Question set A: ten items, mixed
a two-column answer grid at the foot of the page with an item number, a confidence tick box, and a hand-writable answer field per row.
Set rules. Twelve minutes for ten items. No looking back at earlier items once you have moved on. Write something in every answer box even when you are unsure, because a blank cell scores zero and a considered guess does not.
Item type mix: 3 MC · 2 SATA · 1 ORD · 1 FIB · 2 MATRIX · 1 DDT
1. A charge nurse is distributing tasks on a medical-surgical unit. Which task is appropriate to assign to the unlicensed assistive personnel?
- Ambulating a client for the first time after a total knee arthroplasty
- Measuring and recording the intake and output of a client receiving intravenous fluids
- Reinforcing discharge teaching about a newly prescribed anticoagulant
- Assessing a surgical incision that the client reports has begun draining
Answer: ______
2. A client is admitted with profuse watery diarrhea and a stool specimen positive for Clostridioides difficile. Which actions should the nurse take? Select all that apply.
- Place the client on contact precautions in a private room.
- Wash hands with soap and water after removing gloves.
- Use an alcohol-based hand rub as the primary hand hygiene method after client contact.
- Wear a gown and gloves for every entry into the room.
- Clean the room and shared equipment with a registered sporicidal disinfectant.
- Place the client in a negative-pressure airborne infection isolation room.
Answer: ______
3. A 52-year-old client with no chronic conditions asks the nurse at a wellness visit which vaccines are recommended today. The client received a tetanus, diphtheria, and pertussis booster 4 years ago and an influenza vaccine last fall. Which response by the nurse is correct?
- "You are due for the recombinant zoster vaccine, given as two doses two to six months apart."
- "Zoster vaccination is not recommended until you turn 60."
- "You need another tetanus booster this year."
- "No vaccines are recommended for you until age 65."
Answer: ______
4. A client who has just been told she has metastatic breast cancer sits silently for a moment and then says, "I don't even know what to think right now." Which response by the nurse is most therapeutic?
- "Try not to worry. The treatments available today are very good."
- "This is a lot to take in. What is going through your mind?"
- "Would you like me to call the chaplain for you?"
- "Most people in your situation feel angry at first."
Answer: ______
5. A client has moderate dysphagia following a stroke and is cleared for a modified diet. For each nursing action, select whether it is indicated or contraindicated.
| Action | INDICATED | CONTRAINDICATED |
|---|---|---|
| Position the client fully upright at 90 degrees for all meals | ☐ | ☐ |
| Offer thin liquids through a straw to speed intake | ☐ | ☐ |
| Coach the client to tuck the chin toward the chest when swallowing | ☐ | ☐ |
| Provide oral care before and after every meal | ☐ | ☐ |
| Encourage conversation during the meal to keep the client alert | ☐ | ☐ |
| Keep the client upright for 30 to 60 minutes after eating | ☐ | ☐ |
Answer: ______
6. A prescription reads levothyroxine 0.075 mg by mouth daily. The pharmacy supplies scored levothyroxine 50 microgram tablets. How many tablets should the nurse administer per dose?
Answer: ______ tablets
7. A client has a serum potassium of 2.9 mEq/L and a new prescription for intravenous potassium chloride. Which actions are appropriate? Select all that apply.
- Use a commercially prepared premixed potassium solution rather than adding potassium to an infusing bag.
- Administer the dose by intravenous push over 2 minutes.
- Confirm adequate urine output before beginning the infusion.
- Infuse through an infusion pump and assess the site for pain, swelling, and patency.
- Apply continuous cardiac monitoring when the prescribed rate exceeds 10 mEq per hour.
- Withhold the client's potassium-rich foods for 24 hours after the infusion.
Answer: ______
8. A nurse is preparing to give an intermittent feeding through an established nasogastric tube. Place the actions in the order they should be performed.
- Test the pH of the aspirate.
- Perform hand hygiene and put on gloves.
- Flush the tube with water and begin the feeding.
- Compare the external tube length and exit-site mark with the measurement documented at insertion.
- Aspirate gastric contents and note the color and consistency.
Answer: ______
9. Read the nurses' note and complete the sentence by choosing one option from each list.
> 1030. Client with type 1 diabetes received insulin lispro at 0800 and did not eat breakfast. Now diaphoretic, tremulous, and irritable. Skin cool and moist. Heart rate 108. Respirations 20 and unlabored. Point-of-care glucose 48 mg/dL.
"The client is most likely experiencing [1] as evidenced by [2]."
List 1: hypoglycemia · hyperglycemia · diabetic ketoacidosis · hyperosmolar hyperglycemic state List 2: cool moist skin with tremor and a glucose of 48 mg/dL · deep rapid respirations with a fruity breath odor · polyuria with dry mucous membranes · a serum glucose above 600 mg/dL
Answer: [1] ______ [2] ______
10. A client is on the second day of treatment for community-acquired pneumonia. For each finding, select whether the nurse should report it to the provider now or document it and continue monitoring.
| Finding | REPORT NOW | DOCUMENT AND MONITOR |
|---|---|---|
| Oral temperature 100.2°F, down from 101.8°F yesterday | ☐ | ☐ |
| Respiratory rate 30 with accessory muscle use | ☐ | ☐ |
| Oxygen saturation 87% on 2 liters per minute by nasal cannula | ☐ | ☐ |
| Productive cough with thick yellow sputum | ☐ | ☐ |
| Systolic blood pressure fallen from 118 to 86 over 4 hours | ☐ | ☐ |
Answer: ______
Margin note: "answer every cell, even the ugly ones."
> Confidence, not correctness: ☐1 ☐2 ☐3 ☐4 ☐5 ☐6 ☐7 ☐8 ☐9 ☐10 > → P76 for the scorecard.
Delegation and assignment decisions are governed by the Nurse Practice Act of the state in which you are licensed, which varies. Answer to the national standard on the exam.
Takeaway. A set built to test-plan proportions tells you where you are weak. A set built from your favorite topics tells you nothing.