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KAPLAN COMPREHENSIVE PREDICTOR EXAM 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
KAPLAN
Prepare for the Kaplan Comprehensive Predictor Exam with a focused study resource
designed to reinforce nursing knowledge across major NCLEX content areas. It
supports review of clinical judgment, patient safety, prioritization, pharmacology,
health assessment, nursing interventions, and evidence-based care. Use the material
to identify knowledge gaps, strengthen test-taking skills, and build confidence for
comprehensive exam preparation. This resource is best suited for nursing students
and NCLEX candidates preparing for comprehensive predictor assessments.
MULTIPLE CHOICE.
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-15)
1. A client is admitted with dehydration. Which assessment finding is
most indicative of severe dehydration?
a) Thirst and dry mucous membranes
b) Orthostatic hypotension and tachycardia
c) Decreased skin turgor and oliguria
d) Lethargy and confusion
Answer: d) Lethargy and confusion
Rationale: Lethargy and confusion indicate cerebral hypoperfusion and are
signs of severe dehydration. Thirst, dry mucous membranes, orthostatic
hypotension, tachycardia, decreased skin turgor, and oliguria are signs of
moderate to severe dehydration but do not indicate the level of cerebral
involvement seen in severe dehydration.
2. The nurse is preparing to administer an intramuscular injection using
the Z-track technique. Which action is correct?
a) Use a 1-inch needle for all IM injections
b) Displace the skin laterally before inserting the needle
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c) Massage the site vigorously after injection
d) Use the deltoid muscle for all IM injections
Answer: b) Displace the skin laterally before inserting the needle
Rationale: The Z-track technique involves displacing the skin laterally before
inserting the needle. After injection, the skin is released, which seals the
medication track and prevents leakage. The site should not be massaged.
Needle length depends on the muscle and client size.
3. A client is receiving a blood transfusion. Fifteen minutes after the
transfusion begins, the client reports chills, low back pain, and shortness
of breath. What is the nurse's priority action?
a) Slow the transfusion rate
b) Stop the transfusion immediately
c) Administer acetaminophen for chills
d) Notify the provider
Answer: b) Stop the transfusion immediately
Rationale: Chills, low back pain, and shortness of breath suggest a potential
hemolytic transfusion reaction. The priority action is to stop the transfusion
immediately, maintain IV access with normal saline, and notify the provider.
Slowing the rate is not appropriate for a suspected reaction.
4. A client is on strict bed rest. Which nursing intervention is most
important to prevent deep vein thrombosis?
a) Applying elastic stockings
b) Performing passive range of motion exercises
c) Administering prophylactic anticoagulants as prescribed
d) Encouraging ankle and foot exercises
Answer: c) Administering prophylactic anticoagulants as prescribed
Rationale: While all options help prevent VTE, prophylactic anticoagulation is
the most effective intervention for high-risk clients. The other measures are
supportive but do not replace pharmacological prophylaxis.
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5. A client requires a sterile dressing change. Which action by the nurse
maintains sterile technique?
a) Opening the sterile package toward the body
b) Keeping the sterile field at waist level
c) Pouring sterile solution directly onto the sterile field
d) Allowing the sterile field to become wet and continuing to use it
Answer: b) Keeping the sterile field at waist level
Rationale: A sterile field should be kept at or above waist level to prevent
contamination. Sterile packages should be opened away from the body, not
toward it. Pouring sterile solution should be done from a height of 4-6 inches,
not directly onto the field. A wet sterile field is considered contaminated.
6. A client with a new diagnosis of diabetes mellitus is learning to self-
administer insulin. Which statement by the client indicates a need for
further teaching?
a) "I will rotate my injection sites to prevent lumps."
b) "I will store my unopened insulin vials in the refrigerator."
c) "I will draw up the regular insulin first, then the NPH insulin."
d) "I can use the same syringe for multiple injections if I recap it."
Answer: d) "I can use the same syringe for multiple injections if I recap it."
Rationale: Insulin syringes are for single use only and should never be reused.
Reusing syringes increases the risk of infection and inaccurate dosing. The
other statements reflect correct understanding.
7. A client is 2 days post-operative from abdominal surgery. The nurse
notes that the wound edges are separated and there is protrusion of
abdominal contents. What is the nurse's priority action?
a) Apply a sterile saline-soaked dressing and notify the surgeon
b) Gently push the abdominal contents back into the wound
c) Place the client in a supine position with knees flat
d) Apply an abdominal binder tightly
Answer: a) Apply a sterile saline-soaked dressing and notify the surgeon
Rationale: This is an evisceration, a surgical emergency. The nurse should
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cover the wound with a sterile saline-soaked dressing, place the client in a
supine position with knees bent (to reduce abdominal tension), and notify the
surgeon immediately. Never attempt to push organs back into the wound.
8. A client is receiving continuous enteral feeding through a nasogastric
tube. Which position should the nurse maintain to reduce the risk of
aspiration?
a) Supine position
b) Left lateral recumbent position
c) Semi-Fowler's position with head of bed elevated 30-45 degrees
d) Trendelenburg position
Answer: c) Semi-Fowler's position with head of bed elevated 30-45
degrees
Rationale: Elevating the head of the bed to 30-45 degrees uses gravity to
prevent reflux and aspiration during enteral feeding. Supine and
Trendelenburg positions increase aspiration risk.
9. A client reports pain rated 8 on a scale of 0-10. The nurse administers
morphine sulfate 4 mg IV. Thirty minutes later, the client reports pain
rated 4. Which nursing action is most appropriate?
a) Document that the pain medication was effective
b) Assess for side effects of the medication
c) Administer another dose of morphine
d) Reassess pain in 60 minutes
Answer: b) Assess for side effects of the medication
Rationale: Before administering another dose or leaving the client, the nurse
must assess for potential side effects, especially respiratory depression. A
decrease from 8 to 4 indicates some effectiveness. Safety assessment
(respiratory rate, sedation level) is the priority.
10. A client is prescribed a clear liquid diet. Which item can the client
have?
KAPLAN COMPREHENSIVE PREDICTOR EXAM 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
KAPLAN
Prepare for the Kaplan Comprehensive Predictor Exam with a focused study resource
designed to reinforce nursing knowledge across major NCLEX content areas. It
supports review of clinical judgment, patient safety, prioritization, pharmacology,
health assessment, nursing interventions, and evidence-based care. Use the material
to identify knowledge gaps, strengthen test-taking skills, and build confidence for
comprehensive exam preparation. This resource is best suited for nursing students
and NCLEX candidates preparing for comprehensive predictor assessments.
MULTIPLE CHOICE.
SECTION 1: FUNDAMENTALS OF NURSING (Questions 1-15)
1. A client is admitted with dehydration. Which assessment finding is
most indicative of severe dehydration?
a) Thirst and dry mucous membranes
b) Orthostatic hypotension and tachycardia
c) Decreased skin turgor and oliguria
d) Lethargy and confusion
Answer: d) Lethargy and confusion
Rationale: Lethargy and confusion indicate cerebral hypoperfusion and are
signs of severe dehydration. Thirst, dry mucous membranes, orthostatic
hypotension, tachycardia, decreased skin turgor, and oliguria are signs of
moderate to severe dehydration but do not indicate the level of cerebral
involvement seen in severe dehydration.
2. The nurse is preparing to administer an intramuscular injection using
the Z-track technique. Which action is correct?
a) Use a 1-inch needle for all IM injections
b) Displace the skin laterally before inserting the needle
, Page 2 of 39
c) Massage the site vigorously after injection
d) Use the deltoid muscle for all IM injections
Answer: b) Displace the skin laterally before inserting the needle
Rationale: The Z-track technique involves displacing the skin laterally before
inserting the needle. After injection, the skin is released, which seals the
medication track and prevents leakage. The site should not be massaged.
Needle length depends on the muscle and client size.
3. A client is receiving a blood transfusion. Fifteen minutes after the
transfusion begins, the client reports chills, low back pain, and shortness
of breath. What is the nurse's priority action?
a) Slow the transfusion rate
b) Stop the transfusion immediately
c) Administer acetaminophen for chills
d) Notify the provider
Answer: b) Stop the transfusion immediately
Rationale: Chills, low back pain, and shortness of breath suggest a potential
hemolytic transfusion reaction. The priority action is to stop the transfusion
immediately, maintain IV access with normal saline, and notify the provider.
Slowing the rate is not appropriate for a suspected reaction.
4. A client is on strict bed rest. Which nursing intervention is most
important to prevent deep vein thrombosis?
a) Applying elastic stockings
b) Performing passive range of motion exercises
c) Administering prophylactic anticoagulants as prescribed
d) Encouraging ankle and foot exercises
Answer: c) Administering prophylactic anticoagulants as prescribed
Rationale: While all options help prevent VTE, prophylactic anticoagulation is
the most effective intervention for high-risk clients. The other measures are
supportive but do not replace pharmacological prophylaxis.
, Page 3 of 39
5. A client requires a sterile dressing change. Which action by the nurse
maintains sterile technique?
a) Opening the sterile package toward the body
b) Keeping the sterile field at waist level
c) Pouring sterile solution directly onto the sterile field
d) Allowing the sterile field to become wet and continuing to use it
Answer: b) Keeping the sterile field at waist level
Rationale: A sterile field should be kept at or above waist level to prevent
contamination. Sterile packages should be opened away from the body, not
toward it. Pouring sterile solution should be done from a height of 4-6 inches,
not directly onto the field. A wet sterile field is considered contaminated.
6. A client with a new diagnosis of diabetes mellitus is learning to self-
administer insulin. Which statement by the client indicates a need for
further teaching?
a) "I will rotate my injection sites to prevent lumps."
b) "I will store my unopened insulin vials in the refrigerator."
c) "I will draw up the regular insulin first, then the NPH insulin."
d) "I can use the same syringe for multiple injections if I recap it."
Answer: d) "I can use the same syringe for multiple injections if I recap it."
Rationale: Insulin syringes are for single use only and should never be reused.
Reusing syringes increases the risk of infection and inaccurate dosing. The
other statements reflect correct understanding.
7. A client is 2 days post-operative from abdominal surgery. The nurse
notes that the wound edges are separated and there is protrusion of
abdominal contents. What is the nurse's priority action?
a) Apply a sterile saline-soaked dressing and notify the surgeon
b) Gently push the abdominal contents back into the wound
c) Place the client in a supine position with knees flat
d) Apply an abdominal binder tightly
Answer: a) Apply a sterile saline-soaked dressing and notify the surgeon
Rationale: This is an evisceration, a surgical emergency. The nurse should
, Page 4 of 39
cover the wound with a sterile saline-soaked dressing, place the client in a
supine position with knees bent (to reduce abdominal tension), and notify the
surgeon immediately. Never attempt to push organs back into the wound.
8. A client is receiving continuous enteral feeding through a nasogastric
tube. Which position should the nurse maintain to reduce the risk of
aspiration?
a) Supine position
b) Left lateral recumbent position
c) Semi-Fowler's position with head of bed elevated 30-45 degrees
d) Trendelenburg position
Answer: c) Semi-Fowler's position with head of bed elevated 30-45
degrees
Rationale: Elevating the head of the bed to 30-45 degrees uses gravity to
prevent reflux and aspiration during enteral feeding. Supine and
Trendelenburg positions increase aspiration risk.
9. A client reports pain rated 8 on a scale of 0-10. The nurse administers
morphine sulfate 4 mg IV. Thirty minutes later, the client reports pain
rated 4. Which nursing action is most appropriate?
a) Document that the pain medication was effective
b) Assess for side effects of the medication
c) Administer another dose of morphine
d) Reassess pain in 60 minutes
Answer: b) Assess for side effects of the medication
Rationale: Before administering another dose or leaving the client, the nurse
must assess for potential side effects, especially respiratory depression. A
decrease from 8 to 4 indicates some effectiveness. Safety assessment
(respiratory rate, sedation level) is the priority.
10. A client is prescribed a clear liquid diet. Which item can the client
have?
