Ultimate RN Comprehensive Predictor (NGN Edition): 180
Exam-Style Questions for NCLEX Success Complete RN
Exit Exam Simulator: 180 NCLEX Predictor Questions +
Rationales
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which finding should
the nurse report to the provider?
A. Weight loss of 1 kg in 24 hours
B. Serum potassium 3.0 mEq/L
C. Blood pressure 118/78 mm Hg
D. Urine output 2,000 mL/24 hr
Answer: B
Rationale: Furosemide causes potassium loss; a K⁺ of 3.0 is hypokalemia and requires provider
notification.
2. A nurse is reinforcing teaching about insulin injections. The client says, “I’ll reuse my syringes as long
as I recap them.” Which response should the nurse make?
A. “That’s fine if you disinfect the needle with alcohol.”
B. “You should use a new syringe each time.”
C. “Store the used syringe in the refrigerator.”
D. “Recapping will keep it sterile.”
Answer: B
Rationale: Insulin syringes should be single-use to prevent infection and needle dullness.
3. A client with COPD is prescribed oxygen at 3 L/min via nasal cannula. Which action should the nurse
take?
A. Increase oxygen flow for dyspnea
B. Use a nonrebreather mask
C. Maintain oxygen saturation 90–92%
D. Encourage coughing suppression
Answer: C
Rationale: For COPD, O₂ should maintain SpO₂ between 90–92% to prevent CO₂ retention.
4. A client receiving heparin has an aPTT of 90 seconds. What should the nurse do first?
A. Continue the infusion
B. Stop the infusion
C. Increase the infusion rate
D. Give vitamin K
,Answer: B
Rationale: aPTT >80 seconds indicates excess anticoagulation; stop heparin and notify provider.
5. Which client should the nurse assess first?
A. A postoperative client with pain rated 8/10
B. A client with pneumonia and RR 30/min
C. A client awaiting discharge
D. A client with a blood glucose of 140 mg/dL
Answer: B
Rationale: Respiratory distress takes priority according to ABCs.
6. A nurse prepares to administer digoxin. The apical pulse is 52 bpm. What should the nurse do?
A. Give the medication
B. Hold and notify provider
C. Give half the dose
D. Recheck in 15 minutes
Answer: B
Rationale: Withhold digoxin if pulse <60 bpm due to risk of bradycardia.
7. Which statement by a client indicates understanding of warfarin therapy?
A. “I’ll eat more green leafy vegetables.”
B. “I’ll use a soft toothbrush.”
C. “I’ll take aspirin for headaches.”
D. “I can stop the drug when I feel well.”
Answer: B
Rationale: Warfarin increases bleeding risk; soft toothbrush prevents gum injury.
8. A nurse finds a client on the floor. What is the first action?
A. Check for injuries
B. Call for help
C. Move the client to bed
D. Document the incident
Answer: A
Rationale: Safety first—assess for injury before movement.
9. Which lab value indicates effective diabetes management?
A. Fasting glucose 180 mg/dL
B. HbA1c 6.0%
C. Random glucose 220 mg/dL
,D. HbA1c 9.0%
Answer: B
Rationale: HbA1c <7% indicates good long-term glucose control.
10. A nurse administers IV potassium chloride. Which action is essential?
A. Give IV push
B. Dilute and infuse slowly
C. Restrict oral fluids
D. Mix with antibiotics
Answer: B
Rationale: KCl must be diluted and infused slowly to prevent cardiac arrest.
11. A nurse prepares to insert an indwelling urinary catheter for a female client. Which step maintains
sterility?
A. Touching the catheter to adjust its position
B. Placing the catheter on a sterile field before insertion
C. Cleaning from back to front with antiseptic swabs
D. Using clean gloves to insert the catheter
Answer: B
Rationale: The catheter must remain sterile until inserted; it’s placed on a sterile field to maintain
asepsis.
12. A client with myasthenia gravis reports difficulty swallowing after taking medication. The nurse
should:
A. Hold the next dose
B. Encourage rest before meals
C. Give medication after meals
D. Administer medication earlier
Answer: D
Rationale: Giving meds 30–45 min before meals ensures peak strength for chewing and swallowing.
13. A nurse cares for a client on contact precautions. Which PPE is required?
A. Gown and gloves
B. Mask and goggles
C. Gown, mask, gloves, and goggles
D. Mask only
Answer: A
Rationale: Contact precautions require gown and gloves to prevent spread via direct or indirect contact.
, 14. A nurse assesses a client with hypocalcemia. Which finding is expected?
A. Bradycardia
B. Positive Chvostek’s sign
C. Decreased deep tendon reflexes
D. Hypoactive bowel sounds
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability; a positive Chvostek’s sign confirms this.
15. Which food should a client taking MAOI antidepressants avoid?
A. Fresh fruits
B. Yogurt
C. Aged cheese
D. Whole grains
Answer: C
Rationale: Tyramine-rich foods like aged cheese can cause hypertensive crisis with MAOIs.
16. Which instruction should a nurse give to prevent venous thromboembolism after surgery?
A. Maintain bedrest
B. Cross legs frequently
C. Perform leg exercises
D. Limit fluid intake
Answer: C
Rationale: Leg exercises promote venous return and prevent clot formation.
17. A nurse cares for a client after a thyroidectomy. Which finding requires immediate intervention?
A. Voice hoarseness
B. Mild neck pain
C. Difficulty breathing
D. Nausea
Answer: C
Rationale: Airway obstruction from swelling or hematoma is life-threatening; assess airway
immediately.
18. A client taking lithium reports tremors and nausea. What should the nurse do?
A. Withhold medication and notify provider
B. Encourage extra fluids
C. Give an antiemetic
D. Administer next dose early
Answer: A
Exam-Style Questions for NCLEX Success Complete RN
Exit Exam Simulator: 180 NCLEX Predictor Questions +
Rationales
1. A nurse is caring for a client who has heart failure and is receiving furosemide. Which finding should
the nurse report to the provider?
A. Weight loss of 1 kg in 24 hours
B. Serum potassium 3.0 mEq/L
C. Blood pressure 118/78 mm Hg
D. Urine output 2,000 mL/24 hr
Answer: B
Rationale: Furosemide causes potassium loss; a K⁺ of 3.0 is hypokalemia and requires provider
notification.
2. A nurse is reinforcing teaching about insulin injections. The client says, “I’ll reuse my syringes as long
as I recap them.” Which response should the nurse make?
A. “That’s fine if you disinfect the needle with alcohol.”
B. “You should use a new syringe each time.”
C. “Store the used syringe in the refrigerator.”
D. “Recapping will keep it sterile.”
Answer: B
Rationale: Insulin syringes should be single-use to prevent infection and needle dullness.
3. A client with COPD is prescribed oxygen at 3 L/min via nasal cannula. Which action should the nurse
take?
A. Increase oxygen flow for dyspnea
B. Use a nonrebreather mask
C. Maintain oxygen saturation 90–92%
D. Encourage coughing suppression
Answer: C
Rationale: For COPD, O₂ should maintain SpO₂ between 90–92% to prevent CO₂ retention.
4. A client receiving heparin has an aPTT of 90 seconds. What should the nurse do first?
A. Continue the infusion
B. Stop the infusion
C. Increase the infusion rate
D. Give vitamin K
,Answer: B
Rationale: aPTT >80 seconds indicates excess anticoagulation; stop heparin and notify provider.
5. Which client should the nurse assess first?
A. A postoperative client with pain rated 8/10
B. A client with pneumonia and RR 30/min
C. A client awaiting discharge
D. A client with a blood glucose of 140 mg/dL
Answer: B
Rationale: Respiratory distress takes priority according to ABCs.
6. A nurse prepares to administer digoxin. The apical pulse is 52 bpm. What should the nurse do?
A. Give the medication
B. Hold and notify provider
C. Give half the dose
D. Recheck in 15 minutes
Answer: B
Rationale: Withhold digoxin if pulse <60 bpm due to risk of bradycardia.
7. Which statement by a client indicates understanding of warfarin therapy?
A. “I’ll eat more green leafy vegetables.”
B. “I’ll use a soft toothbrush.”
C. “I’ll take aspirin for headaches.”
D. “I can stop the drug when I feel well.”
Answer: B
Rationale: Warfarin increases bleeding risk; soft toothbrush prevents gum injury.
8. A nurse finds a client on the floor. What is the first action?
A. Check for injuries
B. Call for help
C. Move the client to bed
D. Document the incident
Answer: A
Rationale: Safety first—assess for injury before movement.
9. Which lab value indicates effective diabetes management?
A. Fasting glucose 180 mg/dL
B. HbA1c 6.0%
C. Random glucose 220 mg/dL
,D. HbA1c 9.0%
Answer: B
Rationale: HbA1c <7% indicates good long-term glucose control.
10. A nurse administers IV potassium chloride. Which action is essential?
A. Give IV push
B. Dilute and infuse slowly
C. Restrict oral fluids
D. Mix with antibiotics
Answer: B
Rationale: KCl must be diluted and infused slowly to prevent cardiac arrest.
11. A nurse prepares to insert an indwelling urinary catheter for a female client. Which step maintains
sterility?
A. Touching the catheter to adjust its position
B. Placing the catheter on a sterile field before insertion
C. Cleaning from back to front with antiseptic swabs
D. Using clean gloves to insert the catheter
Answer: B
Rationale: The catheter must remain sterile until inserted; it’s placed on a sterile field to maintain
asepsis.
12. A client with myasthenia gravis reports difficulty swallowing after taking medication. The nurse
should:
A. Hold the next dose
B. Encourage rest before meals
C. Give medication after meals
D. Administer medication earlier
Answer: D
Rationale: Giving meds 30–45 min before meals ensures peak strength for chewing and swallowing.
13. A nurse cares for a client on contact precautions. Which PPE is required?
A. Gown and gloves
B. Mask and goggles
C. Gown, mask, gloves, and goggles
D. Mask only
Answer: A
Rationale: Contact precautions require gown and gloves to prevent spread via direct or indirect contact.
, 14. A nurse assesses a client with hypocalcemia. Which finding is expected?
A. Bradycardia
B. Positive Chvostek’s sign
C. Decreased deep tendon reflexes
D. Hypoactive bowel sounds
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability; a positive Chvostek’s sign confirms this.
15. Which food should a client taking MAOI antidepressants avoid?
A. Fresh fruits
B. Yogurt
C. Aged cheese
D. Whole grains
Answer: C
Rationale: Tyramine-rich foods like aged cheese can cause hypertensive crisis with MAOIs.
16. Which instruction should a nurse give to prevent venous thromboembolism after surgery?
A. Maintain bedrest
B. Cross legs frequently
C. Perform leg exercises
D. Limit fluid intake
Answer: C
Rationale: Leg exercises promote venous return and prevent clot formation.
17. A nurse cares for a client after a thyroidectomy. Which finding requires immediate intervention?
A. Voice hoarseness
B. Mild neck pain
C. Difficulty breathing
D. Nausea
Answer: C
Rationale: Airway obstruction from swelling or hematoma is life-threatening; assess airway
immediately.
18. A client taking lithium reports tremors and nausea. What should the nurse do?
A. Withhold medication and notify provider
B. Encourage extra fluids
C. Give an antiemetic
D. Administer next dose early
Answer: A
