Florida NCLEX Adult Medical-Surgical Nursing Practice Exam III
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1. A nurse is assessing a client admitted with left-sided heart failure. Which
assessment finding requires immediate intervention?
A. Bilateral ankle edema
B. Weight gain of 2 lb (0.9 kg) in 24 hours
C. Crackles throughout both lung fields and oxygen saturation of 86%
D. Jugular vein distention
Answer: C. Crackles throughout both lung fields and oxygen saturation of 86%
Rationale: Diffuse crackles accompanied by hypoxemia indicate pulmonary edema and
impaired gas exchange, making this the highest-priority finding. Immediate interventions
include administering oxygen, positioning the client upright, and notifying the healthcare
provider. Peripheral edema, jugular vein distention, and mild weight gain are expected
findings in heart failure but are less immediately life-threatening.
2. A client with chronic kidney disease has a serum potassium level of 6.5 mEq/L.
Which action should the nurse take first?
A. Encourage foods rich in potassium.
B. Obtain a prescription for sodium polystyrene sulfonate.
C. Place the client on continuous cardiac monitoring.
D. Restrict fluid intake.
Answer: C. Place the client on continuous cardiac monitoring.
Rationale: Hyperkalemia significantly increases the risk for life-threatening cardiac
dysrhythmias. Continuous cardiac monitoring is the immediate priority while interventions
to lower the potassium level are initiated.
,3. Which assessment finding is most concerning in a client receiving intravenous
heparin?
A. Platelet count of 65,000/mm³
B. Heart rate of 84 beats/minute
C. Blood pressure of 128/76 mm Hg
D. Temperature of 98.7°F (37.1°C)
Answer: A. Platelet count of 65,000/mm³
Rationale: A marked decrease in platelet count may indicate heparin-induced
thrombocytopenia (HIT), a potentially life-threatening immune-mediated complication. The
nurse should stop the heparin infusion and notify the healthcare provider immediately.
4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which oxygen saturation goal is most appropriate?
A. 100%
B. 98–100%
C. 88–92%
D. Above 95%
Answer: C. 88–92%
Rationale: Many clients with advanced COPD rely partly on hypoxic respiratory drive.
Maintaining oxygen saturation between 88% and 92% provides adequate oxygenation while
reducing the risk of carbon dioxide retention.
5. A nurse is caring for a client 24 hours after thyroidectomy. Which finding requires
immediate action?
A. Hoarseness when speaking
B. Tingling around the mouth and fingertips
C. Mild incisional pain
D. Blood pressure of 132/78 mm Hg
Answer: B. Tingling around the mouth and fingertips
, Rationale: Perioral and fingertip tingling are early signs of hypocalcemia caused by
accidental injury or removal of the parathyroid glands. Untreated hypocalcemia can
progress to tetany and airway compromise. The nurse should promptly notify the
healthcare provider.
6. Which laboratory value indicates that treatment for bacterial infection is effective?
A. White blood cell count decreased from 18,000/mm³ to 9,000/mm³
B. Hemoglobin decreased from 13 g/dL to 11 g/dL
C. Platelets increased from 180,000/mm³ to 220,000/mm³
D. Sodium increased from 136 to 140 mEq/L
Answer: A. White blood cell count decreased from 18,000/mm³ to 9,000/mm³
Rationale: Normalization of an elevated white blood cell count suggests improvement of
the infectious process. The remaining laboratory values are unrelated to evaluating
treatment effectiveness for bacterial infection.
7. A client with diabetes mellitus becomes diaphoretic, confused, and shaky. Which
intervention should the nurse perform first?
A. Administer regular insulin.
B. Check the client's blood glucose level.
C. Encourage ambulation.
D. Obtain a hemoglobin A1C level.
Answer: B. Check the client's blood glucose level.
Rationale: These symptoms strongly suggest hypoglycemia. The nurse should first verify
the blood glucose level if feasible, then administer rapid-acting carbohydrates if
hypoglycemia is confirmed or strongly suspected.
8. Which client has the highest priority for assessment?
A. A client with rheumatoid arthritis reporting joint stiffness.
B. A client with pneumonia whose respiratory rate is 32 breaths/minute.
C. A client with osteoarthritis requesting pain medication.
D. A client with hypertension awaiting discharge instructions.
Updated Exam 2026 WITH Recent Newest Verified And Well
Analyzed Exam Questions (Actual Exam 2026-2027) Correct
Detailed & Verified ANSWERS (100% Accurate Solutions)
ALREADY GRADED A+||NEWEST VERSION Of
The Exam Guarantee Pass!!
1. A nurse is assessing a client admitted with left-sided heart failure. Which
assessment finding requires immediate intervention?
A. Bilateral ankle edema
B. Weight gain of 2 lb (0.9 kg) in 24 hours
C. Crackles throughout both lung fields and oxygen saturation of 86%
D. Jugular vein distention
Answer: C. Crackles throughout both lung fields and oxygen saturation of 86%
Rationale: Diffuse crackles accompanied by hypoxemia indicate pulmonary edema and
impaired gas exchange, making this the highest-priority finding. Immediate interventions
include administering oxygen, positioning the client upright, and notifying the healthcare
provider. Peripheral edema, jugular vein distention, and mild weight gain are expected
findings in heart failure but are less immediately life-threatening.
2. A client with chronic kidney disease has a serum potassium level of 6.5 mEq/L.
Which action should the nurse take first?
A. Encourage foods rich in potassium.
B. Obtain a prescription for sodium polystyrene sulfonate.
C. Place the client on continuous cardiac monitoring.
D. Restrict fluid intake.
Answer: C. Place the client on continuous cardiac monitoring.
Rationale: Hyperkalemia significantly increases the risk for life-threatening cardiac
dysrhythmias. Continuous cardiac monitoring is the immediate priority while interventions
to lower the potassium level are initiated.
,3. Which assessment finding is most concerning in a client receiving intravenous
heparin?
A. Platelet count of 65,000/mm³
B. Heart rate of 84 beats/minute
C. Blood pressure of 128/76 mm Hg
D. Temperature of 98.7°F (37.1°C)
Answer: A. Platelet count of 65,000/mm³
Rationale: A marked decrease in platelet count may indicate heparin-induced
thrombocytopenia (HIT), a potentially life-threatening immune-mediated complication. The
nurse should stop the heparin infusion and notify the healthcare provider immediately.
4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which oxygen saturation goal is most appropriate?
A. 100%
B. 98–100%
C. 88–92%
D. Above 95%
Answer: C. 88–92%
Rationale: Many clients with advanced COPD rely partly on hypoxic respiratory drive.
Maintaining oxygen saturation between 88% and 92% provides adequate oxygenation while
reducing the risk of carbon dioxide retention.
5. A nurse is caring for a client 24 hours after thyroidectomy. Which finding requires
immediate action?
A. Hoarseness when speaking
B. Tingling around the mouth and fingertips
C. Mild incisional pain
D. Blood pressure of 132/78 mm Hg
Answer: B. Tingling around the mouth and fingertips
, Rationale: Perioral and fingertip tingling are early signs of hypocalcemia caused by
accidental injury or removal of the parathyroid glands. Untreated hypocalcemia can
progress to tetany and airway compromise. The nurse should promptly notify the
healthcare provider.
6. Which laboratory value indicates that treatment for bacterial infection is effective?
A. White blood cell count decreased from 18,000/mm³ to 9,000/mm³
B. Hemoglobin decreased from 13 g/dL to 11 g/dL
C. Platelets increased from 180,000/mm³ to 220,000/mm³
D. Sodium increased from 136 to 140 mEq/L
Answer: A. White blood cell count decreased from 18,000/mm³ to 9,000/mm³
Rationale: Normalization of an elevated white blood cell count suggests improvement of
the infectious process. The remaining laboratory values are unrelated to evaluating
treatment effectiveness for bacterial infection.
7. A client with diabetes mellitus becomes diaphoretic, confused, and shaky. Which
intervention should the nurse perform first?
A. Administer regular insulin.
B. Check the client's blood glucose level.
C. Encourage ambulation.
D. Obtain a hemoglobin A1C level.
Answer: B. Check the client's blood glucose level.
Rationale: These symptoms strongly suggest hypoglycemia. The nurse should first verify
the blood glucose level if feasible, then administer rapid-acting carbohydrates if
hypoglycemia is confirmed or strongly suspected.
8. Which client has the highest priority for assessment?
A. A client with rheumatoid arthritis reporting joint stiffness.
B. A client with pneumonia whose respiratory rate is 32 breaths/minute.
C. A client with osteoarthritis requesting pain medication.
D. A client with hypertension awaiting discharge instructions.
