KMLE Q&A Bank

KMLE nursing questions, phrased the way the real exam phrases them

Single-best-answer stems, each with a full written rationale. The bank is tagged by domain, so you can drill exactly the KMLE topics your mock scores flag as weak.

What the bank drills

Priority and 'first action' questionsDelegation and scope-of-practice callsMedication safety and calculation problemsInfection control scenariosMaternal-newborn warning signsPaediatric assessment findings

Sample KMLE questions with rationales

Setting priorities

During handover the nurse takes report on four patients. Who needs attention first?

The patient breathing 8 times a minute after receiving IV morphine.

Why: Airway and breathing beat every other concern. Opioid-induced respiratory depression can be reversed immediately with naloxone, so this patient is checked before pain complaints, wound concerns or discharge tasks.

Electrolyte imbalance

A dialysis patient's potassium comes back at 6.8 mmol/L. What's the nurse's next move?

Order a 12-lead ECG.

Why: Peaked T waves and a widening QRS point to cardiac instability, and that finding decides whether emergency calcium gluconate is needed before starting any potassium-lowering treatment.

Obstetric care

The CTG shows late decelerations while an oxytocin infusion is running. What comes first?

Turn off the oxytocin and position the mother on her left side.

Why: Late decelerations point to uteroplacental insufficiency. Stopping the stimulant and improving placental blood flow takes priority over oxygen, IV fluids or calling for escalation.

Infection control

A patient arrives with active pulmonary tuberculosis. Which room assignment is correct?

A negative-pressure single room, with staff wearing N95 respirators.

Why: TB travels on droplet nuclei that linger in the air. Neither a surgical mask nor a standard room stops airborne spread.

A method for reading a KMLE stem

1. Read the closing line first — it tells you whether the question wants an assessment, an action or a teaching point.
2. Work out if the patient is stable. If not, airway, breathing and circulation outrank everything else.
3. Cut any option that delegates, delays or documents when the patient actually needs the nurse right now.
4. Between two clinically sound options, pick the one the nurse can carry out alone, immediately.
5. Don't switch an answer unless you can put the reason for it into words.

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KMLE nursing questions, phrased the way the real exam phrases them

What the bank drills

Sample KMLE questions with rationales

During handover the nurse takes report on four patients. Who needs attention first?

A dialysis patient's potassium comes back at 6.8 mmol/L. What's the nurse's next move?

The CTG shows late decelerations while an oxytocin infusion is running. What comes first?

A patient arrives with active pulmonary tuberculosis. Which room assignment is correct?

A method for reading a KMLE stem

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