. Stop IV infusion completely Correct Answer: C. Hang antibiotic higher than primary IV Rationale: Gravity ensures medication infuses before primary fluid resumes. Question 18: Which IV catheter size is most appropriate for routine adult IV therapy? A. 14 gauge B. 16 gauge C. 20 gauge D. 24 gauge Correct Answer: C. 20 gauge Rationale: 20-gauge is standard for most adult IV therapies. Question 19: What action should the nurse take before administering digoxin with HR 50? A. Give medication B. Hold dose and notify provider C. Double dose D. Administer with food Correct Answer: B. Hold dose and notify provider Rationale: Digoxin is withheld if HR is below 60 due to risk of toxicity. Question 20: What is the safest restraint option for a confused client pulling at tubes? A. Wrist restraints B. Mittens C. Belt restraints D. Chemical sedation Correct Answer: B. Mittens Rationale: Mittens are the least restrictive physical restraint. Question 21: A nurse is caring for a client with severe abdominal pain rated 10/10 who has been advised to use nonpharmacological pain management strategies such as heat therapy, relaxation, and guided imagery. Which outcome best indicates that these interventions were effective? A. Client sleeps for 6 hours without interruption B. Client reports a reduction in blood pressure C. Client states they feel “more comfortable” D. Client requests fewer pain medications Correct Answer: C. Client states they feel “more comfortable”