NCLEX-RN Predictor Comprehensive Exam 2026 Update
1. A nurse is caring for a client with a potassium level of 2.8 mEq/L. Which
assessment finding is the priority?
A. Muscle weakness
B. Irregular heart rhythm
C. Abdominal cramping
D. Increased deep tendon reflexes
Answer: B
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias, making cardiac monitoring the priority.
2. Which medication should a nurse question for a client with a history of
asthma?
A. Atorvastatin
B. Lisinopril
C. Propranolol
D. Furosemide
Answer: C
Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction
and trigger asthma attacks.
,3. A nurse is preparing to administer digoxin. Which vital sign must be checked
before administration?
A. Blood pressure
B. Respiratory rate
C. Apical pulse
D. Temperature
Answer: C
Rationale: The nurse must assess the apical pulse for one full minute and withhold the
medication if the pulse is less than 60 beats per minute in an adult.
4. A client reports seeing ‘yellow halos’ around lights. Which medication toxicity
should the nurse suspect?
A. Warfarin
B. Lithium
C. Phenytoin
D. Digoxin
Answer: D
Rationale: Visual disturbances, such as yellow-green halos, are a classic sign of digoxin
toxicity.
5. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Low potassium levels sensitize the myocardium to digoxin, significantly
increasing the risk of toxicity.
, 6. A nurse is caring for a client with Type 1 Diabetes who is shaky and
diaphoretic. What is the first action?
A. Check the client’s blood glucose level
B. Administer 10 units of regular insulin
C. Call the healthcare provider
D. Provide a complex carbohydrate snack
Answer: A
Rationale: The client is showing signs of hypoglycemia; the nurse should verify the blood
glucose level first before intervening.
7. Which finding is expected in a client with Grave’s Disease?
A. Weight gain
B. Bradycardia
C. Exophthalmos
D. Cold intolerance
Answer: C
Rationale: Exophthalmos (bulging eyes) is a common manifestation of
hyperthyroidism/Grave’s Disease due to tissue swelling behind the eyes.
8. What is the priority assessment for a client receiving Magnesium Sulfate for
preeclampsia?
A. Deep tendon reflexes
B. Serum glucose
C. Bowel sounds
D. Pupillary response
Answer: A
Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, which can
lead to respiratory depression and cardiac arrest.
1. A nurse is caring for a client with a potassium level of 2.8 mEq/L. Which
assessment finding is the priority?
A. Muscle weakness
B. Irregular heart rhythm
C. Abdominal cramping
D. Increased deep tendon reflexes
Answer: B
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias, making cardiac monitoring the priority.
2. Which medication should a nurse question for a client with a history of
asthma?
A. Atorvastatin
B. Lisinopril
C. Propranolol
D. Furosemide
Answer: C
Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction
and trigger asthma attacks.
,3. A nurse is preparing to administer digoxin. Which vital sign must be checked
before administration?
A. Blood pressure
B. Respiratory rate
C. Apical pulse
D. Temperature
Answer: C
Rationale: The nurse must assess the apical pulse for one full minute and withhold the
medication if the pulse is less than 60 beats per minute in an adult.
4. A client reports seeing ‘yellow halos’ around lights. Which medication toxicity
should the nurse suspect?
A. Warfarin
B. Lithium
C. Phenytoin
D. Digoxin
Answer: D
Rationale: Visual disturbances, such as yellow-green halos, are a classic sign of digoxin
toxicity.
5. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B
Rationale: Low potassium levels sensitize the myocardium to digoxin, significantly
increasing the risk of toxicity.
, 6. A nurse is caring for a client with Type 1 Diabetes who is shaky and
diaphoretic. What is the first action?
A. Check the client’s blood glucose level
B. Administer 10 units of regular insulin
C. Call the healthcare provider
D. Provide a complex carbohydrate snack
Answer: A
Rationale: The client is showing signs of hypoglycemia; the nurse should verify the blood
glucose level first before intervening.
7. Which finding is expected in a client with Grave’s Disease?
A. Weight gain
B. Bradycardia
C. Exophthalmos
D. Cold intolerance
Answer: C
Rationale: Exophthalmos (bulging eyes) is a common manifestation of
hyperthyroidism/Grave’s Disease due to tissue swelling behind the eyes.
8. What is the priority assessment for a client receiving Magnesium Sulfate for
preeclampsia?
A. Deep tendon reflexes
B. Serum glucose
C. Bowel sounds
D. Pupillary response
Answer: A
Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, which can
lead to respiratory depression and cardiac arrest.
