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Kaplan Nursing School Exit Exam | 180 Comprehensive
Predictor Questions and Answers
Safe and Effective Care Environment
1. The charge nurse is making assignments for the medical-surgical unit. Which
client should be assigned to the most experienced registered nurse (RN)?
A. A client with a new diagnosis of diabetes who needs insulin teaching
B. A client with cirrhosis whose blood pressure has dropped from 120/80 to 92/60
mmHg over the past hour
C. A client with pneumonia who is being discharged this afternoon
D. A client with a fractured femur in balanced skeletal traction
: Correct Answer : B
Rationale: The client with cirrhosis and a significant drop in blood pressure is at
risk for hypovolemic shock from a possible variceal bleed, requiring rapid
assessment and intervention by the most experienced nurse. The other clients
have more stable or predictable needs.
2. The nurse is caring for a client with active tuberculosis. Which personal
protective equipment is essential when entering the client's room?
A. Surgical mask and gloves
B. N95 respirator mask
C. Gown and goggles
D. Shoe covers and hair cover
: Correct Answer : B
Rationale: Tuberculosis requires airborne precautions. A fit-tested N95 respirator
(or powered air-purifying respirator) is necessary to filter airborne droplet nuclei.
A surgical mask does not provide adequate protection.
3. The nurse is preparing to administer a unit of packed red blood cells. Which
solution is used to prime the IV tubing?
pg. 1
,2
A. 5% dextrose in water
B. Lactated Ringer's
C. 0.9% normal saline
D. 0.45% normal saline
: Correct Answer : C
Rationale: Only 0.9% normal saline is compatible with blood products. Dextrose
can cause hemolysis, and lactated Ringer's contains calcium, which may cause
clotting of the blood product.
4. A client has a do-not-resuscitate (DNR) order. The client stops breathing and
has no pulse. What should the nurse do first?
A. Initiate cardiopulmonary resuscitation (CPR)
B. Call the family to come to the bedside
C. Confirm the absence of pulse and respirations, note the time, and document
D. Call the healthcare provider to pronounce death
: Correct Answer : C
Rationale: A DNR order means CPR should not be started. The nurse first confirms
the client's status, notes the time, documents the findings, and then notifies the
provider.
5. The nurse is delegating tasks to the unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
A. Assessing a client's lung sounds after a nebulizer treatment
B. Measuring and recording hourly urine output
C. Developing a plan of care for a client with a pressure ulcer
D. Teaching a client about a low-sodium diet
: Correct Answer : B
Rationale: The UAP may measure and record intake and output. Assessment, care
plan development, and client education are responsibilities of the RN and cannot
be delegated.
pg. 2
,3
6. A client with Clostridioides difficile infection is admitted. Which type of
precautions should the nurse implement?
A. Standard precautions only
B. Droplet precautions
C. Airborne precautions
D. Contact precautions
: Correct Answer : D
Rationale: C. difficile is transmitted via the fecal-oral route, and spores can
survive on surfaces. Contact precautions (gown, gloves, dedicated equipment) are
required. Hand hygiene must be performed with soap and water, not alcohol-
based sanitizer.
7. The nurse observes a coworker diverting a narcotic pain medication for
personal use. What is the priority action?
A. Confront the coworker directly
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police
: Correct Answer : C
Rationale: The nurse has a legal and ethical duty to report impaired practice to a
supervisor. Confrontation may lead to conflict; the incident should not be
documented in the client's chart. Law enforcement is not the first step.
8. The nurse is caring for a client on a mechanical ventilator. The high-pressure
alarm sounds. What should the nurse do first?
A. Call the respiratory therapist
B. Assess the client for biting the tube, kinks in the tubing, or mucus plugs
C. Silence the alarm and reset the ventilator
D. Hyperventilate the client with a manual resuscitation bag
: Correct Answer : B
Rationale: The high-pressure alarm indicates increased resistance. The nurse
pg. 3
, 4
should first assess for common, easily correctable causes such as the client biting
the tube, a kink, or need for suctioning.
9. A client is scheduled for a magnetic resonance imaging (MRI) scan. Which
question is most important for the nurse to ask?
A. "Have you ever had a head injury?"
B. "Do you have any metal implants, such as a pacemaker or aneurysm clips?"
C. "Are you allergic to iodine or shellfish?"
D. "Do you have a family history of seizures?"
: Correct Answer : B
Rationale: MRI uses a powerful magnet; metal objects can move, heat up, or
malfunction, causing serious injury. This safety screening question is critical.
10. The nurse is teaching a client about home oxygen safety. Which statement
by the client indicates a need for further teaching?
A. "I will keep the oxygen tank at least 6 feet from open flames."
B. "It is safe to smoke as long as I am not wearing the oxygen."
C. "I will not use petroleum-based products on my face."
D. "I should have a fire extinguisher in my home."
: Correct Answer : B
Rationale: Smoking is strictly prohibited when oxygen is in use, as it can cause
serious burns and fire. The other statements demonstrate appropriate safety
measures.
11. The nurse finds a client lying on the floor next to the bed. What should the
nurse do first?
A. Call the healthcare provider
B. Document the incident in the chart
C. Complete an incident report
D. Assess the client for injuries and take vital signs
pg. 4
Kaplan Nursing School Exit Exam | 180 Comprehensive
Predictor Questions and Answers
Safe and Effective Care Environment
1. The charge nurse is making assignments for the medical-surgical unit. Which
client should be assigned to the most experienced registered nurse (RN)?
A. A client with a new diagnosis of diabetes who needs insulin teaching
B. A client with cirrhosis whose blood pressure has dropped from 120/80 to 92/60
mmHg over the past hour
C. A client with pneumonia who is being discharged this afternoon
D. A client with a fractured femur in balanced skeletal traction
: Correct Answer : B
Rationale: The client with cirrhosis and a significant drop in blood pressure is at
risk for hypovolemic shock from a possible variceal bleed, requiring rapid
assessment and intervention by the most experienced nurse. The other clients
have more stable or predictable needs.
2. The nurse is caring for a client with active tuberculosis. Which personal
protective equipment is essential when entering the client's room?
A. Surgical mask and gloves
B. N95 respirator mask
C. Gown and goggles
D. Shoe covers and hair cover
: Correct Answer : B
Rationale: Tuberculosis requires airborne precautions. A fit-tested N95 respirator
(or powered air-purifying respirator) is necessary to filter airborne droplet nuclei.
A surgical mask does not provide adequate protection.
3. The nurse is preparing to administer a unit of packed red blood cells. Which
solution is used to prime the IV tubing?
pg. 1
,2
A. 5% dextrose in water
B. Lactated Ringer's
C. 0.9% normal saline
D. 0.45% normal saline
: Correct Answer : C
Rationale: Only 0.9% normal saline is compatible with blood products. Dextrose
can cause hemolysis, and lactated Ringer's contains calcium, which may cause
clotting of the blood product.
4. A client has a do-not-resuscitate (DNR) order. The client stops breathing and
has no pulse. What should the nurse do first?
A. Initiate cardiopulmonary resuscitation (CPR)
B. Call the family to come to the bedside
C. Confirm the absence of pulse and respirations, note the time, and document
D. Call the healthcare provider to pronounce death
: Correct Answer : C
Rationale: A DNR order means CPR should not be started. The nurse first confirms
the client's status, notes the time, documents the findings, and then notifies the
provider.
5. The nurse is delegating tasks to the unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
A. Assessing a client's lung sounds after a nebulizer treatment
B. Measuring and recording hourly urine output
C. Developing a plan of care for a client with a pressure ulcer
D. Teaching a client about a low-sodium diet
: Correct Answer : B
Rationale: The UAP may measure and record intake and output. Assessment, care
plan development, and client education are responsibilities of the RN and cannot
be delegated.
pg. 2
,3
6. A client with Clostridioides difficile infection is admitted. Which type of
precautions should the nurse implement?
A. Standard precautions only
B. Droplet precautions
C. Airborne precautions
D. Contact precautions
: Correct Answer : D
Rationale: C. difficile is transmitted via the fecal-oral route, and spores can
survive on surfaces. Contact precautions (gown, gloves, dedicated equipment) are
required. Hand hygiene must be performed with soap and water, not alcohol-
based sanitizer.
7. The nurse observes a coworker diverting a narcotic pain medication for
personal use. What is the priority action?
A. Confront the coworker directly
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police
: Correct Answer : C
Rationale: The nurse has a legal and ethical duty to report impaired practice to a
supervisor. Confrontation may lead to conflict; the incident should not be
documented in the client's chart. Law enforcement is not the first step.
8. The nurse is caring for a client on a mechanical ventilator. The high-pressure
alarm sounds. What should the nurse do first?
A. Call the respiratory therapist
B. Assess the client for biting the tube, kinks in the tubing, or mucus plugs
C. Silence the alarm and reset the ventilator
D. Hyperventilate the client with a manual resuscitation bag
: Correct Answer : B
Rationale: The high-pressure alarm indicates increased resistance. The nurse
pg. 3
, 4
should first assess for common, easily correctable causes such as the client biting
the tube, a kink, or need for suctioning.
9. A client is scheduled for a magnetic resonance imaging (MRI) scan. Which
question is most important for the nurse to ask?
A. "Have you ever had a head injury?"
B. "Do you have any metal implants, such as a pacemaker or aneurysm clips?"
C. "Are you allergic to iodine or shellfish?"
D. "Do you have a family history of seizures?"
: Correct Answer : B
Rationale: MRI uses a powerful magnet; metal objects can move, heat up, or
malfunction, causing serious injury. This safety screening question is critical.
10. The nurse is teaching a client about home oxygen safety. Which statement
by the client indicates a need for further teaching?
A. "I will keep the oxygen tank at least 6 feet from open flames."
B. "It is safe to smoke as long as I am not wearing the oxygen."
C. "I will not use petroleum-based products on my face."
D. "I should have a fire extinguisher in my home."
: Correct Answer : B
Rationale: Smoking is strictly prohibited when oxygen is in use, as it can cause
serious burns and fire. The other statements demonstrate appropriate safety
measures.
11. The nurse finds a client lying on the floor next to the bed. What should the
nurse do first?
A. Call the healthcare provider
B. Document the incident in the chart
C. Complete an incident report
D. Assess the client for injuries and take vital signs
pg. 4
