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Proctored Exam 2025: Complete Guide for Nursing
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Question 1: A nurse is performing an admission assessment on a client. When measuring her vital signs, the nurse finds that her radial pulse rate is 68/min and her simultaneous apical pulse rate is 84/min. What is the client's pulse deficit? A. 6/min B. 16/min C. 24/min D. 15 2/min Rationale: The correct answer is B. The pulse deficit is the difference between the apical pulse rate and the radial pulse rate. In this case, the apical pulse (84/min) is higher than the radial pulse (68/min). Pulse Deficit = Apical Pulse - Radial Pulse Pulse Deficit = 84/min - 68/min = 16/min Question 2: A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following information should the nurse include when explaining the procedure to the client? A. Eating more protein is optimal prior to testing. B. One stool specimen is sufficient for testing. C. A red color change indicates a positive test. D. The stool specimens cannot be contaminated. Rationale: The correct answer is D. It is crucial that stool specimens for fecal occult blood testing are not contaminated with water or urine, as this can affect the test results. Dietary
restrictions (avoiding red meat, certain fruits and vegetables, and high doses of vitamin C) are usually recommended prior to testing to prevent false positives, so eating more protein (A) is not optimal. Typically, three stool specimens are collected on consecutive days (B is incorrect). A blue color change usually indicates a positive test for blood, not red (C is incorrect). Question 3: A nurse is talking with a client who reports constipation. When the nurse discusses dietary changes that can help prevent constipation, which of the following foods should the nurse recommend? A. Macaroni and cheese. B. Fresh fruit and whole wheat toast. C. Rice pudding and ripe bananas. D. Roast chicken and white rice. Rationale: The correct answer is B. Fresh fruits and whole wheat toast are high in fiber, which helps to add bulk to the stool and promote regular bowel elimination. Macaroni and cheese (A), rice pudding and ripe bananas (C), and roast chicken and white rice (D) are generally low in fiber and can contribute to constipation. Question 4: A nurse is caring for a client who has had diarrhea for the past 4 days. When assessing the client, the nurse should expect which of the following findings? Select all that apply. A. Bradycardia B. Hypotension C. Fever D. Poor skin turgor E. Peripheral edema Rationale: The correct answers are B, C, and D. Prolonged diarrhea can lead to dehydration and electrolyte imbalances. Expected findings include:
- Hypotension (B): Dehydration leads to a decrease in circulating blood volume, resulting in lower blood pressure.
- Fever (C): Dehydration can sometimes cause a slight increase in body temperature. Additionally, if the diarrhea is due to an infection, a fever is likely.
Rationale: The correct answer is D. Lowering the enema fluid container will decrease the pressure and rate of instillation, which can help to relieve abdominal cramping. Having the client hold their breath briefly (A) is not a recognized intervention for enema-related cramping. Discontinuing the enema (B) may be necessary if the cramping is severe or persistent, but lowering the container should be tried first. While some cramping is expected (C), the nurse should intervene to minimize the client's discomfort. A nurse on a med-surg unit has received change-of-shift report & will care for 4 clients. Which of the following client's needs may the nurse assign to an assistive personnel (AP)? A. Feeding a client who was admitted 24 hrs ago w/aspiration pneumonia B. Reinforcing teaching w/a client who is learning to walk using a quad cane C. Reapplying a condom catheter for a client who has urinary incontinence D. Applying a sterile dressing to a pressure ulcer - - correct ans- - C. Reapplying a condom catheter for a client who has urinary incontinence Rationale: The application of a condom catheter is a noninvasive, routine procedure that the nurse may delegate to the AP A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? Select All. A. The roommate is up independently. B. The client ambulates w/his slippers on over his antiembolic stockings C. The client uses a front-wheeled walker when ambulating D. The client had pain medication 30 min ago
E. The client is allergic to codeine F. The client ate 50% of his breakfast this morning - - correct ans- - B, C, D An RN is making assignments for client care to a LPN at the beginning of the shift. Which of the following assignments should the LPN question? A. Assisting a client who is 24hr postop to use an incentive spirometer B. Collecting a clean-catch urine specimen from a client who was admitted on the previous shift C. Providing nasopharyngeal suctioning for a client who has pneumonia D. Replacing the cartridge and tubing on a PCA pump - - correct ans- - D. Replacing the cartridge and tubing on a PCA pump Rationale: The RN is responsible for the PCA pump A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation? Select all. A. Right client B. Right supervision/evaluation C. Right direction/communication D. Right time E. Right circumstances - - correct ans- - B, C, E A and D are rights of medication administration
A. Assault B. False imprisonment C. Negligence D. Breach of confidentiality - - correct ans- - B. False imprisonment The nurse gave the med as a chemical restraint to keep the client from leaving the facility against medical advice. The client did not consent. A client who will undergo neurosurgery the following week tells the nurse in the surgeon's office that he will prepare his advance directives before he goes to the hospital. Which of the following statements by the client indicates to the nurse that he understands advance directives? A. "I'd rather have my brother make decisions for me, but I know it has to be my wife." B. "I know they won't go ahead w/the surgery unless I prepare these forms." C. "I plan to write that I don't want them to keep me on a breathing machine." D. "I will get my regular doctor to approve my plan before I hand it in at the hospital." - - correct ans- - C. The client has the right to decide and specify which medical procedures he wants when a lifethreatening situation arrives A client is about to undergo an elective surgical procedure. Which of the following actions are appropriate for the nurse who is providing preop care regarding informed consent? Select all. A. Make sure the surgeon obtained the client's consent B. Witness the client's signature on the consent form C. Explain the risks and benefits of the procedure D. Describe the consequences of choosing not to have the surgery
E. Tell the client about alternatives to having the surgery - - correct ans- - A, B The rest of the choices are the surgeon's responsibility, not the nurse A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy & unable to focus on the issue at hand. Today, she found the nurse asleep in a chair in the break room when she was not on break. Which of the following actions should the nurse take? A. Remind the nurse that safe client care is a priority on the unit B. Ask others on the team whether they have observed the same behavior C. Report observations to the nurse manager on the unit D. Conclude that her coworker's fatigue is not her problem to solve - - correct ans- - C. Any nurse who notices behavior that could possibly jeopardize client care or indicate a substance abuse problem has a duty to report the situation immediately to the nurse manager A nurse is preparing info for a change-of-shift report. Which of the following info should the nurse include in the report? A. The client's input & output for the shift B. The client's BP from the previous day C. A bone scan that is scheduled for today D. The med routine from the med administration record - - correct ans- - C. A bone scan that is scheduled for today This is important because the nurse might have to modify the client's care to accommodate them leaving the unit A nurse enters a client's room & finds him sitting in his chair. He states, "I fell in the shower, but I got myself back up & into my chair." How should the nurse document this in the client's chart?
A nurse is receiving a provider's prescription by telephone for morphine for a client who is reporting moderate to severe pain. Which of the following nursing actions are appropriate? Select all. A. Repeat the details of the prescription back to the provider B. Have another nurse listen to the telephone prescription C. Obtain the prescriber's signature on the prescription within 24hrs D. Decline the verbal prescription because it is not an emergency situation E. Tell the charge nurse that the provider has prescribed morphine by telephone - - correct ans- - A, B, C A nurse is caring for an older adult client who lives alone & is to be discharged in 3 days. He states that it is difficult to prepare adequate nutritious meals at home for just 1 person. To which of the following members of the health care team should the nurse refer him? A. Registered dietitian B. Occupational therapist C. Physical therapist D. Social worker - - correct ans- - D. social worker A social worker can make arrangements for a meal delivery service to provide nutritious meals daily, or recommend a congregate meal site near the client's home A goal for a client who has difficulty w/self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral w/which of the following members of the interprofessional care team? A. Social worker
B. Certified nursing assistant C. Registered dietitian D. Occupational therapist - - correct ans- - D. An occupational therapist can assist clients who have physical challenges to use adaptive devices & strategies to help w/self-care activities A client who is postop following a knee arthroplasty is concerned about the adverse effects of the medication he is receiving for pain management. Which of the following members of the interprofessional care team may assist the client in understanding the medication's effects? Select all. A. Provider B. CNA C. Pharmacist D. RN E. Respiratory therapist - - correct ans- - A, C, D A client who has had a cerebrovascular accident has persistent problems w/dysphagia. The nurse caring for the client should initiate a referral w/which of the following members of the interprofessional care team? A. Social worker B. CNA C. Occupational therapist D. Speech-language pathologist - - correct ans- - D A speech-language pathologist can initiate specific therapy for clients who have difficulty feeding due to swallowing difficulties
B. A number she traces on the palm of his hand C. The vibration of a tuning fork she places on his foot D. A familiar object she places in his hand - - correct ans- - D. Stereognosis is tactile recognition A nurse is assessing a client who reports pain when the nurse evaluates the internal rotation of her right shoulder. Which of the following activities is this problem likely to affect? A. Mopping her floors B. Brushing the back of her hair C. Fastening her bra behind her back D. Reaching into a cabinet above her sink - - correct ans- - C. Fastening a bra from behind requires internal rotation of the shoulder, so this activity will illicit pain A nurse is preforming a neurosensory examination for a client. Which of the following tests should the nurse preform to test the client's balance? Select all. A. Romberg test B. Heel-to-toe walk C. Snellen test D. Spinal accessory function E. Rosenbaum test - - correct ans- - A, B C and E test visual acuity , D tests cranial nerve XI is intact by asking the client to shrug shoulders without complication.
A nurse is collecting data from an older adult client as part of a neurosensory examination. Which of the following findings should the nurse expect as changes associated w/aging? Select all. A. Slower light touch sensation B. Some vision & hearing decline C. Slower fine finger movement D. Some short-term memory decline E. Slower superficial pain sensation - - correct ans- - B, C, D A nurse is providing discharge instructions to a client who has a prescription for the use of oxygen in his home. Which of the following should the nurse teach the client about using oxygen safely in his home? Select all. A. Family members who smoke must be at least 10 ft from the client when the oxygen is in use B. Nail polish should not be used near a client who is receiving oxygen C. A "No smoking" sign should be placed on the front door D. Cotton bedding & clothing should be replaced w/items made from wool E. A fire extinguisher should be readily available in the home - - correct ans- - B, C, E Family members that smoke should do so outside, and wool creates static electricity so it should be avoided. A nurse educator is conducting a parenting class for new parents. Which of the following statements made by a participant indicates a need for further clarification & instruction? A. "I will begin swimming lessons as soon as my baby can close her mouth under water." B. "Once my baby can sit up, he should be safe in the bathtub."
Tachycardia, hot dry skin, and tachypnea are other manifestations of heat stroke A home health nurse is discussing the dangers of food poisoning w/a client. Which of the following info should the nurse include in her counseling? Select all. A. Most food poisoning is caused by a virus B. Immunocompromised individuals are at risk for complications from food poisoning C. Clients who are especially at risk are instructed to eat or drink only pasteurized milk, yogurt, cheese, or other dairy products D. Healthy individuals usually recover from the illness in a few weeks E. Handling raw & fresh food separately to avoid cross contamination may prevent food poisoning - correct ans- - B, C, E Most food poisoning is caused by a bacteria such as E. coli. Healthy individuals usually recover in a few days. A nurse is caring for a client diagnosed w/severe acute respiratory syndrome (SARS). The nurse is aware that health care professionals are required to report communicable & infectious diseases. Which of the following illustrate the rationale for reporting? Select all. A. Planning & evaluating control & prevention strategies B. Determining public health priorities C. Ensuring proper medical treatment D. Identifying endemic disease E. Monitoring for common-source outbreaks - - correct ans- - A, B, C, E
Not D because endemic disease is already prevalent within a population, so reporting is not necessary A nurse is contributing to the plan of care for a client who is being admitted to the facility w/a suspected diagnosis of pertussis. Which of the following should the nurse include in the plan of care? Select all. A. Place the client in a room that has negative air pressure of at least 6 exchanges/hr B. Wear a mask when providing care within 3 ft of the client C. Place a surgical mask on the client if transportation to another dept is unavoidable D. Use sterile gloves when handling soiled linens E. Wear a gown when preforming care that may result in contamination from secretions - - correct ans- B, C, E Private room w/droplet precautions indicated for this client. The nurse should wear a gown when contamination from body fluids might happen A nurse is caring for a client who presents w/linear clusters of fluid-containing vesicles w/some crustings. Which of the following should the nurse suspect? A. Allergic reaction B. Ringworm C. Systemic lupus erythematosus D. Herpes zoster - - correct ans- - D. Herpes zoster pink body rash=allergic reaction red circles w/white
B. "It is important to schedule routine health care visits even if I'm feeling well." C. "If I'm having any discomfort, I'll just got to an urgent care center." D. "If I am felling stressed, I will remind myself that this is something I should expect." - - correct ans- - B. routine health screenings are important at any age A nursing instructor is explaining the various stages of the lifespan to a group of nursing students. The nurse should offer which of the following behaviors by a young adult as an example of appropriate psychosocial development? A. Becoming actively involved in providing guidance to the next generation B. Adjusting to major changes in roles and relationships due to losses C. Devoting a great deal of time to establishing an occupation D. Finding oneself "sandwiched" in between & being responsible for 2 generations - - correct ans-
- C. Exploring and establishing career options & establishing oneself is important developmental task in a young adult A nurse is counseling a young adult who describes having difficulty dealing w/several issues. Which of the following problems the client verbalized should the nurse identify as the priority for further assessment & intervention? A. "I have my own apartment now, but it's not easy living away from my parents." B. "It's been so stressful for me to even think about having my own family." C. "I don't even know who I am yet, & now I'm supposed to know what to do." D. "My girlfriend is pregnant, & I don't think I have what it takes to be a good father." - - correct ans- - C. Applying Erikson stages of development, knowing oneself is done in adolescence, and this requires the most urgent help
A nurse is reviewing safety precautions w/a group of young adults at a community health fair. Which of the following recommendations should the nurse include specifically for this age group? Select all. A. Install bath rails & grab bars in bathrooms B. Wear a helmet while skiing C. Install a carbon monoxide detector D. Secure firearms in a safe location E. Remove throw rugs from the home - - correct ans- - B, C, D A is recommended for older adults and E as well for risk of falls A nurse is reviewing the CDC's immunization recommendations w/a young adult client. Which of the following recommendations should the nurse include in this discussion? Select all. A. Human papillomavirus B. Measles, mumps, rubella C. Varicella D. Haemophilus influenzae type b E. Polio - - correct ans- - A, B, C D is not for after 18 months of age and polio is also given as a child and not usually beyond 18 yrs old
