IQN CBT Part B Mock Test (108 Questions)

Q1. A patient with a history of chronic obstructive pulmonary disease (COPD) presents with increased shortness of breath, a productive cough with purulent sputum, and a low-grade fever. Which assessment finding would most indicate the need for immediate medical intervention?
A) The patient’s oxygen saturation is 92% on room air.
B) The patient reports using their rescue inhaler four times in the past 24 hours.
C) The patient is sitting upright and leaning forward on the bedside table.
D) The patient’s respiratory rate has increased from 22 to 28 breaths per minute.

Q2. A patient is receiving a continuous heparin infusion for a deep vein thrombosis (DVT). The aPTT result is 95 seconds (therapeutic range is 60-85 seconds). What is the nurse’s priority action?
A) Increase the infusion rate as per the protocol.
B) Stop the infusion for one hour and then restart at a lower rate as per protocol.
C) Administer vitamin K as an antidote.
D) Continue the infusion at the same rate and repeat the aPTT in 6 hours.

Q3. A patient is admitted with chest pain and a suspected myocardial infarction. Which of the following troponin level results would be most concerning and confirmatory of an acute MI?
A) A single troponin level drawn in the emergency department that is within the normal range.
B) A troponin level that remains elevated but unchanged over two consecutive draws.
C) A troponin level that shows a rise and fall pattern over serial measurements.
D) A troponin level that is slightly elevated but the patient is now pain-free.

Q4. A patient with type 1 diabetes is found unconscious and profusely diaphoretic. The nurse is unable to obtain a blood glucose reading immediately. What is the most appropriate initial nursing intervention?
A) Administer glucagon intramuscularly.
B) Administer 50% dextrose intravenously.
C) Wait for a venous blood gas result before acting.
D) Administer a small amount of orange juice if the patient can swallow.

Q5. A patient post-operative day 1 from a total knee replacement has a urine output of 80 mL over the last 4 hours. The nurse notes the patient’s blood pressure is 98/58 mmHg and heart rate is 110 bpm. What should the nurse suspect first?
A) Acute kidney injury.
B) Urinary tract infection.
C) Hypovolemia.
D) Syndrome of inappropriate antidiuretic hormone (SIADH).

Q6. A patient is prescribed regular insulin (Humulin R) 10 units and NPH insulin (Humulin N) 20 units subcutaneously at 0730. At what time would it be most important for the nurse to ensure the patient has breakfast?
A) Immediately after the injection.
B) Within 15-30 minutes.
C) Within 1-2 hours.
D) Anytime before lunch.

Q7. A patient is admitted with hyperkalemia. Which electrocardiogram (ECG) change is most characteristic of this electrolyte imbalance?
A) Flattened T waves and prominent U waves.
B) Prolonged PR interval and widened QRS complex.
C) Peaked (tented) T waves.
D) ST-segment elevation.

Q8. A patient is receiving a blood transfusion. Fifteen minutes after the transfusion begins, the patient reports lower back pain and appears flushed and anxious. What is the nurse’s first action?
A) Slow the transfusion and monitor the patient closely.
B) Stop the transfusion and maintain IV access with normal saline.
C) Administer diphenhydramine (Benadryl) as prescribed.
D) Re-check the patient’s vital signs and compare to baseline.

Q9. A patient with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which laboratory value requires the most immediate attention and reporting to the healthcare provider before administering this dose?
A) Sodium: 135 mEq/L
B) Potassium: 3.0 mEq/L
C) Glucose: 110 mg/dL
D) Creatinine: 1.0 mg/dL

Q10. During a sterile dressing change, the nurse accidentally brushes the sterile tip of the forceps against the patient’s bare skin two inches from the wound edge. What is the most appropriate action?
A) Continue using the forceps as the patient’s skin is not sterile but is clean.
B) Obtain a new pair of sterile forceps and continue the procedure.
C) Wipe the forceps tip with an alcohol swab and continue.
D) Continue the procedure but ensure to not touch the wound with that part of the forceps.

Q11. A patient is prescribed warfarin (Coumadin) 5 mg daily. The patient’s INR is 1.2. Based on this result, the nurse anticipates the healthcare provider will:
A) Increase the warfarin dose.
B) Decrease the warfarin dose.
C) Hold the next dose of warfarin.
D) Administer the dose as prescribed.

Q12. A patient is experiencing an acute asthma exacerbation. The nurse administers albuterol via nebulizer as prescribed. What is the primary therapeutic action of this medication?
A) It reduces inflammation in the airways.
B) It inhibits the cough reflex.
C) It relaxes bronchial smooth muscles.
D) It thins respiratory secretions.

Q13. A patient is admitted with a small bowel obstruction and has a nasogastric (NG) tube connected to low intermittent suction. The nurse assesses the patient and notes the NG tube is not draining. What is the first action the nurse should take?
A) Irrigate the NG tube with 30 mL of normal saline.
B) Reposition the patient and check the tube for kinks.
C) Advance the tube 5 cm to ensure it is in the stomach.
D) Notify the healthcare provider immediately.

Q14. A patient with a history of alcohol use disorder is admitted for a detoxification program. Which assessment finding is most indicative of impending delirium tremens (DTs)?
A) Mild hand tremors and diaphoresis.
B) Complaints of headache and nausea.
C) Visual or tactile hallucinations and profound confusion.
D) Difficulty sleeping and mild anxiety.

Q15. A patient is diagnosed with bacterial meningitis. Which isolation precaution is most appropriate to initiate immediately?
A) Contact precautions.
B) Droplet precautions.
C) Airborne precautions.
D) Protective environment.

Q16. A nurse is preparing to administer a transdermal fentanyl patch to a patient for chronic pain. Which of the following is a critical safety step before application?
A) Shave the area to ensure the patch adheres properly.
B) Assess the patient’s respiratory rate and depth.
C) Apply the patch to the patient’s chest for faster absorption.
D) Cleanse the area with an alcohol wipe and let it dry completely.

Q17. A patient is admitted with a fever of unknown origin. The healthcare provider orders blood cultures. Which nursing action is most important for ensuring accurate results?
A) Draw the cultures from a peripheral IV line immediately upon insertion.
B) Obtain the cultures from two different sites at least one hour apart.
C) Clean the collection sites with chlorhexidine and allow them to dry before venipuncture.
D) Ensure the patient has been fasting for at least 8 hours before drawing the cultures.

Q18. A patient with a traumatic brain injury has an intraventricular catheter (EVD) in place to monitor intracranial pressure (ICP). The nurse notes a sudden ICP reading of 25 mmHg. What is the nurse’s priority action?
A) Document the reading in the patient’s chart.
B) Check the level of the transducer relative to the patient’s head.
C) Immediately administer the prescribed dose of mannitol.
D) Notify the neurosurgeon of the reading.

Q19. A patient is ordered a clear liquid diet following surgery. Which of the following items is appropriate for the nurse to provide?
A) A cup of creamy tomato soup.
B) A bowl of plain yogurt.
C) A glass of apple juice.
D) A dish of vanilla pudding.

Q20. A patient who had a stroke is experiencing dysphagia. What is the most important nursing intervention during meal times?
A) Place the patient in a semi-recumbent position.
B) Encourage the use of a straw to make drinking easier.
C) Offer a soft, pureed diet and have the patient sit upright with head slightly flexed.
D) Thicken all liquids to a honey consistency to prevent aspiration.

Q21. A patient is receiving IV fluids at 150 mL/hr. The nurse’s morning assessment reveals new onset crackles in the lung bases, pitting edema in the lower extremities, and a weight gain of 2 kg since yesterday. What is the nurse’s priority action?
A) Increase the patient’s bed rest to promote diuresis.
B) Assess the patient’s jugular venous distention.
C) Slow the IV fluid rate and notify the healthcare provider.
D) Administer a prescribed PRN diuretic.

Q22. A patient with a pneumothorax has a chest tube inserted and is placed on underwater seal drainage with -20 cm suction. Which finding indicates that the lung may be re-expanding?
A) Continuous bubbling in the water seal chamber.
B) Cessation of tidaling in the water seal chamber.
C) A sudden gush of drainage from the chest tube.
D) Subcutaneous emphysema around the insertion site.

Q23. A patient with end-stage renal disease is scheduled for hemodialysis. Which medication should the nurse hold based on this scheduled treatment?
A) Acetaminophen (Tylenol)
B) Sevelamer (Renagel)
C) Erythropoietin (Epogen)
D) Lisinopril (Zestril)

Q24. A patient is admitted with lower gastrointestinal bleeding. Which assessment finding is most concerning and requires immediate action?
A) The patient reports feeling dizzy when standing up.
B) The patient’s hemoglobin is 9 g/dL, down from 12 g/dL yesterday.
C) The patient has a large, maroon-colored, loose stool in the bedpan.
D) The patient’s heart rate increases from 88 to 110 bpm and BP drops from 118/70 to 90/50 mmHg.

Q25. A patient is prescribed metformin (Glucophage) for type 2 diabetes. The nurse should withhold the medication and contact the healthcare provider if the patient has which of the following?
A) A blood glucose level of 180 mg/dL.
B) An order for an IV contrast dye procedure.
C) A history of lactose intolerance.
D) A mild upper respiratory infection.

Q26. A patient is admitted with a pulmonary embolism. The nurse notes the patient is on a continuous heparin infusion. Which laboratory value is most important to monitor to assess for a therapeutic effect of the heparin?
A) Prothrombin time (PT).
B) International normalized ratio (INR).
C) Activated partial thromboplastin time (aPTT).
D) Platelet count.

Q27. A patient is 2 hours post-operative from a coronary artery bypass graft (CABG) surgery. The mediastinal chest tube drainage was 150 mL in the first hour and is now 50 mL in the current hour. What is the most appropriate nursing action?
A) Strip or milk the chest tube to ensure patency.
B) Notify the surgeon immediately as output is decreasing too quickly.
C) Document the output and continue to monitor closely.
D) Increase the suction pressure to facilitate drainage.

Q28. A patient has a seizure while the nurse is in the room. Which of the following actions is the nurse’s priority?
A) Insert a padded tongue blade into the patient’s mouth.
B) Restrain the patient’s limbs to prevent injury.
C) Move furniture away from the patient and protect their head.
D) Administer the prescribed PRN diazepam.

Q29. A patient with an indwelling urinary catheter for three days now has a fever and suprapubic tenderness. What is the most likely cause?
A) The catheter is too large.
B) An allergic reaction to the catheter material.
C) A catheter-associated urinary tract infection (CAUTI).
D) Dehydration leading to concentrated urine.

Q30. A patient is admitted with a diagnosis of meningitis. The nurse is preparing to administer the first dose of IV antibiotics. Which action is most important before administration?
A) Ensure blood cultures have been obtained.
B) Assess the patient’s level of consciousness.
C) Check the patient’s medication allergy history.
D) Pre-medicate the patient with acetaminophen.

Q31. A patient with a terminal illness is experiencing breakthrough pain. The prescription reads “morphine 10 mg sublingual every 1 hour PRN for breakthrough pain.” Which patient assessment finding indicates it is safe to administer the medication?
A) The patient’s respiratory rate is 8 breaths per minute.
B) The patient is somnolent and difficult to arouse.
C) The patient rates their pain as 8 on a 0-10 scale.
D) The patient received a dose of long-acting morphine 45 minutes ago.

Q32. A patient is on a strict input and output (I&O) chart. Which of the following items should the nurse record as an output?
A) 250 mL of tube feeding.
B) 100 mL of emesis.
C) 500 mL of IV fluid.
D) 200 mL of wound irrigation fluid.

Q33. A patient has a stage 3 pressure injury on the sacrum. Which finding warrants immediate notification of the healthcare provider?
A) The wound bed is 75% covered with red granulation tissue.
B) The patient reports increasing pain at the wound site.
C) There is a small amount of serosanguinous drainage.
D) The wound edges are beginning to roll inward.

Q34. A patient with hypertension is prescribed lisinopril. The nurse teaches the patient to report which potential side effect immediately?
A) A dry, persistent cough.
B) Swelling of the tongue or lips.
C) Dizziness upon standing.
D) A metallic taste in the mouth.

Q35. A patient is admitted with a bowel obstruction. The nurse passes a nasogastric (NG) tube and connects it to low intermittent suction. What is the primary expected outcome of this intervention?
A) To provide a route for enteral nutrition.
B) To decompress the stomach and relieve vomiting.
C) To obtain a specimen for gastric analysis.
D) To prevent stress ulcer formation.

Q36. A patient is one day post-thyroidectomy. The nurse assesses the patient and notes they are complaining of tingling in their fingers and around their mouth. What complication should the nurse suspect?
A) Thyroid storm.
B) Hypocalcemia.
C) Hemorrhage.
D) Recurrent laryngeal nerve damage.

Q37. A patient with chronic kidney disease is being discharged. Which statement by the patient indicates a need for further teaching?
A) “I will weigh myself every day and report a gain of 2 pounds.”
B) “I can continue to use my salt substitute to season my food.”
C) “I will take my phosphate binder with meals as prescribed.”
D) “I need to avoid non-steroidal anti-inflammatory drugs (NSAIDs).”

Q38. A patient is admitted with suspected appendicitis. The nurse should avoid which of the following interventions?
A) Administering a prescribed opioid for pain relief.
B) Placing the patient in a comfortable position, such as side-lying with knees flexed.
C) Applying an ice pack to the lower abdomen for comfort.
D) Administering a laxative to relieve constipation.

Q39. A patient is receiving a unit of packed red blood cells. At what rate should the nurse plan to administer the transfusion during the first 15 minutes?
A) As fast as possible to correct the anemia quickly.
B) At a slower rate (e.g., 50 mL/hr) to monitor for a reaction.
C) At the prescribed maintenance IV rate.
D) The rate is not important; the total time of transfusion is.

Q40. A patient is on a telemetry unit. The monitor shows a rhythm with no visible P waves, an irregularly irregular ventricular rate, and a normal QRS complex. How should the nurse interpret this rhythm?
A) Ventricular tachycardia.
B) Sinus arrhythmia.
C) Atrial fibrillation.
D) Third-degree heart block.

Q41. A patient with a chest tube has the drainage collection device accidentally broken. What is the nurse’s priority action?
A) Notify the charge nurse immediately.
B) Obtain a new drainage system and set it up.
C) Clamp the chest tube near the insertion site.
D) Place the end of the chest tube in a bottle of sterile water.

Q42. A patient is diagnosed with Clostridioides difficile (C. diff) infection. Which type of isolation precautions is most appropriate?
A) Standard precautions only.
B) Contact precautions.
C) Droplet precautions.
D) Airborne precautions.

Q43. A patient with a fractured femur suddenly develops chest pain and shortness of breath. The nurse notes the patient appears anxious and has an oxygen saturation of 88% on room air. What should the nurse suspect first?
A) Atelectasis.
B) Myocardial infarction.
C) Pulmonary embolism.
D) Pneumonia.

Q44. A patient is prescribed digoxin (Lanoxin). Which assessment finding would be most indicative of digoxin toxicity?
A) The patient reports seeing yellow halos around lights.
B) The patient’s heart rate is 64 beats per minute.
C) The patient has developed a dry, hacking cough.
D) The patient’s ankles are swollen.

Q45. A patient is receiving an IV infusion of potassium chloride (KCl). What is the most important safety principle the nurse must follow?
A) Administer KCl as a slow IV push over at least 10 minutes.
B) Ensure the KCl is diluted and infused via an IV pump.
C) Monitor the patient’s blood glucose levels closely.
D) Administer KCl through a central line only.

Q46. A patient has a new colostomy. The nurse is teaching the patient about stoma care. Which observation indicates the patient understands the teaching?
A) The patient cleans the stoma with a mild soap and water, then rinses and dries it gently.
B) The patient uses a vigorous scrubbing motion to ensure the skin around the stoma is clean.
C) The patient reports they expect the stoma to decrease in size over the next few weeks.
D) The patient states they will not eat for 24 hours before changing the appliance.

Q47. A patient is admitted with diabetic ketoacidosis (DKA). Which assessment finding is most consistent with this diagnosis?
A) Slow, shallow respirations and bradycardia.
B) Fruity-scented breath and Kussmaul respirations.
C) Hypertension and bounding pulses.
D) Hot, dry, flushed skin and an absence of thirst.

Q48. A nurse is preparing to administer an IM injection to an adult patient. Which site is preferred for rapid medication absorption?
A) The dorsogluteal site.
B) The ventrogluteal site.
C) The deltoid site.
D) The rectus femoris site.

Q49. A patient has a serum sodium level of 158 mEq/L (normal 135-145). Which nursing intervention is most appropriate?
A) Restrict the patient’s oral fluid intake.
B) Administer hypertonic saline as prescribed.
C) Encourage foods and fluids high in potassium.
D) Offer the patient oral fluids frequently.

Q50. A patient with heart failure is being discharged on a low-sodium diet. Which food selection by the patient indicates a good understanding of the teaching?
A) Grilled chicken breast with a side of steamed vegetables.
B) A can of chicken noodle soup with saltine crackers.
C) A ham and cheese sandwich on whole wheat bread.
D) Frozen pizza with a salad.

Q51. A patient is admitted with a head injury and has an ICP monitor in place. Which nursing action is most important for preventing an increase in ICP?
A) Encouraging the patient to cough and deep breathe every 2 hours.
B) Suctioning the patient’s airway frequently to maintain patency.
C) Clustering nursing care activities to allow for rest periods.
D) Placing the patient in the Trendelenburg position to promote venous return.

Q52. A patient is receiving oxygen via a simple face mask at 8 L/min. What is the approximate concentration of oxygen being delivered?
A) 24-28%
B) 35-45%
C) 50-60%
D) 80-90%

Q53. A patient post-hip replacement surgery is being turned for the first time. Which action by the nursing assistant requires immediate intervention from the nurse?
A) The assistant places an abduction pillow between the patient’s legs.
B) The assistant instructs the patient to keep the operative leg straight.
C) The assistant has the patient cross their legs to help with the log-roll.
D) The assistant uses a turning sheet to move the patient as a unit.

Q54. A patient with a new diagnosis of epilepsy is being started on phenytoin (Dilantin). Which statement by the patient indicates a need for further teaching?
A) “I need to practice good oral hygiene, including flossing and brushing regularly.”
B) “I should notify my doctor if I develop a rash or fever.”
C) “I can stop taking this medication if I have not had a seizure for 6 months.”
D) “It is important to avoid drinking alcohol while on this medication.”

Q55. A patient is admitted with a suspected stroke. The nurse performs a rapid neurological assessment. Which finding is most indicative of a left hemispheric stroke?
A) Inattention to or neglect of the left side of the body.
B) Difficulty understanding spoken language (receptive aphasia) and speaking (expressive aphasia).
C) Impulsive behavior and poor judgment.
D) Inability to recognize familiar objects (agnosia).

Q56. A patient is prescribed enoxaparin (Lovenox) 40 mg subcutaneously. Which injection technique is correct?
A) Aspirate for blood return before injecting the medication.
B) Massage the injection site thoroughly after administration.
C) Administer the injection in the abdomen, at least 2 inches from the umbilicus.
D) Expel the air bubble from the prefilled syringe before injection.

Q57. A patient is admitted with an acute exacerbation of COPD. The nurse notes the patient is using accessory muscles to breathe and has an O2 sat of 84% on room air. The healthcare provider prescribes oxygen at 2 L/min via nasal cannula. What is the rationale for this low flow rate?
A) To prevent oxygen toxicity.
B) To dry out the nasal mucosa as little as possible.
C) To avoid removing the patient’s hypoxic drive to breathe.
D) To allow for a gradual weaning process later.

Q58. A patient is to have a wound culture done. Which technique is correct for obtaining the specimen?
A) Culture the area of pooled or purulent drainage.
B) Clean the wound with sterile saline before obtaining the culture.
C) Swab the wound from the center outwards to the edges.
D) Obtain the culture from necrotic tissue in the wound bed.

Q59. A patient is receiving morphine via a patient-controlled analgesia (PCA) pump. The nurse finds the patient unresponsive with a respiratory rate of 6 breaths per minute. What is the priority action?
A) Administer naloxone (Narcan) as prescribed.
B) Stop the PCA pump and increase the IV fluids.
C) Call a code blue.
D) Stimulate the patient to try to arouse them.

Q60. A patient with liver cirrhosis has ascites. Which nursing intervention is most important to manage this condition?
A) Encourage a high-sodium diet.
B) Restrict oral fluid intake to 500 mL per day.
C) Measure abdominal girth daily.
D) Keep the head of the bed flat.

Q61. A patient is diagnosed with a urinary tract infection (UTI). The nurse expects the healthcare provider to prescribe which type of medication?
A) Antiviral medication.
B) Antifungal medication.
C) Antibiotic medication.
D) Corticosteroid medication.

Q62. A patient has a serum potassium level of 5.8 mEq/L. Which assessment finding would the nurse expect?
A) Skeletal muscle weakness.
B) Hyperactive bowel sounds.
C) Tall, peaked T waves on the ECG.
D) Increased blood pressure.

Q63. A patient is admitted with a deep vein thrombosis (DVT) in the left leg. Which nursing intervention is most appropriate?
A) Massage the left leg to promote circulation.
B) Apply a heating pad to the left leg for comfort.
C) Measure and compare the circumference of both calves daily.
D) Keep the patient on bed rest with the left leg flat.

Q64. A patient is prescribed a peak flow meter to manage their asthma. The nurse teaches the patient that this device measures:
A) The amount of oxygen in the blood.
B) The maximum speed of expiration.
C) The volume of air inhaled with maximum effort.
D) The degree of airway inflammation.

Q65. A patient post-laparoscopic cholecystectomy complains of pain in the right shoulder. What is the most likely cause of this referred pain?
A) The incision site on the abdomen.
B) Positioning during the surgery.
C) Residual carbon dioxide gas in the abdomen.
D) A developing pulmonary embolism.

Q66. A patient is receiving a heparin infusion. The nurse notices the patient has developed a new, rapidly spreading petechial rash on their trunk. The nurse should review the patient’s latest:
A) Hemoglobin and hematocrit.
B) aPTT level.
C) Platelet count.
D) White blood cell count.

Q67. A patient with an ileostomy has a high output. The nurse should monitor the patient most closely for which electrolyte imbalance?
A) Hyperkalemia and hypernatremia.
B) Hypokalemia and hyponatremia.
C) Hypercalcemia and hypermagnesemia.
D) Hypochloremia and hyperphosphatemia.

Q68. A patient is admitted with a fracture of the femur and is in skeletal traction. Which assessment finding would indicate a potential complication of fat embolism syndrome?
A) Pain and swelling at the fracture site.
B) Ecchymosis around the ankle.
C) Petechial rash on the chest and axilla.
D) Decreased urine output.

Q69. A patient with chronic pain is being transitioned from an oral opioid to a transdermal fentanyl patch. The nurse should instruct the patient that:
A) The pain relief will be immediate after applying the patch.
B) They should continue their oral pain medication for the first 12-24 hours.
C) The patch can be cut in half if a lower dose is needed.
D) Heat should be applied over the patch to increase absorption.

Q70. A patient is one hour post-cardiac catheterization via the right femoral artery. The nurse notes the right pedal pulse is weak compared to the left, and the right foot feels cool. What is the priority action?
A) Elevate the right leg on two pillows.
B) Apply a warm blanket to the right foot.
C) Check the right groin site for bleeding or hematoma.
D) Document the findings as a normal post-procedure variation.

Q71. A patient is admitted with acute pancreatitis. Which laboratory value is most consistent with this diagnosis?
A) Decreased serum amylase.
B) Elevated serum lipase.
C) Decreased white blood cell count.
D) Elevated hemoglobin.

Q72. A patient with a new tracheostomy is being taught about stoma care. The nurse explains the purpose of humidified oxygen. What is the primary reason for this?
A) To keep the patient warm and comfortable.
B) To loosen secretions and prevent mucus plugs.
C) To decrease the risk of infection.
D) To provide a higher concentration of oxygen.

Q73. A patient is prescribed a thiazide diuretic for hypertension. Which instruction should the nurse include in the discharge teaching?
A) “Take this medication at bedtime to avoid dizziness.”
B) “Increase your intake of potassium-rich foods.”
C) “Avoid direct sunlight while on this medication.”
D) “Expect your urine to turn a bluish-green color.”

Q74. A patient has been NPO for surgery and has an order for IV fluids at 125 mL/hr. The IV bag has 1000 mL remaining. At what time should the nurse hang a new bag if it is currently 0800?
A) 1200
B) 1400
C) 1600
D) 1800

Q75. A patient with HIV is admitted with Pneumocystis jirovecii pneumonia (PCP). The nurse would expect to administer which type of medication?
A) Broad-spectrum antibiotics.
B) Antiretroviral therapy (ART) and trimethoprim-sulfamethoxazole (TMP-SMX).
C) Antifungal agents.
D) Corticosteroids alone.

Q76. A patient is experiencing a tonic-clonic seizure. After the seizure activity stops, what is the nurse’s priority action?
A) Reorient the patient to time, place, and person.
B) Assess the patient’s airway and breathing.
C) Document the duration and type of seizure.
D) Administer the patient’s prescribed PRN antiseizure medication.

Q77. A patient is admitted with a possible bowel obstruction. The healthcare provider orders an NG tube to be placed. Which position is best for the nurse to place the patient in during the insertion?
A) Supine with a small pillow under the head.
B) Left lateral (Sims’) position.
C) High Fowler’s position with the neck flexed forward.
D) Trendelenburg position.

Q78. A patient with type 2 diabetes is prescribed metformin. The nurse should teach the patient to report which potential adverse effect?
A) Unexplained weight gain.
B) Hypoglycemia.
C) Muscle cramps.
D) Severe, persistent diarrhea.

Q79. A patient is diagnosed with bacterial pneumonia. Which assessment finding would the nurse expect?
A) Non-productive cough and clear breath sounds.
B) Production of rust-colored sputum and crackles over the affected area.
C) Stridor and wheezing on expiration.
D) Sudden onset of sharp chest pain that worsens with inspiration.

Q80. A patient is receiving a heparin infusion. The aPTT result is 120 seconds (therapeutic range is 60-85 seconds). The nurse should anticipate an order to:
A) Increase the heparin infusion rate.
B) Decrease the heparin infusion rate.
C) Administer protamine sulfate.
D) Continue the infusion at the same rate.

Q81. A patient has a serum calcium level of 6.0 mg/dL. Which assessment finding is most consistent with this level?
A) Positive Trousseau’s sign.
B) Diminished deep tendon reflexes.
C) Lethargy and confusion.
D) Nausea and vomiting.

Q82. A patient is admitted with a small bowel obstruction. Which of the following findings is the highest priority and requires immediate notification of the healthcare provider?
A) The patient reports crampy, intermittent abdominal pain.
B) The NG tube drains 800 mL of greenish fluid in 8 hours.
C) The patient’s abdomen is distended and tympanic to percussion.
D) The patient’s abdominal pain becomes constant and severe.

Q83. A patient is prescribed IV amphotericin B for a systemic fungal infection. Which nursing intervention is most important during the infusion?
A) Monitor the patient’s blood glucose levels hourly.
B) Pre-medicate with acetaminophen and diphenhydramine as ordered.
C) Administer the medication as a rapid IV push.
D) Restrict oral fluids during the infusion.

Q84. A patient has a chest tube in place for a pneumothorax. The nurse notes intermittent bubbling in the water seal chamber. This indicates:
A) An air leak in the system.
B) That the lung is re-expanding.
C) The system is functioning normally.
D) The suction pressure is too high.

Q85. A patient is one day post-operative from a thyroidectomy. The nurse is most concerned if which of the following is observed?
A) The patient complains of a sore throat.
B) The patient’s voice is hoarse when speaking.
C) The patient has stridor and is pulling at their trachea.
D) The patient’s calcium level is 9.0 mg/dL.

Q86. A patient with end-stage liver disease is at risk for bleeding due to impaired clotting factor synthesis. Which laboratory value is most important to monitor?
A) Prothrombin time (PT).
B) Serum albumin.
C) Ammonia level.
D) Serum bilirubin.

Q87. A patient is admitted with a hypertensive emergency. An IV infusion of sodium nitroprusside (Nipride) is started. Which nursing action is most important during the infusion?
A) Monitor the patient for tinnitus and hearing loss.
B) Assess for reflex tachycardia.
C) Protect the IV bag from light by wrapping it in an opaque cover.
D) Monitor the patient’s blood glucose levels closely.

Q88. A patient with a new colostomy asks the nurse when they will be able to start eating normally again. The nurse’s best response is based on the understanding that bowel sounds typically return:
A) Within 24-48 hours.
B) Within 72-96 hours.
C) Immediately after surgery.
D) After the first passage of flatus.

Q89. A patient is diagnosed with pyelonephritis. Which assessment finding is most characteristic of this condition?
A) Dysuria and urinary frequency.
B) Flank pain and high fever with chills.
C) Suprapubic tenderness and hematuria.
D) Urinary retention and overflow incontinence.

Q90. A patient with a history of heart failure is admitted with shortness of breath. The nurse auscultates the lungs and hears crackles that do not clear with coughing. This finding is most indicative of:
A) Atelectasis.
B) Pneumonia.
C) Pulmonary edema.
D) Pleural effusion.

Q91. A patient is prescribed a low-molecular-weight heparin (LMWH) such as enoxaparin for DVT prophylaxis. The nurse understands that this medication:
A) Requires daily monitoring of aPTT levels.
B) Has a more predictable anticoagulant response than unfractionated heparin.
C) Is contraindicated in patients with a history of heparin-induced thrombocytopenia (HIT).
D) Should be administered intramuscularly for best absorption.

Q92. A patient has been on bed rest for several days and attempts to get up for the first time. The patient becomes pale and dizzy. The nurse’s priority action is to:
A) Check the patient’s blood pressure.
B) Have the patient sit back down or lie down.
C) Get the patient a glass of orange juice.
D) Call for help immediately.

Q93. A patient with chronic kidney disease is prescribed calcium acetate (PhosLo). The nurse explains that the purpose of this medication is to:
A) Increase the patient’s serum calcium level.
B) Bind with phosphate in the gut and eliminate it.
C) Provide a calcium supplement for bone health.
D) Prevent muscle cramps associated with dialysis.

Q94. A patient is admitted with a head injury. The nurse performs a Glasgow Coma Scale (GCS) assessment and scores the patient a 9. How should the nurse interpret this score?
A) The patient is alert and oriented.
B) The patient has moderate brain injury.
C) The patient is in a deep coma.
D) The patient is brain dead.

Q95. A patient is receiving total parenteral nutrition (TPN) via a central line. The TPN bag is empty, and the new bag is not yet available from the pharmacy. What is the nurse’s priority action?
A) Hang a bag of 10% dextrose until the new TPN is available.
B) Slow the infusion rate of the current TPN to make it last longer.
C) Flush the line with saline and cap it until the new TPN arrives.
D) Discontinue the central line per protocol.

Q96. A patient with schizophrenia is heard talking to themselves and appears to be responding to internal stimuli. This behavior is best described as:
A) A delusion.
B) A hallucination.
C) An illusion.
D) Flight of ideas.

Q97. A patient is prescribed lithium for bipolar disorder. The nurse should teach the patient that which of the following can increase the risk of lithium toxicity?
A) Increased intake of dietary sodium.
B) Dehydration or sodium depletion.
C) Drinking caffeinated beverages.
D) Taking the medication with food.

Q98. A patient with depression is started on a selective serotonin reuptake inhibitor (SSRI). The nurse should instruct the patient that therapeutic effects may not be fully realized for:
A) Immediately, with the first dose.
B) Within 24-48 hours.
C) In 2-4 weeks.
D) After 3 months of therapy.

Q99. A patient who has been taking an SSRI for depression reports sudden onset of agitation, confusion, muscle rigidity, and a fever. What should the nurse suspect?
A) A severe allergic reaction.
B) Serotonin syndrome.
C) Neuroleptic malignant syndrome (NMS).
D) A panic attack.

Q100. A patient with Alzheimer’s disease is becoming increasingly agitated and is attempting to get out of bed unsafely. Which intervention should the nurse try first?
A) Apply soft wrist restraints to prevent the patient from falling.
B) Administer a prescribed PRN sedative medication.
C) Try to redirect the patient to a calming activity or familiar object.
D) Place the bed in the lowest position with all side rails up.

Q101. A patient with a history of heart failure is admitted with pulmonary edema. Which assessment finding requires the most immediate action by the nurse?
A) The patient has 3+ pitting edema in both lower extremities.
B) The patient is sitting upright, unable to speak in full sentences due to shortness of breath.
C) The patient’s heart rate is 102 beats per minute.
D) The patient’s oxygen saturation is 88% on room air.

Q102. A patient is receiving a continuous enteral tube feeding. Which nursing intervention is most important to prevent aspiration?
A) Flush the tube with 30 mL of water every 4 hours.
B) Check the gastric residual volume every 4-6 hours.
C) Elevate the head of the bed to 30-45 degrees at all times.
D) Change the feeding tube administration set every 24 hours.

Q103. A patient with a urinary tract infection is prescribed phenazopyridine (Pyridium) for symptom relief. What information should the nurse include in the patient teaching?
A) “This medication will cure the infection within 3 days.”
B) “You may experience a temporary, harmless orange discoloration of your urine.”
C) “Take this medication on an empty stomach for best absorption.”
D) “This medication may cause you to retain fluid and gain weight.”

Q104. A patient is diagnosed with iron deficiency anemia and is prescribed oral ferrous sulfate. Which statement by the patient indicates a correct understanding of the medication teaching?
A) “I should take this medication with a glass of milk to prevent stomach upset.”
B) “I will take this medication with orange juice to help with absorption.”
C) “My stools may become black and tarry, and I should report this immediately.”
D) “I can stop taking the medication once my energy levels return to normal.”

Q105. A patient is receiving a heparin infusion for a pulmonary embolism. The nurse notes the patient’s platelet count has dropped from 250,000 to 110,000 over two days. What is the nurse’s priority action?
A) Continue to monitor the platelet count as this is an expected finding.
B) Prepare to administer protamine sulfate as an antidote.
C) Stop the heparin infusion and notify the healthcare provider immediately.
D) Increase the heparin infusion rate to prevent further clot formation.

Q106. A patient with cirrhosis and ascites has a serum sodium level of 128 mEq/L. Which assessment finding is most concerning and requires immediate intervention?
A) The patient reports a weight gain of 1 kg over the past week.
B) The patient has 2+ pitting edema in the lower extremities.
C) The patient is confused and has difficulty following commands.
D) The patient’s abdominal girth has increased by 2 cm since yesterday.

Q107. A patient is admitted with a suspected stroke. The nurse performs a neurological assessment and notes the patient has difficulty forming words, although their comprehension appears intact. How should the nurse document this finding?
A) Receptive aphasia.
B) Global aphasia.
C) Expressive aphasia.
D) Dysarthria.

Q108. A patient with hypertension is started on hydrochlorothiazide. Which laboratory value should the nurse monitor most closely?
A) Serum potassium.
B) Serum calcium.
C) Serum sodium.
D) Serum magnesium.