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Preparation
Question 1. Which of the following best describes the primary purpose of the “Five Rights” of medication administration? A) To reduce medication costs B) To ensure accurate documentation only C) To prevent medication errors and promote patient safety D) To speed up the medication administration process Answer: C Explanation: The “Five Rights” (right patient, drug, dose, route, time) are fundamental safeguards designed to prevent medication errors and protect patient safety. Question 2. A nurse is delegating a task to an Unlicensed Assistive Personnel (UAP). Which of the following tasks is appropriate for the UAP to perform? A) Initiate a new IV infusion B) Perform a comprehensive respiratory assessment C) Measure and record a client’s temperature and pulse D) Administer a prescribed medication Answer: C Explanation: UAPs may perform basic vital sign measurements, but they cannot initiate IVs, conduct comprehensive assessments, or administer medications. Question 3. When applying standard precautions, which personal protective equipment (PPE) is required for a client with known hepatitis B infection undergoing a dressing change? A) Gloves only B) Gloves and a surgical mask C) Gloves, gown, and eye protection
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D) No PPE is needed because hepatitis B is not transmitted by contact Answer: A Explanation: Standard precautions require gloves for any procedure that may involve exposure to blood or bodily fluids. Additional PPE is not required unless there is a risk of splash. Question 4. A client with chronic obstructive pulmonary disease (COPD) is experiencing increased shortness of breath. Which of the following interventions should the nurse prioritize? A) Administer a bronchodilator via nebulizer B) Encourage the client to ambulate for 30 minutes C) Provide a high‑fat, high‑calorie diet D) Offer a warm blanket for comfort Answer: A Explanation: Bronchodilators are the first‑line treatment to relieve airway obstruction and improve breathing in COPD exacerbations. Question 5. Which of the following is a hallmark sign of early shock? A) Hypertension B) Warm, flushed skin C) Decreased capillary refill time D) Bradycardia Answer: B Explanation: Early (compensated) shock often presents with warm, flushed skin due to peripheral vasodilation as the body attempts to maintain perfusion.
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C) Respect the client’s decision and document the refusal after ensuring informed consent D) Notify law enforcement Answer: C Explanation: Clients have the right to refuse treatment, including blood products, after being fully informed. The nurse must respect the decision and document it. Question 9. A client with a newly placed Foley catheter reports burning during urination. Which of the following is the most likely cause? A) Urinary tract infection B) Catheter blockage C) Irritation from the catheter balloon D) Normal post‑insertion discomfort Answer: D Explanation: Mild burning is common shortly after catheter insertion and usually resolves; infection signs would include fever, foul odor, and cloudy urine. Question 10. Which of the following statements best reflects the nurse’s role in advocacy? A) “I will inform the client of all possible treatments, but I will not influence their decision.” B) “I will ensure the client’s preferences are communicated to the health‑care team and support their informed choices.” C) “I will make decisions on behalf of the client to expedite care.” D) “I will delegate all advocacy tasks to the social worker.” Answer: B
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Explanation: Advocacy involves representing the client’s wishes, ensuring they are informed, and communicating those wishes to the health‑care team. Question 11. A client with type 1 diabetes presents with a blood glucose of 45 mg/dL. Which of the following is the most appropriate immediate intervention? A) Administer regular insulin intravenously B) Give 15–20 g of rapid‑acting carbohydrate orally (if conscious) C) Start a glucose‑containing IV infusion at 100 mL/hr D) Encourage the client to rest and monitor glucose Answer: B Explanation: Hypoglycemia is treated promptly with fast‑acting carbohydrates if the client is conscious and able to swallow. Question 12. Which of the following is a key component of an effective emergency response plan for a “Code Blue” situation? A) Immediate notification of the client’s family B) Activation of the rapid response team before checking the airway C) Performing chest compressions after confirming unresponsiveness and absent pulse D) Waiting for a physician’s orders before starting resuscitation Answer: C Explanation: In a cardiac arrest, the nurse should immediately assess responsiveness and pulse, then begin chest compressions if there is no pulse. Question 13. A client is receiving total parenteral nutrition (TPN). Which laboratory value should the nurse monitor most closely to prevent complications?
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Answer: B Explanation: Adequate lighting reduces the risk of falls, especially at night, making it a critical discharge instruction. Question 16. Which of the following signs is most indicative of a pressure ulcer developing under a patient’s sacrum? A) Redness that does not blanch when pressed B) A raised, painful bump that blanches with pressure C) A dry, scaly patch of skin D) A small, painless blister Answer: A Explanation: Non‑blanchable erythema is an early sign of tissue damage and indicates a pressure ulcer in its initial stage. Question 17. A client with a recent diagnosis of schizophrenia is experiencing auditory hallucinations. Which therapeutic communication technique is most effective? A) Confront the client about the reality of the voices B) Use “I” statements to express concern C) Encourage the client to describe the content of the voices without judgment D) Redirect the conversation to physical symptoms Answer: C Explanation: Allowing the client to discuss hallucinations promotes trust and helps the nurse assess the severity without confrontation.
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Question 18. Which of the following is the most appropriate method for verifying a client’s identity before administering medication? A) Asking the client’s name only B) Checking the client’s wristband and asking for name and date of birth C) Looking at the client’s medical record on the computer D) Asking the nurse on duty to confirm Answer: B Explanation: The “two‑identifier” method (name and date of birth) plus visual confirmation of the wristband ensures correct client identification. Question 19. A client with a newly placed central line develops a fever, chills, and a reddened area at the insertion site. Which action should the nurse take first? A) Apply a warm compress to the site B) Obtain blood cultures through the line and peripheral vein C) Remove the central line immediately D) Document the findings and notify the physician Answer: B Explanation: Obtaining cultures before antibiotics are started is the priority to identify the causative organism. Question 20. Which of the following is an example of a transmission‑based precaution for a client with active pulmonary tuberculosis? A) Contact precautions with gloves and gown B) Droplet precautions with surgical mask C) Airborne precautions with N95 respirator and negative‑pressure room
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Question 23. A client with a new diagnosis of heart failure is prescribed furosemide. Which of the following assessments should the nurse monitor to detect a potential adverse effect? A) Blood glucose level B) Skin turgor and daily weight C) Visual acuity D) Reflexes Answer: B Explanation: Loop diuretics cause fluid loss; monitoring skin turgor and daily weight helps detect dehydration and excessive diuresis. Question 24. Which of the following statements best reflects the nurse’s legal responsibility when obtaining informed consent? A) The nurse must sign the consent form on the client’s behalf. B) The nurse must ensure the client understands the procedure, risks, benefits, and alternatives before signing. C) The nurse can proceed with the procedure if the client nods in agreement. D) The nurse is not involved in the consent process. Answer: B Explanation: The nurse’s role includes verifying that the client comprehends the information and voluntarily agrees before signing. Question 25. A client is being discharged after treatment for cellulitis. Which instruction is most important to prevent recurrence? A) Apply a warm compress to the affected area three times daily for 10 minutes
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B) Keep the affected limb elevated and continue the prescribed antibiotics for the full course C) Use a heating pad on high setting for 30 minutes each day D) Massage the area vigorously to improve circulation Answer: B Explanation: Elevation reduces edema, and completing the antibiotic regimen prevents recurrence and resistance. Question 26. Which of the following is the most appropriate nursing action when a client with a history of seizures requests to leave the unit to use the restroom? A) Allow the client to go alone because they are ambulatory B) Escort the client to the restroom and stay nearby C) Restrain the client to prevent a fall D) Cancel the restroom request and keep the client in bed Answer: B Explanation: Providing supervision while allowing bathroom use balances safety with autonomy. Question 27. A client undergoing chemotherapy develops neutropenia (ANC < 500). Which of the following precautions is most appropriate? A) Implement contact precautions only B) Place the client in a positive‑pressure room C) Use strict hand hygiene, protective gloves, and limit visitors with infections D) No additional precautions are needed Answer: C
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A) Provide a nicotine patch and schedule a follow‑up in 2 weeks B) Encourage the client to quit smoking by discussing the benefits and offering cessation resources C) Advise the client to reduce the number of cigarettes by half D) Recommend a low‑fat diet Answer: B Explanation: Education and referral to cessation programs are essential components of smoking cessation strategies. Question 31. A client with a new diagnosis of ulcerative colitis is prescribed sulfasalazine. Which adverse effect should the nurse monitor for? A) Hyperglycemia B) Photosensitivity rash C) Peripheral neuropathy D) Renal calculi Answer: B Explanation: Sulfasalazine can cause photosensitivity; clients should be advised to avoid excessive sunlight. Question 32. Which of the following is the most appropriate action when a client’s family member demands information that the client has not authorized to be shared? A) Provide the requested information to maintain family harmony B) Explain the privacy policy and that the client’s consent is required before disclosure C) Ask the client to clarify their wishes in front of the family member D) Refuse to answer any questions from the family altogether
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Answer: B Explanation: Confidentiality rules require client authorization before sharing health information with family members. Question 33. A client with an indwelling urinary catheter reports a sudden onset of flank pain and chills. Which complication should the nurse suspect? A) Catheter‑associated urinary tract infection (CAUTI) B) Bladder spasm C) Ureteral obstruction from a stone D) Acute renal failure unrelated to the catheter Answer: A Explanation: Sudden flank pain, chills, and fever suggest a possible upper urinary tract infection secondary to the catheter. Question 34. Which of the following statements best demonstrates therapeutic communication with a client who is grieving the loss of a spouse? A) “You need to be strong for your children.” B) “I can’t imagine how hard this is, but you’ll get over it.” C) “It sounds like you’re feeling overwhelmed and sad about your loss.” D) “Let’s focus on your medication schedule now.” Answer: C Explanation: Reflecting the client’s feelings validates their experience and promotes therapeutic rapport.
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D) “They replace the need for antiretroviral therapy.” Answer: B Explanation: Prophylactic antibiotics reduce the risk of opportunistic infections in immunocompromised HIV patients. Question 38. Which of the following is the most appropriate nursing intervention for a client who is experiencing a panic attack? A) Encourage the client to take deep, slow breaths and use grounding techniques B) Restrain the client to prevent self‑harm C) Administer a high‑dose sedative immediately D) Leave the client alone to calm down Answer: A Explanation: Controlled breathing and grounding help reduce anxiety during a panic attack without the need for restraints or immediate medication. Question 39. A client with a recent diagnosis of chronic kidney disease (stage 3) is being educated about dietary restrictions. Which nutrient should be limited most? A) Carbohydrates B) Protein C) Vitamin C D) Fiber Answer: B Explanation: Reducing protein intake helps decrease the workload on the kidneys and slows progression of CKD.
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Question 40. Which of the following is the most appropriate action for a nurse who observes a colleague stealing medication from the supply cabinet? A) Confront the colleague in front of the client B) Report the incident to the appropriate supervisor or ethics committee according to facility policy C) Ignore the situation to avoid conflict D) Take the medication for personal use Answer: B Explanation: Ethical and legal obligations require reporting suspected theft to protect patient safety and maintain professional standards. Question 41. A client with a recent traumatic brain injury (TBI) has a Glasgow Coma Scale (GCS) score of 8. Which of the following actions is most appropriate? A) Keep the client on a regular diet B) Initiate continuous cardiac monitoring only C) Secure the airway with endotracheal intubation D) Encourage the client to ambulate Answer: C Explanation: A GCS ≤ 8 indicates a compromised airway; intubation is indicated to protect the airway. Question 42. Which of the following best describes an anaphylactic reaction? A) Localized rash and itching only B) Fever, chills, and malaise
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Answer: B Explanation: Ensuring free flow of irrigation and proper bag height prevents bladder distention and clot formation. Question 45. A client with a history of chronic alcoholism presents with tremors, agitation, and hallucinations. Which condition is most likely? A) Alcoholic liver disease B) Delirium tremens C) Wernicke’s encephalopathy D) Acute pancreatitis Answer: B Explanation: Delirium tremens is a severe alcohol withdrawal syndrome characterized by tremors, agitation, and hallucinations. Question 46. Which of the following is an essential component of a discharge plan for a client with congestive heart failure? A) Advise the client to limit fluid intake to 3 L per day B) Schedule a follow‑up appointment within 7–10 days and provide weight‑monitoring instructions C) Discontinue all diuretics after discharge D) Encourage unrestricted sodium diet Answer: B Explanation: Close follow‑up and daily weight monitoring are critical for early detection of fluid overload in heart failure.
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Question 47. A client with severe asthma is receiving nebulized albuterol. Which of the following assessments should the nurse perform before each treatment? A) Blood glucose level B) Respiratory rate and wheezing intensity C) Urine output D) Skin turgor Answer: B Explanation: Baseline respiratory assessment (rate, wheeze) helps evaluate treatment effectiveness. Question 48. Which of the following statements best illustrates the concept of “cultural humility” in nursing practice? A) Assuming all clients share the same cultural beliefs as the nurse B) Learning about a client’s culture and acknowledging the limits of one’s own knowledge while seeking to understand the client’s perspective C) Ignoring cultural differences to treat all clients equally D) Providing care based solely on hospital policy Answer: B Explanation: Cultural humility involves ongoing self‑reflection, recognizing knowledge gaps, and actively learning from the client’s cultural viewpoint. Question 49. A client with a recent diagnosis of atrial fibrillation is prescribed dabigatran. Which of the following is the most important teaching point? A) “Take the medication with food to improve absorption.” B) “Report any signs of unusual bleeding or bruising immediately.”
