**The RN Licensure Preparation Exam:
Comprehensive NCLEX-RN Review**
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### Question 1 of 84
A nurse is caring for a client with new DVT on heparin. aPTT is 110 sec, control 30 sec. Action?
A) Continue infusion
B) Decrease rate
C) Stop infusion, notify provider
D) Give vitamin K
💫RATIONALE✔️✔️: aPTT 110 >3.9x control, supratherapeutic. Stop heparin, notify provider. Vitamin K
reverses warfarin.
💫ANSWER✔️✔️: C) Stop infusion, notify provider
---
### Question 2 of 84
A client with chest tube has continuous bubbling in water-seal chamber. First action?
A) Clamp tube
,B) Tighten connections
C) Notify provider
D) Document
💫RATIONALE✔️✔️: Continuous bubbling = air leak. First tighten connections (B). Clamping dangerous.
💫ANSWER✔️✔️: B) Tighten connections
---
### Question 3 of 84
**Select-All-That-Apply (SATA):** COPD exacerbation. Which findings indicate severe? (Select all that
apply.)
A) Silent chest
B) SpO2 88% on RA
C) Pulsus paradoxus 15 mmHg
D) Speaking full sentences
E) PEF 50% personal best
💫RATIONALE✔️✔️: Severe: silent chest (A), SpO2 <90% (B), pulsus paradoxus >12 (C). Full sentences
mild. PEF 50% moderate.
💫ANSWER✔️✔️: A, B, C
---
### Question 4 of 84
A client with HF on lisinopril. Which finding requires immediate reporting?
,A) Dry cough
B) K+ 4.8
C) BP 110/70
D) Angioedema
💫RATIONALE✔️✔️: Angioedema (D) is life-threatening allergic reaction to ACE inhibitors. Dry cough
common but not emergent.
💫ANSWER✔️✔️: D) Angioedema
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### Question 5 of 84
A client on warfarin for AF. Which INR indicates therapeutic range?
A) 1.0
B) 1.5
C) 2.5
D) 4.5
💫RATIONALE✔️✔️: Target INR for AF is 2-3 (C). 1.0 normal. <2 increases clot risk. >4 increases bleeding.
💫ANSWER✔️✔️: C) 2.5
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### Question 6 of 84
A client receiving blood transfusion reports low back pain and chills. First action?
, A) Slow infusion
B) Stop transfusion
C) Give acetaminophen
D) Notify provider
💫RATIONALE✔️✔️: Low back pain/chills = hemolytic reaction. First stop transfusion (B), then notify
provider.
💫ANSWER✔️✔️: B) Stop transfusion
---
### Question 7 of 84
**Select-All-That-Apply (SATA):** Hyperthyroidism findings. Which expected? (Select all that apply.)
A) Weight loss
B) Bradycardia
C) Heat intolerance
D) Exophthalmos
E) Constipation
💫RATIONALE✔️✔️: Hyperthyroidism: weight loss (A), heat intolerance (C), exophthalmos (D).
Bradycardia/constipation are hypothyroidism.
💫ANSWER✔️✔️: A, C, D
---
### Question 8 of 84
Comprehensive NCLEX-RN Review**
---
### Question 1 of 84
A nurse is caring for a client with new DVT on heparin. aPTT is 110 sec, control 30 sec. Action?
A) Continue infusion
B) Decrease rate
C) Stop infusion, notify provider
D) Give vitamin K
💫RATIONALE✔️✔️: aPTT 110 >3.9x control, supratherapeutic. Stop heparin, notify provider. Vitamin K
reverses warfarin.
💫ANSWER✔️✔️: C) Stop infusion, notify provider
---
### Question 2 of 84
A client with chest tube has continuous bubbling in water-seal chamber. First action?
A) Clamp tube
,B) Tighten connections
C) Notify provider
D) Document
💫RATIONALE✔️✔️: Continuous bubbling = air leak. First tighten connections (B). Clamping dangerous.
💫ANSWER✔️✔️: B) Tighten connections
---
### Question 3 of 84
**Select-All-That-Apply (SATA):** COPD exacerbation. Which findings indicate severe? (Select all that
apply.)
A) Silent chest
B) SpO2 88% on RA
C) Pulsus paradoxus 15 mmHg
D) Speaking full sentences
E) PEF 50% personal best
💫RATIONALE✔️✔️: Severe: silent chest (A), SpO2 <90% (B), pulsus paradoxus >12 (C). Full sentences
mild. PEF 50% moderate.
💫ANSWER✔️✔️: A, B, C
---
### Question 4 of 84
A client with HF on lisinopril. Which finding requires immediate reporting?
,A) Dry cough
B) K+ 4.8
C) BP 110/70
D) Angioedema
💫RATIONALE✔️✔️: Angioedema (D) is life-threatening allergic reaction to ACE inhibitors. Dry cough
common but not emergent.
💫ANSWER✔️✔️: D) Angioedema
---
### Question 5 of 84
A client on warfarin for AF. Which INR indicates therapeutic range?
A) 1.0
B) 1.5
C) 2.5
D) 4.5
💫RATIONALE✔️✔️: Target INR for AF is 2-3 (C). 1.0 normal. <2 increases clot risk. >4 increases bleeding.
💫ANSWER✔️✔️: C) 2.5
---
### Question 6 of 84
A client receiving blood transfusion reports low back pain and chills. First action?
, A) Slow infusion
B) Stop transfusion
C) Give acetaminophen
D) Notify provider
💫RATIONALE✔️✔️: Low back pain/chills = hemolytic reaction. First stop transfusion (B), then notify
provider.
💫ANSWER✔️✔️: B) Stop transfusion
---
### Question 7 of 84
**Select-All-That-Apply (SATA):** Hyperthyroidism findings. Which expected? (Select all that apply.)
A) Weight loss
B) Bradycardia
C) Heat intolerance
D) Exophthalmos
E) Constipation
💫RATIONALE✔️✔️: Hyperthyroidism: weight loss (A), heat intolerance (C), exophthalmos (D).
Bradycardia/constipation are hypothyroidism.
💫ANSWER✔️✔️: A, C, D
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### Question 8 of 84
