PN Comprehensive Exit Exam Questions & Rationales
Question 1:
A nurse is caring for a client who has a new diagnosis of type 1 diabetes
mellitus and is receiving a teaching session about insulin administration;
which of the following statements by the client indicates an understanding
of the teaching?
A) "I will store my unopened insulin vials in the freezer."
B) "I will shake the NPH insulin vial vigorously before drawing it up."
C) "I will roll the NPH insulin vial between my palms before drawing it up."
D) "I will discard any unused insulin after 3 months."
VERIFIED ANSWER: C) "I will roll the NPH insulin vial between my palms
before drawing it up."
Rationale: NPH insulin is an intermediate-acting insulin that appears
cloudy; rolling the vial between the palms gently resuspends the particles
without creating air bubbles or damaging the insulin, ensuring accurate
dosing. Shaking the vial vigorously should be avoided because it can cause
bubbles and denature the insulin. Unopened insulin should be refrigerated,
not frozen, and opened vials can be stored at room temperature for up to
28 days.
,Question 2:
A nurse is reinforcing discharge teaching with a client who has a new
prescription for furosemide; which of the following food choices by the
client indicates an understanding of the teaching?
A) A banana
B) A glass of milk
C) A baked potato with salt
D) A serving of white rice
VERIFIED ANSWER: A) A banana
Rationale: Furosemide is a loop diuretic that causes potassium wasting;
bananas are rich in potassium and help prevent hypokalemia, which can
lead to muscle weakness and cardiac dysrhythmias. Other potassium-rich
foods include oranges, spinach, and potatoes, but the baked potato option
included added salt, which is not recommended due to sodium retention.
Question 3:
A nurse is collecting data from a client who is receiving a blood
transfusion and reports low back pain and chills; which of the following
actions should the nurse take first?
A) Notify the provider
B) Stop the transfusion
C) Administer acetaminophen
D) Obtain a urine sample
,VERIFIED ANSWER: B) Stop the transfusion
Rationale: Low back pain and chills are classic signs of a hemolytic
transfusion reaction; the priority action is to stop the transfusion
immediately to prevent further complications, then maintain IV access
with normal saline and notify the provider. Administering medications and
obtaining a urine sample are important but should occur after stopping
the transfusion.
Question 4:
A nurse is caring for a client who has a nasogastric tube attached to
continuous suction; which of the following findings should indicate to the
nurse that the tube is properly placed?
A) The client reports no discomfort
B) The aspirate has a pH of 4
C) The aspirate has a pH of 7
D) Bubbling is heard when air is instilled
VERIFIED ANSWER: B) The aspirate has a pH of 4
Rationale: Gastric aspirate typically has a pH of 1 to 4, confirming
placement in the stomach; a pH greater than 5 may indicate intestinal or
respiratory placement, requiring further verification before use. The
auscultation method for checking tube placement is no longer considered
reliable.
, Question 5:
A nurse is reinforcing teaching with a client who has a new prescription
for warfarin; which of the following statements by the client indicates a
need for further teaching?
A) "I will use a soft toothbrush to brush my teeth."
B) "I will increase my intake of green leafy vegetables."
C) "I will wear a medical alert bracelet."
D) "I will report any unusual bleeding to my provider."
VERIFIED ANSWER: B) "I will increase my intake of green leafy
vegetables."
Rationale: Green leafy vegetables are high in vitamin K, which
antagonizes the effects of warfarin and can decrease the international
normalized ratio, increasing the risk of clot formation; clients taking
warfarin should maintain consistent vitamin K intake rather than
increasing it. The other statements reflect correct understanding of
bleeding precautions and safety.
Question 6:
A nurse is caring for a client who has a history of falls and is receiving
morphine via patient-controlled analgesia; which of the following actions
should the nurse take?
A) Instruct the client to call for assistance before getting out of bed
B) Place the PCA pump on the client's non-dominant side
Question 1:
A nurse is caring for a client who has a new diagnosis of type 1 diabetes
mellitus and is receiving a teaching session about insulin administration;
which of the following statements by the client indicates an understanding
of the teaching?
A) "I will store my unopened insulin vials in the freezer."
B) "I will shake the NPH insulin vial vigorously before drawing it up."
C) "I will roll the NPH insulin vial between my palms before drawing it up."
D) "I will discard any unused insulin after 3 months."
VERIFIED ANSWER: C) "I will roll the NPH insulin vial between my palms
before drawing it up."
Rationale: NPH insulin is an intermediate-acting insulin that appears
cloudy; rolling the vial between the palms gently resuspends the particles
without creating air bubbles or damaging the insulin, ensuring accurate
dosing. Shaking the vial vigorously should be avoided because it can cause
bubbles and denature the insulin. Unopened insulin should be refrigerated,
not frozen, and opened vials can be stored at room temperature for up to
28 days.
,Question 2:
A nurse is reinforcing discharge teaching with a client who has a new
prescription for furosemide; which of the following food choices by the
client indicates an understanding of the teaching?
A) A banana
B) A glass of milk
C) A baked potato with salt
D) A serving of white rice
VERIFIED ANSWER: A) A banana
Rationale: Furosemide is a loop diuretic that causes potassium wasting;
bananas are rich in potassium and help prevent hypokalemia, which can
lead to muscle weakness and cardiac dysrhythmias. Other potassium-rich
foods include oranges, spinach, and potatoes, but the baked potato option
included added salt, which is not recommended due to sodium retention.
Question 3:
A nurse is collecting data from a client who is receiving a blood
transfusion and reports low back pain and chills; which of the following
actions should the nurse take first?
A) Notify the provider
B) Stop the transfusion
C) Administer acetaminophen
D) Obtain a urine sample
,VERIFIED ANSWER: B) Stop the transfusion
Rationale: Low back pain and chills are classic signs of a hemolytic
transfusion reaction; the priority action is to stop the transfusion
immediately to prevent further complications, then maintain IV access
with normal saline and notify the provider. Administering medications and
obtaining a urine sample are important but should occur after stopping
the transfusion.
Question 4:
A nurse is caring for a client who has a nasogastric tube attached to
continuous suction; which of the following findings should indicate to the
nurse that the tube is properly placed?
A) The client reports no discomfort
B) The aspirate has a pH of 4
C) The aspirate has a pH of 7
D) Bubbling is heard when air is instilled
VERIFIED ANSWER: B) The aspirate has a pH of 4
Rationale: Gastric aspirate typically has a pH of 1 to 4, confirming
placement in the stomach; a pH greater than 5 may indicate intestinal or
respiratory placement, requiring further verification before use. The
auscultation method for checking tube placement is no longer considered
reliable.
, Question 5:
A nurse is reinforcing teaching with a client who has a new prescription
for warfarin; which of the following statements by the client indicates a
need for further teaching?
A) "I will use a soft toothbrush to brush my teeth."
B) "I will increase my intake of green leafy vegetables."
C) "I will wear a medical alert bracelet."
D) "I will report any unusual bleeding to my provider."
VERIFIED ANSWER: B) "I will increase my intake of green leafy
vegetables."
Rationale: Green leafy vegetables are high in vitamin K, which
antagonizes the effects of warfarin and can decrease the international
normalized ratio, increasing the risk of clot formation; clients taking
warfarin should maintain consistent vitamin K intake rather than
increasing it. The other statements reflect correct understanding of
bleeding precautions and safety.
Question 6:
A nurse is caring for a client who has a history of falls and is receiving
morphine via patient-controlled analgesia; which of the following actions
should the nurse take?
A) Instruct the client to call for assistance before getting out of bed
B) Place the PCA pump on the client's non-dominant side
