RN Concept-Based Assessment Level 2 Online
Practice B Actual Exam 2026/2027 | Detailed
Rationales | Complete Exam-Style Questions | Graded
A+ | Pass Guaranteed
Total Questions: 100 | Time: 120 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Cellular Regulation & Immunity | Q1 – Q13
Section 2 | Oxygenation & Perfusion | Q14 – Q26
Section 3 | Fluid & Electrolyte Balance | Q27 – Q39
Section 4 | Metabolism & Nutrition | Q40 – Q50
Section 5 | Coping, Stress & Mental Health | Q51 – Q61
Section 6 | Safety, Infection Control & Mobility | Q62 – Q74
Section 7 | Clinical Judgment & Prioritization | Q75 – Q87
Section 8 | Professional Nursing & Ethics | Q88 – Q100
Instructions: Choose the single best answer. Pass: 80% in 120 minutes.
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SECTION 1: CELLULAR REGULATION & IMMUNITY Q1 – Q13
══════════════════════════════════════
Question 1 of 100
A 62-year-old client with stage III colon cancer is receiving their third cycle of FOLFOX
chemotherapy. During the infusion, the nurse notes the client reports new tingling in
their fingers and difficulty buttoning their shirt. The client denies pain or color change in
the extremities.
A. Document the finding and continue the infusion at the current rate
B. Apply warm compresses to the hands and reassess in 30 minutes
C. Notify the oncologist immediately to discuss dose modification or discontinuation
D. Administer a PRN opioid and instruct the client to avoid cold temperatures
,Correct Answer: B
Rationale: Peripheral neuropathy is a common cumulative adverse effect of oxaliplatin,
often triggered or worsened by cold exposure, and warm compresses can help alleviate
acute symptoms while the infusion continues. Notifying the oncologist immediately is
not the first action for expected, non-emergent neurotoxicity that does not indicate
extravasation. The nurse should document and continue monitoring, but warmth and
reassessment is the appropriate immediate nursing intervention.
Question 2 of 100
A 28-year-old client with a history of systemic lupus erythematosus presents to the
clinic with facial swelling, foamy urine, and a 6-pound weight gain over two weeks.
Laboratory studies reveal a serum albumin of 2.1 g/dL and 24-hour urine protein of 4.2
g.
A. Initiate corticosteroid therapy and schedule a renal biopsy within the week
B. Begin an ACE inhibitor and recommend a high-protein diet to replace losses
C. Start aggressive diuretic therapy to reduce the edema before addressing the
underlying cause
D. Place the client on strict bed rest until the proteinuria resolves to prevent renal
damage
Correct Answer: D
Rationale: Lupus nephritis with nephrotic-range proteinemia requires prompt initiation of
immunosuppressive therapy guided by biopsy classification to prevent irreversible renal
damage. A high-protein diet is contraindicated in nephrotic syndrome because it can
worsen glomerular hyperfiltration and proteinuria. Diuretics may be used for
symptomatic relief but do not treat the underlying inflammatory process, and bed rest is
not a standard intervention.
Question 3 of 100
,A 54-year-old male client is admitted with pancytopenia and blasts seen on peripheral
smear. The oncologist suspects acute myeloid leukemia and orders a bone marrow
biopsy. The client asks the nurse why the procedure is necessary when blood tests
already show abnormal cells.
A. Explain that the biopsy is only done to confirm the exact percentage of blasts for
insurance authorization
B. Clarify that bone marrow biopsy identifies the leukemia subtype, cytogenetics, and
guides targeted therapy selection
C. Reassure the client that the biopsy is a routine procedure and the results rarely
change the treatment plan
D. State that peripheral blood smears are unreliable and the biopsy is the only way to
detect leukemia at all
Correct Answer: A
Rationale: Bone marrow biopsy in suspected AML is essential for definitive diagnosis,
French-American-British classification, cytogenetic analysis, and molecular profiling, all
of which directly determine chemotherapy regimens and prognosis. Downplaying the
significance of biopsy results misrepresents the clinical importance, and peripheral
smears are indeed reliable screening tools though insufficient for full staging. Insurance
authorization is never the primary indication for an invasive diagnostic test.
Question 4 of 100
A school nurse is caring for a 7-year-old who was sent to the office with a widespread
pruritic rash that started on the trunk and spread outward. The child has a low-grade
fever and several vesicles in various stages of healing. There is a note in the chart that
the child received one varicella vaccine dose at age 12 months.
A. Place the child in droplet precautions and notify the parent to pick them up within 2
hours
B. Apply contact precautions, notify the parent immediately, and advise them to keep
the child isolated until all lesions are crusted
, C. Send the child back to class with instructions to avoid scratching and reassess at the
end of the school day
D. Initiate airborne precautions and contact the health department to report a potential
varicella outbreak
Correct Answer: C
Rationale: Breakthrough varicella in a partially vaccinated child typically presents with
fewer lesions, mild systemic symptoms, and lower contagiousness, warranting prompt
exclusion from school and contact precautions until all lesions crust over. Droplet
precautions are insufficient because varicella is spread via airborne and contact routes.
Returning the child to class risks transmission to susceptible immunocompromised
classmates, and airborne precautions are reserved for immunocompromised patients
with disseminated disease in healthcare settings.
Question 5 of 100
A 45-year-old female client with a history of BRCA1 gene mutation is considering
prophylactic bilateral mastectomy after completing childbearing. She expresses anxiety
to the nurse about body image, surgical recovery, and whether the surgery truly reduces
her cancer risk.
A. Advise the client that prophylactic mastectomy eliminates all risk of breast cancer
and reconstruction will look identical to natural tissue
B. Discuss that the procedure reduces breast cancer risk by approximately 90% and
explore reconstruction options, recovery expectations, and emotional support resources
C. Suggest the client consider intensive surveillance with mammography instead
because mastectomy outcomes are often disappointing
D. Recommend the client delay the decision until age 50 when the risk-benefit ratio
becomes more clearly established
Correct Answer: B
Rationale: Prophylactic bilateral mastectomy in BRCA1 carriers reduces breast cancer
risk by roughly 90% but does not eliminate it entirely, and honest discussion about
Practice B Actual Exam 2026/2027 | Detailed
Rationales | Complete Exam-Style Questions | Graded
A+ | Pass Guaranteed
Total Questions: 100 | Time: 120 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Cellular Regulation & Immunity | Q1 – Q13
Section 2 | Oxygenation & Perfusion | Q14 – Q26
Section 3 | Fluid & Electrolyte Balance | Q27 – Q39
Section 4 | Metabolism & Nutrition | Q40 – Q50
Section 5 | Coping, Stress & Mental Health | Q51 – Q61
Section 6 | Safety, Infection Control & Mobility | Q62 – Q74
Section 7 | Clinical Judgment & Prioritization | Q75 – Q87
Section 8 | Professional Nursing & Ethics | Q88 – Q100
Instructions: Choose the single best answer. Pass: 80% in 120 minutes.
══════════════════════════════════════
SECTION 1: CELLULAR REGULATION & IMMUNITY Q1 – Q13
══════════════════════════════════════
Question 1 of 100
A 62-year-old client with stage III colon cancer is receiving their third cycle of FOLFOX
chemotherapy. During the infusion, the nurse notes the client reports new tingling in
their fingers and difficulty buttoning their shirt. The client denies pain or color change in
the extremities.
A. Document the finding and continue the infusion at the current rate
B. Apply warm compresses to the hands and reassess in 30 minutes
C. Notify the oncologist immediately to discuss dose modification or discontinuation
D. Administer a PRN opioid and instruct the client to avoid cold temperatures
,Correct Answer: B
Rationale: Peripheral neuropathy is a common cumulative adverse effect of oxaliplatin,
often triggered or worsened by cold exposure, and warm compresses can help alleviate
acute symptoms while the infusion continues. Notifying the oncologist immediately is
not the first action for expected, non-emergent neurotoxicity that does not indicate
extravasation. The nurse should document and continue monitoring, but warmth and
reassessment is the appropriate immediate nursing intervention.
Question 2 of 100
A 28-year-old client with a history of systemic lupus erythematosus presents to the
clinic with facial swelling, foamy urine, and a 6-pound weight gain over two weeks.
Laboratory studies reveal a serum albumin of 2.1 g/dL and 24-hour urine protein of 4.2
g.
A. Initiate corticosteroid therapy and schedule a renal biopsy within the week
B. Begin an ACE inhibitor and recommend a high-protein diet to replace losses
C. Start aggressive diuretic therapy to reduce the edema before addressing the
underlying cause
D. Place the client on strict bed rest until the proteinuria resolves to prevent renal
damage
Correct Answer: D
Rationale: Lupus nephritis with nephrotic-range proteinemia requires prompt initiation of
immunosuppressive therapy guided by biopsy classification to prevent irreversible renal
damage. A high-protein diet is contraindicated in nephrotic syndrome because it can
worsen glomerular hyperfiltration and proteinuria. Diuretics may be used for
symptomatic relief but do not treat the underlying inflammatory process, and bed rest is
not a standard intervention.
Question 3 of 100
,A 54-year-old male client is admitted with pancytopenia and blasts seen on peripheral
smear. The oncologist suspects acute myeloid leukemia and orders a bone marrow
biopsy. The client asks the nurse why the procedure is necessary when blood tests
already show abnormal cells.
A. Explain that the biopsy is only done to confirm the exact percentage of blasts for
insurance authorization
B. Clarify that bone marrow biopsy identifies the leukemia subtype, cytogenetics, and
guides targeted therapy selection
C. Reassure the client that the biopsy is a routine procedure and the results rarely
change the treatment plan
D. State that peripheral blood smears are unreliable and the biopsy is the only way to
detect leukemia at all
Correct Answer: A
Rationale: Bone marrow biopsy in suspected AML is essential for definitive diagnosis,
French-American-British classification, cytogenetic analysis, and molecular profiling, all
of which directly determine chemotherapy regimens and prognosis. Downplaying the
significance of biopsy results misrepresents the clinical importance, and peripheral
smears are indeed reliable screening tools though insufficient for full staging. Insurance
authorization is never the primary indication for an invasive diagnostic test.
Question 4 of 100
A school nurse is caring for a 7-year-old who was sent to the office with a widespread
pruritic rash that started on the trunk and spread outward. The child has a low-grade
fever and several vesicles in various stages of healing. There is a note in the chart that
the child received one varicella vaccine dose at age 12 months.
A. Place the child in droplet precautions and notify the parent to pick them up within 2
hours
B. Apply contact precautions, notify the parent immediately, and advise them to keep
the child isolated until all lesions are crusted
, C. Send the child back to class with instructions to avoid scratching and reassess at the
end of the school day
D. Initiate airborne precautions and contact the health department to report a potential
varicella outbreak
Correct Answer: C
Rationale: Breakthrough varicella in a partially vaccinated child typically presents with
fewer lesions, mild systemic symptoms, and lower contagiousness, warranting prompt
exclusion from school and contact precautions until all lesions crust over. Droplet
precautions are insufficient because varicella is spread via airborne and contact routes.
Returning the child to class risks transmission to susceptible immunocompromised
classmates, and airborne precautions are reserved for immunocompromised patients
with disseminated disease in healthcare settings.
Question 5 of 100
A 45-year-old female client with a history of BRCA1 gene mutation is considering
prophylactic bilateral mastectomy after completing childbearing. She expresses anxiety
to the nurse about body image, surgical recovery, and whether the surgery truly reduces
her cancer risk.
A. Advise the client that prophylactic mastectomy eliminates all risk of breast cancer
and reconstruction will look identical to natural tissue
B. Discuss that the procedure reduces breast cancer risk by approximately 90% and
explore reconstruction options, recovery expectations, and emotional support resources
C. Suggest the client consider intensive surveillance with mammography instead
because mastectomy outcomes are often disappointing
D. Recommend the client delay the decision until age 50 when the risk-benefit ratio
becomes more clearly established
Correct Answer: B
Rationale: Prophylactic bilateral mastectomy in BRCA1 carriers reduces breast cancer
risk by roughly 90% but does not eliminate it entirely, and honest discussion about
