(Practice Exam)
Question 1
A patient with chronic obstructive pulmonary disease (COPD) is admitted with
worsening dyspnea. Which nursing intervention is the priority?
A. Encourage fluid intake of 3 L/day
B. Administer oxygen at 2 L/min via nasal cannula
C. Teach pursed-lip breathing techniques
D. Provide high-calorie snacks between meals
Rationale: The immediate priority is to improve oxygenation. COPD patients require
low-flow oxygen to prevent CO₂ retention. Teaching and nutrition are important but not
urgent in an acute exacerbation.
Question 2
A patient with heart failure is prescribed furosemide. Which finding requires immediate
intervention?
A. Weight loss of 2 lbs in 24 hours
B. Serum potassium of 2.9 mEq/L
C. Mild ankle edema
D. Blood pressure of 110/70 mmHg
Rationale: Hypokalemia is a dangerous side effect of loop diuretics and can lead to life-
threatening arrhythmias. The other findings are expected or not immediately critical.
Question 3
A patient with type 2 diabetes is scheduled for surgery. Which preoperative lab result is
most concerning?
A. Hemoglobin A1c of 7.2%
B. Blood glucose of 250 mg/dL
C. Serum creatinine of 1.0 mg/dL
D. White blood cell count of 9,000/mm³
Rationale: Elevated blood glucose increases the risk of poor wound healing and
infection. The other values are within acceptable ranges for surgery.
Question 4
A patient with cirrhosis develops ascites. Which nursing action is most appropriate?
A. Restrict sodium intake
B. Encourage ambulation
C. Increase fluid intake
D. Administer acetaminophen for pain
,Rationale: Sodium restriction helps reduce fluid retention in ascites. Increasing fluids
would worsen the condition, and acetaminophen is contraindicated in liver disease.
Question 5
A patient with pneumonia is receiving IV antibiotics. Which assessment finding indicates
the treatment is effective?
A. Decreased white blood cell count
B. Increased sputum production
C. Persistent fever of 101°F
D. Oxygen saturation of 88%
Rationale: A reduction in WBC count suggests resolution of infection. Persistent fever
and low oxygen saturation indicate ongoing illness.
Question 6
A patient with acute pancreatitis reports severe abdominal pain radiating to the back.
Which intervention is most appropriate?
A. Place the patient supine
B. Administer prescribed opioid analgesics
C. Encourage ambulation
D. Provide a high-fat diet
Rationale: Pain control is the priority in acute pancreatitis. Supine positioning worsens
pain, ambulation is not appropriate during acute pain, and high-fat diets exacerbate
symptoms.
Question 7
A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which
action should the nurse take first?
A. Place the patient on a cardiac monitor
B. Restrict dietary potassium
C. Administer prescribed sodium polystyrene sulfonate
D. Prepare the patient for dialysis
Rationale: Hyperkalemia can cause fatal arrhythmias. Continuous cardiac monitoring is
the immediate priority before other interventions.
Question 8
A patient with multiple sclerosis is experiencing muscle spasticity. Which intervention is
most effective?
A. Encourage bed rest
B. Administer prescribed muscle relaxants
C. Provide a high-protein diet
D. Limit fluid intake
, Rationale: Muscle relaxants reduce spasticity and improve mobility. Bed rest worsens
deconditioning, and diet/fluids do not directly address spasticity.
Question 9
A patient with a history of stroke has difficulty swallowing. Which nursing action is most
appropriate?
A. Offer thin liquids
B. Place food on the affected side of the mouth
C. Position the patient upright during meals
D. Encourage rapid eating
Rationale: Upright positioning reduces aspiration risk. Thin liquids increase aspiration
risk, and food should be placed on the unaffected side.
Question 10
A patient with rheumatoid arthritis reports morning stiffness. Which intervention is most
helpful?
A. Encourage cold compresses
B. Suggest warm showers before activity
C. Restrict physical activity
D. Provide high-protein snacks
Rationale: Heat therapy reduces stiffness and improves mobility. Cold compresses are
more useful for acute inflammation.
Question 11
A patient with chronic heart failure is prescribed digoxin. Which finding indicates
toxicity?
A. Heart rate of 88 bpm
B. Nausea and visual disturbances
C. Blood pressure of 130/80 mmHg
D. Weight gain of 2 lbs in 2 days
Rationale: Classic signs of digoxin toxicity include nausea, vomiting, and blurred/yellow
vision.
Question 12
A patient with COPD is receiving oxygen therapy. Which finding requires immediate
action?
A. Oxygen saturation of 90%
B. Respiratory rate of 10 breaths/min
C. Productive cough with thick sputum
D. Clubbing of fingers
Rationale: Hypoventilation may indicate CO₂ retention and impending respiratory failure.