1. A nurse is caring for four patients. Which should be seen first? *

A. Post-op patient with pain 6/10

B. COPD patient with RR 8 and drowsy

C. Diabetic with BG 210

D. Patient with 100.1°F and chills

2. Which finding should a nurse report immediately after administering digoxin? *

A. HR 58 bpm

B. Nausea

C. Blurred vision

D. Vomiting

3. What PPE is required for caring for a patient with active TB? *

A. Surgical mask

B. Gloves and gown

C. N95 respirator

D. Face shield only

4. A client at 38 weeks’ gestation reports a sudden gush of fluid. What’s the nurse’s first action? *

A. Check fetal heart tones

B. Start an IV

C. Administer oxygen

D. Perform a cervical exam

5. A patient states, "I want to die." What is the nurse’s priority response? *

A. “Let’s talk about what’s bothering you.”

B. “Do you have a plan to harm yourself?”

C. “That must be hard for you.”

D. “Don’t talk like that.”

6. Which client should the nurse see first? *

A. A client with a new colostomy asking for help

B. A client requesting a blanket

C. A patient with tingling post-cast application

D. A patient due for a daily weight check

7. Which finding is most concerning in a 2-month-old infant? *

A. Moro reflex present

B. Posterior fontanel closed

C. HR of 190 bpm

D. Soft stools

8. Which ECG finding indicates ventricular tachycardia? *

A. Irregular rhythm with P waves

B. Wide QRS, no P waves

C. ST segment elevation

D. Inverted T waves

9. A client with pancreatitis has a calcium of 7.5 mg/dL. What is the priority intervention? *

A. Give calcium gluconate

B. Prepare for dialysis

C. Restrict fluids

D. Encourage ambulation

10. Which meal is best for a client on a low-sodium diet? *

A. Ham sandwich, chips, soda

B. Grilled chicken, brown rice, broccoli

C. Ramen noodles and fruit cup

D. Turkey hot dog with fries

11. A client with asthma is using albuterol frequently. Which symptom is most concerning? *

A. Tremors

B. HR 110 bpm

C. No relief from wheezing

D. Nausea

12. Which action violates HIPAA? *

A. Calling out a patient’s name in the waiting room

B. Posting a patient’s photo on social media

C. Explaining meds at bedside

D. Discussing treatment with the patient’s spouse with consent

13. Which finding should the nurse report in a client 1 day postpartum? *

A. Fundus firm and midline

B. Moderate lochia rubra

C. Temperature 100.4°F

D. Foul-smelling discharge

14. Which symptom is most urgent after head trauma? *

A. Dizziness

B. Nausea

C. Unequal pupils

D. Bruising behind ears

15. A patient taking oral iron supplements reports black stools. What should the nurse say? *

A. “Stop taking the supplement.”

B. “This is a normal side effect.”

C. “It could indicate GI bleeding.”

D. “Call the provider immediately.”

16. Which task can the nurse delegate to a UAP? *

A. Administer oral meds

B. Assess for skin breakdown

C. Assist with ambulation

D. Teach incentive spirometer use

17. Which finding is priority in a client with DKA? *

A. K+ 3.5 mEq/L

B. Fruity breath

C. Deep rapid respirations

D. Mental confusion

18. Order: 500 mg acetaminophen. Available: 250 mg/5 mL. How many mL will you give? *

A. 5 mL

B. 7.5 mL

C. 10 mL

D. 15 mL

19. Which client is at greatest risk for fluid volume deficit? *

A. Chronic kidney disease

B. Severe vomiting

C. Hypertension

D. SIADH

20. Which vaccine is safe in pregnancy? *

A. MMR

B. Varicella

C. Influenza (inactivated)

D. HPV

21–23. Case Study: Sepsis in Elderly Patient

Stem:
An 82-year-old client with a urinary catheter presents with fever, low BP, and confusion. Vitals: BP 88/50, HR 120, Temp 102.2°F.

21. What’s the priority nursing action? *

A. Administer acetaminophen

B. Notify provider

C. Begin IV fluids

D. Check blood glucose

22. Which lab confirms sepsis? *

A. WBC 6,000

B. BUN 20

C. Lactate 4.0

D. Na 135

23. Which medication should the nurse anticipate? *

A. Furosemide

B. Morphine

C. Vancomycin

D. Metformin

24–25. Case Study: Postpartum Hemorrhage

Stem:
A woman 2 hours postpartum begins soaking a pad every 10 minutes. Fundus is boggy and midline.

24. What is the nurse’s priority action?

A. Notify the provider

B. Begin fundal massage

C. Administer IV fluids

D. Place in Trendelenburg

25. Which medication would be expected? *

A. Oxytocin

B. Magnesium sulfate

C. Nifedipine

D. Misoprostol

26–27. Case Study: Pediatric Dehydration

Stem:
A 3-year-old child presents with diarrhea for 3 days. Skin is dry, fontanel is sunken, cap refill >3 seconds.

26. Which is the best initial intervention? *

A. Encourage oral fluids

B. Start IV normal saline

C. Administer anti-diarrheal

D. Give fruit juice

27. Which finding shows improvement? *

A. HR 150

B. Cap refill <2 seconds

C. Sunken eyes

D. Crying without tears

28. A nurse is caring for a patient with a basilar skull fracture. Which finding requires immediate intervention? *

A. Bruising behind the ears

B. Suspect cerebrospinal fluid leak and notify the provider

C. Complaint of headache

D. Nausea and vomiting

29. Which task should the RN NOT delegate to a licensed practical nurse (LPN)? *

A. Administering oral antibiotics

B. Reinforcing teaching about insulin injection

C. Monitoring a stable post-op patient

D. Performing initial assessment on a newly admitted patient

30. A nurse is preparing to administer IV furosemide to a client with heart failure. Which of the following lab values requires provider notification before administration? *

A. Sodium 138 mEq/L

B. Potassium 2.9 mEq/L

C. Creatinine 1.0 mg/dL

D. Magnesium 1.8 mg/dL

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21–23. Case Study: Sepsis in Elderly Patient

24–25. Case Study: Postpartum Hemorrhage

26–27. Case Study: Pediatric Dehydration

Stem:A 3-year-old child presents with diarrhea for 3 days. Skin is dry, fontanel is sunken, cap refill >3 seconds.

Get your results! Enter your info below

Stem:
A 3-year-old child presents with diarrhea for 3 days. Skin is dry, fontanel is sunken, cap refill >3 seconds.