RN Comprehensive Predictor 2026 Exit
Ultimate Study Guide and Practice Test.
Question 1 (Medical-Surgical / Prioritization)
A nurse is caring for a client who is 1 day post-operative following a total hip
arthroplasty. Which of the following findings should the nurse report to the
provider immediately?
A. Heart rate 88/min
B. Pain level 4 on a 0-10 scale
C. Oxygen saturation 89% on room air
D. Urinary output of 40 mL in the past hour
Answer: C. Oxygen saturation 89% on room air
Rationale: An oxygen saturation of 89% indicates hypoxemia and is a priority finding
that requires immediate intervention. It could indicate a pulmonary embolism, which is a
serious complication following hip surgery. The other findings are within expected
ranges or require monitoring but are not immediately life-threatening (ABCs—Airway,
Breathing, Circulation—take priority).
,Question 2 (Pharmacology)
A nurse is preparing to administer digoxin to a client who has heart failure. Which
of the following findings should indicate to the nurse that the client is at risk for
digoxin toxicity?
A. Serum potassium 3.1 mEq/L
B. Serum sodium 140 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum magnesium 2.2 mEq/L
Answer: A. Serum potassium 3.1 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk of digoxin toxicity.
Low potassium levels enhance the effects of digoxin on the heart, potentially leading to
dysrhythmias. The other values are within normal limits.
Question 3 (Maternal-Newborn)
A nurse is assessing a client who is at 38 weeks of gestation and is in active labor.
The client's contractions are every 3 minutes, lasting 60 seconds, and are moderate
in intensity. The fetal heart rate is 140/min with moderate variability. Which of the
following actions should the nurse take?
A. Prepare the client for a cesarean birth
B. Administer oxytocin to augment labor
C. Continue to monitor the client and fetus
D. Notify the provider immediately
Answer: C. Continue to monitor the client and fetus
,Rationale: This client is in active labor with adequate contractions (3 minutes apart, 60
seconds duration, moderate intensity) and a reassuring fetal heart rate (140/min with
moderate variability). These findings indicate normal progress, and the nurse should
continue to monitor. No intervention is needed at this time.
Question 4 (Pediatrics)
A nurse is caring for a 6-month-old infant who has gastroenteritis with vomiting
and diarrhea. Which of the following findings should indicate to the nurse that the
infant is experiencing severe dehydration?
A. Heart rate 120/min
B. Sunken fontanels
C. Dry mucous membranes
D. Urine output 2 mL/kg/hr
Answer: B. Sunken fontanels
Rationale: Sunken fontanels are a late sign of severe dehydration in infants. Other signs
include poor skin turgor, lethargy, and significantly decreased urine output (< 1
mL/kg/hr). A heart rate of 120/min is elevated but can be seen with mild to moderate
dehydration. Dry mucous membranes and decreased urine output are also signs of
dehydration but are not specific to severe dehydration.
Question 5 (Mental Health)
, A nurse is caring for a client who has major depressive disorder and is prescribed
fluoxetine. Which of the following statements by the client indicates a need for
further teaching?
A. "I should take this medication with food."
B. "I might not feel better for a few weeks."
C. "I can stop taking this medication when I feel better."
D. "I should avoid drinking alcohol while taking this medication."
Answer: C. "I can stop taking this medication when I feel better."
Rationale: Antidepressants like fluoxetine (an SSRI) should not be stopped abruptly
without provider guidance, as this can lead to withdrawal symptoms and relapse of
depression. It takes several weeks for therapeutic effects to occur, and the medication
should be taken as prescribed. Taking with food can reduce GI upset, and alcohol should
be avoided.
Question 6 (Leadership & Management)
A charge nurse is assigning client care on a medical-surgical unit. Which of the
following clients should the charge nurse assign to a practical nurse (PN)?
A. A client who is 1 day post-operative following a colectomy with a new colostomy
B. A client who has diabetes mellitus and requires insulin administration
C. A client who has unstable angina and is on a continuous telemetry monitor
D. A client who has a new diagnosis of stroke and is receiving thrombolytic therapy
Answer: B. A client who has diabetes mellitus and requires insulin administration
Ultimate Study Guide and Practice Test.
Question 1 (Medical-Surgical / Prioritization)
A nurse is caring for a client who is 1 day post-operative following a total hip
arthroplasty. Which of the following findings should the nurse report to the
provider immediately?
A. Heart rate 88/min
B. Pain level 4 on a 0-10 scale
C. Oxygen saturation 89% on room air
D. Urinary output of 40 mL in the past hour
Answer: C. Oxygen saturation 89% on room air
Rationale: An oxygen saturation of 89% indicates hypoxemia and is a priority finding
that requires immediate intervention. It could indicate a pulmonary embolism, which is a
serious complication following hip surgery. The other findings are within expected
ranges or require monitoring but are not immediately life-threatening (ABCs—Airway,
Breathing, Circulation—take priority).
,Question 2 (Pharmacology)
A nurse is preparing to administer digoxin to a client who has heart failure. Which
of the following findings should indicate to the nurse that the client is at risk for
digoxin toxicity?
A. Serum potassium 3.1 mEq/L
B. Serum sodium 140 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum magnesium 2.2 mEq/L
Answer: A. Serum potassium 3.1 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk of digoxin toxicity.
Low potassium levels enhance the effects of digoxin on the heart, potentially leading to
dysrhythmias. The other values are within normal limits.
Question 3 (Maternal-Newborn)
A nurse is assessing a client who is at 38 weeks of gestation and is in active labor.
The client's contractions are every 3 minutes, lasting 60 seconds, and are moderate
in intensity. The fetal heart rate is 140/min with moderate variability. Which of the
following actions should the nurse take?
A. Prepare the client for a cesarean birth
B. Administer oxytocin to augment labor
C. Continue to monitor the client and fetus
D. Notify the provider immediately
Answer: C. Continue to monitor the client and fetus
,Rationale: This client is in active labor with adequate contractions (3 minutes apart, 60
seconds duration, moderate intensity) and a reassuring fetal heart rate (140/min with
moderate variability). These findings indicate normal progress, and the nurse should
continue to monitor. No intervention is needed at this time.
Question 4 (Pediatrics)
A nurse is caring for a 6-month-old infant who has gastroenteritis with vomiting
and diarrhea. Which of the following findings should indicate to the nurse that the
infant is experiencing severe dehydration?
A. Heart rate 120/min
B. Sunken fontanels
C. Dry mucous membranes
D. Urine output 2 mL/kg/hr
Answer: B. Sunken fontanels
Rationale: Sunken fontanels are a late sign of severe dehydration in infants. Other signs
include poor skin turgor, lethargy, and significantly decreased urine output (< 1
mL/kg/hr). A heart rate of 120/min is elevated but can be seen with mild to moderate
dehydration. Dry mucous membranes and decreased urine output are also signs of
dehydration but are not specific to severe dehydration.
Question 5 (Mental Health)
, A nurse is caring for a client who has major depressive disorder and is prescribed
fluoxetine. Which of the following statements by the client indicates a need for
further teaching?
A. "I should take this medication with food."
B. "I might not feel better for a few weeks."
C. "I can stop taking this medication when I feel better."
D. "I should avoid drinking alcohol while taking this medication."
Answer: C. "I can stop taking this medication when I feel better."
Rationale: Antidepressants like fluoxetine (an SSRI) should not be stopped abruptly
without provider guidance, as this can lead to withdrawal symptoms and relapse of
depression. It takes several weeks for therapeutic effects to occur, and the medication
should be taken as prescribed. Taking with food can reduce GI upset, and alcohol should
be avoided.
Question 6 (Leadership & Management)
A charge nurse is assigning client care on a medical-surgical unit. Which of the
following clients should the charge nurse assign to a practical nurse (PN)?
A. A client who is 1 day post-operative following a colectomy with a new colostomy
B. A client who has diabetes mellitus and requires insulin administration
C. A client who has unstable angina and is on a continuous telemetry monitor
D. A client who has a new diagnosis of stroke and is receiving thrombolytic therapy
Answer: B. A client who has diabetes mellitus and requires insulin administration
