1. Which electrolyte imbalance is characterized by peaked T waves on ECG?
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia
d) Hypocalcemia
Answer: Hyperkalemia
2. A patient with septic shock is most likely to present initially with which hemodynamic change?
a) Increased cardiac output
b) Decreased cardiac output
c) Bradycardia
d) Complete heart block
Answer: Increased cardiac output
3. Which antidote is used for heparin overdose?
a) Vitamin K
b) Protamine sulfate
c) Naloxone
d) Atropine
Answer: Protamine sulfate
4. A nurse is caring for a patient receiving digoxin. Which finding may indicate digoxin toxicity?
a) Night blindness
b) Yellow-green vision
c) Hearing loss
d) Polyuria
Answer: Yellow-green vision
5. Which action should be taken first when a patient develops fever and chills during a blood transfusion?
a) Increase the infusion rate
b) Stop the transfusion
c) Administer an antipyretic
d) Observe the patient
Answer: Stop the transfusion
6. Which isolation precaution is required for pulmonary tuberculosis?
a) Contact precaution
b) Droplet precaution
c) Airborne precaution
d) Standard precaution
Answer: Airborne precaution
7. A patient is receiving 1200 mL IV fluid over 10 hours. What is the infusion rate?
a) 100 mL/hr
b) 110 mL/hr
c) 120 mL/hr
d) 130 mL/hr
Answer: 120 mL/hr
8. Which ECG finding is characteristic of hyperkalemia?
a) U wave
b) Peaked T wave
c) Short PR interval
d) Delta wave
Answer: Peaked T wave
9. What is the first priority in managing an unconscious patient?
a) Nutrition
b) Airway
c) Elimination
d) Communication
Answer: Airway
10. Which drug is commonly used during cardiac arrest according to ACLS guidelines?
a) Furosemide
b) Epinephrine
c) Digoxin
d) Atropine
Answer: Epinephrine
11. Which assessment finding indicates increased intracranial pressure?
a) Bradycardia
b) Tachycardia
c) Hypotension
d) Warm skin
Answer: Bradycardia
12. The most effective method for preventing hospital-acquired infections is:
a) Antibiotic prophylaxis
b) Hand hygiene
c) Patient isolation
d) Vaccination
Answer: Hand hygiene
13. Which pediatric condition is characterized by a barking cough?
a) Bronchiolitis
b) Croup
c) Pneumonia
d) Asthma
Answer: Croup
14. A child with dehydration is best assessed by monitoring:
a) Blood pressure
b) Weight
c) Temperature
d) Respiratory rate
Answer: Weight
15. Which psychiatric disorder is characterized by elevated mood, grandiosity, and decreased need for sleep?
a) Depression
b) Schizophrenia
c) Mania
d) Anxiety disorder
Answer: Mania
16. A patient taking lithium should be monitored for:
a) Serum lithium level
b) INR
c) Troponin
d) Hemoglobin
Answer: Serum lithium level
17. Which principle of ethics refers to telling the truth?
a) Justice
b) Veracity
c) Beneficence
d) Fidelity
Answer: Veracity
18. Which nursing action demonstrates beneficence?
a) Maintaining confidentiality
b) Acting in the patient's best interest
c) Respecting patient choices
d) Obtaining informed consent
Answer: Acting in the patient's best interest
19. Which cardiac marker rises earliest after myocardial infarction?
a) Troponin
b) CK-MB
c) Myoglobin
d) LDH
Answer: Myoglobin
20. What is the antidote for warfarin toxicity?
a) Naloxone
b) Vitamin K
c) Protamine sulfate
d) Flumazenil
Answer: Vitamin K
21. A patient with COPD is at risk for which acid-base imbalance?
a) Metabolic alkalosis
b) Respiratory acidosis
c) Respiratory alkalosis
d) Metabolic acidosis
Answer: Respiratory acidosis
22. Which complication is most likely after prolonged immobility?
a) Improved circulation
b) Pressure injury
c) Increased appetite
d) Bradycardia
Answer: Pressure injury
23. During blood transfusion, which sign may indicate a transfusion reaction?
a) Chills
b) Improved appetite
c) Increased urine output
d) Dry skin
Answer: Chills
24. Which electrolyte is primarily responsible for cardiac muscle contraction?
a) Potassium
b) Calcium
c) Magnesium
d) Phosphate
Answer: Calcium
25. A patient with diabetic ketoacidosis is expected to have:
a) Hyperglycemia
b) Hypoglycemia
c) Bradycardia
d) Metabolic alkalosis
Answer: Hyperglycemia
26. Which position is preferred for a patient with acute pulmonary edema?
a) Trendelenburg
b) Prone
c) High Fowler's
d) Supine
Answer: High Fowler's
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27. What is the recommended chest compression depth in an adult during CPR?
a) 1 cm
b) 2 cm
c) At least 5 cm
d) 8 cm
Answer: At least 5 cm
28. Which medication requires monitoring of apical pulse before administration?
a) Paracetamol
b) Digoxin
c) Omeprazole
d) Ceftriaxone
Answer: Digoxin
29. What is the most common cause of healthcare-associated urinary tract infection?
a) Poor nutrition
b) Urinary catheterization
c) Hypertension
d) Obesity
Answer: Urinary catheterization
30. Which electrolyte imbalance may cause tetany?
a) Hypercalcemia
b) Hypocalcemia
c) Hypernatremia
d) Hyperkalemia
Answer: Hypocalcemia
31. Which condition requires droplet precautions?
a) Tuberculosis
b) Measles
c) Influenza
d) Chickenpox
Answer: Influenza
32. A nurse notices sudden absence of waveform on a pulse oximeter. What should be checked first?
a) Doctor's order
b) Sensor placement
c) Blood glucose
d) Temperature
Answer: Sensor placement
33. Which drug is commonly used to reverse benzodiazepine overdose?
a) Flumazenil
b) Naloxone
c) Vitamin K
d) Protamine sulfate
Answer: Flumazenil
34. Which parameter best reflects kidney function?
a) Hemoglobin
b) Serum creatinine
c) Troponin
d) ALT
Answer: Serum creatinine
35. A patient develops stridor after extubation. What should the nurse suspect?
a) Airway obstruction
b) Hypertension
c) Hypoglycemia
d) UTI
Answer: Airway obstruction
36. Which infection control measure is essential before inserting a urinary catheter?
a) Sterile technique
b) Droplet mask
c) Eye shield only
d) Isolation room
Answer: Sterile technique
37. Which finding is most concerning in a patient receiving magnesium sulfate?
a) Absent deep tendon reflexes
b) Mild flushing
c) Warm skin
d) Slight drowsiness
Answer: Absent deep tendon reflexes
38. A patient in ICU becomes suddenly confused and agitated. What is the most likely condition?
a) Delirium
b) Dementia
c) Depression
d) Psychosis
Answer: Delirium
39. Which laboratory value is used to assess long-term diabetic control?
a) Random blood sugar
b) HbA1c
c) Fasting blood sugar
d) Urine glucose
Answer: HbA1c
40. Which action is appropriate when a medication error occurs?
a) Hide the error
b) Document and report immediately
c) Ignore if patient is stable
d) Ask another nurse to document
Answer: Document and report immediately
41. A nurse receives an order to administer potassium chloride IV push. What should the nurse do?
a) Administer immediately
b) Give slowly IV push
c) Question the order
d) Mix with distilled water and push
Answer: Question the order
42. Which patient is at highest risk for aspiration?
a) Patient sitting upright
b) Unconscious patient
c) Walking patient
d) Patient with hypertension
Answer: Unconscious patient
43. Which rhythm is most commonly associated with sudden cardiac arrest?
a) Atrial flutter
b) Ventricular fibrillation
c) Sinus bradycardia
d) First-degree AV block
Answer: Ventricular fibrillation
44. A patient with septic shock has a serum lactate of 5 mmol/L. This finding suggests:
a) Adequate perfusion
b) Tissue hypoperfusion
c) Normal metabolism
d) Hyperventilation only
Answer: Tissue hypoperfusion
45. Which nursing intervention is most important to prevent ventilator-associated pneumonia?
a) Limit oral care
b) Keep patient flat
c) Oral care and head elevation
d) Fluid restriction
Answer: Oral care and head elevation
46. A postoperative patient suddenly becomes restless and oxygen saturation drops to 86%. What should the nurse assess first?
a) Family history
b) Airway and breathing
c) Diet history
d) Bowel sounds
Answer: Airway and breathing
47. Which clinical sign is an early indicator of hypovolemic shock?
a) Bradycardia
b) Tachycardia
c) Anuria
d) Cyanosis
Answer: Tachycardia
48. A patient suddenly develops chest pain, dyspnea, and tachycardia after surgery. Which condition should be suspected first?
a) Pneumonia
b) Pulmonary embolism
c) Pleural effusion
d) Bronchitis
Answer: Pulmonary embolism
49. Which antidote is used for opioid overdose?
a) Atropine
b) Naloxone
c) Protamine sulfate
d) Vitamin K
Answer: Naloxone
50. Which laboratory value is most important to monitor in a patient receiving warfarin?
a) aPTT
b) Bleeding time
c) INR
d) Platelet count
Answer: INR
