NCLEX-RN Comprehensive
Practice Exam 008 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. A nurse is assessing a client with heart failure. Which finding
requires immediate intervention?
A. 1+ bilateral ankle edema
B. Weight gain of 1 lb (0.45 kg) in 24 hours
C. Pink, frothy sputum
D. Fatigue after activity
Answer: C. Pink, frothy sputum
Rationale: Pink, frothy sputum is a classic sign of acute pulmonary
edema and requires immediate intervention to improve oxygenation
and prevent respiratory failure.
2. A client receiving digoxin has an apical pulse of 52/min. What
should the nurse do?
A. Administer the medication as prescribed
B. Give the medication with food
C. Hold the medication and notify the provider
D. Recheck the pulse after ambulation
,Answer: C. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. The medication is generally
withheld when the adult apical pulse is below 60/min, and the
provider should be notified.
3. A client with diabetes is confused, diaphoretic, and shaky. Which
action should the nurse take first?
A. Administer regular insulin
B. Check the blood glucose level
C. Encourage ambulation
D. Administer glucagon immediately
Answer: B. Check the blood glucose level
Rationale: The symptoms strongly suggest hypoglycemia. The nurse
should rapidly confirm the blood glucose when possible and then
provide appropriate treatment.
4. Which finding is most concerning in a client with increased
intracranial pressure?
A. Headache
B. Nausea
C. Unequal pupils
D. Photophobia
Answer: C. Unequal pupils
Rationale: Unequal or fixed pupils may indicate cranial nerve
compression and worsening intracranial pressure, requiring
immediate assessment and intervention.
5. A client with chronic obstructive pulmonary disease is receiving
oxygen. Which prescription should the nurse question?
,A. Oxygen at 2 L/min by nasal cannula
B. Oxygen titrated according to oxygen saturation
C. Oxygen at 10 L/min by nonrebreather mask without severe
hypoxemia
D. Positioning in high-Fowler position
Answer: C. Oxygen at 10 L/min by nonrebreather mask without severe
hypoxemia
Rationale: Excessive oxygen administration may worsen carbon
dioxide retention in some clients with chronic hypercapnia. Oxygen
should be carefully titrated to the prescribed target.
6. Which assessment finding is expected in a client with
dehydration?
A. Bounding pulse
B. Crackles
C. Poor skin turgor
D. Increased urine output
Answer: C. Poor skin turgor
Rationale: Dehydration commonly causes decreased skin turgor, dry
mucous membranes, tachycardia, hypotension, and decreased urine
output.
7. A client taking warfarin should be taught to report which finding
immediately?
A. Mild hunger
B. Black, tarry stools
C. Occasional thirst
D. Increased appetite
Answer: B. Black, tarry stools
, Rationale: Black, tarry stools can indicate gastrointestinal bleeding,
an important complication of anticoagulant therapy.
8. Which laboratory value is most important to monitor for a client
receiving heparin?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Serum calcium
Answer: B. aPTT
Rationale: The activated partial thromboplastin time is commonly
used to monitor therapeutic unfractionated heparin therapy.
9. A client with pneumonia has a respiratory rate of 32/min and
oxygen saturation of 86%. What is the nurse's priority?
A. Offer oral fluids
B. Apply oxygen as prescribed
C. Obtain a dietary history
D. Encourage ambulation
Answer: B. Apply oxygen as prescribed
Rationale: Hypoxemia is an immediate priority. Oxygen should be
administered according to the prescription or emergency protocol
while further assessment occurs.
10. Which client should the nurse assess first?
A. Client with chronic arthritis reporting pain of 6/10
B. Client with asthma who has difficulty speaking in complete sentences
C. Client with diabetes requesting a snack
D. Client awaiting discharge instructions
Practice Exam 008 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. A nurse is assessing a client with heart failure. Which finding
requires immediate intervention?
A. 1+ bilateral ankle edema
B. Weight gain of 1 lb (0.45 kg) in 24 hours
C. Pink, frothy sputum
D. Fatigue after activity
Answer: C. Pink, frothy sputum
Rationale: Pink, frothy sputum is a classic sign of acute pulmonary
edema and requires immediate intervention to improve oxygenation
and prevent respiratory failure.
2. A client receiving digoxin has an apical pulse of 52/min. What
should the nurse do?
A. Administer the medication as prescribed
B. Give the medication with food
C. Hold the medication and notify the provider
D. Recheck the pulse after ambulation
,Answer: C. Hold the medication and notify the provider
Rationale: Digoxin can cause bradycardia. The medication is generally
withheld when the adult apical pulse is below 60/min, and the
provider should be notified.
3. A client with diabetes is confused, diaphoretic, and shaky. Which
action should the nurse take first?
A. Administer regular insulin
B. Check the blood glucose level
C. Encourage ambulation
D. Administer glucagon immediately
Answer: B. Check the blood glucose level
Rationale: The symptoms strongly suggest hypoglycemia. The nurse
should rapidly confirm the blood glucose when possible and then
provide appropriate treatment.
4. Which finding is most concerning in a client with increased
intracranial pressure?
A. Headache
B. Nausea
C. Unequal pupils
D. Photophobia
Answer: C. Unequal pupils
Rationale: Unequal or fixed pupils may indicate cranial nerve
compression and worsening intracranial pressure, requiring
immediate assessment and intervention.
5. A client with chronic obstructive pulmonary disease is receiving
oxygen. Which prescription should the nurse question?
,A. Oxygen at 2 L/min by nasal cannula
B. Oxygen titrated according to oxygen saturation
C. Oxygen at 10 L/min by nonrebreather mask without severe
hypoxemia
D. Positioning in high-Fowler position
Answer: C. Oxygen at 10 L/min by nonrebreather mask without severe
hypoxemia
Rationale: Excessive oxygen administration may worsen carbon
dioxide retention in some clients with chronic hypercapnia. Oxygen
should be carefully titrated to the prescribed target.
6. Which assessment finding is expected in a client with
dehydration?
A. Bounding pulse
B. Crackles
C. Poor skin turgor
D. Increased urine output
Answer: C. Poor skin turgor
Rationale: Dehydration commonly causes decreased skin turgor, dry
mucous membranes, tachycardia, hypotension, and decreased urine
output.
7. A client taking warfarin should be taught to report which finding
immediately?
A. Mild hunger
B. Black, tarry stools
C. Occasional thirst
D. Increased appetite
Answer: B. Black, tarry stools
, Rationale: Black, tarry stools can indicate gastrointestinal bleeding,
an important complication of anticoagulant therapy.
8. Which laboratory value is most important to monitor for a client
receiving heparin?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Serum calcium
Answer: B. aPTT
Rationale: The activated partial thromboplastin time is commonly
used to monitor therapeutic unfractionated heparin therapy.
9. A client with pneumonia has a respiratory rate of 32/min and
oxygen saturation of 86%. What is the nurse's priority?
A. Offer oral fluids
B. Apply oxygen as prescribed
C. Obtain a dietary history
D. Encourage ambulation
Answer: B. Apply oxygen as prescribed
Rationale: Hypoxemia is an immediate priority. Oxygen should be
administered according to the prescription or emergency protocol
while further assessment occurs.
10. Which client should the nurse assess first?
A. Client with chronic arthritis reporting pain of 6/10
B. Client with asthma who has difficulty speaking in complete sentences
C. Client with diabetes requesting a snack
D. Client awaiting discharge instructions
