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Practice Final Pt. 1

Total questions: 25

Worksheet time: 13mins

Name
Class
Date
1.

A nurse calls a provider and says, “Mr. Lopez’s BP has dropped from 130/80 to 84/50 in the last 10 minutes, his skin is cold and clammy, and he is complaining of chest pressure. I’m concerned he may be unstable and need to be seen immediately.” Which SBAR pieces are MOST clearly included here?

a)

Situation and Background

b)

Background and Recommendation

c)

Assessment and Recommendation

d)

Situation and Assessment

2.

Which statement would BEST improve the Background part of an SBAR handoff about a patient with shortness of breath?

a)

His wife is very worried.

b)

He lives alone in a two-story home.

c)

He has COPD, smokes 1 pack per day, and was admitted last week for pneumonia.

d)

He says he doesn’t like hospitals.

3.

A nurse states in SBAR: “Based on his worsening oxygen levels and increased work of breathing, I’m worried he might need higher-level care or a rapid response.” This represents which component AND why is it important?

a)

Situation; it summarizes the chief complaint

b)

Assessment; it shares the nurse’s clinical impression

c)

Background; it lists history details

d)

Recommendation; it documents vital signs

4.

A new nurse gives SBAR but forgets to include allergies and current medications in the Background. What is the MOST likely risk?

a)

Delayed lab processing

b)

Increased chance of duplicate tests

c)

Possible ordering of a harmful or contraindicated medication

d)

The patient might be discharged too early

5.

During a shift handoff, the outgoing nurse only says, “He’s fine, just keep an eye on his pain meds.” What is the BIGGEST problem with this handoff?

a)

It uses too much medical jargon

b)

It doesn’t follow a structured format like SBAR

c)

It’s too long and detailed

d)

It focuses too much on vitals

6.

Which of the following SBAR errors is MOST likely to lead to miscommunication in an emergency?

a)

Speaking too loudly

b)

Including the patient’s date of birth in the Situation

c)

Failing to clearly state what you are asking the provider to do

d)

Writing down key points before calling

7.

A nurse brings lab tubes into the room already labeled with a patient’s sticker but then realizes there are two patients with very similar names on the unit. What is the BEST action?

a)

Use the tubes anyway to save time

b)

Cross out one name and write the other

c)

Discard the pre-labeled tubes and relabel new ones at the bedside after confirming ID

d)

Ask the lab to fix any labeling issues later

8.

A patient is extremely anxious about a blood draw and moves suddenly as the needle is inserted. What is the MOST important immediate priority?

a)

Finish filling all tubes quickly

b)

Stabilize the needle, stop if needed, and ensure patient safety and vein integrity

c)

Tighten the tourniquet further

d)

Ignore the movement if blood is flowing

9.

A nurse notices mild swelling and coolness around an IV site while the infusion is running. The patient reports discomfort. What is the BEST first action?

a)

Increase the IV rate to flush the vein

b)

Stop the infusion and assess for infiltration

c)

Ignore the findings if vitals are stable

d)

Tape the IV more tightly in place

10.

During an IV start, the nurse palpates a vein that feels “hard and rope-like” and the patient reports tenderness. What is the BEST interpretation?

a)

This is a perfect vein for IV insertion

b)

The vein is likely sclerosed or thrombosed and should be avoided

c)

The patient is dehydrated but the vein is normal

d)

The vein is superficial and ideal for large-bore catheters

11.

Which combination of findings is MOST consistent with a correctly placed peripheral IV site?

a)

No redness, no swelling, patient reports minimal discomfort, and fluids run easily

b)

Redness, warmth, and severe pain with any infusion

c)

Extreme swelling, cool skin, and no blood return

d)

Fluid leaking onto the skin around the catheter

12.

A patient reports burning pain along the vein during IV medication administration. What is the nurse’s BEST action?

a)

Ignore it if the IV is still running

b)

Immediately stop the medication, assess the site, and check for phlebitis or infiltration

c)

Tighten the tubing to reduce flow

d)

Ask the patient not to complain

13.

A patient’s WBC count has risen from 8,000 to 19,000 over 24 hours and they have a new fever and productive cough. Which conclusion is MOST appropriate?

a)

This is a normal variation and not concerning

b)

This suggests a possible developing infection

c)

This is probably a lab error and should be ignored

d)

This proves the patient has leukemia

14.

A patient with anemia has hemoglobin of 7 g/dL (low). Which symptom is MOST consistent with this lab result?

a)

Sudden joint swelling

b)

Fatigue, shortness of breath with activity, and pale skin

c)

Increased hair growth

d)

High fever and stiff neck

15.

A patient has platelets of 35,000 (very low). Which nursing instruction is MOST appropriate?

a)

It’s okay to play contact sports as usual.

b)

Avoid shaving with a razor; use an electric shaver and watch for unusual bruising or bleeding.

c)

Drink a lot of water for your kidneys.

d)

Take extra aspirin for pain relief.

16.

Which combination of lab values is MOST consistent with worsening kidney function?

a)

High BUN, high creatinine, low GFR

b)

Low BUN, low creatinine, high GFR

c)

High AST, high ALT, normal creatinine

d)

Normal BUN, high HDL, low LDL

17.

A patient with chronic kidney disease has a rising creatinine and complains of nausea and metallic taste in the mouth. What is the BEST explanation for these symptoms?

a)

Liver failure

b)

Build-up of waste products in the blood due to poor filtration

c)

Low platelet count

d)

Excess stomach acid

18.

A patient with liver damage has very high AST and ALT and an elevated INR. Which complication is MOST concerning?

a)

Increased risk of clot formation

b)

Increased risk of bleeding because clotting factor production is impaired

c)

Improved oxygen transport

d)

Increased bone density

19.

A patient has chest pain and their troponin is within normal range. What conclusion is MOST appropriate?

a)

They definitely do not have heart disease

b)

A heart attack is less likely at that moment, but clinical symptoms still need evaluation

c)

The lab is wrong; ignore the result

d)

Troponin has no value in evaluating chest pain

20.

Which patient is at the HIGHEST risk of cardiovascular disease based on lipid profile alone?

a)

LDL 80, HDL 60, triglycerides 90

b)

LDL 110, HDL 50, triglycerides 100

c)

LDL 190, HDL 30, triglycerides 220

d)

LDL 130, HDL 70, triglycerides 70

21.

A patient’s PT/INR is much higher than the target range while taking a blood thinner. Which symptom would be MOST concerning?

a)

Mild thirst

b)

Nosebleeds and bleeding gums

c)

Restless legs at night

d)

Increased appetite

22.

Why are trends in GFR over several months more helpful than a single GFR value?

a)

Lab machines can only report averages

b)

Trends show whether kidney function is stable, improving, or worsening over time

c)

Single values are never accurate

d)

GFR does not change over time

23.

Which combination BEST describes the three main skin layers from outermost to innermost AND one key feature of each?

a)

Hypodermis – pigment; Epidermis – fat; Dermis – bone

b)

Epidermis – barrier; Dermis – vessels/nerves; Hypodermis – fat/insulation

c)

Dermis – barrier; Hypodermis – pigments; Epidermis – cushioning

d)

Epidermis – cushioning; Hypodermis – immune cells; Dermis – hair only

24.

A patient with extensive loss of the epidermis and dermis is at high risk for which complication and why?

a)

Improved immunity because skin is gone

b)

Dehydration and infection due to loss of barrier and fluid regulation

c)

Higher blood pressure

d)

Increased bone density

25.

Which statement BEST describes how the integumentary system supports immune function?

a)

The skin produces antibodies directly

b)

The skin acts as a physical barrier and contains immune cells that detect pathogens

c)

The skin replaces white blood cells

d)

The skin pumps lymph through the body