NCLEX-PN Advanced Practice Test
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. Acute Respiratory Distress
A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The
client becomes increasingly somnolent and difficult to arouse.
Respirations are 8/min. Which action should the practical nurse take
first?
A. Increase oxygen to 6 L/min
B. Obtain a temperature
C. Assess airway and initiate emergency respiratory support
D. Encourage coughing
Rationale: A respiratory rate of 8/min with decreased level of
consciousness indicates severe hypoventilation and possible
respiratory failure. Airway and breathing take priority. Simply
increasing oxygen does not correct inadequate ventilation.
2. Hyperkalemia
A client with renal failure has a potassium level of 6.8 mEq/L and
peaked T waves on the ECG. Which prescription should the nurse
anticipate as the priority?
,A. Oral potassium supplement
B. IV calcium gluconate
C. Spironolactone
D. Lactated Ringer's solution
Rationale: IV calcium stabilizes the cardiac membrane and reduces the
immediate risk of fatal dysrhythmias associated with severe
hyperkalemia. It does not remove potassium but provides urgent
cardiac protection.
3. Chest Pain
A client reports crushing substernal chest pain radiating to the left arm.
Which assessment finding requires the most immediate intervention?
A. Blood pressure 148/88 mmHg
B. Anxiety
C. Oxygen saturation 86%
D. Heart rate 104/min
Rationale: Significant hypoxemia threatens tissue oxygenation and
requires immediate attention. Airway and breathing take priority over
less immediately dangerous findings.
4. Digoxin Toxicity
A client taking digoxin reports nausea, blurred yellow vision, and
anorexia. The apical pulse is 54/min. What should the nurse do?
A. Administer the medication
B. Give the medication with food
C. Hold digoxin and notify the provider
D. Encourage increased sodium intake
,Rationale: Bradycardia, gastrointestinal symptoms, and visual
disturbances are classic manifestations of digoxin toxicity. The
medication should be withheld and the provider notified.
5. Insulin Administration
A client with type 1 diabetes is prescribed regular insulin and NPH
insulin. Which action is correct when mixing the insulins?
A. Draw NPH before regular insulin
B. Shake both insulin vials vigorously
C. Draw regular insulin before NPH insulin
D. Mix glargine with NPH
Rationale: When regular and NPH insulin are mixed, the clear regular
insulin is drawn before the cloudy NPH insulin to avoid contaminating
the regular insulin vial with NPH.
6. Stroke
A client suddenly develops right-sided weakness and expressive
aphasia. What is the nurse's priority action?
A. Give oral fluids
B. Place the client in Trendelenburg position
C. Determine the time the symptoms began and activate the stroke
response
D. Administer aspirin immediately
Rationale: Time of symptom onset is critical when determining
eligibility for reperfusion therapy. Rapid stroke evaluation is essential.
, 7. Blood Transfusion
Fifteen minutes after a blood transfusion begins, the client develops
chills, fever, and low back pain. What should the nurse do first?
A. Slow the transfusion
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Increase the IV flow rate
Rationale: These findings may indicate an acute hemolytic transfusion
reaction. The transfusion must be stopped immediately to prevent
further exposure.
8. Sepsis
A client with pneumonia has a temperature of 39.4°C, BP 82/46 mmHg,
HR 128/min, and altered mental status. Which intervention has the
highest priority?
A. Restrict fluids
B. Initiate rapid sepsis management and prescribed IV fluid
resuscitation
C. Administer an oral antipyretic
D. Encourage ambulation
Rationale: Hypotension, tachycardia, fever, and altered mental status
indicate possible septic shock. Rapid fluid resuscitation and treatment
of infection are critical.
9. Hypoglycemia
Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A Instant Download Pdf
1. Acute Respiratory Distress
A client with COPD is receiving oxygen at 2 L/min by nasal cannula. The
client becomes increasingly somnolent and difficult to arouse.
Respirations are 8/min. Which action should the practical nurse take
first?
A. Increase oxygen to 6 L/min
B. Obtain a temperature
C. Assess airway and initiate emergency respiratory support
D. Encourage coughing
Rationale: A respiratory rate of 8/min with decreased level of
consciousness indicates severe hypoventilation and possible
respiratory failure. Airway and breathing take priority. Simply
increasing oxygen does not correct inadequate ventilation.
2. Hyperkalemia
A client with renal failure has a potassium level of 6.8 mEq/L and
peaked T waves on the ECG. Which prescription should the nurse
anticipate as the priority?
,A. Oral potassium supplement
B. IV calcium gluconate
C. Spironolactone
D. Lactated Ringer's solution
Rationale: IV calcium stabilizes the cardiac membrane and reduces the
immediate risk of fatal dysrhythmias associated with severe
hyperkalemia. It does not remove potassium but provides urgent
cardiac protection.
3. Chest Pain
A client reports crushing substernal chest pain radiating to the left arm.
Which assessment finding requires the most immediate intervention?
A. Blood pressure 148/88 mmHg
B. Anxiety
C. Oxygen saturation 86%
D. Heart rate 104/min
Rationale: Significant hypoxemia threatens tissue oxygenation and
requires immediate attention. Airway and breathing take priority over
less immediately dangerous findings.
4. Digoxin Toxicity
A client taking digoxin reports nausea, blurred yellow vision, and
anorexia. The apical pulse is 54/min. What should the nurse do?
A. Administer the medication
B. Give the medication with food
C. Hold digoxin and notify the provider
D. Encourage increased sodium intake
,Rationale: Bradycardia, gastrointestinal symptoms, and visual
disturbances are classic manifestations of digoxin toxicity. The
medication should be withheld and the provider notified.
5. Insulin Administration
A client with type 1 diabetes is prescribed regular insulin and NPH
insulin. Which action is correct when mixing the insulins?
A. Draw NPH before regular insulin
B. Shake both insulin vials vigorously
C. Draw regular insulin before NPH insulin
D. Mix glargine with NPH
Rationale: When regular and NPH insulin are mixed, the clear regular
insulin is drawn before the cloudy NPH insulin to avoid contaminating
the regular insulin vial with NPH.
6. Stroke
A client suddenly develops right-sided weakness and expressive
aphasia. What is the nurse's priority action?
A. Give oral fluids
B. Place the client in Trendelenburg position
C. Determine the time the symptoms began and activate the stroke
response
D. Administer aspirin immediately
Rationale: Time of symptom onset is critical when determining
eligibility for reperfusion therapy. Rapid stroke evaluation is essential.
, 7. Blood Transfusion
Fifteen minutes after a blood transfusion begins, the client develops
chills, fever, and low back pain. What should the nurse do first?
A. Slow the transfusion
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Increase the IV flow rate
Rationale: These findings may indicate an acute hemolytic transfusion
reaction. The transfusion must be stopped immediately to prevent
further exposure.
8. Sepsis
A client with pneumonia has a temperature of 39.4°C, BP 82/46 mmHg,
HR 128/min, and altered mental status. Which intervention has the
highest priority?
A. Restrict fluids
B. Initiate rapid sepsis management and prescribed IV fluid
resuscitation
C. Administer an oral antipyretic
D. Encourage ambulation
Rationale: Hypotension, tachycardia, fever, and altered mental status
indicate possible septic shock. Rapid fluid resuscitation and treatment
of infection are critical.
9. Hypoglycemia
