HEALTHSTREAM TEST Practice Exam with Answers and Rationales
1. A patient has distended neck veins, pulsus paradoxus, and falling
systolic blood pressure. Which condition is most consistent with these
findings?
A. Cardiac tamponade
B. Left-sided heart failure
C. Stable angina
D. Aortic stenosis
Correct answer: A. Cardiac tamponade
Rationale: The combination of venous distention, pulsus paradoxus,
and hypotension is characteristic of impaired cardiac filling from
cardiac tamponade.
2. A patient with severe sepsis develops third-degree heart block and
hypotension. Which intervention may be required urgently?
A. Transcutaneous pacing
B. Encouraging ambulation
C. Oral fluid restriction
D. Routine outpatient follow-up
Correct answer: A. Transcutaneous pacing
Rationale: High-grade AV block with hemodynamic instability may
require immediate pacing while definitive management is arranged.
Healthstream Practice Exam | Page 1
,3. A patient may have a cervical spinal cord injury after a motor
vehicle collision. What is the priority nursing action?
A. Maintain head and neck immobilization
B. Flex the neck to assess range of motion
C. Sit the patient upright without support
D. Remove the cervical collar for comfort
Correct answer: A. Maintain head and neck immobilization
Rationale: Spinal motion restriction helps prevent secondary injury
until the cervical spine has been evaluated.
4. Two hours after thoracic surgery, chest-tube drainage totals 200
mL. What is the safest interpretation?
A. Promptly assess and report the amount in context of the rate and
protocol
B. Ignore it because all drainage is expected
C. Clamp the tube routinely
D. Remove the tube immediately
Correct answer: A. Promptly assess and report the amount in context
of the rate and protocol
Rationale: The source flags 200 mL in two hours as excessive. Assess
the trend and patient status and promptly notify the surgical team
according to local thresholds.
Healthstream Practice Exam | Page 2
,5. A nurse without CRRT training is assigned to a patient requiring
continuous renal replacement therapy. The charge nurse reassigns the
patient to a trained nurse. This best illustrates which principle?
A. Matching patient needs with staff competencies
B. Avoiding all delegation
C. Using a first-come, first-served assignment
D. Reducing documentation
Correct answer: A. Matching patient needs with staff competencies
Rationale: Safe staffing aligns the complexity of care with the
clinician's education and experience; the source calls this the synergy
model.
6. A patient with acute tubular necrosis enters the polyuric phase.
Which nursing focus is most important?
A. Monitor electrolytes and signs of fluid depletion
B. Restrict all fluids regardless of status
C. Expect urine output to remain absent
D. Stop all laboratory monitoring
Correct answer: A. Monitor electrolytes and signs of fluid depletion
Rationale: Polyuria can cause significant fluid and electrolyte losses,
so close monitoring is important.
Healthstream Practice Exam | Page 3
, 7. An elevated central venous pressure most strongly suggests which
possibility in the source's clinical context?
A. Right-sided cardiac dysfunction or elevated right-sided filling
pressure
B. Isolated low blood volume
C. Hypoglycemia
D. Middle-ear infection
Correct answer: A. Right-sided cardiac dysfunction or elevated right-
sided filling pressure
Rationale: CVP reflects right atrial pressure and may be elevated with
right-sided heart failure; interpret it with the whole clinical picture.
8. Which medication is commonly used to replace antidiuretic
hormone activity in diabetes insipidus?
A. Desmopressin or vasopressin, depending on the clinical setting
B. Nitroglycerin
C. Adenosine
D. Alteplase
Correct answer: A. Desmopressin or vasopressin, depending on the
clinical setting
Rationale: The source lists vasopressin. Desmopressin is also
commonly used, particularly for central diabetes insipidus.
Healthstream Practice Exam | Page 4
1. A patient has distended neck veins, pulsus paradoxus, and falling
systolic blood pressure. Which condition is most consistent with these
findings?
A. Cardiac tamponade
B. Left-sided heart failure
C. Stable angina
D. Aortic stenosis
Correct answer: A. Cardiac tamponade
Rationale: The combination of venous distention, pulsus paradoxus,
and hypotension is characteristic of impaired cardiac filling from
cardiac tamponade.
2. A patient with severe sepsis develops third-degree heart block and
hypotension. Which intervention may be required urgently?
A. Transcutaneous pacing
B. Encouraging ambulation
C. Oral fluid restriction
D. Routine outpatient follow-up
Correct answer: A. Transcutaneous pacing
Rationale: High-grade AV block with hemodynamic instability may
require immediate pacing while definitive management is arranged.
Healthstream Practice Exam | Page 1
,3. A patient may have a cervical spinal cord injury after a motor
vehicle collision. What is the priority nursing action?
A. Maintain head and neck immobilization
B. Flex the neck to assess range of motion
C. Sit the patient upright without support
D. Remove the cervical collar for comfort
Correct answer: A. Maintain head and neck immobilization
Rationale: Spinal motion restriction helps prevent secondary injury
until the cervical spine has been evaluated.
4. Two hours after thoracic surgery, chest-tube drainage totals 200
mL. What is the safest interpretation?
A. Promptly assess and report the amount in context of the rate and
protocol
B. Ignore it because all drainage is expected
C. Clamp the tube routinely
D. Remove the tube immediately
Correct answer: A. Promptly assess and report the amount in context
of the rate and protocol
Rationale: The source flags 200 mL in two hours as excessive. Assess
the trend and patient status and promptly notify the surgical team
according to local thresholds.
Healthstream Practice Exam | Page 2
,5. A nurse without CRRT training is assigned to a patient requiring
continuous renal replacement therapy. The charge nurse reassigns the
patient to a trained nurse. This best illustrates which principle?
A. Matching patient needs with staff competencies
B. Avoiding all delegation
C. Using a first-come, first-served assignment
D. Reducing documentation
Correct answer: A. Matching patient needs with staff competencies
Rationale: Safe staffing aligns the complexity of care with the
clinician's education and experience; the source calls this the synergy
model.
6. A patient with acute tubular necrosis enters the polyuric phase.
Which nursing focus is most important?
A. Monitor electrolytes and signs of fluid depletion
B. Restrict all fluids regardless of status
C. Expect urine output to remain absent
D. Stop all laboratory monitoring
Correct answer: A. Monitor electrolytes and signs of fluid depletion
Rationale: Polyuria can cause significant fluid and electrolyte losses,
so close monitoring is important.
Healthstream Practice Exam | Page 3
, 7. An elevated central venous pressure most strongly suggests which
possibility in the source's clinical context?
A. Right-sided cardiac dysfunction or elevated right-sided filling
pressure
B. Isolated low blood volume
C. Hypoglycemia
D. Middle-ear infection
Correct answer: A. Right-sided cardiac dysfunction or elevated right-
sided filling pressure
Rationale: CVP reflects right atrial pressure and may be elevated with
right-sided heart failure; interpret it with the whole clinical picture.
8. Which medication is commonly used to replace antidiuretic
hormone activity in diabetes insipidus?
A. Desmopressin or vasopressin, depending on the clinical setting
B. Nitroglycerin
C. Adenosine
D. Alteplase
Correct answer: A. Desmopressin or vasopressin, depending on the
clinical setting
Rationale: The source lists vasopressin. Desmopressin is also
commonly used, particularly for central diabetes insipidus.
Healthstream Practice Exam | Page 4
