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RN CONCEPT-BASED ASSESSMENT LEVEL 2 EXAM
NEWEST 2026-2027 QUESTIONS AND CORRECT
ANSWERS, EXAMS OF NURSING
A nurse is caring for a client who has pneumonia. Which of the following actions is the priority for the nurse to take?
- Monitor intake and output
- Provide teaching about antibiotic therapy
- Administer the influenza vaccine
- Observe the client perform incentive spirometry - - ANS✔️ --Observe the client perform incentive spirometry When using the airway, breathing, and circulation framework, the priority action the nurse should take is to observe the client perform incentive spirometry. Incentive spirometry improves gas exchange and oxygenation and stimulates coughing, which assists in clearing secretions. A nurse is assessing a client who has hyperthyroidism and has been taking methimazole for 6 months. Which of the following findings indicates a therapeutic response to the medication
- The client's skin is warm and moist
- The client reports sleeping longer during the night
- The client is experiencing increased bowel movements
- The client's weight is 1.4 kg (3.1 lb) less than baseline - - ANS✔️ --The client reports sleeping longer during the night The nurse should recognize that insomnia is a manifestation of hyperthyroidism. The client's ability to sleep longer during the night indicates a therapeutic response to the medication. A nurse is planning discharge teaching for the guardian of a child who had a cardiac catheterization. Which of the following instructions should the nurse include?
- Monitor the site daily for drainage
- Leave the pressure dressing on the 48 hr
- Administer aspirin if the child reports pain
- Resume tub baths in 24hr - - ANS✔️ --Monitor the site daily for drainage The nurse should instruct the guardian to monitor the site daily for manifestations of infection, such as drainage, redness, and swelling. The guardian should report these findings to the provider. A nurse is reviewing the medical record of a client who is receiving total parenteral nutrition for a malabsorption disorder. Which of the following findings should the nurse identify as an indication that the client's nutritional status is improving?
The nurse should recommend the client consume a clear liquid diet until manifestations such as abdominal pain, nausea, and vomiting have resolved. A clear liquid diet is low in fiber and does not stimulate intestinal motility. A nurse is providing teaching to a client who has a methicillin-resistant Staphylococcus aureus (MRSA) skin infection. Which of the following client statements indicates an understanding of the management of antibiotic resistant infections?
- I will keep the infected area open to air to help it heal
- I can sleep in the same bed as my partner after I have been taking antibiotics for 24 hours
- I should sit on upholstered chairs instead of hardback chairs
- I will wash all uninfected skin areas with a fresh washcloth - - ANS✔️ --I will wash all uninfected skin areas with a fresh washcloth The nurse should instruct the client to wash the uninfected skin areas with a fresh washcloth to prevent contamination of the unaffected areas of the skin with the MRSA infection. A nurse is providing teaching to a client about preventing hearing loss from trauma. Which of the following instructions should the nurse include in the teaching?
- Keep your mouth open when sneezing
- Block one nostril when blowing your nose
- Use an ear wick candle to remove excess cerumen from the canal
- Lubricate cotton-tipped applicators with mineral oil to clean the ear canal - - ANS✔️ --Keep your mouth open when sneezing The nurse should instruct the client to keep the mouth open while sneezing to reduce the pressure in the middle ear. Sudden pressure changes can damage the ossicles and perforate the ear drum. A nurse is teaching a client who recently lost his partner to a terminal illness. The client asks how his 4-year-old son is expected to react to the death of his partner. Which of the following information should the nurse include in the teaching?
- A preschooler has no concept of death
- A preschooler is often interested in what happens to the body after death
- A preschooler often believes that death is reversible
- A preschooler understands that death happens to everyone - - ANS✔️ --A preschooler often believes that death is reversible The nurse should identify that preschoolers tend to have difficulty understanding the reality of death and often believe that it is reversible. Because of magical thinking, the preschooler might think that his thoughts or behavior might have caused the person to die. A nurse is assessing a client who has gestational diabetes and ketoacidosis. Which of the following manifestations should the nurse expect?
- Increased urination
- Sweating
A nurse is providing teaching about home care with an adolescent client who has a skin infection caused by MRSA. Which of the following client statements indicates an understanding of the teaching?
- I will soak in a bathtub filled one-fourth full of water with one-half cup of bleach
- I will wash my clothes in cold water and detergent
- I will throw away my razor after using it three times
- I will apply imiquimod cream to the lesions before going to bed each night - - ANS✔️ --I will soak in a bathtub filled one-fourth full of water with one-half cup of bleach The client should soak for at least 5 min in a bathtub filled one-fourth full of water with ½ cup of bleach once or twice per week. This will help prevent reoccurrence of the infection. A nurse is caring for a client who is experiencing an asthma attack. Which of the following procedures should the nurse use to assess the client's respiratory status?
- Peak expiratory flow meter testing
- Spirometry monitoring
- Pulmonary function testing
- Chest x-ray - - ANS✔️ --Peak expiratory flow meter testing The peak expiratory flow meter provides a means of evaluating the maximum flow of air the client expels during forceful exhalation. It provides information on how well asthma is being controlled as a part of daily monitoring and can be used when a client is having an asthma attack. The flow meter testing helps to gauge the peak-expiratory zone the client is experiencing and
determines if the client should use immediate-acting bronchial dilator inhalers or seek emergency help. A nurse is caring for a client who has renal calculi and is taking oxybutynin for pain. Which of the following findings should the nurse identify as an adverse effect of this medication?
- Increased salivation
- Bradycardia
- Tinnitus
- Distended bladder - - ANS✔️ --Distended bladder The nurse should identify oxybutynin as having anticholinergic effects that can result in urinary retention. The nurse should monitor the client's intake and output and assess for bladder distention. A nurse is planning discharge for a postpartum client. The client tells the nurse she is having subdermal implant placed for contraception at her 6 week follow-up examination and asks about the adverse effects of the implant. Which of the following manifestations should the nurse include?
- Irregular bleeding
- Fatigue
- Shoulder pain
- Recurrent urinary tract infections (UTIs) - - ANS✔️ --Irregular bleeding
- nasogastric suctioning - - ANS✔️ --A client who has abdominal ascites The nurse should identify that a client who has abdominal ascites can experience a restriction of chest expansion, which impairs gas exchange and places the client at an increased risk for developing respiratory acidosis. A nurse is assessing a client who has peripheral arterial disease. Which of the following findings should the nurse expect?
- Brown discoloration of the lower extremities
- Superficial ulcer on the medial aspect of the ankle
- Dependent rubor
- Telangiectasias - - ANS✔️ --Dependent rubor The nurse should expect redness to the lower extremities, or dependent rubor, when the client's legs are dangling or in a dependent position. A nurse is assessing a client for manifestations of right-sided heart failure. Which of the following findings should the nurse expect?
- Jugular vein distention
- Fatigue
- Angina
- Hacking cough - - ANS✔️ --Jugular vein distention
The nurse should expect to find jugular vein distention (JVD) in the client who has right-sided heart failure due to right ventricular failure and pressure building in the venous system. A nurse is assessing a client for manifestations of GERD. Which of the following findings indicates to the nurse that the client might have GERD?
- Decreased salivation
- Diarrhea
- Tonsillitis
- Globus - - ANS✔️ --Globus The client who has manifestations of GERD will have globus, which is a feeling of something being in the back of the throat. A nurse is preparing to mix NPH insulin aspart in a single syringe for a client who has type 2 diabetes mellitus. Identify the sequence the nurse should follow. - - ANS ✔️ --1. Inject air into the vial equal to the amount of NPH insulin prescribed
- Inject air into the vial equal to the amount of insulin aspart prescribed
- Withdraw the prescribed volume of insulin aspart into the syringe
- Withdraw the prescribed volume of NPH insulin into the syringe A nurse is assessing a client who has acute cholecystitis. Which of the following findings should the nurse expect? Select all that apply A: Fever
A nurse is monitoring a client who has metabolic acidosis due to salicylate overdose. For which of the following findings should the nurse monitor?
- Flushed, dry skin
- Seizures
- Hyperreflexia
- Positive Trousseau's sign - - ANS✔️ --Flushed, dry skin The nurse should monitor a client who has metabolic acidosis for manifestations of warm, flushed, and dry skin due to vasodilation from an increased respiratory rate and the loss of CO2. A nurse in an emergency department is caring for a client who has appendicitis. Which of the following actions should the nurse take?
- restrict oral intake to clear fluids
- place a heating pad on the client's abdomen
- place the client in semi-Fowler's position
- Administer an enema - - ANS✔️ --Place the client in semi-Fowler's position The nurse should place the client in semi-Fowler's position to contain abdominal drainage in the lower abdomen and prevent it from seeping into the peritoneum. A nurse is participating in a health fair by providing screenings for osteoporosis. Which of the following should the nurse recognize as a risk factor for the disease?
- BMI 26 or above
- Excessive sun exposure
- Frequent weight-bearing exercise
- Hip fracture 6 months ago - - ANS✔️ --Hip fracture 6 months ago The nurse should recognize that a client who has a history of hip fracture, especially after the age of 50, is at greater risk for developing regional osteoporosis. A nurse is reviewing a client's home medication list during admission to a long-term care facility. The nurse should identify that the client takes which of the following medications to manage osteoarthritis? Select all that apply A: Lidocaine 5% patches B: Celecoxib C: Vancomycin D: Cyclobenzaprine E: Glucosamine - - - ANS✔️ --Lidocaine 5% patches, Celecoxib, Cyclobenzaprine, Glucosamine A nurse is assessing a client who has renal calculi. For which of the following findings should the nurse notify the provider immediately?
- Flank pain with radiation toward the scrotum
- 150 mL emesis
- Oliguria with bladder distention
- Blood pressure 160/90 mmHg - - ANS✔️ --Oliguria with bladder distention
A nurse is reviewing the laboratory records of a client who has AIDS. Which of the following laboratory results should the nurse review to determine if the client is at risk for malnutrition? A: WBC count B: Albumin level C: CD4 T cell count D: C-reactive protein level - - ANS✔️ --Albumin level A nurse is assessing for adverse medication reactions with a client who reports taking more than the recommended doses of acetaminophen for the management of chronic pain. Which of the following findings should the nurse identify as an adverse effect of acetaminophen? A: Elevated aspartate aminotransferase levels B: Decreased skin turgor C: Elevated WBC count D: Decreased audio acuity - - ANS✔️ --Elevated aspartate aminotransferase levels A nurse is teaching a client who has COPD about preventing pneumonia. Which of the following client statements indicates an understanding of the teaching?" A. I will drink one and a half liters of fluids every day." B: "I will get the pneumonia vaccine yearly." C: "I will spray an aerosol disinfectant in my house every day." D: "I will wash my hands whenever I come home from the grocery store." - - ANS✔️ --I will wash my hands whenever I come home from the grocery store
A nurse in a provider's office is reviewing the medical record of a client who has COPD. Which of the following findings is the priority for the nurse to report to the provider? A: Chest x-ray results show increased lung space. B: Sputum culture shows gram positive bacteria. C: SpO2 level is 88%. D: Weight loss of 1.4 kg (3 lb) since prior visit. - - ANS✔️ --Sputum culture shows gram positive bacteria A nurse is providing teaching for a client who has peripheral neuropathy of the lower extremities. Which of the following client statements indicates an understanding of the teaching? A: "I should wash my feet with soap before I try to treat my calluses." B: "I should limit wearing the same shoes 2 days in a row." C: "I should use home remedies to treat any blisters or sores on my feet." D: "I should use adhesive tape to secure a dressing on my foot when I have skin breakdown." - - ANS✔️ --I should limit wearing the same shoes 2 days in a row A nurse is providing teaching about exercise to a client who has osteoarthritis. Which of the following information should the nurse include? A: Increase daily intake of foods containing vitamin A. B: Limit alcohol consumption to 10 oz daily .C: Perform exercises to strengthen the abdominal core.
C: Shortened PR interval D: QRS 0.08 seconds - - ANS✔️ --Tall T-waves A nurse is counseling a client who recently lost her partner in a motor-vehicle crash. Which of the following reactions should the nurse identify as part of the second stage of the grieving process? A: Persistent feelings of hopelessness B: Loss of self-esteem C: Chronic physical manifestations D: Feeling anger toward family members - - ANS✔️ --Feeling anger toward family members A nurse is providing teaching about home care to the parent of a child who has pediculosis capitis. Which of the following information should the nurse include? A: Soak the child's combs and brushes in hot water for 5 min .B: Rinse the child's hair each day with 236.5 mL (1 cup) of vinegar .C: Seal the child's nonwashable toys in plastic bags for 7 days. D: Comb the child's hair daily with an extra fine-tooth comb. - - ANS✔️ --Comb the child's hair daily with an extra fine-tooth comb A nurse is assessing a client who has generalized anxiety disorder and is experiencing a moderate level of anxiety. Which of the following manifestations should the nurse expect? A: Focuses on the source of the anxiety B: Exhibits an inability to speak
C: Experiences auditory hallucinations D: Feels surroundings are unreal - - ANS✔️ --Focuses on the source of anxiety A nurse is providing teaching about home care to the parent of an adolescent who has infectious mononucleosis. Which of the following manifestations should the nurse intruct the parent to report to the provider? A: Swollen cervical lymph nodes B: Exudate on tonsils C: Lack of energy D: Onset of abdominal pain - - ANS✔️ --onset of abdominal pain A nurse is reviewing the medical record of a client who has decreased urinary output. Which of the following findings should the nurse identify as a risk factor for the development of pyelonephritis? - - ANS✔️ --Diabetes mellitus A nurse is reviewing the medical record of a client who has AIDS and is experiencing anorexia. Which of the following medications should the nurse expect the provider to prescribe to reduce the client's risk of failure to thrive? A: Megestrol B: Ondansetron C: Famotidine D: Pancrelipase - - ANS ✔️ --Megestrol
