HNB BC 2025”2026 REAL EXAM REVIEW 150 QUESTIONS AND
CORRECT ANSWERS WITH RATIONALES COVERING THE RECENT
TESTED QUESTIONS GUARANTEE HIGH PASS MARK
1. A nurse is caring for a patient with congestive heart failure. Which symptom indicates
worsening left-sided heart failure?
A. Peripheral edema
B. ☑ Pulmonary crackles and dyspnea
C. Jugular vein distension
D. Hepatomegaly
Rationale: Left-sided heart failure causes pulmonary congestion due to fluid backup in the
lungs.
2. Which lab value should a nurse monitor closely for a patient receiving furosemide?
A. Blood glucose
B. Calcium
C. Sodium
D. ☑ Potassium
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, leading to arrhythmias.
3. A patient with hypovolemic shock presents with tachycardia and hypotension. What is the
priority nursing intervention?
A. Administer antipyretics
B. Encourage ambulation
C. Restrict fluids
D. ☑ Rapid IV fluid replacement
Rationale: Restoring circulating volume is essential to maintain perfusion and prevent organ
failure.
4. A patient with DKA is receiving insulin therapy. Which electrolyte must be closely
monitored?
A. Sodium
B. ☑ Potassium
C. Calcium
D. Magnesium
Rationale: Insulin drives potassium into cells, risking hypokalemia and cardiac arrhythmias.
5. Which action reduces the risk of catheter-associated urinary tract infection?
A. Irrigate catheter daily
B. Replace catheter weekly
C. Encourage fluid restriction
,D. ☑ Maintain a closed drainage system and proper hygiene
Rationale: A closed system prevents bacterial contamination and reduces infection risk.
6. Which nursing intervention is priority for a patient experiencing angina?
A. Encourage exercise
B. Apply heat to chest
C. Administer beta-blockers at home
D. ☑ Assess vital signs and administer prescribed nitroglycerin
Rationale: Nitroglycerin relieves ischemic chest pain; monitoring prevents hypotension and
adverse events.
7. Which patient is at greatest risk for hospital-acquired pneumonia?
A. Healthy adolescent
B. Ambulatory adult
C. Patient with mild dehydration
D. ☑ Intubated patient on mechanical ventilation
Rationale: Intubation impairs airway defenses, increasing infection risk.
8. Which lab indicates effective anticoagulation in a patient on heparin therapy?
A. Hemoglobin 14 g/dL
B. Platelets 250,000
C. INR 1.0
D. ☑ aPTT 60–80 seconds
Rationale: aPTT measures the therapeutic effect of heparin and helps prevent under- or over-
anticoagulation.
9. A patient with hypocalcemia reports tingling in fingers. What is the priority intervention?
A. Encourage exercise
B. Apply heat packs
C. Provide a high-calcium diet
D. ☑ Administer calcium gluconate IV as prescribed
Rationale: IV calcium rapidly reverses neuromuscular excitability and prevents tetany.
10. A patient with heart failure is taking furosemide. Which assessment is most important
before administration?
A. Temperature
B. Oxygen saturation
C. Weight only
D. ☑ Blood pressure and potassium level
Rationale: Furosemide lowers BP and potassium; monitoring prevents hypotension and
arrhythmias.
, 11. Which patient is at highest risk for aspiration?
A. Ambulatory adult
B. Patient eating slowly
C. Healthy adolescent
D. ☑ Patient with impaired swallowing post-stroke
Rationale: Dysphagia increases risk for food or liquid entering the airway.
12. Early signs of septic shock include:
A. Cyanosis
B. Bradycardia
C. Jaundice
D. ☑ Tachycardia and hypotension
Rationale: Early septic shock manifests as hypotension with compensatory tachycardia.
13. A patient with acute pulmonary edema should receive which intervention first?
A. Apply heat to chest
B. Restrict oral fluids only
C. Encourage ambulation
D. ☑ Administer oxygen and diuretics as prescribed
Rationale: Oxygen improves hypoxemia; diuretics reduce pulmonary fluid overload.
14. A patient with chronic kidney disease has hyperphosphatemia. Which dietary
modification is appropriate?
A. High potassium diet
B. High sodium diet
C. High protein diet
D. ☑ Limit dairy and phosphate-rich foods
Rationale: Limiting phosphate intake prevents complications, including secondary bone
disease.
15. Which finding suggests hypomagnesemia?
A. Hyperglycemia
B. Polyuria only
C. Bradycardia only
D. ☑ Muscle tremors and positive Chvostek sign
Rationale: Low magnesium increases neuromuscular excitability.
16. Which action prevents DVT in a post-operative patient?
A. High-sodium diet
B. Bedrest
C. Restrict fluids
CORRECT ANSWERS WITH RATIONALES COVERING THE RECENT
TESTED QUESTIONS GUARANTEE HIGH PASS MARK
1. A nurse is caring for a patient with congestive heart failure. Which symptom indicates
worsening left-sided heart failure?
A. Peripheral edema
B. ☑ Pulmonary crackles and dyspnea
C. Jugular vein distension
D. Hepatomegaly
Rationale: Left-sided heart failure causes pulmonary congestion due to fluid backup in the
lungs.
2. Which lab value should a nurse monitor closely for a patient receiving furosemide?
A. Blood glucose
B. Calcium
C. Sodium
D. ☑ Potassium
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, leading to arrhythmias.
3. A patient with hypovolemic shock presents with tachycardia and hypotension. What is the
priority nursing intervention?
A. Administer antipyretics
B. Encourage ambulation
C. Restrict fluids
D. ☑ Rapid IV fluid replacement
Rationale: Restoring circulating volume is essential to maintain perfusion and prevent organ
failure.
4. A patient with DKA is receiving insulin therapy. Which electrolyte must be closely
monitored?
A. Sodium
B. ☑ Potassium
C. Calcium
D. Magnesium
Rationale: Insulin drives potassium into cells, risking hypokalemia and cardiac arrhythmias.
5. Which action reduces the risk of catheter-associated urinary tract infection?
A. Irrigate catheter daily
B. Replace catheter weekly
C. Encourage fluid restriction
,D. ☑ Maintain a closed drainage system and proper hygiene
Rationale: A closed system prevents bacterial contamination and reduces infection risk.
6. Which nursing intervention is priority for a patient experiencing angina?
A. Encourage exercise
B. Apply heat to chest
C. Administer beta-blockers at home
D. ☑ Assess vital signs and administer prescribed nitroglycerin
Rationale: Nitroglycerin relieves ischemic chest pain; monitoring prevents hypotension and
adverse events.
7. Which patient is at greatest risk for hospital-acquired pneumonia?
A. Healthy adolescent
B. Ambulatory adult
C. Patient with mild dehydration
D. ☑ Intubated patient on mechanical ventilation
Rationale: Intubation impairs airway defenses, increasing infection risk.
8. Which lab indicates effective anticoagulation in a patient on heparin therapy?
A. Hemoglobin 14 g/dL
B. Platelets 250,000
C. INR 1.0
D. ☑ aPTT 60–80 seconds
Rationale: aPTT measures the therapeutic effect of heparin and helps prevent under- or over-
anticoagulation.
9. A patient with hypocalcemia reports tingling in fingers. What is the priority intervention?
A. Encourage exercise
B. Apply heat packs
C. Provide a high-calcium diet
D. ☑ Administer calcium gluconate IV as prescribed
Rationale: IV calcium rapidly reverses neuromuscular excitability and prevents tetany.
10. A patient with heart failure is taking furosemide. Which assessment is most important
before administration?
A. Temperature
B. Oxygen saturation
C. Weight only
D. ☑ Blood pressure and potassium level
Rationale: Furosemide lowers BP and potassium; monitoring prevents hypotension and
arrhythmias.
, 11. Which patient is at highest risk for aspiration?
A. Ambulatory adult
B. Patient eating slowly
C. Healthy adolescent
D. ☑ Patient with impaired swallowing post-stroke
Rationale: Dysphagia increases risk for food or liquid entering the airway.
12. Early signs of septic shock include:
A. Cyanosis
B. Bradycardia
C. Jaundice
D. ☑ Tachycardia and hypotension
Rationale: Early septic shock manifests as hypotension with compensatory tachycardia.
13. A patient with acute pulmonary edema should receive which intervention first?
A. Apply heat to chest
B. Restrict oral fluids only
C. Encourage ambulation
D. ☑ Administer oxygen and diuretics as prescribed
Rationale: Oxygen improves hypoxemia; diuretics reduce pulmonary fluid overload.
14. A patient with chronic kidney disease has hyperphosphatemia. Which dietary
modification is appropriate?
A. High potassium diet
B. High sodium diet
C. High protein diet
D. ☑ Limit dairy and phosphate-rich foods
Rationale: Limiting phosphate intake prevents complications, including secondary bone
disease.
15. Which finding suggests hypomagnesemia?
A. Hyperglycemia
B. Polyuria only
C. Bradycardia only
D. ☑ Muscle tremors and positive Chvostek sign
Rationale: Low magnesium increases neuromuscular excitability.
16. Which action prevents DVT in a post-operative patient?
A. High-sodium diet
B. Bedrest
C. Restrict fluids
