BSN NCLEX-RN Predictor Examination
Practice Questions & [Verified Answers],
Plus Explained Rationales|2026 Latest
Update| Instant Download PDF
1. A nurse is caring for a client who has developed hypovolemic
shock following a gastrointestinal hemorrhage. Which assessment
finding requires the nurse's immediate attention?
A. Urine output of 35 mL/hr
B. Heart rate of 108/min
C. Blood pressure of 88/54 mm Hg
D. Cool, pale extremities
Answer: C. Blood pressure of 88/54 mm Hg
Rationale: Severe hypotension indicates inadequate tissue perfusion
and potentially worsening shock. The nurse should prioritize
circulation and initiate prescribed interventions such as rapid IV fluid
or blood-product replacement. The other findings are also consistent
with hypovolemia but are less immediately indicative of life-
threatening circulatory compromise.
2. A client with heart failure is prescribed furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Sodium
B. Potassium
1|Page
,C. Calcium
D. Hemoglobin
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion and can cause hypokalemia. Severe hypokalemia
can produce muscle weakness and potentially life-threatening cardiac
dysrhythmias.
3. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen at 2 L/min via nasal cannula. Which finding
indicates that the intervention is effective?
A. Oxygen saturation increases from 84% to 90%
B. Respiratory rate increases from 20 to 30/min
C. Client becomes increasingly drowsy
D. PaCO₂ increases substantially
Answer: A. Oxygen saturation increases from 84% to 90%
Rationale: Controlled oxygen therapy should improve oxygenation in
a client with COPD while avoiding unnecessary excessive oxygen
administration. An increase in oxygen saturation toward the
prescribed target indicates improved oxygenation. Increasing
somnolence and rising PaCO₂ can indicate worsening carbon dioxide
retention.
4. A client receiving a continuous IV infusion of unfractionated
heparin has an activated partial thromboplastin time (aPTT) that is
significantly above the therapeutic range. What should the nurse
do first?
2|Page
,A. Increase the infusion rate
B. Administer vitamin K
C. Stop or hold the infusion according to protocol
D. Administer aspirin
Answer: C. Stop or hold the infusion according to protocol
Rationale: An excessively prolonged aPTT increases the risk of
bleeding. The nurse should stop or hold the heparin infusion according
to the prescribed protocol and notify the appropriate provider.
Vitamin K reverses warfarin, not heparin.
5. A client taking warfarin reports black, tarry stools. What is the
nurse's priority action?
A. Reassure the client that this is expected
B. Instruct the client to take the next dose with food
C. Assess for additional evidence of bleeding and notify the provider
D. Encourage increased intake of green leafy vegetables
Answer: C. Assess for additional evidence of bleeding and notify the
provider
Rationale: Melena can indicate gastrointestinal bleeding, which is a
serious complication of anticoagulant therapy. The nurse should
assess the client and promptly report suspected bleeding. Increasing
vitamin K intake can interfere with warfarin therapy.
6. A client with diabetes mellitus becomes diaphoretic, tremulous,
confused, and irritable. The client's blood glucose is 52 mg/dL,
and the client is awake and able to swallow. Which intervention is
appropriate?
3|Page
, A. Administer 15 g of rapid-acting carbohydrate
B. Administer long-acting insulin
C. Restrict oral intake
D. Administer glucagon immediately
Answer: A. Administer 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can safely swallow should receive
approximately 15 g of rapid-acting carbohydrate, followed by
reassessment of blood glucose. Glucagon is generally used when the
client cannot safely take oral glucose.
7. A client is admitted with diabetic ketoacidosis (DKA). Which
prescription should the nurse anticipate implementing first?
A. IV regular insulin
B. IV isotonic fluid replacement
C. Oral potassium supplementation
D. Sodium bicarbonate for all clients
Answer: B. IV isotonic fluid replacement
Rationale: Severe dehydration and intravascular volume depletion are
major problems in DKA. Initial management typically prioritizes
isotonic IV fluid resuscitation, followed by insulin and careful
electrolyte management.
8. A client with a traumatic brain injury has increasing intracranial
pressure. Which positioning intervention should the nurse use?
A. Place the client flat with the neck flexed
B. Elevate the head of the bed approximately 30 degrees and maintain
neutral neck alignment
4|Page
Practice Questions & [Verified Answers],
Plus Explained Rationales|2026 Latest
Update| Instant Download PDF
1. A nurse is caring for a client who has developed hypovolemic
shock following a gastrointestinal hemorrhage. Which assessment
finding requires the nurse's immediate attention?
A. Urine output of 35 mL/hr
B. Heart rate of 108/min
C. Blood pressure of 88/54 mm Hg
D. Cool, pale extremities
Answer: C. Blood pressure of 88/54 mm Hg
Rationale: Severe hypotension indicates inadequate tissue perfusion
and potentially worsening shock. The nurse should prioritize
circulation and initiate prescribed interventions such as rapid IV fluid
or blood-product replacement. The other findings are also consistent
with hypovolemia but are less immediately indicative of life-
threatening circulatory compromise.
2. A client with heart failure is prescribed furosemide. Which
laboratory value is most important for the nurse to monitor?
A. Sodium
B. Potassium
1|Page
,C. Calcium
D. Hemoglobin
Answer: B. Potassium
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion and can cause hypokalemia. Severe hypokalemia
can produce muscle weakness and potentially life-threatening cardiac
dysrhythmias.
3. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen at 2 L/min via nasal cannula. Which finding
indicates that the intervention is effective?
A. Oxygen saturation increases from 84% to 90%
B. Respiratory rate increases from 20 to 30/min
C. Client becomes increasingly drowsy
D. PaCO₂ increases substantially
Answer: A. Oxygen saturation increases from 84% to 90%
Rationale: Controlled oxygen therapy should improve oxygenation in
a client with COPD while avoiding unnecessary excessive oxygen
administration. An increase in oxygen saturation toward the
prescribed target indicates improved oxygenation. Increasing
somnolence and rising PaCO₂ can indicate worsening carbon dioxide
retention.
4. A client receiving a continuous IV infusion of unfractionated
heparin has an activated partial thromboplastin time (aPTT) that is
significantly above the therapeutic range. What should the nurse
do first?
2|Page
,A. Increase the infusion rate
B. Administer vitamin K
C. Stop or hold the infusion according to protocol
D. Administer aspirin
Answer: C. Stop or hold the infusion according to protocol
Rationale: An excessively prolonged aPTT increases the risk of
bleeding. The nurse should stop or hold the heparin infusion according
to the prescribed protocol and notify the appropriate provider.
Vitamin K reverses warfarin, not heparin.
5. A client taking warfarin reports black, tarry stools. What is the
nurse's priority action?
A. Reassure the client that this is expected
B. Instruct the client to take the next dose with food
C. Assess for additional evidence of bleeding and notify the provider
D. Encourage increased intake of green leafy vegetables
Answer: C. Assess for additional evidence of bleeding and notify the
provider
Rationale: Melena can indicate gastrointestinal bleeding, which is a
serious complication of anticoagulant therapy. The nurse should
assess the client and promptly report suspected bleeding. Increasing
vitamin K intake can interfere with warfarin therapy.
6. A client with diabetes mellitus becomes diaphoretic, tremulous,
confused, and irritable. The client's blood glucose is 52 mg/dL,
and the client is awake and able to swallow. Which intervention is
appropriate?
3|Page
, A. Administer 15 g of rapid-acting carbohydrate
B. Administer long-acting insulin
C. Restrict oral intake
D. Administer glucagon immediately
Answer: A. Administer 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can safely swallow should receive
approximately 15 g of rapid-acting carbohydrate, followed by
reassessment of blood glucose. Glucagon is generally used when the
client cannot safely take oral glucose.
7. A client is admitted with diabetic ketoacidosis (DKA). Which
prescription should the nurse anticipate implementing first?
A. IV regular insulin
B. IV isotonic fluid replacement
C. Oral potassium supplementation
D. Sodium bicarbonate for all clients
Answer: B. IV isotonic fluid replacement
Rationale: Severe dehydration and intravascular volume depletion are
major problems in DKA. Initial management typically prioritizes
isotonic IV fluid resuscitation, followed by insulin and careful
electrolyte management.
8. A client with a traumatic brain injury has increasing intracranial
pressure. Which positioning intervention should the nurse use?
A. Place the client flat with the neck flexed
B. Elevate the head of the bed approximately 30 degrees and maintain
neutral neck alignment
4|Page
