RN Capstone All Exams

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Sample questions from RN Capstone All Exams

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

1. 1.A 68-year-old client arrives in the emergency department with sudden right-sided weakness and slurred speech that began 45 minutes ago. Blood pressure is 178/96 mm Hg, glucose is 112 mg/dL, and oxygen saturation is 96% on room air. Which action should the nurse take first?

   • A.Activate the facility's stroke response and prepare the client for an immediate noncontrast head CT
   • B.Administer aspirin and reassess the client's speech in 30 minutes
   • C.Lower the blood pressure to below 140/90 mm Hg with an IV antihypertensive
   • D.Offer oral fluids to assess the client's ability to swallow

   Rationale: The client has acute stroke symptoms within a potential reperfusion-treatment window, so rapid stroke activation and noncontrast CT are priorities to distinguish ischemic from hemorrhagic stroke. Aspirin is delayed until hemorrhage is excluded. Rapid blood pressure reduction is not routinely indicated at this level and may reduce cerebral perfusion. Oral fluids are unsafe until swallowing has been assessed.

2. 2.A 74-year-old client with heart failure is admitted to a medical unit with increasing dyspnea. The client is restless, has crackles bilaterally, oxygen saturation of 84% on room air, and a respiratory rate of 32/min. Which action should the nurse take first?

   • A.Place the client in high-Fowler position and apply prescribed oxygen
   • B.Obtain a daily weight before providing treatment
   • C.Administer the scheduled oral furosemide
   • D.Teach the client to limit sodium in the diet

   Rationale: Positioning upright and supporting oxygenation address the immediate threat of impaired gas exchange. A daily weight is useful for fluid monitoring but does not treat acute hypoxemia. Oral furosemide may be part of treatment, but the client needs immediate respiratory support and may require a different route. Sodium teaching is important later, not during respiratory distress.

3. 3.A 59-year-old client is 2 hours post-op after a thyroidectomy. The client reports tingling around the mouth and has hand spasms; vital signs are stable. Which action should the nurse take first?

   • A.Assess for stridor and ensure emergency airway equipment is available
   • B.Encourage the client to ambulate to reduce postoperative complications
   • C.Give the prescribed oral calcium with the next meal
   • D.Reassure the client that tingling is an expected effect of anesthesia

   Rationale: Perioral tingling and spasms suggest hypocalcemia from parathyroid injury, which can progress to laryngospasm and airway obstruction. Airway assessment and readiness for emergency intervention take priority. Ambulation does not address the acute risk. Oral calcium may be inadequate if symptoms are progressing, and dismissing the symptoms as anesthesia effects delays care.

4. 4.A 23-year-old client with type 1 diabetes is admitted with vomiting and abdominal pain. The client is drowsy, has deep rapid respirations, glucose 548 mg/dL, potassium 5.6 mEq/L, and pH 7.18. Which order should the nurse implement first?

   • A.Begin the prescribed isotonic IV fluid bolus
   • B.Administer IV regular insulin before starting fluids
   • C.Give sodium bicarbonate to normalize the pH
   • D.Administer IV potassium replacement

   Answer and rationale are in the full material.

5. 5.A 66-year-old client with chronic kidney disease has a potassium level of 6.8 mEq/L and peaked T waves on the ECG. The client is alert and denies chest pain. Which medication should the nurse anticipate administering first?

   • A.IV calcium gluconate
   • B.Oral potassium chloride
   • C.IV furosemide as the only treatment
   • D.Sodium polystyrene sulfonate by mouth

   Answer and rationale are in the full material.