"Exclusive Chamberlain BSN NCLEX prep resource — detailed nursing
exam guide with rationales and practice questions for exam mastery."
---
**🏆 CHAMBERLAIN UNIVERSITY BSN COMPREHENSIVE FINAL EXAM
MASTERY GUIDE | NCLEX-RN READINESS ASSESSMENT, CLINICAL
JUDGMENT, PRIORITIZATION & DELEGATION PRACTICE QUESTIONS
WITH DETAILED RATIONALES | 2025–2026 ACADEMIC CYCLE | NURS
101, NURS 200, NURS 300, NURS 400 INTEGRATED REVIEW**
---
**1. A nurse is caring for a client with heart failure who reports worsening shortness of breath and
swelling in the lower extremities. Which of the following assessment findings would be the earliest
indicator of fluid volume overload?**
A. Jugular venous distention
B. Weight gain of 2 pounds in 24 hours
C. Crackles auscultated in the lung bases
D. Pitting edema in the feet and ankles
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Weight gain of 2 pounds in 24 hours is the earliest indicator of fluid volume overload,
as it reflects fluid retention before physical signs like crackles or edema manifest. This NCLEX prep
question emphasizes the importance of daily weights for Chamberlain BSN students in managing heart
failure. Crackles, jugular venous distention, and pitting edema are later signs of fluid overload, making
weight gain the most sensitive early indicator for nursing success.
---
,**2. A client who is post-operative day two after abdominal surgery reports sudden sharp pain in the
right calf and mild shortness of breath. What is the priority nursing action?**
A. Administer prescribed PRN analgesic
B. Apply a warm compress to the calf
C. Instruct the client to perform ankle exercises
D. Assess for Homans' sign and notify the provider immediately
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The client's symptoms suggest a possible deep vein thrombosis (DVT) with a risk of
pulmonary embolism. Assessing for Homans' sign and notifying the provider are priority actions. This
nursing exam guide for Chamberlain BSN students highlights the need for rapid intervention to prevent
complications. Warm compresses and ankle exercises could dislodge a clot, and analgesics do not
address the underlying emergency.
---
**3. A nurse is preparing to administer digoxin to a client with atrial fibrillation. Which of the following
findings would warrant withholding the medication and contacting the healthcare provider?**
A. Apical pulse of 62 beats per minute
B. Serum potassium level of 3.2 mEq/L
C. Serum digoxin level of 1.2 ng/mL
D. Blood pressure of 118/76 mmHg
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: A serum potassium level of 3.2 mEq/L is below the normal range (3.5-5.0 mEq/L) and
increases the risk of digoxin toxicity. This Chamberlain BSN NCLEX prep resource emphasizes the need to
monitor potassium levels carefully with digoxin therapy. An apical pulse below 60 would also warrant
holding the medication, but a pulse of 62 is acceptable. A digoxin level of 1.2 ng/mL is within the
therapeutic range (0.8-2.0 ng/mL).
---
,**4. A nurse is providing discharge teaching to a client prescribed warfarin. Which of the following
statements by the client indicates a need for further teaching?**
A. "I will take my medication at the same time every day."
B. "I need to report any unusual bleeding or bruising."
C. "I can continue to eat green leafy vegetables as much as I want."
D. "I should avoid drinking alcohol while on this medication."
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Green leafy vegetables are high in vitamin K, which can antagonize the effects of
warfarin, so intake should be consistent rather than variable. This nursing exam guide for Chamberlain
BSN students teaches the importance of dietary consistency with anticoagulant therapy. Taking the
medication at the same time daily, reporting bleeding, and avoiding alcohol are all correct statements.
---
**5. A client with type 2 diabetes mellitus is admitted with a blood glucose of 650 mg/dL and signs of
dehydration. Which of the following is the nurse’s priority intervention?**
A. Administer 10 units of regular insulin subcutaneously
B. Start an IV of 0.9% normal saline
C. Check the client's urine for ketones
D. Monitor blood glucose every hour
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The priority intervention for hyperglycemic hyperosmolar state (HHS) is fluid
resuscitation with IV normal saline to correct dehydration and improve perfusion. This Chamberlain BSN
NCLEX prep question underscores the ABCs and fluid balance in diabetic emergencies. While insulin
administration and glucose monitoring are important, fluid replacement is the immediate priority.
---
, **6. A nurse is caring for a client with a nasogastric tube set to low intermittent suction. Which of the
following electrolyte imbalances is the client most at risk for?**
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Nasogastric suction removes gastric fluids that contain potassium, leading to
hypokalemia. This nursing exam practice for Chamberlain BSN students highlights the risk of electrolyte
loss with GI suctioning. Hyponatremia and hyperkalemia are less likely, and hypercalcemia is not
associated with NG suction.
---
**7. A client who is receiving a blood transfusion develops chills, fever, and a headache 30 minutes after
the transfusion begins. What is the nurse’s priority action?**
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer prescribed antihistamines
D. Notify the healthcare provider after completing the transfusion
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: These symptoms indicate a febrile non-hemolytic reaction or a potential hemolytic
reaction, so the transfusion must be stopped immediately to prevent further complications. This NCLEX
prep resource for Chamberlain BSN students stresses the importance of rapid action during transfusion
reactions. Slowing the rate or administering antihistamines without stopping is unsafe, and notifying the
provider should occur after stopping the infusion.
---
exam guide with rationales and practice questions for exam mastery."
---
**🏆 CHAMBERLAIN UNIVERSITY BSN COMPREHENSIVE FINAL EXAM
MASTERY GUIDE | NCLEX-RN READINESS ASSESSMENT, CLINICAL
JUDGMENT, PRIORITIZATION & DELEGATION PRACTICE QUESTIONS
WITH DETAILED RATIONALES | 2025–2026 ACADEMIC CYCLE | NURS
101, NURS 200, NURS 300, NURS 400 INTEGRATED REVIEW**
---
**1. A nurse is caring for a client with heart failure who reports worsening shortness of breath and
swelling in the lower extremities. Which of the following assessment findings would be the earliest
indicator of fluid volume overload?**
A. Jugular venous distention
B. Weight gain of 2 pounds in 24 hours
C. Crackles auscultated in the lung bases
D. Pitting edema in the feet and ankles
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Weight gain of 2 pounds in 24 hours is the earliest indicator of fluid volume overload,
as it reflects fluid retention before physical signs like crackles or edema manifest. This NCLEX prep
question emphasizes the importance of daily weights for Chamberlain BSN students in managing heart
failure. Crackles, jugular venous distention, and pitting edema are later signs of fluid overload, making
weight gain the most sensitive early indicator for nursing success.
---
,**2. A client who is post-operative day two after abdominal surgery reports sudden sharp pain in the
right calf and mild shortness of breath. What is the priority nursing action?**
A. Administer prescribed PRN analgesic
B. Apply a warm compress to the calf
C. Instruct the client to perform ankle exercises
D. Assess for Homans' sign and notify the provider immediately
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The client's symptoms suggest a possible deep vein thrombosis (DVT) with a risk of
pulmonary embolism. Assessing for Homans' sign and notifying the provider are priority actions. This
nursing exam guide for Chamberlain BSN students highlights the need for rapid intervention to prevent
complications. Warm compresses and ankle exercises could dislodge a clot, and analgesics do not
address the underlying emergency.
---
**3. A nurse is preparing to administer digoxin to a client with atrial fibrillation. Which of the following
findings would warrant withholding the medication and contacting the healthcare provider?**
A. Apical pulse of 62 beats per minute
B. Serum potassium level of 3.2 mEq/L
C. Serum digoxin level of 1.2 ng/mL
D. Blood pressure of 118/76 mmHg
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: A serum potassium level of 3.2 mEq/L is below the normal range (3.5-5.0 mEq/L) and
increases the risk of digoxin toxicity. This Chamberlain BSN NCLEX prep resource emphasizes the need to
monitor potassium levels carefully with digoxin therapy. An apical pulse below 60 would also warrant
holding the medication, but a pulse of 62 is acceptable. A digoxin level of 1.2 ng/mL is within the
therapeutic range (0.8-2.0 ng/mL).
---
,**4. A nurse is providing discharge teaching to a client prescribed warfarin. Which of the following
statements by the client indicates a need for further teaching?**
A. "I will take my medication at the same time every day."
B. "I need to report any unusual bleeding or bruising."
C. "I can continue to eat green leafy vegetables as much as I want."
D. "I should avoid drinking alcohol while on this medication."
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Green leafy vegetables are high in vitamin K, which can antagonize the effects of
warfarin, so intake should be consistent rather than variable. This nursing exam guide for Chamberlain
BSN students teaches the importance of dietary consistency with anticoagulant therapy. Taking the
medication at the same time daily, reporting bleeding, and avoiding alcohol are all correct statements.
---
**5. A client with type 2 diabetes mellitus is admitted with a blood glucose of 650 mg/dL and signs of
dehydration. Which of the following is the nurse’s priority intervention?**
A. Administer 10 units of regular insulin subcutaneously
B. Start an IV of 0.9% normal saline
C. Check the client's urine for ketones
D. Monitor blood glucose every hour
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The priority intervention for hyperglycemic hyperosmolar state (HHS) is fluid
resuscitation with IV normal saline to correct dehydration and improve perfusion. This Chamberlain BSN
NCLEX prep question underscores the ABCs and fluid balance in diabetic emergencies. While insulin
administration and glucose monitoring are important, fluid replacement is the immediate priority.
---
, **6. A nurse is caring for a client with a nasogastric tube set to low intermittent suction. Which of the
following electrolyte imbalances is the client most at risk for?**
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypercalcemia
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Nasogastric suction removes gastric fluids that contain potassium, leading to
hypokalemia. This nursing exam practice for Chamberlain BSN students highlights the risk of electrolyte
loss with GI suctioning. Hyponatremia and hyperkalemia are less likely, and hypercalcemia is not
associated with NG suction.
---
**7. A client who is receiving a blood transfusion develops chills, fever, and a headache 30 minutes after
the transfusion begins. What is the nurse’s priority action?**
A. Slow the transfusion rate
B. Stop the transfusion immediately
C. Administer prescribed antihistamines
D. Notify the healthcare provider after completing the transfusion
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: These symptoms indicate a febrile non-hemolytic reaction or a potential hemolytic
reaction, so the transfusion must be stopped immediately to prevent further complications. This NCLEX
prep resource for Chamberlain BSN students stresses the importance of rapid action during transfusion
reactions. Slowing the rate or administering antihistamines without stopping is unsafe, and notifying the
provider should occur after stopping the infusion.
---
