RN Comprehensive Predictor
ACTUAL EXAM 2026/2027: 100%
Verified Questions & Correct Answers
Question 1:
A 68-year-old man with COPD, HR 118, BP 162/94, RR 26, SpO₂ 89% on 2 L NC, ABG: pH 7.28,
PaCO₂ 68 mmHg, HCO₃⁻ 32 mEq/L. Which action is most urgent?
A. Increase O₂ to 4 L/min via NC
B. Obtain CXR stat
C. Initiate BiPAP per protocol
D. Give albuterol 2.5 mg neb
Correct Answer: C
Rationale: Acute hypercapnic respiratory failure (pH <7.30, PaCO₂ >60) mandates non-invasive
positive-pressure ventilation (BiPAP) to decrease work of breathing and improve acidosis (Global
Initiative for COPD 2026).
,Question 2:
A term neonate is delivered with tight nuchal cord; HR 80 bpm, weak gasp, cyanotic. What is the
priority intervention?
A. Dry and stimulate
B. Begin positive-pressure ventilation
C. Start chest compressions
D. Administer epinephrine via ETT
Correct Answer: B
Rationale: HR <100 bpm + inadequate respirations = immediate PPV per Neonatal Resuscitation
Program 7th ed. 2026.
Question 3:
A client at 28 weeks gestation reports severe headache and visual changes; BP 170/110, platelets
88,000/mm³, AST 92 U/L. Which order should the nurse implement first?
A. Start magnesium sulfate 4 g IV load
B. Give hydralazine 20 mg IV
C. Insert Foley catheter
,D. Obtain fetal heart tracing
Correct Answer: A
Rationale: Severe preeclampsia with HELLP criteria; magnesium sulfate prevents eclampsia
seizures (ACOG Practice Bulletin #222, 2026).
Question 4:
A 5-year-old with acute lymphoblastic leukemia receiving asparaginase develops acute right-leg
pain, pallor, absent pedal pulse. What is the priority nursing action?
A. Elevate extremity
B. Check capillary refill
C. Notify provider stat
D. Administer morphine 0.05 mg/kg
Correct Answer: C
Rationale: Asparaginase-associated thrombosis is a medical emergency; immediate provider
notification enables stat imaging and anticoagulation (Children’s Oncology Group 2026).
Question 5:
, A client with schizophrenia on clozapine reports fever 38.7°C, WBC 2,800/mm³, ANC 1,100/mm³.
Which instruction should the nurse give?
A. Hold clozapine and contact provider immediately
B. Administer acetaminophen 650 mg PO
C. Obtain blood cultures ×2
D. Increase fluid intake
Correct Answer: A
Rationale: ANC <1,500/mm³ mandates immediate discontinuation to prevent progression to
agranulocytosis (Clozapine REMS 2026).
Question 6:
During shift report, the charge nurse learns that a new RN hung nitroprusside 0.5 mg/mL without
protecting the bag from light. The bag was hung 1 hour ago. What is the priority?
A. Remove bag and replace immediately
B. Cover bag with amber sleeve
C. Continue infusion and document
D. Obtain BP q15 min
ACTUAL EXAM 2026/2027: 100%
Verified Questions & Correct Answers
Question 1:
A 68-year-old man with COPD, HR 118, BP 162/94, RR 26, SpO₂ 89% on 2 L NC, ABG: pH 7.28,
PaCO₂ 68 mmHg, HCO₃⁻ 32 mEq/L. Which action is most urgent?
A. Increase O₂ to 4 L/min via NC
B. Obtain CXR stat
C. Initiate BiPAP per protocol
D. Give albuterol 2.5 mg neb
Correct Answer: C
Rationale: Acute hypercapnic respiratory failure (pH <7.30, PaCO₂ >60) mandates non-invasive
positive-pressure ventilation (BiPAP) to decrease work of breathing and improve acidosis (Global
Initiative for COPD 2026).
,Question 2:
A term neonate is delivered with tight nuchal cord; HR 80 bpm, weak gasp, cyanotic. What is the
priority intervention?
A. Dry and stimulate
B. Begin positive-pressure ventilation
C. Start chest compressions
D. Administer epinephrine via ETT
Correct Answer: B
Rationale: HR <100 bpm + inadequate respirations = immediate PPV per Neonatal Resuscitation
Program 7th ed. 2026.
Question 3:
A client at 28 weeks gestation reports severe headache and visual changes; BP 170/110, platelets
88,000/mm³, AST 92 U/L. Which order should the nurse implement first?
A. Start magnesium sulfate 4 g IV load
B. Give hydralazine 20 mg IV
C. Insert Foley catheter
,D. Obtain fetal heart tracing
Correct Answer: A
Rationale: Severe preeclampsia with HELLP criteria; magnesium sulfate prevents eclampsia
seizures (ACOG Practice Bulletin #222, 2026).
Question 4:
A 5-year-old with acute lymphoblastic leukemia receiving asparaginase develops acute right-leg
pain, pallor, absent pedal pulse. What is the priority nursing action?
A. Elevate extremity
B. Check capillary refill
C. Notify provider stat
D. Administer morphine 0.05 mg/kg
Correct Answer: C
Rationale: Asparaginase-associated thrombosis is a medical emergency; immediate provider
notification enables stat imaging and anticoagulation (Children’s Oncology Group 2026).
Question 5:
, A client with schizophrenia on clozapine reports fever 38.7°C, WBC 2,800/mm³, ANC 1,100/mm³.
Which instruction should the nurse give?
A. Hold clozapine and contact provider immediately
B. Administer acetaminophen 650 mg PO
C. Obtain blood cultures ×2
D. Increase fluid intake
Correct Answer: A
Rationale: ANC <1,500/mm³ mandates immediate discontinuation to prevent progression to
agranulocytosis (Clozapine REMS 2026).
Question 6:
During shift report, the charge nurse learns that a new RN hung nitroprusside 0.5 mg/mL without
protecting the bag from light. The bag was hung 1 hour ago. What is the priority?
A. Remove bag and replace immediately
B. Cover bag with amber sleeve
C. Continue infusion and document
D. Obtain BP q15 min
