PN COMPREHENSIVE ONLINE PRACTICE
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST
RECENT!!) (BRAND NEW!!)
1. A client with heart failure is receiving furosemide (Lasix) 40 mg IV push. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Increased heart rate
B) Decreased peripheral edema
C) Increased blood pressure
D) Decreased urinary output
Correct Answer: B
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart failure.
The desired therapeutic effect is diuresis, which reduces peripheral edema, pulmonary
congestion, and weight. Increased urinary output (not decreased) would be expected,
and blood pressure should decrease rather than increase with reduced fluid volume .
2. A client with diabetes mellitus type 2 is prescribed metformin. The nurse should
monitor for which potentially serious adverse effect?
A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Hyperkalemia
Correct Answer: B
Rationale: Metformin can cause lactic acidosis, a rare but serious complication.
Symptoms include muscle pain, weakness, difficulty breathing, dizziness, and abdominal
,pain. It is more common in clients with renal impairment, hepatic disease, or
dehydration. Hypoglycemia is less common with metformin compared to sulfonylureas
or insulin .
3. A client is 24 hours post-operative following a total hip replacement. Which
intervention is most important for the practical nurse to implement?
A) Maintain the client in a supine position
B) Keep the legs abducted with a pillow between the knees
C) Encourage the client to cross the legs at the ankles
D) Flex the hips to 90 degrees for comfort
Correct Answer: B
Rationale: Following total hip replacement, the client must maintain abduction of the
legs (using an abduction pillow or pillow between the knees) to prevent dislocation of
the new hip prosthesis. Adduction (crossing the legs) and excessive hip flexion (>90
degrees) increase the risk of dislocation .
4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
at 2 L/min via nasal cannula. The client's spouse asks why the oxygen is set at such
a low rate when the client seems short of breath. Which response by the nurse is
correct?
A) "The oxygen level can be increased if you feel it is necessary"
B) "Clients with COPD rely on a low oxygen drive to breathe, and too much oxygen can
decrease their respiratory effort"
C) "The doctor ordered a low dose, so the client must have mild COPD"
D) "We are trying to wean the client off oxygen completely"
Correct Answer: B
Rationale: Clients with COPD often have a hypoxic drive, meaning their primary
stimulus to breathe is low oxygen levels rather than high carbon dioxide levels.
Administering high-flow oxygen can decrease their respiratory drive, leading to carbon
dioxide retention and respiratory depression .
,5. A client is receiving a continuous tube feeding via gastrostomy tube. The nurse
should place the client in which position during the feeding?
A) Supine
B) Left side-lying
C) Semi-Fowler's (30-45 degrees)
D) Trendelenburg
Correct Answer: C
Rationale: Semi-Fowler's position (30-45 degrees) reduces the risk of aspiration by
allowing gastric contents to remain in the stomach and facilitating digestive flow. Supine
positioning increases aspiration risk .
6. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
electrocardiogram change should the nurse anticipate?
A) Flattened T waves
B) Peaked T waves
C) Prolonged PR interval
D) U waves
Correct Answer: B
Rationale: Hyperkalemia (potassium >5.0 mEq/L) typically causes peaked (tall, tented) T
waves on ECG. Flattened T waves and U waves are associated with hypokalemia .
7. A client with a history of seizures is prescribed phenytoin (Dilantin). Which
finding indicates a common side effect of this medication?
A) Gingival hyperplasia
B) Weight gain
C) Hypotension
D) Hypoglycemia
Correct Answer: A
Rationale: Gingival hyperplasia (overgrowth of gum tissue) is a common side effect of
phenytoin. Good oral hygiene and regular dental care are important for clients taking
this medication .
, 8. A client is receiving heparin via continuous IV infusion. Which laboratory value
should the nurse monitor to evaluate the therapeutic effect of heparin?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Correct Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effect of unfractionated heparin. The therapeutic goal is typically 1.5 to 2.5
times the normal control value. INR is used for warfarin monitoring .
9. A client with pneumonia has a temperature of 102.4°F (39.1°C). Which
intervention should the nurse implement first?
A) Administer the prescribed antibiotic
B) Apply a cooling blanket
C) Administer the prescribed antipyretic
D) Obtain a sputum culture
Correct Answer: D
Rationale: Sputum culture should be obtained before administering antibiotics to
identify the causative organism and guide appropriate antibiotic therapy. Antipyretics
can be given for fever, but obtaining the culture first is the priority .
10. A client is receiving IV fluids at 125 mL/hr. The nurse calculates the total
volume the client will receive in 8 hours. What is the correct total?
A) 500 mL
B) 750 mL
C) 1000 mL
D) 1250 mL
Correct Answer: C
Rationale: 125 mL/hr × 8 hours = 1000 mL .
EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (MOST
RECENT!!) (BRAND NEW!!)
1. A client with heart failure is receiving furosemide (Lasix) 40 mg IV push. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Increased heart rate
B) Decreased peripheral edema
C) Increased blood pressure
D) Decreased urinary output
Correct Answer: B
Rationale: Furosemide is a loop diuretic used to reduce fluid overload in heart failure.
The desired therapeutic effect is diuresis, which reduces peripheral edema, pulmonary
congestion, and weight. Increased urinary output (not decreased) would be expected,
and blood pressure should decrease rather than increase with reduced fluid volume .
2. A client with diabetes mellitus type 2 is prescribed metformin. The nurse should
monitor for which potentially serious adverse effect?
A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Hyperkalemia
Correct Answer: B
Rationale: Metformin can cause lactic acidosis, a rare but serious complication.
Symptoms include muscle pain, weakness, difficulty breathing, dizziness, and abdominal
,pain. It is more common in clients with renal impairment, hepatic disease, or
dehydration. Hypoglycemia is less common with metformin compared to sulfonylureas
or insulin .
3. A client is 24 hours post-operative following a total hip replacement. Which
intervention is most important for the practical nurse to implement?
A) Maintain the client in a supine position
B) Keep the legs abducted with a pillow between the knees
C) Encourage the client to cross the legs at the ankles
D) Flex the hips to 90 degrees for comfort
Correct Answer: B
Rationale: Following total hip replacement, the client must maintain abduction of the
legs (using an abduction pillow or pillow between the knees) to prevent dislocation of
the new hip prosthesis. Adduction (crossing the legs) and excessive hip flexion (>90
degrees) increase the risk of dislocation .
4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
at 2 L/min via nasal cannula. The client's spouse asks why the oxygen is set at such
a low rate when the client seems short of breath. Which response by the nurse is
correct?
A) "The oxygen level can be increased if you feel it is necessary"
B) "Clients with COPD rely on a low oxygen drive to breathe, and too much oxygen can
decrease their respiratory effort"
C) "The doctor ordered a low dose, so the client must have mild COPD"
D) "We are trying to wean the client off oxygen completely"
Correct Answer: B
Rationale: Clients with COPD often have a hypoxic drive, meaning their primary
stimulus to breathe is low oxygen levels rather than high carbon dioxide levels.
Administering high-flow oxygen can decrease their respiratory drive, leading to carbon
dioxide retention and respiratory depression .
,5. A client is receiving a continuous tube feeding via gastrostomy tube. The nurse
should place the client in which position during the feeding?
A) Supine
B) Left side-lying
C) Semi-Fowler's (30-45 degrees)
D) Trendelenburg
Correct Answer: C
Rationale: Semi-Fowler's position (30-45 degrees) reduces the risk of aspiration by
allowing gastric contents to remain in the stomach and facilitating digestive flow. Supine
positioning increases aspiration risk .
6. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
electrocardiogram change should the nurse anticipate?
A) Flattened T waves
B) Peaked T waves
C) Prolonged PR interval
D) U waves
Correct Answer: B
Rationale: Hyperkalemia (potassium >5.0 mEq/L) typically causes peaked (tall, tented) T
waves on ECG. Flattened T waves and U waves are associated with hypokalemia .
7. A client with a history of seizures is prescribed phenytoin (Dilantin). Which
finding indicates a common side effect of this medication?
A) Gingival hyperplasia
B) Weight gain
C) Hypotension
D) Hypoglycemia
Correct Answer: A
Rationale: Gingival hyperplasia (overgrowth of gum tissue) is a common side effect of
phenytoin. Good oral hygiene and regular dental care are important for clients taking
this medication .
, 8. A client is receiving heparin via continuous IV infusion. Which laboratory value
should the nurse monitor to evaluate the therapeutic effect of heparin?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Correct Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effect of unfractionated heparin. The therapeutic goal is typically 1.5 to 2.5
times the normal control value. INR is used for warfarin monitoring .
9. A client with pneumonia has a temperature of 102.4°F (39.1°C). Which
intervention should the nurse implement first?
A) Administer the prescribed antibiotic
B) Apply a cooling blanket
C) Administer the prescribed antipyretic
D) Obtain a sputum culture
Correct Answer: D
Rationale: Sputum culture should be obtained before administering antibiotics to
identify the causative organism and guide appropriate antibiotic therapy. Antipyretics
can be given for fever, but obtaining the culture first is the priority .
10. A client is receiving IV fluids at 125 mL/hr. The nurse calculates the total
volume the client will receive in 8 hours. What is the correct total?
A) 500 mL
B) 750 mL
C) 1000 mL
D) 1250 mL
Correct Answer: C
Rationale: 125 mL/hr × 8 hours = 1000 mL .
