HealthStream Jane Assessment Test
Exam 2025/2026 – Verified Questions
with Correct Solutions (100%
Guaranteed Pass)
Section 1: Cardiovascular & Respiratory (Questions 1-15)
1 CHF Hallmark Signs SOB, orthopnea, productive cough (pink frothy sputum), JVD,
crackles, edema, weight gain, anxiety, restlessness, oliguria, tachycardia, tachypnea, HTN,
nagging cough, increased abd girth, ascites Rationale: Left-sided CHF causes pulmonary
congestion (SOB, crackles, frothy sputum); right-sided systemic (edema, JVD, ascites). Monitor
trends; report >2 kg gain (HealthStream CV Module 2025; ATI Med-Surg Ch. 32). NGN SATA:
All apply; bow-tie cue (frothy sputum) → hypothesis (pulmonary edema) → action (diuretics).
2 CHF Interventions Focused cardiopulmonary assessment: Check VS (HR, RR, BP, SpO2),
supplemental O2 if needed, elevate HOB 45-90°, elevate legs for venous return, IV access,
strict I&O (monitor UOP), daily weight; call MD for CXR, diuretics, echo (EF 50%), BMP,
cardiac enzymes Rationale: GDMT stabilizes (O2 for SpO2 <92%, HOB for orthopnea); labs
assess electrolytes/renal (HealthStream Heart Failure Pathway; AHA 2025). Case study:
Tachycardia cue → analyze (decompensation) → plan (beta-blocker if EF low).
3 A patient assessment reveals distended neck veins, pulsus paradoxus, and decreased systolic
pressure. Consistent with? Cardiac tamponade Rationale: Beck's triad + pulsus >10 mmHg
drop on inspiration; emergent pericardiocentesis (HealthStream Emergencies 2025; ATI CV Ch.
29). NGN: Cue (JVD/hypotension) → prioritize (echo/FAST).
4 The nurse is caring for a patient with severe sepsis and third-degree heart block. Next action?
Prepare for transcutaneous pacing Rationale: Sepsis tachycardia usual, but AV block needs
stabilization; atropine 0.5 mg IV first-line (HealthStream Sepsis Bundle; ACLS 2025). Bow-tie:
Rhythm cue → intervention (pace if unstable).
5 Expected ABG in COPD exacerbation? pH 7.28, PaCO2 55 mmHg, PaO2 60 mmHg, HCO3
28 mEq/L Rationale: Acute respiratory acidosis with partial compensation; target PaO2 55-70
mmHg (HealthStream Respiratory Module; GOLD 2025). SATA: Not metabolic alkalosis.
6 Priority for client with pulmonary edema? High Fowler's position + furosemide IV
Rationale: Reduces preload; O2 mask if SpO2 <90% (HealthStream CHF; ATI Med-Surg). Case
study: Frothy sputum → diuretics.
, 7 A client with atrial fibrillation. Expected ECG? Irregularly irregular rhythm, no P waves
Rationale: Chaotic atrial activity; rate control with beta-blockers (HealthStream EKG; AHA
AFib 2025). NGN: Cue (palpitations) → analyze (AFib) → action (anticoagulate if CHA2DS2-
VASc ≥2).
8 Chest tube drainage >200 mL/hr post-lobectomy. Action? Notify surgeon Rationale:
Hemorrhage threshold; clamp if massive (>500 mL initial) (HealthStream Post-Op Thoracic;
ATI Respiratory). Bow-tie: Output cue → hypothesis (bleed) → plan (transfusion).
9 Expected finding in cor pulmonale? Right ventricular hypertrophy, peripheral edema
Rationale: Pulmonary HTN overloads RV; echo confirms (HealthStream CV; ATS 2025). SATA:
Not left failure signs.
10 A client with pneumonia. Incentive spirometry teaching? 10 deep breaths/hour while awake
Rationale: Prevents atelectasis; hold 3 sec (HealthStream Respiratory Therapy; ATI Med-Surg).
Rationale: Improves V/Q mismatch.
11 Priority assessment for client with acute asthma? Peak expiratory flow (PEF) <50%
predicted Rationale: Indicates severe; continuous nebs (HealthStream Asthma Pathway; GINA
2025). NGN: Wheezing cue → PEF measure → steroids if low.
12 Expected SpO2 target for COPD patient? 88-92% Rationale: Avoids hypoxic drive
suppression; ABG if <88% (HealthStream COPD; GOLD Guidelines).
13 A client with pericarditis. Expected pain? Pleuritic, relieved by leaning forward Rationale:
Inflammatory; ECG diffuse ST elevation (HealthStream CV Emergencies; AHA 2025).
Differential: MI vs. PE.
14 Client with DVT. Expected calf finding? Homan's sign positive (pain on dorsiflexion)
Rationale: Vein thrombosis; ultrasound gold standard (HealthStream VTE; ASH 2025). Caution:
Not diagnostic alone.
15 A nurse is assessing a client with mitral regurgitation. Expected murmur? Holosystolic at
apex, radiates to axilla Rationale: Backflow during systole; echo confirms (HealthStream
Cardiac Assessment; ACC 2025).
Section 2: Endocrine & Metabolic (Questions 16-30)
16 Client with DKA. Expected labs? Glucose >250 mg/dL, pH <7.3, anion gap >12 Rationale:
Ketoacidosis; IV insulin + NS bolus (HealthStream Diabetes; ADA 2025). NGN case: Polyuria
cue → glucose check → fluids.
17 A client with hypothyroidism. Expected skin? Dry, cool, coarse Rationale: Decreased
metabolism; TSH elevated (HealthStream Endocrine; ATI Ch. 61). SATA: Not flushed/hot.
Exam 2025/2026 – Verified Questions
with Correct Solutions (100%
Guaranteed Pass)
Section 1: Cardiovascular & Respiratory (Questions 1-15)
1 CHF Hallmark Signs SOB, orthopnea, productive cough (pink frothy sputum), JVD,
crackles, edema, weight gain, anxiety, restlessness, oliguria, tachycardia, tachypnea, HTN,
nagging cough, increased abd girth, ascites Rationale: Left-sided CHF causes pulmonary
congestion (SOB, crackles, frothy sputum); right-sided systemic (edema, JVD, ascites). Monitor
trends; report >2 kg gain (HealthStream CV Module 2025; ATI Med-Surg Ch. 32). NGN SATA:
All apply; bow-tie cue (frothy sputum) → hypothesis (pulmonary edema) → action (diuretics).
2 CHF Interventions Focused cardiopulmonary assessment: Check VS (HR, RR, BP, SpO2),
supplemental O2 if needed, elevate HOB 45-90°, elevate legs for venous return, IV access,
strict I&O (monitor UOP), daily weight; call MD for CXR, diuretics, echo (EF 50%), BMP,
cardiac enzymes Rationale: GDMT stabilizes (O2 for SpO2 <92%, HOB for orthopnea); labs
assess electrolytes/renal (HealthStream Heart Failure Pathway; AHA 2025). Case study:
Tachycardia cue → analyze (decompensation) → plan (beta-blocker if EF low).
3 A patient assessment reveals distended neck veins, pulsus paradoxus, and decreased systolic
pressure. Consistent with? Cardiac tamponade Rationale: Beck's triad + pulsus >10 mmHg
drop on inspiration; emergent pericardiocentesis (HealthStream Emergencies 2025; ATI CV Ch.
29). NGN: Cue (JVD/hypotension) → prioritize (echo/FAST).
4 The nurse is caring for a patient with severe sepsis and third-degree heart block. Next action?
Prepare for transcutaneous pacing Rationale: Sepsis tachycardia usual, but AV block needs
stabilization; atropine 0.5 mg IV first-line (HealthStream Sepsis Bundle; ACLS 2025). Bow-tie:
Rhythm cue → intervention (pace if unstable).
5 Expected ABG in COPD exacerbation? pH 7.28, PaCO2 55 mmHg, PaO2 60 mmHg, HCO3
28 mEq/L Rationale: Acute respiratory acidosis with partial compensation; target PaO2 55-70
mmHg (HealthStream Respiratory Module; GOLD 2025). SATA: Not metabolic alkalosis.
6 Priority for client with pulmonary edema? High Fowler's position + furosemide IV
Rationale: Reduces preload; O2 mask if SpO2 <90% (HealthStream CHF; ATI Med-Surg). Case
study: Frothy sputum → diuretics.
, 7 A client with atrial fibrillation. Expected ECG? Irregularly irregular rhythm, no P waves
Rationale: Chaotic atrial activity; rate control with beta-blockers (HealthStream EKG; AHA
AFib 2025). NGN: Cue (palpitations) → analyze (AFib) → action (anticoagulate if CHA2DS2-
VASc ≥2).
8 Chest tube drainage >200 mL/hr post-lobectomy. Action? Notify surgeon Rationale:
Hemorrhage threshold; clamp if massive (>500 mL initial) (HealthStream Post-Op Thoracic;
ATI Respiratory). Bow-tie: Output cue → hypothesis (bleed) → plan (transfusion).
9 Expected finding in cor pulmonale? Right ventricular hypertrophy, peripheral edema
Rationale: Pulmonary HTN overloads RV; echo confirms (HealthStream CV; ATS 2025). SATA:
Not left failure signs.
10 A client with pneumonia. Incentive spirometry teaching? 10 deep breaths/hour while awake
Rationale: Prevents atelectasis; hold 3 sec (HealthStream Respiratory Therapy; ATI Med-Surg).
Rationale: Improves V/Q mismatch.
11 Priority assessment for client with acute asthma? Peak expiratory flow (PEF) <50%
predicted Rationale: Indicates severe; continuous nebs (HealthStream Asthma Pathway; GINA
2025). NGN: Wheezing cue → PEF measure → steroids if low.
12 Expected SpO2 target for COPD patient? 88-92% Rationale: Avoids hypoxic drive
suppression; ABG if <88% (HealthStream COPD; GOLD Guidelines).
13 A client with pericarditis. Expected pain? Pleuritic, relieved by leaning forward Rationale:
Inflammatory; ECG diffuse ST elevation (HealthStream CV Emergencies; AHA 2025).
Differential: MI vs. PE.
14 Client with DVT. Expected calf finding? Homan's sign positive (pain on dorsiflexion)
Rationale: Vein thrombosis; ultrasound gold standard (HealthStream VTE; ASH 2025). Caution:
Not diagnostic alone.
15 A nurse is assessing a client with mitral regurgitation. Expected murmur? Holosystolic at
apex, radiates to axilla Rationale: Backflow during systole; echo confirms (HealthStream
Cardiac Assessment; ACC 2025).
Section 2: Endocrine & Metabolic (Questions 16-30)
16 Client with DKA. Expected labs? Glucose >250 mg/dL, pH <7.3, anion gap >12 Rationale:
Ketoacidosis; IV insulin + NS bolus (HealthStream Diabetes; ADA 2025). NGN case: Polyuria
cue → glucose check → fluids.
17 A client with hypothyroidism. Expected skin? Dry, cool, coarse Rationale: Decreased
metabolism; TSH elevated (HealthStream Endocrine; ATI Ch. 61). SATA: Not flushed/hot.
