PN COMPREHENSIVE PREDICTOR EXAM 2026/2027 -
COMPLETE QUESTION BANK WITH VERIFIED ANSWERS
1. A client receiving MAOI therapy reports eating aged cheese and
experiencing severe headache and hypertension. Which food
substance should the nurse identify as the cause of this reaction?
A. Tryptophan
B. Tyramine
C. Phenylalanine
D. Histamine
Correct Answer: B. Tyramine is found in aged cheeses, cured meats, and
fermented foods. MAOIs inhibit the breakdown of tyramine, leading to
hypertensive crisis. This interaction can be life-threatening and requires
immediate intervention.
2. The nurse is caring for a client with lithium toxicity who exhibits
coarse hand tremors and an unsteady gait. What additional finding
should the nurse expect?
A. Hypertension and bradycardia
B. Severe nausea, diarrhea, and vomiting
C. Hyperthermia and diaphoresis
D. Polyuria and polydipsia
Correct Answer: B. Lithium toxicity presents with severe gastrointestinal
symptoms including nausea, diarrhea, and vomiting, along with
neurological manifestations such as coarse tremors, confusion,
,drowsiness, muscle weakness, and unsteady gait. Cardiac palpitations
may also occur.
3. A client presents with tachycardia, hyperthermia, chest pain, and
profuse sweating. Which condition should the nurse suspect?
A. Hypothyroidism
B. Thyroid storm
C. Myxedema coma
D. Addisonian crisis
Correct Answer: B. Thyroid storm is a life-threatening condition
characterized by tachycardia, hyperthermia, chest pain, sweating,
weakness, heart failure, anxiety, shortness of breath, and
disorientation. It requires immediate medical intervention.
4. The nurse is assessing a client for neuroleptic malignant syndrome.
Which body temperature reading would be most concerning?
A. 99.2°F
B. 100.8°F
C. 102.5°F
D. 98.6°F
Correct Answer: C. Neuroleptic malignant syndrome is characterized by
a very high fever ranging from 102-104°F. This extreme hyperthermia,
along with muscle rigidity and altered mental status, indicates a medical
emergency requiring immediate intervention.
5. Which assessment finding indicates neuroleptic malignant
syndrome?
A. Decreased muscle tone and hyporeflexia
B. Muscle rigidity and altered mental status
,C. Hypotension and bradycardia
D. Hypothermia and decreased respiratory rate
Correct Answer: B. Neuroleptic malignant syndrome presents with
severe muscle rigidity, altered mental status, autonomic instability
(including blood pressure fluctuations), hyperthermia (102-104°F),
tachycardia, tachypnea, and profuse perspiration.
6. A client with neuroleptic malignant syndrome exhibits an irregular
pulse and tachycardia. What other autonomic sign should the nurse
monitor?
A. Hypothermia
B. Hypotension and hypertension
C. Bradycardia
D. Respiratory depression
Correct Answer: B. Neuroleptic malignant syndrome causes autonomic
nervous system dysfunction resulting in both hypo/hypertension,
tachycardia, and irregular pulse. These cardiovascular changes require
continuous monitoring.
7. The nurse is preparing to provide tracheostomy care. What is the
correct sequence of steps?
A. Replace trach ties, clean stoma, remove soiled dressing, remove
inner cannula
B. Remove inner cannula, remove soiled dressing, clean stoma, replace
trach ties
C. Clean stoma, remove inner cannula, remove soiled dressing, replace
trach ties
D. Remove soiled dressing, replace trach ties, remove inner cannula,
clean stoma
, Correct Answer: B. The correct order for tracheostomy care is: remove
inner cannula, remove soiled dressing, clean stoma, then replace trach
ties. This sequence ensures proper cleaning and reduces infection risk.
8. A client has a urine specific gravity of 1.035. What does this finding
indicate?
A. Overhydration
B. Kidney failure
C. Dehydration
D. Diabetes insipidus
Correct Answer: C. Urine specific gravity elevates with dehydration as
the kidneys concentrate urine to conserve water. Normal range is 1.005-
1.030. Elevated specific gravity indicates concentrated urine from
decreased fluid intake or excessive fluid loss.
9. Which signs are associated with Reye's syndrome?
A. Hyperglycemia and decreased ammonia
B. Confusion, brain swelling, and liver damage
C. Hypertension and tachycardia
D. Increased appetite and weight gain
Correct Answer: B. Reye's syndrome presents with confusion, swelling
of the brain (cerebral edema), liver damage, hypoglycemia, and
elevated ammonia levels. It is a rare but serious condition often
triggered by aspirin use in children with viral infections.
10. The nurse is assessing a client with encephalitis. Which finding is
most characteristic of this condition?
A. Decreased appetite and mild headache
B. Severe headache, stiff neck, and fever
COMPLETE QUESTION BANK WITH VERIFIED ANSWERS
1. A client receiving MAOI therapy reports eating aged cheese and
experiencing severe headache and hypertension. Which food
substance should the nurse identify as the cause of this reaction?
A. Tryptophan
B. Tyramine
C. Phenylalanine
D. Histamine
Correct Answer: B. Tyramine is found in aged cheeses, cured meats, and
fermented foods. MAOIs inhibit the breakdown of tyramine, leading to
hypertensive crisis. This interaction can be life-threatening and requires
immediate intervention.
2. The nurse is caring for a client with lithium toxicity who exhibits
coarse hand tremors and an unsteady gait. What additional finding
should the nurse expect?
A. Hypertension and bradycardia
B. Severe nausea, diarrhea, and vomiting
C. Hyperthermia and diaphoresis
D. Polyuria and polydipsia
Correct Answer: B. Lithium toxicity presents with severe gastrointestinal
symptoms including nausea, diarrhea, and vomiting, along with
neurological manifestations such as coarse tremors, confusion,
,drowsiness, muscle weakness, and unsteady gait. Cardiac palpitations
may also occur.
3. A client presents with tachycardia, hyperthermia, chest pain, and
profuse sweating. Which condition should the nurse suspect?
A. Hypothyroidism
B. Thyroid storm
C. Myxedema coma
D. Addisonian crisis
Correct Answer: B. Thyroid storm is a life-threatening condition
characterized by tachycardia, hyperthermia, chest pain, sweating,
weakness, heart failure, anxiety, shortness of breath, and
disorientation. It requires immediate medical intervention.
4. The nurse is assessing a client for neuroleptic malignant syndrome.
Which body temperature reading would be most concerning?
A. 99.2°F
B. 100.8°F
C. 102.5°F
D. 98.6°F
Correct Answer: C. Neuroleptic malignant syndrome is characterized by
a very high fever ranging from 102-104°F. This extreme hyperthermia,
along with muscle rigidity and altered mental status, indicates a medical
emergency requiring immediate intervention.
5. Which assessment finding indicates neuroleptic malignant
syndrome?
A. Decreased muscle tone and hyporeflexia
B. Muscle rigidity and altered mental status
,C. Hypotension and bradycardia
D. Hypothermia and decreased respiratory rate
Correct Answer: B. Neuroleptic malignant syndrome presents with
severe muscle rigidity, altered mental status, autonomic instability
(including blood pressure fluctuations), hyperthermia (102-104°F),
tachycardia, tachypnea, and profuse perspiration.
6. A client with neuroleptic malignant syndrome exhibits an irregular
pulse and tachycardia. What other autonomic sign should the nurse
monitor?
A. Hypothermia
B. Hypotension and hypertension
C. Bradycardia
D. Respiratory depression
Correct Answer: B. Neuroleptic malignant syndrome causes autonomic
nervous system dysfunction resulting in both hypo/hypertension,
tachycardia, and irregular pulse. These cardiovascular changes require
continuous monitoring.
7. The nurse is preparing to provide tracheostomy care. What is the
correct sequence of steps?
A. Replace trach ties, clean stoma, remove soiled dressing, remove
inner cannula
B. Remove inner cannula, remove soiled dressing, clean stoma, replace
trach ties
C. Clean stoma, remove inner cannula, remove soiled dressing, replace
trach ties
D. Remove soiled dressing, replace trach ties, remove inner cannula,
clean stoma
, Correct Answer: B. The correct order for tracheostomy care is: remove
inner cannula, remove soiled dressing, clean stoma, then replace trach
ties. This sequence ensures proper cleaning and reduces infection risk.
8. A client has a urine specific gravity of 1.035. What does this finding
indicate?
A. Overhydration
B. Kidney failure
C. Dehydration
D. Diabetes insipidus
Correct Answer: C. Urine specific gravity elevates with dehydration as
the kidneys concentrate urine to conserve water. Normal range is 1.005-
1.030. Elevated specific gravity indicates concentrated urine from
decreased fluid intake or excessive fluid loss.
9. Which signs are associated with Reye's syndrome?
A. Hyperglycemia and decreased ammonia
B. Confusion, brain swelling, and liver damage
C. Hypertension and tachycardia
D. Increased appetite and weight gain
Correct Answer: B. Reye's syndrome presents with confusion, swelling
of the brain (cerebral edema), liver damage, hypoglycemia, and
elevated ammonia levels. It is a rare but serious condition often
triggered by aspirin use in children with viral infections.
10. The nurse is assessing a client with encephalitis. Which finding is
most characteristic of this condition?
A. Decreased appetite and mild headache
B. Severe headache, stiff neck, and fever
