**⚕️ The Ultimate RN Cram: 2026 Board Exam Vault
⚕️**
Question 1: A client with heart failure reports a weight gain of 2 kg in 24 hours and increased dyspnea.
What is the priority?
A) Restrict all oral fluids
B) Administer furosemide as ordered
C) Assess lung sounds bilaterally
D) Elevate the head of the bed
---
💫RATIONALE✔️✔️: Rapid weight gain indicates fluid retention; lung sounds assess for pulmonary edema
before diuretic administration.
💫ANSWER✔️✔️: C) Assess lung sounds bilaterally
Question 2: A nurse assesses a client 2 hours post-cardiac catheterization via the femoral artery. Which
finding requires immediate action?
A) Pedal pulse 2+ on the affected leg
B) Small amount of blood on the dressing
C) Complaints of severe back pain
D) Blood pressure 110/70 mm Hg
---
💫RATIONALE✔️✔️: Severe back pain after femoral catheterization may indicate retroperitoneal bleeding,
a life-threatening complication.
💫ANSWER✔️✔️: C) Complaints of severe back pain
Question 3: A client with a new tracheostomy has copious thick secretions. The nurse attempts to
suction but cannot pass the catheter. What is the priority?
A) Instill 5 mL of normal saline
B) Remove and replace the inner cannula
,C) Deflate the cuff completely
D) Call a code blue
---
💫RATIONALE✔️✔️: A blocked inner cannula prevents suctioning; removing it allows access to the outer
cannula and airway clearance.
💫ANSWER✔️✔️: B) Remove and replace the inner cannula
Question 4: A client with chest pain receives nitroglycerin 0.4 mg SL. Five minutes later the pain is
unchanged. What should the nurse do?
A) Administer a second dose
B) Apply oxygen at 4 L/min
C) Obtain a 12-lead ECG
D) Notify the provider
---
💫RATIONALE✔️✔️: Nitroglycerin can be repeated every 5 minutes for up to 3 doses if BP remains
adequate and pain persists.
💫ANSWER✔️✔️: A) Administer a second dose
Question 5: A client with cirrhosis has an ammonia level of 140 mcg/dL and is confused. Which
medication does the nurse expect?
A) Furosemide
B) Lactulose
C) Spironolactone
D) Omeprazole
---
💫RATIONALE✔️✔️: Lactulose acidifies the colon, trapping ammonia for excretion, and is first-line
treatment for hepatic encephalopathy.
💫ANSWER✔️✔️: B) Lactulose
,Question 6: A nurse assesses a client with a chest tube for a hemothorax. Which finding requires
immediate intervention?
A) Drainage of 80 mL in 4 hours
B) Tidaling in the water seal chamber
C) Sudden drainage of 400 mL of bright red blood
D) Client reports pain of 3/10
---
💫RATIONALE✔️✔️: Sudden drainage of >200 mL of bright red blood indicates active bleeding requiring
immediate provider notification.
💫ANSWER✔️✔️: C) Sudden drainage of 400 mL of bright red blood
Question 7: A client with a spinal cord injury at T5 reports a pounding headache and has a blood
pressure of 210/110 mm Hg. What is the priority?
A) Administer hydralazine IV push
B) Elevate the head of the bed to 90 degrees
C) Check for a distended bladder or fecal impaction
D) Notify the provider immediately
---
💫RATIONALE✔️✔️: Autonomic dysreflexia requires immediate removal of the noxious stimulus; a
distended bladder is the most common cause.
💫ANSWER✔️✔️: C) Check for a distended bladder or fecal impaction
Question 8: A nurse prepares to administer IV potassium chloride. Which action is correct?
A) Give undiluted IV push over 10 minutes
B) Add to a hanging IV bag and invert to mix
C) Infuse via an infusion pump at a controlled rate of 10 mEq/hour
D) Administer through a gravity drip at 100 mL/hour
---
💫RATIONALE✔️✔️: IV potassium must be diluted and infused via an infusion pump at a maximum rate of
10 mEq/hour peripherally.
, 💫ANSWER✔️✔️: C) Infuse via an infusion pump at a controlled rate of 10 mEq/hour
Question 9: A client with major depressive disorder tells the nurse, "I have a bottle of pills saved up."
What is the priority?
A) Place the client on one-to-one observation
B) Ask the client to sign a no-harm contract
C) Notify the provider and arrange for removal of the pills
D) Remove all sharp objects from the room
---
💫RATIONALE✔️✔️: A client with a plan and access to lethal means requires immediate notification of the
provider and safety planning.
💫ANSWER✔️✔️: C) Notify the provider and arrange for removal of the pills
Question 10: A nurse assesses a client with a chest tube. The water seal chamber has continuous
bubbling. What does this indicate?
A) Normal chest tube function
B) An air leak in the system
C) The lung has re-expanded
D) Suction pressure is too high
---
💫RATIONALE✔️✔️: Continuous bubbling in the water seal chamber (not with suction) indicates an air
leak requiring location and repair.
💫ANSWER✔️✔️: B) An air leak in the system
Question 11: A client with a history of DVT is on warfarin and has an INR of 1.2. What is the appropriate
action?
A) Hold the next dose and notify the provider
B) Administer vitamin K 10 mg orally
C) Give the next dose as scheduled and notify the provider
D) Increase the warfarin dose independently
⚕️**
Question 1: A client with heart failure reports a weight gain of 2 kg in 24 hours and increased dyspnea.
What is the priority?
A) Restrict all oral fluids
B) Administer furosemide as ordered
C) Assess lung sounds bilaterally
D) Elevate the head of the bed
---
💫RATIONALE✔️✔️: Rapid weight gain indicates fluid retention; lung sounds assess for pulmonary edema
before diuretic administration.
💫ANSWER✔️✔️: C) Assess lung sounds bilaterally
Question 2: A nurse assesses a client 2 hours post-cardiac catheterization via the femoral artery. Which
finding requires immediate action?
A) Pedal pulse 2+ on the affected leg
B) Small amount of blood on the dressing
C) Complaints of severe back pain
D) Blood pressure 110/70 mm Hg
---
💫RATIONALE✔️✔️: Severe back pain after femoral catheterization may indicate retroperitoneal bleeding,
a life-threatening complication.
💫ANSWER✔️✔️: C) Complaints of severe back pain
Question 3: A client with a new tracheostomy has copious thick secretions. The nurse attempts to
suction but cannot pass the catheter. What is the priority?
A) Instill 5 mL of normal saline
B) Remove and replace the inner cannula
,C) Deflate the cuff completely
D) Call a code blue
---
💫RATIONALE✔️✔️: A blocked inner cannula prevents suctioning; removing it allows access to the outer
cannula and airway clearance.
💫ANSWER✔️✔️: B) Remove and replace the inner cannula
Question 4: A client with chest pain receives nitroglycerin 0.4 mg SL. Five minutes later the pain is
unchanged. What should the nurse do?
A) Administer a second dose
B) Apply oxygen at 4 L/min
C) Obtain a 12-lead ECG
D) Notify the provider
---
💫RATIONALE✔️✔️: Nitroglycerin can be repeated every 5 minutes for up to 3 doses if BP remains
adequate and pain persists.
💫ANSWER✔️✔️: A) Administer a second dose
Question 5: A client with cirrhosis has an ammonia level of 140 mcg/dL and is confused. Which
medication does the nurse expect?
A) Furosemide
B) Lactulose
C) Spironolactone
D) Omeprazole
---
💫RATIONALE✔️✔️: Lactulose acidifies the colon, trapping ammonia for excretion, and is first-line
treatment for hepatic encephalopathy.
💫ANSWER✔️✔️: B) Lactulose
,Question 6: A nurse assesses a client with a chest tube for a hemothorax. Which finding requires
immediate intervention?
A) Drainage of 80 mL in 4 hours
B) Tidaling in the water seal chamber
C) Sudden drainage of 400 mL of bright red blood
D) Client reports pain of 3/10
---
💫RATIONALE✔️✔️: Sudden drainage of >200 mL of bright red blood indicates active bleeding requiring
immediate provider notification.
💫ANSWER✔️✔️: C) Sudden drainage of 400 mL of bright red blood
Question 7: A client with a spinal cord injury at T5 reports a pounding headache and has a blood
pressure of 210/110 mm Hg. What is the priority?
A) Administer hydralazine IV push
B) Elevate the head of the bed to 90 degrees
C) Check for a distended bladder or fecal impaction
D) Notify the provider immediately
---
💫RATIONALE✔️✔️: Autonomic dysreflexia requires immediate removal of the noxious stimulus; a
distended bladder is the most common cause.
💫ANSWER✔️✔️: C) Check for a distended bladder or fecal impaction
Question 8: A nurse prepares to administer IV potassium chloride. Which action is correct?
A) Give undiluted IV push over 10 minutes
B) Add to a hanging IV bag and invert to mix
C) Infuse via an infusion pump at a controlled rate of 10 mEq/hour
D) Administer through a gravity drip at 100 mL/hour
---
💫RATIONALE✔️✔️: IV potassium must be diluted and infused via an infusion pump at a maximum rate of
10 mEq/hour peripherally.
, 💫ANSWER✔️✔️: C) Infuse via an infusion pump at a controlled rate of 10 mEq/hour
Question 9: A client with major depressive disorder tells the nurse, "I have a bottle of pills saved up."
What is the priority?
A) Place the client on one-to-one observation
B) Ask the client to sign a no-harm contract
C) Notify the provider and arrange for removal of the pills
D) Remove all sharp objects from the room
---
💫RATIONALE✔️✔️: A client with a plan and access to lethal means requires immediate notification of the
provider and safety planning.
💫ANSWER✔️✔️: C) Notify the provider and arrange for removal of the pills
Question 10: A nurse assesses a client with a chest tube. The water seal chamber has continuous
bubbling. What does this indicate?
A) Normal chest tube function
B) An air leak in the system
C) The lung has re-expanded
D) Suction pressure is too high
---
💫RATIONALE✔️✔️: Continuous bubbling in the water seal chamber (not with suction) indicates an air
leak requiring location and repair.
💫ANSWER✔️✔️: B) An air leak in the system
Question 11: A client with a history of DVT is on warfarin and has an INR of 1.2. What is the appropriate
action?
A) Hold the next dose and notify the provider
B) Administer vitamin K 10 mg orally
C) Give the next dose as scheduled and notify the provider
D) Increase the warfarin dose independently
