#separator:tab
#html:true
#columns:Front	Back	Tags
Verification of NG tube after initial placement is performed by which of the following methods?<br><br>A. X-ray<br>B. Testing of aspirate pH<br>C. Administering air into the tube (&quot;Whoosh test&quot;)<br>D. Measuring tube length	<b>A. X-ray</b><br><br>Radiographic confirmation is the gold‑standard method for verifying nasogastric tube placement after initial insertion because it directly visualizes the tube tip in the stomach and prevents pulmonary misplacement.<br><i>Question adapted from Open RN, Nursing Advanced Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingadvancedskills/chapter/5-7-learning-activities/); rationale written by Plainwork.</i>	Advanced_Skills
The nurse is providing care for a patient who has an order to include &quot;TKO&quot; fluid infusion. The nurse understands that TKO fluids should be infusing at the following rate:<br><br>A. 5 mL/hr<br>B. 10-20 mL/hr<br>C. 50 mL/hr<br>D. 100 mL/hr	<b>B. 10-20 mL/hr</b><br><br>TKO (to keep open) fluids are administered at a low rate, typically 10–20 mL per hour, sufficient to maintain catheter patency without fluid overload.<br><i>Question adapted from Open RN, Nursing Advanced Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingadvancedskills/chapter/1-8-learning-activities/); rationale written by Plainwork.</i>	Advanced_Skills
The nurse is caring for a patient with a central venous access catheter. The nurse is repositioning the patient in bed when the CVAD extension tubing becomes tangled under the patient. As the patient is being turned, the tubing pulls the central venous catheter from the patient. What is the most appropriate first action?<br><br>A. Cover the insertion site and apply direct manual pressure<br>B. Call a Code Blue<br>C. Have the patient &quot;bear down&quot;<br>D. Attempt to reinsert the line	<b>A. Cover the insertion site and apply direct manual pressure</b><br><br>When a central line is inadvertently pulled out, the first priority is to control bleeding and protect the site; covering the insertion site and applying direct manual pressure prevents hemorrhage and infection before further interventions.<br><i>Question adapted from Open RN, Nursing Advanced Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingadvancedskills/chapter/4-8-learning-activities/); rationale written by Plainwork.</i>	Advanced_Skills
A nurse is caring for a patient with an infusing IV who is receiving 2 grams of Rocephin (Ancef) into their 20 gauge right forearm PIV. The nurse notes that the IV site is swelling, reddened, and fluid is leaking at the infusion site. The nurse takes which of the following actions to appropriate address the complication?<br><br>A. Slow the infusion and elevate the extremity<br>B. Attempt to reposition the cannula and re-tape the infusion site to stabilize the device<br>C. Stop the infusion and remove the cannula<br>D. Increase the infusion rate to finish the Ancef infusion and then discontinue the site.	<b>C. Stop the infusion and remove the cannula</b><br><br>The swelling, redness, and leaking indicate infiltration. The immediate priority is to stop the medication, disconnect the line, and remove the peripheral catheter to prevent tissue damage and allow assessment.<br><i>Question adapted from Open RN, Nursing Advanced Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingadvancedskills/chapter/1-8-learning-activities/); rationale written by Plainwork.</i>	Advanced_Skills
A nurse receives an order to place an NG tube to decompress a patient&#x27;s stomach due to ileus. The nurse correctly selects which type of tube to assist with stomach decompression?<br><br>A. Levin<br>B. Dobhoff<br>C. Salem Sump<br>D. Any of these tubes are appropriate	<b>C. Salem Sump</b><br><br>The Salem Sump tube has a larger lumen and a distal suction port with side holes, allowing effective gastric decompression and continuous suction, which is required for an ileus.<br><i>Question adapted from Open RN, Nursing Advanced Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingadvancedskills/chapter/5-7-learning-activities/); rationale written by Plainwork.</i>	Advanced_Skills
The amount of suction pressure utilized for oropharyngeal suctioning is aligned to the patient&#x27;s:<br><br>A. Weight<br>B. Height<br>C. Age<br>D. Gender	<b>C. Age</b><br><br>Suction pressure limits are determined by the patient&#x27;s age to prevent mucosal damage and hypoxemia. Standard pressures range from 60-80 mmHg for neonates up to 100-150 mmHg for adults, making age the deciding factor.<br><i>Question adapted from Open RN, Nursing Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingskills/chapter/22-8-learning-activities/); rationale written by Plainwork.</i>	Clinical_Skills
The Glascow Coma scale measures patients according to what three categories of response:<br><br>A. Motor, Sensory, and Verbal<br>B. Motor, Cognition, and Verbal<br>C. Motor, Eye Opening, and Verbal<br>D. Eye Opening, Verbal, and Auditory	<b>C. Motor, Eye Opening, and Verbal</b><br><br>The Glasgow Coma Scale (GCS) is a standardized tool used to assess a patient&#x27;s level of consciousness by evaluating three specific categories of response: eye opening, verbal response, and motor response.<br><i>Question adapted from Open RN, Nursing Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingskills/chapter/6-13-learning-activities/); rationale written by Plainwork.</i>	Clinical_Skills
A nurse is performing an abdominal assessment and places his/her hand on the patient&#x27;s abdomen over an area with moderate pressure. The nurse then abruptly withdraws his/her hand. This assessment technique is indicated when assessing for:<br><br>A. abdominal rigidity<br>B. guarding<br>C. borborygmus<br>D. rebound tenderness	<b>D. rebound tenderness</b><br><br>Rebound tenderness is elicited by applying gentle pressure then quickly releasing; pain on release indicates peritoneal irritation, such as appendicitis. The described abrupt hand withdrawal after moderate pressure is classic for this sign.<br><i>Question adapted from Open RN, Nursing Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingskills/chapter/12-7-learning-activities/); rationale written by Plainwork.</i>	Clinical_Skills
&quot;Are you having any issues with seeing, hearing, smelling, tasting, or feeling things?&quot; would fall into what category of functional health assessment?<br><br>A. Self-Perception and Self-Concept<br>B. Health Perception - Health Management<br>C. Cognitive and Perceptual<br>D. Roles and Relationships	<b>C. Cognitive and Perceptual</b><br><br>Gordon&#x27;s Functional Health Patterns classify sensory functions—such as vision, hearing, taste, touch, and smell—along with cognitive abilities and pain perception, under the Cognitive and Perceptual pattern. This question directly assesses these sensory capabilities.<br><i>Question adapted from Open RN, Nursing Skills, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingskills/chapter/2-12-learning-activities/); rationale written by Plainwork.</i>	Clinical_Skills
A nurse is preparing to administer 1 g of cefazolin in 150 mL of normal saline over 45 minutes to a preoperative patient. At what rate in mL/h should the nurse program the infusion pump?<br><br>A. 200 mL/h<br>B. 113 mL/h<br>C. 150 mL/h<br>D. 300 mL/h	<b>A. 200 mL/h</b><br><br>The infusion volume is 150 mL to be given over 45 minutes (0.75 hour). Dividing 150 mL by 0.75 hour yields 200 mL per hour, which is the pump setting accurately.<br><i>Question and rationale by Plainwork. Reference: Calculate with Confidence, 8th Edition</i>	Dosage_Calculations
A pediatric patient weighing 22 lb is prescribed amoxicillin 45 mg/kg/day divided into two equal doses. The oral suspension is available as 250 mg/5 mL. How many milliliters should the nurse administer per dose?<br><br>A. 4.5 mL<br>B. 5.0 mL<br>C. 9.0 mL<br>D. 2.3 mL	<b>A. 4.5 mL</b><br><br>The child weighs 22 lb (≈10 kg). At 45 mg/kg/day the total daily dose is 450 mg, split into two doses of 225 mg. The suspension contains 50 mg/mL, so 225 mg ÷ 50 mg/mL = 4.5 mL.<br><i>Question and rationale by Plainwork. Reference: Silvestri, Saunders Comprehensive Review for the NCLEX-RN Examination, 9th Edition</i>	Dosage_Calculations
A client with deep vein thrombosis is receiving a heparin infusion. The bag contains 25,000 units in 250 mL of 0.9% sodium chloride. The infusion pump is set to 14 mL/h. How many units per hour is the client receiving?<br><br>A. 1,200 units/h<br>B. 1,000 units/h<br>C. 1,400 units/h<br>D. 850 units/h	<b>C. 1,400 units/h</b><br><br>The bag’s concentration is 25,000 units ÷ 250 mL = 100 units/mL. The pump delivers 14 mL each hour, so 14 mL × 100 units/mL = 1,400 units per hour, matching option C.<br><i>Question and rationale by Plainwork. Reference: Morris, D. G. (2021). Calculate with Confidence (8th ed.). Elsevier.</i>	Dosage_Calculations
A client with diabetes is shaky, sweaty, and confused. Blood glucose is 52 mg/dL, and the client can swallow. What should the nurse do first?<br><br>A. Give 15 g of fast-acting carbohydrate<br>B. Give regular insulin<br>C. Recheck the glucose in one hour<br>D. Serve a full meal	<b>A. Give 15 g of fast-acting carbohydrate</b><br><br>A blood glucose level below 70 mg/dL indicates hypoglycemia. Because the client is conscious and able to swallow safely, the immediate priority is raising blood glucose using the Rule of 15 by administering 15 grams of fast-acting carbohydrates.<br><i>Question and rationale by Plainwork. Reference: American Diabetes Association, Standards of Care in Diabetes, Section 6</i>	Endocrine
What is the ideal position for a patient when completing a bladder scan?<br><br>A. High fowlers<br>B. Semi-fowlers<br>C. Supine<br>D. Prone	<b>C. Supine</b><br><br>The bladder scan requires the patient to lie flat on their back so the scanner can obtain an unobstructed view of the full bladder without abdominal compression, ensuring accurate volume measurement.<br><i>Question adapted from Open RN, Nursing Fundamentals, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingfundamentals/chapter/16-11-learning-activities/); rationale written by Plainwork.</i>	Fundamentals
The mission of which of the following organizations is to &quot;improve health care for the public by inspiring organizations to excel in providing safe, effective, and high quality health care&quot;.<br><br>A. Centers for Medicare and Medicaid (CMS)<br>B. National Institute of Health (NIH)<br>C. Centers for Disease Control (CDC)<br>D. Joint Commission	<b>D. Joint Commission</b><br><br>The Joint Commission’s mission is to improve health care for the public by inspiring organizations to excel in providing safe, effective, high‑quality care, matching the wording in the stem.<br><i>Question adapted from Open RN, Nursing Fundamentals, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingfundamentals/chapter/1-9-learning-activities/); rationale written by Plainwork.</i>	Fundamentals
Mrs. Johnson is an 84-year-old woman whose husband just passed away from complications of congestive heart failure. She is brought to the clinic by her daughter because of increasing fatigue, malaise, weakness, and loss of appetite. You begin to take her vital signs and she starts weeping saying she misses her husband. Which of the following responses is the best therapeutic response?<br><br>A. Tell me what your relationship with your husband was like.<br>B. Your husband would not want you to be sad.<br>C. At least you had many years together.<br>D. I know how you feel. I recently lost my good friend.	<b>A. Tell me what your relationship with your husband was like.</b><br><br>Asking about her relationship invites her to explore feelings, validates grief, and uses therapeutic communication techniques such as open‑ended questioning, which promotes emotional processing and rapport.<br><i>Question adapted from Open RN, Nursing Fundamentals, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingfundamentals/chapter/17-8-learning-activities/); rationale written by Plainwork.</i>	Fundamentals
This vitamin helps prevent fetal neural tube defects in utero.<br><br>A. B9 (Folic Acid)<br>B. B3 (Niacin)<br>C. B6 (Pyridoxine)<br>D. B2 (Riboflavin)	<b>A. B9 (Folic Acid)</b><br><br>Folic acid (vitamin B9) is essential for DNA synthesis and cell division, and adequate maternal intake before conception and during early pregnancy reduces the risk of neural tube defects such as spina bifida.<br><i>Question adapted from Open RN, Nursing Fundamentals, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingfundamentals/chapter/14-5-learning-activities/); rationale written by Plainwork.</i>	Fundamentals
According to the 2026 Brazilian perioperative ventilation guideline, which setting best reduces postoperative pulmonary complications?<br><br>A. Tidal volume 10 mL/kg predicted body weight<br>B. Tidal volume 6-8 mL/kg predicted body weight<br>C. FiO2 100% for the entire case<br>D. PEEP 0 cm H2O throughout surgery	<b>B. Tidal volume 6-8 mL/kg predicted body weight</b><br><br>Using a tidal volume of 6–8 mL/kg predicted body weight provides lung‑protective ventilation, limiting volutrauma and atelectasis, which the 2026 Brazilian guideline identifies as the most effective strategy to lower postoperative pulmonary complications.<br><i>Question and rationale by Plainwork. Reference: (practice guideline, CC BY), 2026-08-18</i>	Guidelines
A nurse cares for a patient diagnosed with a peptic ulcer who has no history of NSAID use and tests negative for Helicobacter pylori. Which emerging etiology should the nurse recognize as an increasing cause of this condition?<br><br>A. Non-H. pylori Helicobacter infection<br>B. Chronic psychological stress<br>C. Gastroesophageal reflux disease<br>D. Excessive dietary spicy food intake	<b>A. Non-H. pylori Helicobacter infection</b><br><br>In patients with peptic ulcer disease who are Helicobacter pylori-negative and do not use NSAIDs, non-H. pylori Helicobacter species (such as Helicobacter heilmannii) are increasingly recognized as a significant emerging cause of mucosal ulceration.<br><i>Question and rationale by Plainwork. Reference: (practice guideline, CC BY), 2026-08-24</i>	Guidelines
A nurse is teaching a client who received botulinum toxin type A injections for cervical dystonia. Which symptom should the nurse instruct the client to report immediately?<br><br>A. Localized flu-like symptoms<br>B. Moderate neck stiffness<br>C. Difficulty swallowing or breathing<br>D. Mild soreness at the injection site	<b>C. Difficulty swallowing or breathing</b><br><br>Botulinum toxin can spread beyond the injection site, causing life-threatening systemic effects like dysphagia and dyspnea. These symptoms indicate respiratory compromise or aspiration risk and require immediate emergency evaluation.<br><i>Question and rationale by Plainwork. Reference: (practice guideline, CC BY), 2026-09-02</i>	Guidelines
A female client with severe plaque psoriasis is prescribed oral acitretin. Which instruction is most important for the nurse to include in the teaching plan?<br><br>A. Donate blood monthly to monitor blood counts.<br>B. Take the medication on an empty stomach.<br>C. Expect your skin to be resistant to sunburn.<br>D. Avoid pregnancy during and for 3 years after therapy.	<b>D. Avoid pregnancy during and for 3 years after therapy.</b><br><br>Acitretin is extremely teratogenic with a long half-life. Female clients of childbearing potential must use effective contraception and avoid pregnancy during therapy and for at least three years after discontinuing the medication to prevent severe birth defects.<br><i>Question and rationale by Plainwork. Reference: (practice guideline, CC BY), 2026-08-29</i>	Guidelines
A patient with suspected active pulmonary tuberculosis requires emergency intubation in the emergency department. Which action should the nurse prioritize to ensure safety?<br><br>A. Position a portable fan to blow air toward the door.<br>B. Move the patient to a negative-pressure room.<br>C. Limit personal protective equipment to sterile gloves.<br>D. Wear a standard surgical mask during the procedure.	<b>B. Move the patient to a negative-pressure room.</b><br><br>Active pulmonary tuberculosis requires airborne precautions to prevent transmission. Moving the patient to a negative-pressure room is the priority, especially during aerosol-generating procedures like intubation, to contain infectious particles.<br><i>Question and rationale by Plainwork. Reference: CDC Infection Prevention and Control Guidelines</i>	Health_Alterations
During the emergency insertion of a central venous catheter for a patient in septic shock, the nurse observes the physician&#x27;s sterile glove touch the non-sterile bedside table. Which action should the nurse take first?<br><br>A. Document the breach and monitor the site for infection.<br>B. Assist with completing the insertion to avoid delay.<br>C. Clean the contaminated glove with chlorhexidine wipes.<br>D. Immediately inform the physician and provide a new glove.	<b>D. Immediately inform the physician and provide a new glove.</b><br><br>Maintaining strict asepsis during central venous catheter insertion is critical to prevent bloodstream infections. The nurse must immediately advocate for patient safety by pointing out the sterile breach and providing a replacement sterile glove.<br><i>Question and rationale by Plainwork. Reference: CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections</i>	Health_Alterations
A nurse is caring for a mechanically ventilated patient receiving continuous enteral feedings. Which action should the nurse prioritize to prevent ventilator-associated pneumonia?<br><br>A. Elevate the head of the bed to 30 to 45 degrees<br>B. Perform deep tracheal suctioning every two hours<br>C. Change the ventilator circuit tubing every 24 hours<br>D. Instill sterile saline before endotracheal suctioning	<b>A. Elevate the head of the bed to 30 to 45 degrees</b><br><br>Elevating the head of the bed to 30 to 45 degrees is the priority intervention to prevent aspiration of gastric contents and enteral formula, which significantly reduces the risk of ventilator-associated pneumonia.<br><i>Question and rationale by Plainwork. Reference: Preventing ventilator-associated pneumonia: A position paper of the International Society for Infectious Diseases, 2024 update. Int J Infect Dis 2025</i>	Health_Alterations
A multi-trauma patient in the resuscitation bay requires emergency urinary catheterization. Which action by the nurse best maintains infection control and sterile technique during this urgent procedure?<br><br>A. Obtain a new sterile kit if contamination occurs.<br>B. Cleanse the perineal area using a back-to-front motion.<br>C. Use clean utility gloves to expedite the insertion.<br>D. Pre-test the balloon by inflating it prior to insertion.	<b>A. Obtain a new sterile kit if contamination occurs.</b><br><br>Strict sterile technique is vital to prevent catheter-associated urinary tract infections. If any contamination of the sterile field or equipment occurs, the nurse must immediately discard the contaminated items and obtain a new sterile kit.<br><i>Question and rationale by Plainwork. Reference: CDC Guidelines for Prevention of Catheter-Associated Urinary Tract Infections</i>	Health_Alterations
Which of the following is a risk factor for developing febrile seizures?<br><br>A. High levels of zinc and iron in the blood<br>B. Family history of seizures<br>C. Maternal diet of fruits and vegetables<br>D. Delayed vaccination schedule	<b>B. Family history of seizures</b><br><br>A family history of febrile or unprovoked seizures is a major risk factor for febrile seizures, indicating a strong genetic predisposition. Other risk factors include a high peak temperature, young age, and certain viral infections.<br><i>Question adapted from Open RN, Nursing Health Promotion, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/healthpromo/chapter/16-24-learning-activities/); rationale written by Plainwork.</i>	Health_Promotion
You are working with a patient whose family expects all members to conform to the same religious practices and discourages any deviation. The patient expresses a desire to explore different beliefs but fears rejection from their family. What term best describes the unhealthy aspect of this family dynamic?<br><br>A. Rigid family expectations<br>B. Poor communication patterns<br>C. Lack of privacy and autonomy<br>D. Role inadequacy	<b>A. Rigid family expectations</b><br><br>The family&#x27;s insistence that all members follow identical religious practices creates inflexible, controlling expectations that suppress individual belief exploration, which is defined as rigid family expectations—a maladaptive dynamic limiting autonomy.<br><i>Question adapted from Open RN, Nursing Health Promotion, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/healthpromo/chapter/4-9-learning-activities/); rationale written by Plainwork.</i>	Health_Promotion
A nurse is educating a client newly diagnosed with primary dysmenorrhea about pain management strategies. Which statement by the client indicates a need for further teaching?<br><br>A. &quot;I will take ibuprofen before my period starts to help prevent pain.&quot;<br>B. &quot;A heating pad on my abdomen can help relieve discomfort.&quot;<br>C. &quot;If NSAIDs don’t work, I can try hormonal therapy like birth control pills.&quot;<br>D. &quot;I should avoid exercise during my period because movement worsens the pain.&quot;	<b>D. &quot;I should avoid exercise during my period because movement worsens the pain.&quot;</b><br><br>Regular physical activity and exercise actually help alleviate primary dysmenorrhea by releasing endorphins, improving pelvic blood flow, and reducing stress. Advising a client to avoid movement during their period is incorrect and indicates a need for further teaching.<br><i>Question adapted from Open RN, Nursing Health Promotion, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/healthpromo/chapter/18-22-learning-activities/); rationale written by Plainwork.</i>	Health_Promotion
Which stage of Kolb’s Experiential Learning Cycle involves looking back on a concrete experience and analyzing it in the context of existing knowledge?<br><br>A. Concrete Experience<br>B. Reflective Observation<br>C. Abstract Conceptualization<br>D. Active Experimentation	<b>B. Reflective Observation</b><br><br>Reflective observation requires the learner to consciously step back from a task to review and assess the experience. During this phase, individuals reflect on what occurred and consider how it aligns with their prior understanding.<br><i>Question adapted from Open RN, Nursing Health Promotion, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/healthpromo/chapter/1-9-learning-activities/); rationale written by Plainwork.</i>	Health_Promotion
A client is admitted with active pulmonary tuberculosis. Which precautions should the nurse use?<br><br>A. Droplet precautions and a surgical mask<br>B. Airborne precautions and an N95 respirator<br>C. Contact precautions and a gown<br>D. Standard precautions only	<b>B. Airborne precautions and an N95 respirator</b><br><br>Active pulmonary TB is transmitted via aerosolized droplet nuclei that remain suspended; therefore airborne precautions are required, and the nurse must wear a fit‑tested N95 respirator to filter particles ≤0.3 µm.<br><i>Question and rationale by Plainwork. Reference: CDC, Guideline for Isolation Precautions (2007, updated)</i>	Infection_Control
A client with acute kidney injury has a serum potassium level of 6.8 mEq/L. Which electrocardiogram change should the nurse expect to observe?<br><br>A. Flattened T waves<br>B. Shortened PR interval<br>C. Tall, peaked T waves<br>D. Prominent U waves	<b>C. Tall, peaked T waves</b><br><br>Severe hyperkalemia (K+ 6.8 mEq/L) depolarizes myocardial cells, producing characteristic tall, peaked T waves on the ECG, often the earliest sign before QRS widening or arrhythmias develop.<br><i>Question and rationale by Plainwork. Reference: Silvestri, Saunders Comprehensive Review for the NCLEX-RN Examination, 8th Edition</i>	Lab_Values
A client with acute exacerbation of chronic obstructive pulmonary disease (COPD) is lethargic and has shallow respirations. Which arterial blood gas (ABG) result should the nurse expect?<br><br>A. pH 7.32, PaCO2 38 mmHg, HCO3 18 mEq/L<br>B. pH 7.49, PaCO2 40 mmHg, HCO3 30 mEq/L<br>C. pH 7.48, PaCO2 30 mmHg, HCO3 22 mEq/L<br>D. pH 7.31, PaCO2 52 mmHg, HCO3 24 mEq/L	<b>D. pH 7.31, PaCO2 52 mmHg, HCO3 24 mEq/L</b><br><br>During an acute COPD flare the patient retains CO₂, producing a primary respiratory acidosis; compensation has not yet raised bicarbonate, so the ABG shows low pH, elevated PaCO₂, and near‑normal HCO₃⁻.<br><i>Question and rationale by Plainwork. Reference: Brunner &amp; Suddarth&#x27;s Textbook of Medical-Surgical Nursing, 15th Edition</i>	Lab_Values
A nurse is teaching a client with type 2 diabetes about a scheduled hemoglobin A1c test. Which statement by the client indicates a correct understanding of this laboratory test?<br><br>A. It determines if my kidneys are filtering sugar properly.<br>B. It detects the amount of sugar in my urine over a week.<br>C. It measures my blood sugar levels right at this moment.<br>D. It shows my average blood sugar over the past three months.	<b>D. It shows my average blood sugar over the past three months.</b><br><br>Hemoglobin A1c reflects the percentage of glycated hemoglobin, indicating average plasma glucose over the previous 8–12 weeks, thus providing a three‑month glycemic trend. It is used to assess diabetes control.<br><i>Question and rationale by Plainwork. Reference: American Diabetes Association Standards of Care in Diabetes 2023</i>	Lab_Values
An unlicensed assistive personnel performs vital signs collection on a group of patients and reports the findings to the nurse providing care. Based upon the information provided, which patient should the nurse see first?<br><br>A. RR 16<br>B. O2 sat 90%<br>C. BP 91/53<br>D. HR 87	<b>B. O2 sat 90%</b><br><br>An oxygen saturation of 90% indicates hypoxemia, which can rapidly compromise tissue oxygenation and requires immediate nursing assessment before other abnormal but less urgent findings.<br><i>Question adapted from Open RN, Nursing Management and Professional Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmpc/chapter/2-7-learning-activities/); rationale written by Plainwork.</i>	Management
As the RN, you review and assess the immediate needs of the clients you are assigned. Based on the client&#x27;s needs, which of the following interventions should the RN delegate to the LPN?<br><br>A. Teach the elderly client about home care of the indwelling Foley catheter.<br>B. Interpret the morning labs on the client with end stage renal disease.<br>C. Administer antineoplastic medications to the client diagnosed with bladder cancer.<br>D. Administer an oral opioid to the client diagnosed with pyelonephritis.	<b>D. Administer an oral opioid to the client diagnosed with pyelonephritis.</b><br><br>Administering routine oral medications, including opioids, to stable clients falls safely within the licensed practical nurse&#x27;s scope of practice. The registered nurse must retain tasks involving complex clinical judgment, specialized administration, and primary client teaching.<br><i>Question adapted from Open RN, Nursing Management and Professional Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmpc/chapter/3-7-learning-activities/); rationale written by Plainwork.</i>	Management
Shared governance models reflect which type of management style?<br><br>A. Autocratic<br>B. Bureaucratic<br>C. Transformative<br>D. Laissez-faire	<b>C. Transformative</b><br><br>Shared governance is a collaborative organizational model that empowers clinical nurses to participate in decision-making. This aligns with transformative leadership, which focuses on empowerment, collaboration, shared vision, and staff development to improve outcomes.<br><i>Question adapted from Open RN, Nursing Management and Professional Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmpc/chapter/10-9-learning-activities/); rationale written by Plainwork.</i>	Management
A nurse is caring for a post-operative coronary artery bypass graft patient who has been transferred to the ICU and is one hour post-op. Which of the following findings requires immediate intervention?<br><br>A. Urinary output of 15 ml/hr<br>B. Hgb 10.4 gm/dL<br>C. BP 96/54<br>D. Potassium 3.2 mmol/L	<b>D. Potassium 3.2 mmol/L</b><br><br>Post‑CABG patients are at high risk for arrhythmias; a potassium of 3.2 mmol/L is below the safe threshold (&lt;3.5) and needs prompt correction to prevent life‑threatening dysrhythmias.<br><i>Question adapted from Open RN, Nursing Management and Professional Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmpc/chapter/2-7-learning-activities/); rationale written by Plainwork.</i>	Management
Namita is a 12 year old student who was recently removed from her home by Child Protective Services because of neglect from her mother who suffers from alcoholism. She has no relationship with her father. At school, she has been having angry outbursts in class yelling at her teachers and bullying her friends. This behavior is characteristic of which category of PTSD symptoms?<br><br>A. Re-experiencing<br>B. Avoidance<br>C. Arousal and Reactivity<br>D. Cognition and Mood	<b>C. Arousal and Reactivity</b><br><br>Alterations in arousal and reactivity in PTSD include irritable behavior, angry outbursts, and aggressive actions toward others. Namita&#x27;s yelling at teachers and bullying peers directly demonstrate these hyperarousal and reactive symptoms following her childhood trauma.<br><i>Question adapted from Open RN, Nursing: Mental Health and Community Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmhcc/chapter/9-12-learning-activity-knowledge-check/); rationale written by Plainwork.</i>	Mental_Health
Which of the following medication orders does the nurse anticipate from the provider?<br><br>A. Sertraline 50mg orally once daily in the morning<br>B. Olanzapine 5mg orally once daily in the morning<br>C. Benztropine 2mg orally prn extrapyramidal symptoms<br>D. Gabapentin 100mg orally daily at bedtime	<b>A. Sertraline 50mg orally once daily in the morning</b><br><br>Sertraline, an SSRI, is first‑line for depression in older adults; a low dose taken each morning minimizes side effects and insomnia, making it the most appropriate initial order.<br><i>Question adapted from Open RN, Nursing: Mental Health and Community Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmhcc/chapter/4-13-learning-activity-virtual-scenario/); rationale written by Plainwork.</i>	Mental_Health
Which of the following actions should a nurse undertake to promote respect and dignity when working with mental health clients?<br><br>A. Make decisions on behalf of the individual<br>B. Use technical language to explain treatment<br>C. Encourage decision making in alignment with clinical preferences<br>D. Provide access to decision making options	<b>D. Provide access to decision making options</b><br><br>Providing access to decision‑making options respects autonomy, promotes dignity, and empowers clients to participate in their own care, aligning with person‑centered mental health practice and supporting recovery.<br><i>Question adapted from Open RN, Nursing: Mental Health and Community Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmhcc/chapter/1-10-knowledge-check/); rationale written by Plainwork.</i>	Mental_Health
Which of the following actions should nurses take to ensure their individual safety when providing care to mental health clients?<br><br>A. Wear visible identification on a lanyard<br>B. Ignore individual feelings and sensitivities<br>C. Avoid wearing necklaces and earrings<br>D. Wear long hair down	<b>C. Avoid wearing necklaces and earrings</b><br><br>Nurses should avoid wearing necklaces and earrings because these items can be grabbed, used as weapons, or become entangled during a client’s aggressive behavior, increasing risk of injury to both nurse and client.<br><i>Question adapted from Open RN, Nursing: Mental Health and Community Concepts, Chippewa Valley Technical College (CC BY 4.0, https://wtcs.pressbooks.pub/nursingmhcc/chapter/1-10-knowledge-check/); rationale written by Plainwork.</i>	Mental_Health
A client taking digoxin reports nausea and seeing yellow-green halos around lights. What should the nurse do first?<br><br>A. Give the dose with a snack<br>B. Hold the dose and notify the provider<br>C. Explain that these are expected side effects<br>D. Give an antiemetic, then the digoxin	<b>B. Hold the dose and notify the provider</b><br><br>Nausea and yellow-green halos are classic signs of digoxin toxicity. Because digoxin has a narrow therapeutic index, the nurse must immediately hold the medication and notify the healthcare provider to prevent life-threatening cardiac arrhythmias.<br><i>Question and rationale by Plainwork. Reference: Lehne&#x27;s Pharmacology for Nursing Care, 11th ed.; FDA Lanoxin (digoxin) label</i>	Pharmacology
A 68-year-old man receives IV unfractionated heparin for DVT. After 6 hours, his aPTT is 85 seconds (reference 25-35 s). Which action is most appropriate?<br><br>A. Hold infusion and administer protamine sulfate.<br>B. Decrease the heparin infusion rate.<br>C. Continue the current infusion rate.<br>D. Increase the heparin infusion rate.	<b>B. Decrease the heparin infusion rate.</b><br><br>The aPTT is markedly above the therapeutic range, indicating excess anticoagulation. The safest step is to reduce the heparin infusion rate to bring the aPTT back into target, rather than stopping or reversing it.<br><i>Question and rationale by Plainwork. Reference: American College of Chest Physicians Antithrombotic Therapy Guidelines, 2022</i>	Pharmacology
A 55-year-old with type 2 diabetes is started on a basal insulin that has no pronounced peak and lasts about 24 hours. Which insulin is most appropriate?<br><br>A. Insulin lispro<br>B. Insulin glargine<br>C. NPH insulin<br>D. Insulin aspart	<b>B. Insulin glargine</b><br><br>Insulin glargine is a long‑acting basal insulin that provides a relatively flat glucose‑lowering profile without a marked peak and maintains activity for approximately 24 hours, matching the described requirements.<br><i>Question and rationale by Plainwork. Reference: American Diabetes Association. Standards of Care in Diabetes—2024.</i>	Pharmacology
A client taking lithium carbonate for bipolar disorder reports persistent bilateral coarse hand tremors and diarrhea. Which action should the nurse take first?<br><br>A. Request a prescription for an antiparkinsonian agent.<br>B. Hold the medication and prepare for a serum lithium draw.<br>C. Administer the dose and encourage increased fluid intake.<br>D. Instruct the client to restrict dietary sodium intake.	<b>B. Hold the medication and prepare for a serum lithium draw.</b><br><br>Persistent coarse tremor and diarrhea are early signs of lithium toxicity; the priority is to stop further exposure and obtain a serum lithium level to determine if the dose is supratherapeutic before any other interventions.<br><i>Question and rationale by Plainwork. Reference: Halter, M. J. (2022). Varcarolis&#x27; Foundations of Psychiatric-Mental Health Nursing (9th ed.).</i>	Pharmacology
Which client should the nurse assess first?<br><br>A. Day 2 after appendectomy, pain 4 out of 10<br>B. COPD, oxygen saturation 90%<br>C. After hip surgery, new restlessness, saturation 86%<br>D. Diabetes, asking for a breakfast tray	<b>C. After hip surgery, new restlessness, saturation 86%</b><br><br>The client shows new restlessness and an oxygen saturation of 86%, indicating acute hypoxemia and possible pulmonary embolism, which requires immediate assessment before other less critical concerns.<br><i>Question and rationale by Plainwork. Reference: Lewis&#x27;s Medical-Surgical Nursing, 12th ed.; GOLD COPD Report (SpO2 target 88-92%)</i>	Prioritization
A public health nurse is implementing a new syphilis screening protocol at a correctional facility intake center. Which action by the nurse best demonstrates the correct application of an opt-out screening strategy?<br><br>A. Informing the client that the test is routine unless refused<br>B. Screening only clients who present with active genital lesions<br>C. Testing only clients who report high-risk sexual behaviors<br>D. Requiring a signed written consent form before drawing blood	<b>A. Informing the client that the test is routine unless refused</b><br><br>Opt-out screening means the test is performed routinely for everyone unless the individual explicitly declines. The nurse informs the client that testing will occur as standard intake care while preserving the client&#x27;s right to refuse.<br><i>Question and rationale by Plainwork. Reference: CDC MMWR, Thu, 17 Sep 2026</i>	Public_Health
A public health nurse is responding to a suspected Ebola outbreak. Which intervention is the highest priority to interrupt the chain of transmission in the community?<br><br>A. Implementing immediate community-wide quarantine<br>B. Rapid identification and isolation of symptomatic contacts<br>C. Administering prophylactic antivirals to all close contacts<br>D. Distributing broad-spectrum antibiotics to the community	<b>B. Rapid identification and isolation of symptomatic contacts</b><br><br>The most effective way to break Ebola transmission is promptly identifying symptomatic individuals and isolating them, preventing contact with infectious fluids; this targeted approach stops spread faster than broad quarantine or unproven treatments.<br><i>Question and rationale by Plainwork. Reference: CDC MMWR, Tue, 15 Sep 2026.</i>	Public_Health
A public health nurse is planning child survival interventions in a region with high under-5 mortality, guided by CHAMPS surveillance data. To address the leading infectious cause of death in this age group, which intervention is most critical?<br><br>A. Implementing mass deworming campaigns<br>B. Distributing insecticide-treated bed nets<br>C. Administering prophylactic zinc supplements<br>D. Expanding pneumococcal conjugate vaccination	<b>D. Expanding pneumococcal conjugate vaccination</b><br><br>Pneumonia, primarily due to Streptococcus pneumoniae, remains the top infectious killer of children under five; pneumococcal conjugate vaccine directly prevents this disease, making its expansion the most impactful intervention.<br><i>Question and rationale by Plainwork. Reference: CDC MMWR, Tue, 08 Sep 2026</i>	Public_Health
A nurse in a travel clinic is counseling an unvaccinated client planning a trip to Cuba. Which vaccine should the nurse recommend to prevent a common foodborne and waterborne viral infection associated with travel to this region?<br><br>A. Hepatitis B vaccine<br>B. Yellow fever vaccine<br>C. Hepatitis A vaccine<br>D. Meningococcal vaccine	<b>C. Hepatitis A vaccine</b><br><br>Hepatitis A is a highly contagious viral liver infection transmitted primarily through the fecal-oral route via contaminated food or water. It is the most common vaccine-preventable disease in travelers visiting developing countries, including Cuba.<br><i>Question and rationale by Plainwork. Reference: CDC MMWR, Thu, 24 Sep 2026</i>	Public_Health
