PN Program

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Sample questions from PN Program

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

1. 1.A 68-year-old client on a medical-surgical unit is 6 hours post-op after abdominal surgery. The client is restless, has a respiratory rate of 30/min, oxygen saturation of 88% on room air, and diminished breath sounds at the bases. Which action should the nurse take first?

   • A.Apply oxygen and raise the head of the bed
   • B.Administer the prescribed opioid for incisional pain
   • C.Encourage oral fluids
   • D.Document the findings and reassess in 1 hour

   Rationale: The low oxygen saturation, tachypnea, and diminished breath sounds indicate impaired oxygenation, so positioning and supplemental oxygen are the priority. An opioid may worsen respiratory depression, fluids do not address the immediate problem, and waiting to reassess delays treatment. The exam takeaway is to address airway and breathing before comfort or routine documentation.

2. 2.A 74-year-old client with heart failure is admitted to a medical unit. The client has new crackles, dyspnea at rest, oxygen saturation of 89% on 2 L/min, and a blood pressure of 168/92 mm Hg. Which prescription should the nurse implement first?

   • A.Administer the prescribed IV furosemide
   • B.Obtain a daily weight
   • C.Restrict sodium in the meal plan
   • D.Teach the client to track fluid intake

   Rationale: The client has signs of acute fluid overload and impaired oxygenation, making the prescribed IV diuretic the most urgent intervention among these options. Daily weights and teaching are useful for ongoing management but will not promptly relieve the current congestion. Sodium restriction supports long-term control but is not the immediate priority. Reassess respiratory status and response after treatment.

3. 3.A 52-year-old client in the emergency department reports sudden chest pressure radiating to the jaw. The client is diaphoretic and nauseated, with a heart rate of 112/min and blood pressure of 92/58 mm Hg. Which action should the nurse take first?

   • A.Obtain a 12-lead ECG and activate the acute chest-pain protocol
   • B.Give the client a prescribed sublingual nitroglycerin dose
   • C.Ask the client to walk to the examination room
   • D.Offer an antacid and reassess the pain

   Rationale: A 12-lead ECG and activation of the chest-pain protocol support rapid identification and treatment of possible acute coronary syndrome. Nitroglycerin can further lower this client's already low blood pressure, and walking increases cardiac workload. An antacid could delay evaluation of a life-threatening cause. Rapid assessment and escalation are the key takeaways.

4. 4.A 23-year-old client with type 1 diabetes is in the emergency department with vomiting and abdominal pain. The client is drowsy, has deep rapid respirations, glucose of 520 mg/dL, potassium of 5.4 mEq/L, and bicarbonate of 12 mEq/L. Which intervention should the nurse anticipate first?

   • A.Begin prescribed isotonic IV fluid replacement
   • B.Administer IV potassium chloride
   • C.Give subcutaneous long-acting insulin only
   • D.Restrict fluids until the glucose decreases

   Answer and rationale are in the full material.

5. 5.A 79-year-old client on a rehabilitation unit suddenly develops facial drooping and right arm weakness. The symptoms began 25 minutes ago; blood pressure is 176/94 mm Hg and oxygen saturation is 96% on room air. What should the nurse do first?

   • A.Activate the facility stroke response and determine the last-known-well time
   • B.Give the client water to assess swallowing
   • C.Administer the client's scheduled aspirin
   • D.Place the client in a chair and reassess strength

   Answer and rationale are in the full material.