NCLEX-RN Comprehensive Predictor Exam
100 Real Exam Questions and Answers
with rationals
Question 1
A nurse is assessing a client who is 2 hours post-cardiac
catheterization via the right femoral artery. Which finding requires
immediate intervention?
A. Pulse oximetry of 94% on room air
B. Right pedal pulse weaker than left
C. Client reports back pain rated 3/10
D. Small amount of dried blood at insertion site
Answer: B – A weaker pedal pulse on the catheterized side
suggests possible arterial thrombus or occlusion. The other
findings are expected or non-critical.
Question 2
A client with heart failure has crackles in both lungs, edema in
lower extremities, and neck vein distention. Which dietary
instruction is most important?
A. "Limit your daily protein intake to 50 grams"
B. "Avoid adding salt to your meals at the table"
C. "Drink at least 3 liters of water daily"
D. "Increase potassium-rich foods like bananas"
,Answer: B – Sodium restriction is critical to reduce fluid overload.
Table salt avoidance is a practical, high-yield intervention. Fluid
intake would be restricted, not encouraged.
Question 3
A nurse is caring for a client receiving a continuous heparin
infusion for DVT. Which lab value requires priority notification to
the provider?
A. aPTT of 85 seconds (therapeutic range 60-80)
B. Platelet count of 40,000/mm³
C. Hemoglobin of 12 g/dL
D. INR of 1.2
Answer: B – A sharp drop in platelets indicates possible heparin-
induced thrombocytopenia (HIT), a life-threatening complication
requiring immediate heparin discontinuation.
Question 4
A client with major depressive disorder has been taking
phenelzine (Nardil) for 6 months. Which food item on their lunch
tray should the nurse remove?
A. Grilled chicken breast
B. Steamed white rice
C. Aged cheddar cheese
D. Apple slices
,Answer: C – Phenelzine is an MAOI. Aged cheeses contain
tyramine, which can precipitate a hypertensive crisis. This is a
classic "remove from tray" NCLEX scenario.
Question 5
A nurse is preparing to administer furosemide 40 mg IV push.
Which assessment finding would contraindicate administration?
A. Serum potassium 3.8 mEq/L
B. Blood pressure 88/52 mm Hg
C. Urine output 40 mL over past hour
D. Mild pedal edema
Answer: B – Furosemide causes vasodilation and diuresis, further
lowering BP. Hypotension is a contraindication. The other findings
are manageable or expected.
Question 6
A client post-hip arthroplasty reports sudden shortness of breath,
chest pain, and feels "dreadful." Vital signs: HR 122, RR 32, BP
98/64, SpO2 88% on 2L nasal cannula. What is the priority action?
A. Administer morphine sulfate as ordered
B. Position client in high Fowler's with legs dependent
C. Prepare for chest tube insertion
D. Apply sequential compression devices to legs
, Answer: B – These symptoms suggest pulmonary embolism. High
Fowler's optimizes breathing; dependent legs may help preload
(though controversial, this is a traditional NCLEX answer). Oxygen
and notification of provider come next.
Question 7
A nurse is teaching a client with newly diagnosed type 1 diabetes
about insulin administration. Which statement indicates correct
understanding?
A. "I should store my current vial of insulin in the freezer"
B. "I will inject air into the vial equal to my insulin dose before
drawing it up"
C. "I can use the same syringe for up to 3 days if I keep the cap
on"
D. "I will give my insulin after I finish eating to prevent
hypoglycemia"
Answer: B – Injecting air equal to the dose into the vial prevents
vacuum formation. Syringes are single-use; insulin should not be
frozen; rapid-acting insulin is given before meals.
Question 8
A client is admitted with suspected meningitis. Which finding is
most indicative of this diagnosis?
A. Positive Brudzinski's sign
B. Glasgow Coma Scale score of 15
100 Real Exam Questions and Answers
with rationals
Question 1
A nurse is assessing a client who is 2 hours post-cardiac
catheterization via the right femoral artery. Which finding requires
immediate intervention?
A. Pulse oximetry of 94% on room air
B. Right pedal pulse weaker than left
C. Client reports back pain rated 3/10
D. Small amount of dried blood at insertion site
Answer: B – A weaker pedal pulse on the catheterized side
suggests possible arterial thrombus or occlusion. The other
findings are expected or non-critical.
Question 2
A client with heart failure has crackles in both lungs, edema in
lower extremities, and neck vein distention. Which dietary
instruction is most important?
A. "Limit your daily protein intake to 50 grams"
B. "Avoid adding salt to your meals at the table"
C. "Drink at least 3 liters of water daily"
D. "Increase potassium-rich foods like bananas"
,Answer: B – Sodium restriction is critical to reduce fluid overload.
Table salt avoidance is a practical, high-yield intervention. Fluid
intake would be restricted, not encouraged.
Question 3
A nurse is caring for a client receiving a continuous heparin
infusion for DVT. Which lab value requires priority notification to
the provider?
A. aPTT of 85 seconds (therapeutic range 60-80)
B. Platelet count of 40,000/mm³
C. Hemoglobin of 12 g/dL
D. INR of 1.2
Answer: B – A sharp drop in platelets indicates possible heparin-
induced thrombocytopenia (HIT), a life-threatening complication
requiring immediate heparin discontinuation.
Question 4
A client with major depressive disorder has been taking
phenelzine (Nardil) for 6 months. Which food item on their lunch
tray should the nurse remove?
A. Grilled chicken breast
B. Steamed white rice
C. Aged cheddar cheese
D. Apple slices
,Answer: C – Phenelzine is an MAOI. Aged cheeses contain
tyramine, which can precipitate a hypertensive crisis. This is a
classic "remove from tray" NCLEX scenario.
Question 5
A nurse is preparing to administer furosemide 40 mg IV push.
Which assessment finding would contraindicate administration?
A. Serum potassium 3.8 mEq/L
B. Blood pressure 88/52 mm Hg
C. Urine output 40 mL over past hour
D. Mild pedal edema
Answer: B – Furosemide causes vasodilation and diuresis, further
lowering BP. Hypotension is a contraindication. The other findings
are manageable or expected.
Question 6
A client post-hip arthroplasty reports sudden shortness of breath,
chest pain, and feels "dreadful." Vital signs: HR 122, RR 32, BP
98/64, SpO2 88% on 2L nasal cannula. What is the priority action?
A. Administer morphine sulfate as ordered
B. Position client in high Fowler's with legs dependent
C. Prepare for chest tube insertion
D. Apply sequential compression devices to legs
, Answer: B – These symptoms suggest pulmonary embolism. High
Fowler's optimizes breathing; dependent legs may help preload
(though controversial, this is a traditional NCLEX answer). Oxygen
and notification of provider come next.
Question 7
A nurse is teaching a client with newly diagnosed type 1 diabetes
about insulin administration. Which statement indicates correct
understanding?
A. "I should store my current vial of insulin in the freezer"
B. "I will inject air into the vial equal to my insulin dose before
drawing it up"
C. "I can use the same syringe for up to 3 days if I keep the cap
on"
D. "I will give my insulin after I finish eating to prevent
hypoglycemia"
Answer: B – Injecting air equal to the dose into the vial prevents
vacuum formation. Syringes are single-use; insulin should not be
frozen; rapid-acting insulin is given before meals.
Question 8
A client is admitted with suspected meningitis. Which finding is
most indicative of this diagnosis?
A. Positive Brudzinski's sign
B. Glasgow Coma Scale score of 15
