**The Next Generation NCLEX-RN Mastery:
Comprehensive Predictor Exam with Clinical
Judgment Case Studies**
---
**Question 113**
A nurse is assessing a client who is 24 hours post-hip replacement surgery. The client suddenly reports
shortness of breath and chest pain. The nurse notes the client is diaphoretic and the heart rate is 120
bpm. Which of the following actions should the nurse take first?
A. Administer oxygen at 4 L/min via nasal cannula
B. Place the client in a high-Fowler’s position
C. Check the client’s oxygen saturation
D. Call a rapid response team
💫ANSWER✔️✔️: D. Call a rapid response team. These symptoms suggest a pulmonary embolism (PE), a
life-threatening emergency requiring immediate team-based intervention.
💫RATIONALE✔️✔️: While oxygen (A) and positioning (B) are important, the priority is to activate the
emergency response system for a suspected PE. Checking SpO2 (C) can be done simultaneously but does
not replace calling for help.
---
**Question 114**
,A nurse is providing education about fall prevention to an older adult client who lives alone. Which of
the following statements by the client indicates an understanding of the teaching?
A. “I will wear socks with grip soles around the house.”
B. “I will use a step stool to reach high shelves.”
C. “I will turn on a light when I get up to use the bathroom at night.”
D. “I will remove the grab bars from my shower because they are ugly.”
💫ANSWER✔️✔️: C. Turning on a light prevents tripping over unseen objects. Darkness is a major fall
hazard.
💫RATIONALE✔️✔️: Grip socks (A) are better than bare feet but not as safe as non-skid slippers. Step
stools (B) increase fall risk. Removing grab bars (D) is dangerous.
---
**Question 115**
A nurse is caring for a client with a new prescription for furosemide (Lasix). Which of the following
laboratory values should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
💫ANSWER✔️✔️: B. Potassium. Furosemide is a loop diuretic that causes significant potassium wasting,
leading to hypokalemia.
, 💫RATIONALE✔️✔️: Hypokalemia increases risk of cardiac arrhythmias and digoxin toxicity. Sodium (A)
may decrease but is less critical. Calcium (C) may increase. Magnesium (D) may decrease but is not the
primary concern.
---
**Question 116**
A nurse is providing anticipatory guidance to the parents of a 4-year-old child. The parents ask, “How
can we help our child cope with a planned hospitalization?” Which of the following is the best
recommendation?
A. “Tell your child about the hospitalization one month in advance to allow time to adjust.”
B. “Bring a favorite toy or blanket from home to the hospital.”
C. “Explain all procedures in detail the night before they happen.”
D. “Tell your child that the shot will not hurt at all.”
💫ANSWER✔️✔️: B. A transitional object (familiar toy/blanket) provides comfort and security in an
unfamiliar environment.
💫RATIONALE✔️✔️: Preschoolers have little concept of time; telling them one month early (A) increases
anxiety. Detailed explanations (C) are age-inappropriate. Lying about pain (D) erodes trust.
---
**Question 117**
A nurse is performing a shift assessment on a client with cirrhosis of the liver. Which finding is most
concerning?
A. Spider angiomas on the chest
Comprehensive Predictor Exam with Clinical
Judgment Case Studies**
---
**Question 113**
A nurse is assessing a client who is 24 hours post-hip replacement surgery. The client suddenly reports
shortness of breath and chest pain. The nurse notes the client is diaphoretic and the heart rate is 120
bpm. Which of the following actions should the nurse take first?
A. Administer oxygen at 4 L/min via nasal cannula
B. Place the client in a high-Fowler’s position
C. Check the client’s oxygen saturation
D. Call a rapid response team
💫ANSWER✔️✔️: D. Call a rapid response team. These symptoms suggest a pulmonary embolism (PE), a
life-threatening emergency requiring immediate team-based intervention.
💫RATIONALE✔️✔️: While oxygen (A) and positioning (B) are important, the priority is to activate the
emergency response system for a suspected PE. Checking SpO2 (C) can be done simultaneously but does
not replace calling for help.
---
**Question 114**
,A nurse is providing education about fall prevention to an older adult client who lives alone. Which of
the following statements by the client indicates an understanding of the teaching?
A. “I will wear socks with grip soles around the house.”
B. “I will use a step stool to reach high shelves.”
C. “I will turn on a light when I get up to use the bathroom at night.”
D. “I will remove the grab bars from my shower because they are ugly.”
💫ANSWER✔️✔️: C. Turning on a light prevents tripping over unseen objects. Darkness is a major fall
hazard.
💫RATIONALE✔️✔️: Grip socks (A) are better than bare feet but not as safe as non-skid slippers. Step
stools (B) increase fall risk. Removing grab bars (D) is dangerous.
---
**Question 115**
A nurse is caring for a client with a new prescription for furosemide (Lasix). Which of the following
laboratory values should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
💫ANSWER✔️✔️: B. Potassium. Furosemide is a loop diuretic that causes significant potassium wasting,
leading to hypokalemia.
, 💫RATIONALE✔️✔️: Hypokalemia increases risk of cardiac arrhythmias and digoxin toxicity. Sodium (A)
may decrease but is less critical. Calcium (C) may increase. Magnesium (D) may decrease but is not the
primary concern.
---
**Question 116**
A nurse is providing anticipatory guidance to the parents of a 4-year-old child. The parents ask, “How
can we help our child cope with a planned hospitalization?” Which of the following is the best
recommendation?
A. “Tell your child about the hospitalization one month in advance to allow time to adjust.”
B. “Bring a favorite toy or blanket from home to the hospital.”
C. “Explain all procedures in detail the night before they happen.”
D. “Tell your child that the shot will not hurt at all.”
💫ANSWER✔️✔️: B. A transitional object (familiar toy/blanket) provides comfort and security in an
unfamiliar environment.
💫RATIONALE✔️✔️: Preschoolers have little concept of time; telling them one month early (A) increases
anxiety. Detailed explanations (C) are age-inappropriate. Lying about pain (D) erodes trust.
---
**Question 117**
A nurse is performing a shift assessment on a client with cirrhosis of the liver. Which finding is most
concerning?
A. Spider angiomas on the chest
