**Chamberlain Nursing Success Pack | 2025/2026 Edition – Complete
Prep Guide with Practice Questions**
*Your student-created study resource for mastering NCLEX concepts –
from Fundamentals to Critical Care.*
Compiled from student notes and practice resources — not an official
exam.
---
**💫QUESTION 1:**
A client with chronic heart failure is prescribed carvedilol (Coreg). Which finding indicates a therapeutic
response to the medication?
A) Heart rate of 52 beats/min and blood pressure of 98/62 mmHg
B) Improved ejection fraction on a follow-up echocardiogram
C) Weight gain of 2 pounds in 2 days
D) Serum potassium of 5.8 mEq/L
💫ANSWER✔️✔️: B) Improved ejection fraction on a follow-up echocardiogram
💫RATIONALE✔️✔️: Carvedilol is a beta-blocker used in heart failure to improve cardiac function over
time. An improved ejection fraction indicates the medication is working. Option A shows bradycardia
and hypotension (could be adverse effects). Option C indicates fluid retention (worsening). Option D is
hyperkalemia (not directly related). *I remember: "Coreg = heart's big beg for a better EF."* This nursing
exam prep question is essential for pharmacology mastery. *(SEO: nursing exam prep, study guide,
practice questions, pharmacology)*
---
**💫QUESTION 2:**
,A client with a suspected pulmonary embolism (PE) is suddenly dyspneic and has an SpO₂ of 84% on
room air. Which action should the nurse take first?
A) Administer oxygen via non-rebreather mask at 15 L/min
B) Place the client in a supine position with legs elevated
C) Administer a heparin bolus as prescribed
D) Obtain a stat arterial blood gas (ABG)
💫ANSWER✔️✔️: A) Administer oxygen via non-rebreather mask at 15 L/min
💫RATIONALE✔️✔️: The priority is to correct hypoxemia with high-flow oxygen. Option B (supine) would
worsen ventilation; heparin is important but not first; ABG can be obtained after oxygenation. *I recall:
"Oxygen first – hypoxia is the worst."* This critical care question is vital for nursing exam prep. *(SEO:
critical care, study guide, nursing exam prep)*
---
**💫QUESTION 3:**
A client with schizophrenia is prescribed risperidone (Risperdal). Which assessment finding is most
concerning?
A) Weight gain of 5 pounds in 1 month
B) Restlessness and fidgeting
C) Temperature of 39.5°C (103.1°F) and muscle rigidity
D) Dry mouth and constipation
💫ANSWER✔️✔️: C) Temperature of 39.5°C (103.1°F) and muscle rigidity
💫RATIONALE✔️✔️: These findings suggest neuroleptic malignant syndrome (NMS), a life-threatening
reaction to antipsychotics requiring immediate intervention (stop the drug, cooling measures,
dantrolene). Weight gain and anticholinergic effects are common but not emergent; restlessness
(akathisia) is uncomfortable but not life-threatening. *I remember: "Fever and rigid = NMS is digid
(serious)."* This mental health/pharmacology question is essential for nursing exam prep. *(SEO: mental
health, pharmacology, nursing exam prep)*
,---
**💫QUESTION 4:**
The nurse is preparing to administer 250 mL of normal saline over 2 hours. The drop factor is 15 gtt/mL.
What is the drip rate in drops per minute?
A) 21 gtt/min
B) 31 gtt/min
C) 41 gtt/min
D) 51 gtt/min
💫ANSWER✔️✔️: B) 31 gtt/min
💫RATIONALE✔️✔️: Formula: (Volume × Drop Factor) ÷ Time in minutes = (250 × 15) ÷ (2 × 60) = 3750 ÷
120 = 31.25 → 31 gtt/min. Option A is too low; Option C is high; Option D is incorrect. *I double-check:
"Slow and steady – 31 is ready."* This dosage calculation question is a staple for nursing exam prep.
*(SEO: dosage calculations, nursing exam prep, student success)*
---
**💫QUESTION 5:**
A client with a colostomy reports that the pouch is leaking frequently. Which action should the nurse
recommend first?
A) Apply a paste around the stoma to fill creases
B) Change the pouch more frequently
C) Use a larger pouch size
D) Reduce fluid intake
💫ANSWER✔️✔️: A) Apply a paste around the stoma to fill creases
, 💫RATIONALE✔️✔️: Leakage often occurs due to skin creases or uneven surfaces around the stoma;
stoma paste or barrier rings can help create a better seal. Changing more frequently can irritate skin;
pouch size should be correct (not too large); reducing fluids is not appropriate. *I remember: "Paste for
the crease – leakage will cease."* This fundamentals/ostomy question is key for nursing exam prep.
*(SEO: fundamentals, ostomy, nursing exam prep)*
---
**💫QUESTION 6:**
A client with a history of chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG)
result of pH 7.32, PaCO₂ 58 mmHg, and HCO₃ 28 mEq/L. Which condition is most consistent with these
results?
A) Acute respiratory acidosis with partial compensation
B) Chronic respiratory acidosis with metabolic compensation
C) Acute metabolic acidosis with respiratory compensation
D) Chronic metabolic alkalosis with respiratory compensation
💫ANSWER✔️✔️: B) Chronic respiratory acidosis with metabolic compensation
💫RATIONALE✔️✔️: The pH is low (acidosis), PaCO₂ is high (respiratory cause), and HCO₃ is elevated
(compensation). In COPD, chronic hypercapnia leads to renal retention of bicarbonate, indicating
metabolic compensation. Option A would have a lower HCO₃; Options C and D are not consistent with
the ABG values. *I remember: "COPD = high CO₂ and high bicarb – they live there."* This med-surg/ABG
question is vital for nursing exam prep. *(SEO: med-surg, ABG, nursing exam prep)*
---
**💫QUESTION 7:**
The nurse is caring for a client with a chest tube drainage system. The nurse notes continuous bubbling
in the water seal chamber. What is the priority nursing action?
A) Clamp the chest tube immediately
Prep Guide with Practice Questions**
*Your student-created study resource for mastering NCLEX concepts –
from Fundamentals to Critical Care.*
Compiled from student notes and practice resources — not an official
exam.
---
**💫QUESTION 1:**
A client with chronic heart failure is prescribed carvedilol (Coreg). Which finding indicates a therapeutic
response to the medication?
A) Heart rate of 52 beats/min and blood pressure of 98/62 mmHg
B) Improved ejection fraction on a follow-up echocardiogram
C) Weight gain of 2 pounds in 2 days
D) Serum potassium of 5.8 mEq/L
💫ANSWER✔️✔️: B) Improved ejection fraction on a follow-up echocardiogram
💫RATIONALE✔️✔️: Carvedilol is a beta-blocker used in heart failure to improve cardiac function over
time. An improved ejection fraction indicates the medication is working. Option A shows bradycardia
and hypotension (could be adverse effects). Option C indicates fluid retention (worsening). Option D is
hyperkalemia (not directly related). *I remember: "Coreg = heart's big beg for a better EF."* This nursing
exam prep question is essential for pharmacology mastery. *(SEO: nursing exam prep, study guide,
practice questions, pharmacology)*
---
**💫QUESTION 2:**
,A client with a suspected pulmonary embolism (PE) is suddenly dyspneic and has an SpO₂ of 84% on
room air. Which action should the nurse take first?
A) Administer oxygen via non-rebreather mask at 15 L/min
B) Place the client in a supine position with legs elevated
C) Administer a heparin bolus as prescribed
D) Obtain a stat arterial blood gas (ABG)
💫ANSWER✔️✔️: A) Administer oxygen via non-rebreather mask at 15 L/min
💫RATIONALE✔️✔️: The priority is to correct hypoxemia with high-flow oxygen. Option B (supine) would
worsen ventilation; heparin is important but not first; ABG can be obtained after oxygenation. *I recall:
"Oxygen first – hypoxia is the worst."* This critical care question is vital for nursing exam prep. *(SEO:
critical care, study guide, nursing exam prep)*
---
**💫QUESTION 3:**
A client with schizophrenia is prescribed risperidone (Risperdal). Which assessment finding is most
concerning?
A) Weight gain of 5 pounds in 1 month
B) Restlessness and fidgeting
C) Temperature of 39.5°C (103.1°F) and muscle rigidity
D) Dry mouth and constipation
💫ANSWER✔️✔️: C) Temperature of 39.5°C (103.1°F) and muscle rigidity
💫RATIONALE✔️✔️: These findings suggest neuroleptic malignant syndrome (NMS), a life-threatening
reaction to antipsychotics requiring immediate intervention (stop the drug, cooling measures,
dantrolene). Weight gain and anticholinergic effects are common but not emergent; restlessness
(akathisia) is uncomfortable but not life-threatening. *I remember: "Fever and rigid = NMS is digid
(serious)."* This mental health/pharmacology question is essential for nursing exam prep. *(SEO: mental
health, pharmacology, nursing exam prep)*
,---
**💫QUESTION 4:**
The nurse is preparing to administer 250 mL of normal saline over 2 hours. The drop factor is 15 gtt/mL.
What is the drip rate in drops per minute?
A) 21 gtt/min
B) 31 gtt/min
C) 41 gtt/min
D) 51 gtt/min
💫ANSWER✔️✔️: B) 31 gtt/min
💫RATIONALE✔️✔️: Formula: (Volume × Drop Factor) ÷ Time in minutes = (250 × 15) ÷ (2 × 60) = 3750 ÷
120 = 31.25 → 31 gtt/min. Option A is too low; Option C is high; Option D is incorrect. *I double-check:
"Slow and steady – 31 is ready."* This dosage calculation question is a staple for nursing exam prep.
*(SEO: dosage calculations, nursing exam prep, student success)*
---
**💫QUESTION 5:**
A client with a colostomy reports that the pouch is leaking frequently. Which action should the nurse
recommend first?
A) Apply a paste around the stoma to fill creases
B) Change the pouch more frequently
C) Use a larger pouch size
D) Reduce fluid intake
💫ANSWER✔️✔️: A) Apply a paste around the stoma to fill creases
, 💫RATIONALE✔️✔️: Leakage often occurs due to skin creases or uneven surfaces around the stoma;
stoma paste or barrier rings can help create a better seal. Changing more frequently can irritate skin;
pouch size should be correct (not too large); reducing fluids is not appropriate. *I remember: "Paste for
the crease – leakage will cease."* This fundamentals/ostomy question is key for nursing exam prep.
*(SEO: fundamentals, ostomy, nursing exam prep)*
---
**💫QUESTION 6:**
A client with a history of chronic obstructive pulmonary disease (COPD) has an arterial blood gas (ABG)
result of pH 7.32, PaCO₂ 58 mmHg, and HCO₃ 28 mEq/L. Which condition is most consistent with these
results?
A) Acute respiratory acidosis with partial compensation
B) Chronic respiratory acidosis with metabolic compensation
C) Acute metabolic acidosis with respiratory compensation
D) Chronic metabolic alkalosis with respiratory compensation
💫ANSWER✔️✔️: B) Chronic respiratory acidosis with metabolic compensation
💫RATIONALE✔️✔️: The pH is low (acidosis), PaCO₂ is high (respiratory cause), and HCO₃ is elevated
(compensation). In COPD, chronic hypercapnia leads to renal retention of bicarbonate, indicating
metabolic compensation. Option A would have a lower HCO₃; Options C and D are not consistent with
the ABG values. *I remember: "COPD = high CO₂ and high bicarb – they live there."* This med-surg/ABG
question is vital for nursing exam prep. *(SEO: med-surg, ABG, nursing exam prep)*
---
**💫QUESTION 7:**
The nurse is caring for a client with a chest tube drainage system. The nurse notes continuous bubbling
in the water seal chamber. What is the priority nursing action?
A) Clamp the chest tube immediately
