Kaplan Nursing School Exit Exam | 180
Comprehensive Predictor Questions and
Answers
SECTION 1: MANAGEMENT OF CARE
1. A charge nurse is making assignments for the medical-surgical unit. Which
client should be assigned to the most experienced registered nurse (RN)?
A. A client with a new diagnosis of diabetes who needs insulin teaching.
B. A client with cirrhosis whose blood pressure has dropped from 120/80 to
92/60 mmHg over the past hour.
C. A client with pneumonia who is being discharged this afternoon.
D. A client with a fractured femur in balanced skeletal traction.
Correct Answer: B
Rationale: The client with cirrhosis and a significant drop in blood pressure is at
risk for hypovolemic shock from a possible variceal bleed, requiring rapid
assessment and intervention by the most experienced nurse. The other clients have
more stable or predictable needs .
2. The nurse is delegating tasks to the unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
A. Assessing a client's lung sounds after a nebulizer treatment.
B. Measuring and recording hourly urine output.
C. Developing a plan of care for a client with a pressure ulcer.
D. Teaching a client about a low-sodium diet.
,Correct Answer: B
Rationale: The UAP may measure and record intake and output. Assessment, care
plan development, and client education are responsibilities of the RN and cannot
be delegated .
3. A client has a do-not-resuscitate (DNR) order. The client stops breathing and
has no pulse. What should the nurse do first?
A. Initiate cardiopulmonary resuscitation (CPR).
B. Call the family to come to the bedside.
C. Confirm the absence of pulse and respirations, note the time, and document.
D. Call the healthcare provider to pronounce death.
Correct Answer: C
Rationale: A DNR order means CPR should not be started. The nurse first confirms
the client's status, notes the time, documents the findings, and then notifies the
provider .
4. The nurse is preparing to administer a unit of packed red blood cells. Which
solution is used to prime the IV tubing?
A. 5% dextrose in water.
B. Lactated Ringer's.
C. 0.9% normal saline.
D. 0.45% normal saline.
Correct Answer: C
Rationale: Only 0.9% normal saline is compatible with blood products. Dextrose
can cause hemolysis, and lactated Ringer's contains calcium, which may cause
clotting of the blood product .
,5. A client is receiving a blood transfusion and reports chills and low back pain.
What is the priority action?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Obtain a urine sample.
Correct Answer: B
Rationale: Chills and back pain suggest a hemolytic transfusion reaction. Stop the
transfusion immediately, then notify the provider and maintain IV access with
normal saline .
6. The charge nurse is making assignments. Which client should be assigned to
the newly graduated RN?
A. A client with a new diagnosis of stroke needing hourly neuro checks.
B. A client with stable pneumonia who needs IV antibiotics.
C. A client with a chest tube who has continuous bubbling.
D. A client who is being discharged with a new colostomy.
Correct Answer: B
Rationale: A stable client with pneumonia needing IV antibiotics is appropriate for
a newly graduated RN with appropriate supervision. Complex neuro checks, chest
tube complications, and discharge teaching require a more experienced RN.
7. The nurse is caring for a client with a chest tube attached to water seal
drainage. The drainage system is accidentally knocked over and breaks. What
should the nurse do first?
A. Clamp the chest tube immediately.
, B. Submerge the end of the chest tube in a bottle of sterile water.
C. Call the healthcare provider.
D. Place the client in Trendelenburg position.
Correct Answer: B
Rationale: If the drainage system breaks, the nurse must create an emergency
water seal to prevent air from entering the pleural space, which could lead to a
tension pneumothorax .
8. A nurse is giving a handoff report using SBAR. The nurse says, "The client's
blood pressure is 160/90, heart rate 110, and he reports a severe headache."
This statement represents which part of SBAR?
A. Situation.
B. Background.
C. Assessment.
D. Recommendation.
Correct Answer: C
Rationale: Assessment includes vital signs, symptoms, and the nurse's clinical
findings. Situation is "what is happening now." Background is relevant history.
Recommendation is "what do you think we should do?"
9. The nurse is caring for a client who is confused and trying to pull out an IV
line. Which intervention should the nurse try first?
A. Apply wrist restraints.
B. Administer a sedative.
C. Offer redirection and check for unmet needs (pain, toileting).
D. Call security to sit with the client.
Comprehensive Predictor Questions and
Answers
SECTION 1: MANAGEMENT OF CARE
1. A charge nurse is making assignments for the medical-surgical unit. Which
client should be assigned to the most experienced registered nurse (RN)?
A. A client with a new diagnosis of diabetes who needs insulin teaching.
B. A client with cirrhosis whose blood pressure has dropped from 120/80 to
92/60 mmHg over the past hour.
C. A client with pneumonia who is being discharged this afternoon.
D. A client with a fractured femur in balanced skeletal traction.
Correct Answer: B
Rationale: The client with cirrhosis and a significant drop in blood pressure is at
risk for hypovolemic shock from a possible variceal bleed, requiring rapid
assessment and intervention by the most experienced nurse. The other clients have
more stable or predictable needs .
2. The nurse is delegating tasks to the unlicensed assistive personnel (UAP).
Which task is appropriate to delegate?
A. Assessing a client's lung sounds after a nebulizer treatment.
B. Measuring and recording hourly urine output.
C. Developing a plan of care for a client with a pressure ulcer.
D. Teaching a client about a low-sodium diet.
,Correct Answer: B
Rationale: The UAP may measure and record intake and output. Assessment, care
plan development, and client education are responsibilities of the RN and cannot
be delegated .
3. A client has a do-not-resuscitate (DNR) order. The client stops breathing and
has no pulse. What should the nurse do first?
A. Initiate cardiopulmonary resuscitation (CPR).
B. Call the family to come to the bedside.
C. Confirm the absence of pulse and respirations, note the time, and document.
D. Call the healthcare provider to pronounce death.
Correct Answer: C
Rationale: A DNR order means CPR should not be started. The nurse first confirms
the client's status, notes the time, documents the findings, and then notifies the
provider .
4. The nurse is preparing to administer a unit of packed red blood cells. Which
solution is used to prime the IV tubing?
A. 5% dextrose in water.
B. Lactated Ringer's.
C. 0.9% normal saline.
D. 0.45% normal saline.
Correct Answer: C
Rationale: Only 0.9% normal saline is compatible with blood products. Dextrose
can cause hemolysis, and lactated Ringer's contains calcium, which may cause
clotting of the blood product .
,5. A client is receiving a blood transfusion and reports chills and low back pain.
What is the priority action?
A. Slow the transfusion rate.
B. Stop the transfusion immediately.
C. Administer acetaminophen.
D. Obtain a urine sample.
Correct Answer: B
Rationale: Chills and back pain suggest a hemolytic transfusion reaction. Stop the
transfusion immediately, then notify the provider and maintain IV access with
normal saline .
6. The charge nurse is making assignments. Which client should be assigned to
the newly graduated RN?
A. A client with a new diagnosis of stroke needing hourly neuro checks.
B. A client with stable pneumonia who needs IV antibiotics.
C. A client with a chest tube who has continuous bubbling.
D. A client who is being discharged with a new colostomy.
Correct Answer: B
Rationale: A stable client with pneumonia needing IV antibiotics is appropriate for
a newly graduated RN with appropriate supervision. Complex neuro checks, chest
tube complications, and discharge teaching require a more experienced RN.
7. The nurse is caring for a client with a chest tube attached to water seal
drainage. The drainage system is accidentally knocked over and breaks. What
should the nurse do first?
A. Clamp the chest tube immediately.
, B. Submerge the end of the chest tube in a bottle of sterile water.
C. Call the healthcare provider.
D. Place the client in Trendelenburg position.
Correct Answer: B
Rationale: If the drainage system breaks, the nurse must create an emergency
water seal to prevent air from entering the pleural space, which could lead to a
tension pneumothorax .
8. A nurse is giving a handoff report using SBAR. The nurse says, "The client's
blood pressure is 160/90, heart rate 110, and he reports a severe headache."
This statement represents which part of SBAR?
A. Situation.
B. Background.
C. Assessment.
D. Recommendation.
Correct Answer: C
Rationale: Assessment includes vital signs, symptoms, and the nurse's clinical
findings. Situation is "what is happening now." Background is relevant history.
Recommendation is "what do you think we should do?"
9. The nurse is caring for a client who is confused and trying to pull out an IV
line. Which intervention should the nurse try first?
A. Apply wrist restraints.
B. Administer a sedative.
C. Offer redirection and check for unmet needs (pain, toileting).
D. Call security to sit with the client.
