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RN COMPREHENSIVE PREDICTOR - PRACTICE QUESTIONS (70 Questions and
answers with rationales) 2026 update
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These 70 practice questions cover high-yield topics for the RN VATI
Comprehensive Predictor and NCLEX-RN examination.
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QUESTION 1 | TOPIC: Cardiovascular
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A client with heart failure is prescribed furosemide 40 mg IV. Which assessment
finding indicates the medication is effective?
A. Weight gain of 2 kg in 24 hours
B. Decreased ankle edema and urine output of 200 mL/hr
C. Increased blood pressure from 110/70 to 140/90 mmHg
D. Potassium level of 2.8 mEq/L
ANSWER: B
RATIONALE:
Furosemide is a loop diuretic that reduces fluid overload in heart failure. Effective
signs include decreased peripheral edema and increased urine output. Weight
gain indicates fluid retention (A). Elevated BP (C) is not a therapeutic goal.
Hypokalemia (D) is an adverse effect requiring intervention.
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QUESTION 2 | TOPIC: Cardiovascular
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A client returns to the unit after cardiac catheterization via the right femoral
artery. Which action should the nurse prioritize?
A. Assess pedal pulses every 15 minutes
B. Maintain the client on bed rest with the leg extended for 4-6 hours
C. Encourage the client to ambulate within 1 hour
D. Apply a heating pad to the insertion site
ANSWER: B
RATIONALE:
After femoral artery catheterization, bed rest with the affected leg extended is
required for 4-6 hours to prevent bleeding and hematoma formation. Pedal pulse
assessment (A) is important but secondary to preventing bleeding. Early
ambulation (C) increases bleeding risk. Heat (D) increases bleeding and is
contraindicated.
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QUESTION 3 | TOPIC: Cardiovascular
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Which client should the nurse assess FIRST?
A. Client with atrial fibrillation, heart rate 110, complaining of fatigue
B. Client 2 hours post-MI with chest pain rated 8/10
C. Client with new-onset heart failure, oxygen saturation 94% on 2L NC
D. Client with hypertension, BP 160/92, asymptomatic
ANSWER: B
,RATIONALE:
Using the ABC framework and Maslow's hierarchy, the client with post-MI chest
pain (8/10) requires immediate assessment as this may indicate recurrent
ischemia, extension of the infarct, or complications. Chest pain in a post-MI client
is a potential emergency. The other clients are stable or have expected findings.
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QUESTION 4 | TOPIC: Cardiovascular
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A client receiving digoxin has a serum level of 2.5 ng/mL. Which finding requires
immediate intervention?
A. Nausea and anorexia
B. Visual disturbances (yellow-green halos)
C. Heart rate of 58 beats/minute
D. All of the above
ANSWER: D
RATIONALE:
All listed findings are signs of digoxin toxicity. The therapeutic range for digoxin is
0.5-2.0 ng/mL; 2.5 ng/mL indicates toxicity. GI symptoms (nausea, anorexia),
visual disturbances, and bradycardia (HR <60) are classic signs. The nurse should
hold the next dose and notify the provider immediately.
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QUESTION 5 | TOPIC: Cardiovascular
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The nurse is caring for a client with a new permanent pacemaker. Which
discharge instruction is MOST important?
, A. Avoid lifting the affected arm above shoulder level for 4-6 weeks
B. You may resume all normal activities immediately
C. You do not need any follow-up appointments
D. Avoid all electronic devices including cell phones
ANSWER: A
RATIONALE:
After pacemaker insertion, the client should avoid lifting the affected arm above
shoulder level for 4-6 weeks to prevent lead dislodgement. Activities are gradually
resumed (B). Regular follow-up is required for pacemaker checks (C). Cell phones
are safe if kept 6 inches from the device (D).
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QUESTION 6 | TOPIC: Cardiovascular
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A client with unstable angina is started on heparin infusion. Which laboratory
value indicates therapeutic anticoagulation?
A. PT 12 seconds
B. aPTT 1.5-2.5 times the control
C. INR 2.0-3.0
D. Platelet count 80,000/mm³
ANSWER: B
RATIONALE:
Heparin therapy is monitored using aPTT, with a therapeutic range of 1.5-2.5
times the control value (typically 60-80 seconds). PT/INR (A, C) monitor warfarin
therapy. A platelet count of 80,000 (D) indicates heparin-induced
thrombocytopenia (HIT), a serious adverse effect.