Nursing School Last Final Exams

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Sample questions from Nursing School Last Final Exams

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift, the charge nurse receives reports on four clients. Which client should the nurse assess first?

   • A.A client with heart failure who has bilateral ankle edema and requests help repositioning
   • B.A client 1 day after hip replacement who reports pain of 7 on a 0-to-10 scale
   • C.A client with diabetes whose blood glucose is 68 mg/dL and who is awake and asking for juice
   • D.A client 2 hours after thyroidectomy who is restless and has inspiratory stridor

   Rationale: Inspiratory stridor after thyroidectomy suggests airway obstruction from laryngeal edema or a hematoma and requires immediate assessment and intervention. The client with hypoglycemia needs prompt treatment, but is awake and able to take oral carbohydrates. Edema and postoperative pain require care but are not as immediately life-threatening as a threatened airway. Use airway, breathing, circulation and acute change to guide prioritization.

2. 2.On a medical-surgical unit, which task is appropriate for the registered nurse to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Evaluate whether a client newly prescribed oxygen has improved after treatment
   • B.Obtain routine vital signs for a stable client awaiting discharge
   • C.Assess a client who reports new-onset chest pressure
   • D.Teach a client how to use a newly prescribed walker

   Rationale: Obtaining routine vital signs for a stable client is a predictable task that can be delegated to a trained UAP, with the RN responsible for reviewing and acting on the results. Evaluating a response to oxygen, teaching walker use, and assessing new chest pressure require nursing judgment and remain the RN's responsibility. Delegation depends on the client's stability, the task's predictability, and the delegatee's competence. The RN retains accountability for appropriate supervision and follow-up.

3. 3.Refer to the client's chart. Which actions should the nurse take now? Select all that apply.

   • A.Establish or maintain IV access and prepare to obtain ordered cultures and laboratory studies
   • B.Activate the rapid response system for the client's acute respiratory and mental-status changes
   • C.Administer the prescribed oxygen and titrate it according to the order or protocol
   • D.Wait for the next scheduled vital-sign assessment before notifying the provider
   • E.Reassess and document the client's response after interventions
   • F.Give an antipyretic as the only immediate intervention

   Rationale: The chart shows acute deterioration: the client is newly confused, has a respiratory rate of 30/min, and has an SpO2 of 89% on room air, so activating rapid response and providing ordered oxygen are appropriate. IV access and preparation for cultures and laboratory studies support timely evaluation and treatment of suspected infection, while reassessment documents whether the interventions are effective. Waiting for routine vital signs delays care, and an antipyretic alone does not address hypoxemia or possible sepsis. Escalate care based on the client's changing condition rather than waiting for a definitive diagnosis.

4. 4.In the emergency department, a 16-year-old client scheduled for an urgent procedure says, "I do not understand what the surgeon is going to do." The consent form is unsigned. What should the nurse do?

   • A.Ask the parent to sign the form immediately because the procedure is urgent
   • B.Explain the procedure and obtain the client's signature
   • C.Notify the surgeon that the client needs further explanation before consent is obtained
   • D.Witness the parent's signature and document that the client appeared calm

   Answer and rationale are in the full material.

5. 5.A home health nurse finds that an older adult has missed several medication doses because the client cannot read the printed labels. Which action is most appropriate?

   • A.Notify the prescriber and pharmacist and collaborate on a safe, understandable medication plan
   • B.Ask a neighbor to organize and administer all of the client's medications
   • C.Tell the client to take the missed doses as soon as the nurse leaves
   • D.Document the missed doses and continue the current plan without changes

   Answer and rationale are in the full material.