Kaplan Integrated Exam
Fundamentals D NGN ACTUAL FINAL
EXAM QUESTIONS AND
ANWERS(NGN)|WELL
STRUCTURED|100 %PASS
Question 1
A nurse is caring for a client who is postoperative day one
following abdominal surgery. The client's heart rate is 112 bpm,
blood pressure is 98/62 mm Hg, and respiratory rate is 24/min.
The client's surgical dressing is dry and intact. Which action
should the nurse take first?
A) Administer a prescribed beta-blocker.
B) Recheck the client's vital signs in 30 minutes.
C) Assess the client's pain level.
D) Increase the IV fluid rate as prescribed.
Answer: C
Rationale: Before implementing any medical or nursing
interventions, the nurse must complete an assessment. The
client's tachycardia and mild hypotension could be due to pain,
dehydration, or bleeding. Since the dressing is dry, pain is a likely
cause. Assessing the client's pain level will help determine the
appropriate intervention. This follows the nursing process
(Assessment -> Analysis -> Planning -> Implementation).
,Question 2
A nurse is preparing to administer a medication to a client. The
client asks the nurse what the medication is for. Which of the
following is the most appropriate response by the nurse?
A) "Don't worry, your doctor knows what's best for you."
B) "I can't tell you; you'll have to ask your doctor."
C) "This medication is to help lower your blood pressure."
D) "Why are you asking me that?"
Answer: C
Rationale: Clients have the right to know the name, purpose, and
potential side effects of any medication they receive. This is a core
ethical and legal principle in nursing practice. Providing a clear,
factual answer promotes client autonomy and trust. Avoiding the
question or deferring to the physician undermines the nurse-
client relationship and is a failure to provide basic client
education.
Question 3
A nurse is caring for a client with a nasogastric (NG) tube set to
low intermittent suction. The nurse should monitor the client for
which of the following acid-base imbalances?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: B
Rationale: Gastric suction removes hydrochloric acid (HCL) and
gastric contents, which are acidic. The loss of this acid causes the
body's pH to become more basic (alkalotic), leading to metabolic
,alkalosis. This is a common complication of prolonged NG
suctioning.
Question 4
A nurse is reinforcing teaching with a client who has a new
prescription for a metered-dose inhaler (MDI) of albuterol. Which
statement by the client indicates a need for further teaching?
A) "I will shake the inhaler well before I use it."
B) "I will hold my breath for 10 seconds after inhaling the
medication."
C) "I will rinse my mouth with water after using the inhaler."
D) "I will use this inhaler every 4 hours, even if I am not feeling
short of breath."
Answer: D
Rationale: Albuterol is a short-acting beta-agonist (SABA)
"rescue" inhaler, not a maintenance medication. It should be used
as needed for acute symptoms of shortness of breath or
wheezing. Using it routinely when asymptomatic can lead to
tachycardia, tremors, and decreased effectiveness over time.
Question 5
A nurse is caring for a client receiving a blood transfusion. Fifteen
minutes after the transfusion begins, the client reports chills and
low back pain. What is the nurse's priority action?
A) Slow the infusion rate.
B) Stop the transfusion.
C) Notify the healthcare provider.
D) Administer an antihistamine.
Answer: B
Rationale: Chills and low back pain are classic signs of a
, hemolytic transfusion reaction. The priority action is to stop the
transfusion immediately to prevent further infusion of the
incompatible blood. After stopping the transfusion, the nurse
should then replace the tubing, keep the IV line open with normal
saline, and notify the provider.
Question 6
A nurse is caring for a client who is 1-day post-operative following
a hip replacement. The client is using a patient-controlled
analgesia (PCA) pump. The client's spouse asks the nurse if they
can push the button for the client while the client is sleeping.
Which of the following is the correct response by the nurse?
A) "No, only the client should push the button to ensure safe
dosing."
B) "Yes, that will help the client rest better."
C) "You can push it once, but only if the client is in pain."
D) "Only a healthcare provider can program the PCA pump."
Answer: A
Rationale: Only the client should activate the PCA pump. The
device is designed to deliver a prescribed dose of analgesic when
the client feels pain, which ensures safe dosing intervals. If
another person activates it, the client may receive too much
medication, leading to respiratory depression and oversedation.
Question 7
A nurse is assessing a client's heart rate. The pulse is irregular.
Which of the following actions should the nurse take to obtain the
most accurate measurement?
A) Count the pulse for 15 seconds and multiply by 4.
B) Count the pulse for 30 seconds and multiply by 2.
Fundamentals D NGN ACTUAL FINAL
EXAM QUESTIONS AND
ANWERS(NGN)|WELL
STRUCTURED|100 %PASS
Question 1
A nurse is caring for a client who is postoperative day one
following abdominal surgery. The client's heart rate is 112 bpm,
blood pressure is 98/62 mm Hg, and respiratory rate is 24/min.
The client's surgical dressing is dry and intact. Which action
should the nurse take first?
A) Administer a prescribed beta-blocker.
B) Recheck the client's vital signs in 30 minutes.
C) Assess the client's pain level.
D) Increase the IV fluid rate as prescribed.
Answer: C
Rationale: Before implementing any medical or nursing
interventions, the nurse must complete an assessment. The
client's tachycardia and mild hypotension could be due to pain,
dehydration, or bleeding. Since the dressing is dry, pain is a likely
cause. Assessing the client's pain level will help determine the
appropriate intervention. This follows the nursing process
(Assessment -> Analysis -> Planning -> Implementation).
,Question 2
A nurse is preparing to administer a medication to a client. The
client asks the nurse what the medication is for. Which of the
following is the most appropriate response by the nurse?
A) "Don't worry, your doctor knows what's best for you."
B) "I can't tell you; you'll have to ask your doctor."
C) "This medication is to help lower your blood pressure."
D) "Why are you asking me that?"
Answer: C
Rationale: Clients have the right to know the name, purpose, and
potential side effects of any medication they receive. This is a core
ethical and legal principle in nursing practice. Providing a clear,
factual answer promotes client autonomy and trust. Avoiding the
question or deferring to the physician undermines the nurse-
client relationship and is a failure to provide basic client
education.
Question 3
A nurse is caring for a client with a nasogastric (NG) tube set to
low intermittent suction. The nurse should monitor the client for
which of the following acid-base imbalances?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: B
Rationale: Gastric suction removes hydrochloric acid (HCL) and
gastric contents, which are acidic. The loss of this acid causes the
body's pH to become more basic (alkalotic), leading to metabolic
,alkalosis. This is a common complication of prolonged NG
suctioning.
Question 4
A nurse is reinforcing teaching with a client who has a new
prescription for a metered-dose inhaler (MDI) of albuterol. Which
statement by the client indicates a need for further teaching?
A) "I will shake the inhaler well before I use it."
B) "I will hold my breath for 10 seconds after inhaling the
medication."
C) "I will rinse my mouth with water after using the inhaler."
D) "I will use this inhaler every 4 hours, even if I am not feeling
short of breath."
Answer: D
Rationale: Albuterol is a short-acting beta-agonist (SABA)
"rescue" inhaler, not a maintenance medication. It should be used
as needed for acute symptoms of shortness of breath or
wheezing. Using it routinely when asymptomatic can lead to
tachycardia, tremors, and decreased effectiveness over time.
Question 5
A nurse is caring for a client receiving a blood transfusion. Fifteen
minutes after the transfusion begins, the client reports chills and
low back pain. What is the nurse's priority action?
A) Slow the infusion rate.
B) Stop the transfusion.
C) Notify the healthcare provider.
D) Administer an antihistamine.
Answer: B
Rationale: Chills and low back pain are classic signs of a
, hemolytic transfusion reaction. The priority action is to stop the
transfusion immediately to prevent further infusion of the
incompatible blood. After stopping the transfusion, the nurse
should then replace the tubing, keep the IV line open with normal
saline, and notify the provider.
Question 6
A nurse is caring for a client who is 1-day post-operative following
a hip replacement. The client is using a patient-controlled
analgesia (PCA) pump. The client's spouse asks the nurse if they
can push the button for the client while the client is sleeping.
Which of the following is the correct response by the nurse?
A) "No, only the client should push the button to ensure safe
dosing."
B) "Yes, that will help the client rest better."
C) "You can push it once, but only if the client is in pain."
D) "Only a healthcare provider can program the PCA pump."
Answer: A
Rationale: Only the client should activate the PCA pump. The
device is designed to deliver a prescribed dose of analgesic when
the client feels pain, which ensures safe dosing intervals. If
another person activates it, the client may receive too much
medication, leading to respiratory depression and oversedation.
Question 7
A nurse is assessing a client's heart rate. The pulse is irregular.
Which of the following actions should the nurse take to obtain the
most accurate measurement?
A) Count the pulse for 15 seconds and multiply by 4.
B) Count the pulse for 30 seconds and multiply by 2.
