NCLEX-RN COMPREHENSIVE FINAL
EXAM STUDY GUIDE QUESTIONS &
ANSWERS (VERIFIED ANSWERS) WITH
EXPERT EXPLANATIONS | 2026 – 2027
UPDATE (PDF)
1. A client with a history of heart failure is prescribed digoxin. Which of the following clinical
manifestations should the nurse identify as an early sign of digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Tachycardia and hypertension
C. Increased urinary output
D. Hyperkalemia
Answer: A
Conceptual Explanation: Early signs of digoxin toxicity are primarily gastrointestinal,
including anorexia, nausea, and vomiting. Visual disturbances like yellow-green halos and
arrhythmias are also common signs.
2. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse prioritize to prevent deep vein
thrombosis (DVT)?
A. Place a pillow under the client’s knees
,B. Massage the client’s calves daily
C. Apply sequential compression devices (SCDs)
D. Restrict fluid intake to 1,000 mL per day
Answer: C
Conceptual Explanation: SCDs and early ambulation are standard protocols for DVT
prophylaxis. Placing a pillow under the knees can actually impede venous return.
3. Which of the following interventions is most critical for a nurse to implement when caring
for a client in the manic phase of bipolar disorder?
A. Encourage the client to lead group therapy sessions
B. Engage the client in competitive sports to release energy
C. Provide a high-calorie, portable finger-food diet
D. Restrict the client to their room for 24 hours
Answer: C
Conceptual Explanation: Clients in a manic state often cannot sit down to eat; providing
high-calorie finger foods helps maintain nutrition. Competition should be avoided as it is
overstimulating.
4. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the LPN?
A. Performing the initial assessment on a new admission
, B. Developing a plan of care for a client with complex needs
C. Administering an intramuscular injection to a stable client
D. Teaching a client how to use a new insulin pump
Answer: C
Conceptual Explanation: LPNs can administer medications via many routes and care for
stable clients. Assessment, planning, and initial teaching are RN responsibilities.
5. A client is admitted with suspected bacterial meningitis. Which of the following
precautions should the nurse implement?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions only
Answer: A
Conceptual Explanation: Bacterial meningitis is transmitted through large-particle
droplets; therefore, droplet precautions (surgical mask within 3 to 6 feet) are required.
6. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.30, PaCO2 52
mmHg, HCO3 26 mEq/L. The nurse interprets these results as:
A. Metabolic acidosis
B. Respiratory alkalosis
EXAM STUDY GUIDE QUESTIONS &
ANSWERS (VERIFIED ANSWERS) WITH
EXPERT EXPLANATIONS | 2026 – 2027
UPDATE (PDF)
1. A client with a history of heart failure is prescribed digoxin. Which of the following clinical
manifestations should the nurse identify as an early sign of digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Tachycardia and hypertension
C. Increased urinary output
D. Hyperkalemia
Answer: A
Conceptual Explanation: Early signs of digoxin toxicity are primarily gastrointestinal,
including anorexia, nausea, and vomiting. Visual disturbances like yellow-green halos and
arrhythmias are also common signs.
2. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse prioritize to prevent deep vein
thrombosis (DVT)?
A. Place a pillow under the client’s knees
,B. Massage the client’s calves daily
C. Apply sequential compression devices (SCDs)
D. Restrict fluid intake to 1,000 mL per day
Answer: C
Conceptual Explanation: SCDs and early ambulation are standard protocols for DVT
prophylaxis. Placing a pillow under the knees can actually impede venous return.
3. Which of the following interventions is most critical for a nurse to implement when caring
for a client in the manic phase of bipolar disorder?
A. Encourage the client to lead group therapy sessions
B. Engage the client in competitive sports to release energy
C. Provide a high-calorie, portable finger-food diet
D. Restrict the client to their room for 24 hours
Answer: C
Conceptual Explanation: Clients in a manic state often cannot sit down to eat; providing
high-calorie finger foods helps maintain nutrition. Competition should be avoided as it is
overstimulating.
4. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the LPN?
A. Performing the initial assessment on a new admission
, B. Developing a plan of care for a client with complex needs
C. Administering an intramuscular injection to a stable client
D. Teaching a client how to use a new insulin pump
Answer: C
Conceptual Explanation: LPNs can administer medications via many routes and care for
stable clients. Assessment, planning, and initial teaching are RN responsibilities.
5. A client is admitted with suspected bacterial meningitis. Which of the following
precautions should the nurse implement?
A. Droplet precautions
B. Contact precautions
C. Airborne precautions
D. Standard precautions only
Answer: A
Conceptual Explanation: Bacterial meningitis is transmitted through large-particle
droplets; therefore, droplet precautions (surgical mask within 3 to 6 feet) are required.
6. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.30, PaCO2 52
mmHg, HCO3 26 mEq/L. The nurse interprets these results as:
A. Metabolic acidosis
B. Respiratory alkalosis
