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NUR Capstone Proctored Exam Questions And
Correct Answers (Verified Answers) Plus Rationales
2025 Q&A | Instant Download Pdf
- Which of the following is the priority action when a patient suddenly develops shortness of breath and decreased oxygen saturation? a) Administer a bronchodilator b) Call the rapid response team c) Raise the head of the bed and apply oxygen d) Obtain a chest x-ray The priority is to maintain airway and oxygenation by raising the head and applying oxygen while preparing for further interventions.
- A patient is prescribed warfarin. Which lab value should the nurse monitor to evaluate the effectiveness of this medication? a) Platelet count b) International Normalized Ratio (INR) c) Partial thromboplastin time (PTT) d) Hemoglobin level INR is used to monitor warfarin therapy to ensure therapeutic anticoagulation.
- When providing teaching about insulin administration to a newly diagnosed diabetic patient, which site has the fastest absorption? a) Thigh
b) Buttocks c) Abdomen d) Upper arm The abdomen has the fastest absorption rate for subcutaneous insulin injections compared to other sites.
- A nurse notes a patient has developed a new-onset fever and purulent drainage at the surgical site. What is the nurse’s best action? a) Administer acetaminophen for fever b) Notify the healthcare provider immediately c) Apply warm compresses to the site d) Document the findings only New signs of infection require prompt communication with the provider for timely treatment.
- Which intervention is most effective to prevent deep vein thrombosis (DVT) in a postoperative patient? a) Encourage bed rest b) Apply cold compresses c) Encourage early ambulation d) Administer stool softeners Early ambulation promotes circulation and reduces the risk of DVT.
- A patient with heart failure presents with dyspnea and bilateral lower extremity edema. Which lab value would the nurse expect to be elevated? a) Hemoglobin b) Sodium
Verifying patient identity and compatibility before starting the transfusion is critical to prevent transfusion reactions. 10.What is the therapeutic range for serum lithium levels in patients treated for bipolar disorder? a) 0.1-0.5 mEq/L b) 0.5-1.0 mEq/L c) 0.6-1.2 mEq/L d) 1. 5 - 2.0 mEq/L Therapeutic lithium levels are maintained between 0.6-1.2 mEq/L to ensure effectiveness and avoid toxicity. 11.A nurse assessing a patient with chronic obstructive pulmonary disease (COPD) expects to find: a) Hyperventilation b) Bradycardia c) Barrel chest d) Weight gain Barrel chest results from chronic air trapping and lung hyperinflation in COPD patients. 12.Which nursing diagnosis is highest priority for a patient experiencing acute chest pain? a) Anxiety related to pain b) Risk for infection c) Ineffective tissue perfusion d) Impaired mobility
Acute chest pain may indicate cardiac ischemia, making tissue perfusion a priority concern. 13.A patient on a continuous heparin infusion has an activated partial thromboplastin time (aPTT) of 100 seconds. What should the nurse do? a) Increase the heparin dose b) Maintain the current dose c) Hold the heparin and notify the provider d) Administer protamine sulfate immediately An aPTT > 90 seconds indicates increased bleeding risk; the infusion should be held and the provider notified. 14.A patient with a history of stroke suddenly has slurred speech and right- sided weakness. The nurse suspects: a) Hypoglycemia b) Seizure activity c) Acute ischemic stroke d) Transient hypotension New focal neurological deficits indicate possible stroke and require immediate intervention. 15.Which electrolyte imbalance is most concerning in a patient taking furosemide? a) Hyperkalemia b) Hypokalemia c) Hypercalcemia d) Hypermagnesemia
19.Which vaccine is contraindicated for a patient who is pregnant? a) Influenza (inactivated) b) Tetanus, diphtheria, pertussis (Tdap) c) Measles, mumps, rubella (MMR) d) Hepatitis B MMR is a live vaccine and contraindicated during pregnancy due to potential fetal harm. 20.Which of the following lab results indicates acute kidney injury? a) Low serum creatinine b) Elevated blood urea nitrogen (BUN) and creatinine c) Low potassium d) High hemoglobin Elevated BUN and creatinine indicate impaired kidney function. 21.What is the expected finding in a patient with hypovolemic shock? a) Bradycardia b) Tachycardia c) Hypertension d) Bounding pulses Tachycardia is a compensatory mechanism to maintain cardiac output during hypovolemia. 22.A patient with diabetes is experiencing diabetic ketoacidosis (DKA). Which lab finding is expected? a) Hypoglycemia b) Respiratory alkalosis
c) Metabolic acidosis with elevated blood glucose d) Hyperkalemia with low blood glucose DKA is characterized by metabolic acidosis and hyperglycemia due to insulin deficiency. 23.A nurse is caring for a patient with a nasogastric tube connected to suction. What is an important nursing intervention? a) Keep the tube clamped at all times b) Irrigate the tube every hour c) Monitor electrolyte levels regularly d) Provide oral intake frequently Continuous suction can lead to electrolyte imbalances; monitoring labs is important. 24.Which medication is contraindicated for a patient with asthma? a) Albuterol b) Beta blockers c) Corticosteroids d) Leukotriene modifiers Beta blockers can worsen bronchospasm in asthma patients. 25.A patient develops sudden unilateral facial drooping. Which cranial nerve is most likely affected? a) Cranial nerve III b) Cranial nerve V c) Cranial nerve VII (facial nerve) d) Cranial nerve IX
b) Patient’s self-report c) Facial expression d) Physical appearance Pain is subjective; patient self-report is the gold standard. 30.Which lab test is used to diagnose diabetes mellitus? a) Fasting lipid profile b) Serum potassium c) Hemoglobin A1c d) Blood urea nitrogen Hemoglobin A1c reflects average blood glucose over 3 months and is diagnostic for diabetes. 31.What is the best way to prevent medication errors in a hospital setting? a) Rely on verbal orders b) Use the “five rights” of medication administration c) Administer medications quickly d) Ignore allergies if minor Following the five rights (right patient, drug, dose, route, time) reduces errors. 32.Which action is appropriate when a patient is experiencing a seizure? a) Restrain the patient’s limbs b) Insert a tongue blade c) Protect the patient from injury d) Offer water immediately after The priority is safety; restraining or putting objects in the mouth can cause harm.
33.Which is the best site to measure blood pressure in an unconscious patient when the arms are inaccessible? a) Radial artery b) Femoral artery c) Brachial artery d) Carotid artery The femoral artery is accessible and can be used to measure BP when arms are inaccessible. 34.Which symptom indicates early shock? a) Bradycardia b) Tachycardia c) Hypotension d) Cool, clammy skin Tachycardia is an early compensatory sign of shock. 35.What is the primary purpose of performing a head-to-toe assessment? a) To document the patient’s history b) To identify actual or potential health problems c) To administer medications d) To evaluate laboratory results The head-to-toe assessment helps detect health issues needing intervention. 36.A patient reports numbness and tingling in the fingers after chemotherapy. The nurse suspects: a) Infection b) Peripheral neuropathy
Frequent repositioning relieves pressure and prevents ulcers. 40.Which statement about wound care is correct? a) Wet-to-dry dressings should be changed weekly b) Keep wounds exposed to air to dry c) Maintain a moist wound environment to promote healing d) Use hydrogen peroxide to clean wounds regularly A moist environment promotes epithelialization and faster healing. 41.When interpreting an electrocardiogram (ECG), the nurse notes a prolonged PR interval. This finding suggests: a) Atrial fibrillation b) Ventricular tachycardia c) First-degree heart block d) Myocardial infarction A prolonged PR interval indicates delayed conduction between atria and ventricles (first-degree heart block). 42.Which action should a nurse take when a patient experiences a hypoglycemic episode? a) Administer insulin b) Provide a high-fat snack c) Administer 15-20 grams of fast-acting carbohydrate d) Restrict fluids Quickly raising blood glucose with fast-acting carbs resolves hypoglycemia.
43.What is the normal range for adult respiratory rate? a) 8-12 breaths per minute b) 12-20 breaths per minute c) 20-30 breaths per minute d) 30-40 breaths per minute 12 - 20 breaths/min is the normal adult respiratory rate range. 44.Which of the following is an appropriate action for a patient with a Clostridium difficile infection? a) Place patient in a shared room b) Use standard precautions only c) Implement contact precautions with hand washing using soap and water d) Use alcohol-based hand sanitizer only C. difficile spores are resistant to alcohol sanitizers; soap and water handwashing and contact precautions are required. 45.What is the first step in performing cardiopulmonary resuscitation (CPR) on an adult? a) Deliver rescue breaths b) Call for help c) Check responsiveness and breathing d) Apply automated external defibrillator (AED) Check if the patient is responsive and breathing before starting CPR. 46.A patient with anemia is likely to experience: a) Hypertension b) Fatigue and pallor
PFTs assess lung function including volumes and airflow to diagnose respiratory conditions. 50.A nurse is caring for a patient with a history of seizure disorder. Which action is priority during a seizure? a) Restrain the patient’s movements b) Insert an oral airway c) Ensure patient safety and prevent injury d) Place patient in a supine position Protecting the patient from injury during seizure is the priority; restraint and airway insertion can cause harm. 51.A patient with a tracheostomy develops sudden respiratory distress and noisy breathing. What should the nurse do first? a) Call the physician immediately b) Suction the tracheostomy c) Check for tracheostomy tube obstruction d) Apply oxygen via face mask Assessing for obstruction ensures airway patency, which is critical before other interventions. 52.What is the earliest sign of hypoxia in a patient? a) Cyanosis b) Bradycardia c) Restlessness and agitation d) Hypotension
Neurological symptoms like restlessness are early signs of inadequate oxygenation before cyanosis develops. 53.A nurse is educating a patient about taking digoxin. Which symptom indicates digoxin toxicity? a) Hypertension b) Visual disturbances such as yellow halos c) Constipation d) Increased appetite Visual changes like yellow halos are classic signs of digoxin toxicity. 54.Which of the following would be a contraindication for administering a live vaccine? a) Mild cold b) Immunosuppression c) History of penicillin allergy d) Age over 60 Live vaccines can cause infection in immunocompromised patients and are contraindicated. 55.A nurse is caring for a patient with acute pancreatitis. Which finding requires immediate intervention? a) Elevated serum amylase b) Abdominal tenderness c) Sudden drop in blood pressure and increased heart rate d) Nausea and vomiting
Elevated CVP often reflects increased right atrial pressure due to fluid overload or cardiac dysfunction. 59.Which symptom is consistent with an allergic reaction to a blood transfusion? a) Bradycardia b) Hypothermia c) Urticaria and itching d) Hypertension Allergic transfusion reactions commonly cause hives and pruritus. 60.What is the most appropriate site for intramuscular injection in an adult patient? a) Deltoid muscle b) Dorsogluteal muscle c) Vastus lateralis muscle d) Subscapular muscle The vastus lateralis is preferred for IM injections due to large muscle mass and low risk of nerve injury. 61.Which condition is a contraindication for using a tourniquet? a) Venous insufficiency b) Arterial insufficiency c) Cellulitis d) Diabetes mellitus Tourniquets are contraindicated in arterial insufficiency as they may further compromise blood flow.
62.What is the most common cause of hospital-acquired pneumonia? a) Viral infection b) Fungal infection c) Aspiration of oral secretions containing bacteria d) Allergic reaction Aspiration of oropharyngeal bacteria is a common cause of nosocomial pneumonia. 63.When documenting a wound assessment, which characteristic is most important? a) Patient’s age b) Room temperature c) Size, depth, and presence of exudate d) Patient’s appetite Wound dimensions and drainage describe wound status and guide treatment. 64.A patient on a low-molecular-weight heparin (LMWH) injection asks about the risk of bleeding. What should the nurse say? a) There is no risk of bleeding b) Bleeding only occurs if you take aspirin c) There is a risk of bleeding; report any unusual bruising or bleeding immediately d) You should stop medication if you notice any bleeding LMWH increases bleeding risk; patients must be educated to report signs promptly.
