Kaplan RN Exit Exam 2026-2027: 560 Q&A
for NCLEX-RN Preparation
Study guide
This comprehensive study document is a targeted resource for nursing students
preparing for the critical Kaplan Exit Exam. It features 160 verified practice questions and
answers aligned with the NCLEX-RN test plan blueprint. The content is designed to
assess and reinforce core competencies in areas such as pharmacology, patient safety,
management of care, and physiological adaptation. By simulating the exam environment
and providing rationales for answers, this document serves as an effective tool for
identifying knowledge gaps, building test-taking confidence, and ensuring academic
progression toward RN licensure.
The nurse is delegating to nursing assistive personnel (NAP) the administration of an
enema for an older adult patient who is recovering from a stroke. The enema order
reads, "Enemas until clear." Which statement made by NAP requires the nurse to
follow-up?
A. "I'll need help to turn her onto her side."
B. "It may take three or four enemas to achieve a clear return."
C. "I'll test the water temperature on the inside of my own wrist."
D. "The enema will wear her out, so I'll wait until after she ambulates." -
,,,,,answer,,,,..B. Stating it may take three or four enemas to achieve a clear return
requires follow-up, since administering more than three enemas can cause fluid and
electrolyte imbalance, especially in an older adult patient. The health care provider
should be notified if the bowel has not been evacuated after three enemas. This
requires no follow-up, since more than one person may be required to turn a patient
onto her side. Testing the water temperature on the wrist is appropriate, so this
,statement requires no follow-up. Stating that the enema will wear her out reflects
appropriate concern for the patient and requires no follow-up.
The nurse has delegated administration of a standard enema for a 72-year-old
patient with constipation. Which statement made by nursing assistive personnel
(NAP) requires the nurse to follow-up?
A. "I'll warm up the solution before instilling it."
B. "I'll place the patient in the left side-lying position with the right knee bent."
C. "I'll put a waterproof pad under the patient before I start."
D. "I'll instill the solution and then check in on my other patients until I get the call
signal." - ,,,,,answer,,,,..D. After instilling the solution, NAP should remain with the
patient until he or she is ready to defecate, this statement requires follow-up.
Warming the solution is appropriate. The patient is placed in a left side-lying position
to allow the solution to flow downward by gravity along the natural curve of the
sigmoid colon and rectum. A waterproof pad may be placed under the patient if
necessary.
Which action would the nurse take to reduce the risk of infection among patients and
staff when administering an enema to an older adult patient with dementia?
A. Lubricate the tip of the rectal tube.
B. Pad the patient's bed thoroughly.
C. Perform hand hygiene before donning gloves.
D. Help the patient onto a bedpan to expel the enema fluid and stool. -
,,,,,answer,,,,..C.
Performing hand hygiene before donning gloves and after removing them is
appropriate in order to reduce the risk of infection among patients and staff. While
lubricating the tip of the rectal tube is appropriate, it pertains to instillation of the
,enema, not to reducing the risk of infection. Padding the patient's bed thoroughly is
appropriate; it pertains to the patient's comfort, not to reducing the risk of infection.
While helping the patient onto a bedpan is appropriate, it pertains to the procedure
itself, not to reducing the risk of infection.
The nurse interprets a client's temperature reading, knowing that certain factors can
affect body temperature. Which statements regarding body temperature are
accurate? Select all that apply.
a. Stress can cause a decrease in body temperature.
b. Body temperature increases just before ovulation.
c. Body temperature increases when the client has an infection.
d. Body temperature is usually higher in the afternoon than in the morning.
e. Body temperature may be lower than the true temperature if the temperature in the
client's room is cool. - ,,,,,answer,,,,..C, D, E
Emotions (stress) increase hormone secretion, leading to increased heat production
and a higher-than-normal temperature. Body temperature decreases slightly just
before ovulation and usually increases by 1° F above normal during ovulation.
Infective agents and the inflammatory response may cause an increase in
temperature. Afternoon body temperature may be high normal as a result of the
metabolic process, activity, and environmental temperature. Body temperature is
lower in cold weather and higher in warm weather.
The nurse is caring for a client who has undergone surgery. The client is anxious and
complains of incision pain. The nurse conducts a pain assessment, checks the
client's vital signs, and notes that the client's blood pressure and pulse rate have
increased. On the basis of these findings, which action by the nurse is most
appropriate?
a. Contacting the primary health care provider
, b. Preparing to administer pain medication
c. Checking for signs/symptoms of postoperative hemorrhage
d. Consulting with the primary health care provider about administering an
antianxiety medication - ,,,,,answer,,,,..B. Because increases in pulse and blood
pressure are expected in a client who is anxious and in pain, most appropriate action
by the nurse would be to prepare and administer pain medication. Anxiety, fear, pain,
and emotional stress all result in sympathetic stimulation, which increases the heart
rate, cardiac output, and peripheral vascular resistance. Sympathetic stimulation
also increases the blood pressure. There is no reason to contact the primary health
care provider at this time. Hemorrhage would result in a decrease in blood pressure.
Although a prescription for an antianxiety medication may be an option, it is not the
most appropriate action to take on the basis of the information in the question.
The nurse asks a colleague to assist in counting a client's pulse to determine whether
the client with a dysrhythmia has a pulse deficit. The nurse's colleague counts the
client's apical heart rate while the nurse counts the client's radial rate. The nurse's
colleague reports an apical heart rate of 90 beats/min, and the nurse obtains a radial
rate of 76 beats/min. Which nursing action is most appropriate?
a. Reassessing the client for a pulse deficit in 15 minutes
b. Documenting that the client has a pulse deficit of 14 beats
c. Asking another colleague to count the apical rate to verify the findings
d. Asking the client to ambulate and then reassess the apical and radial rate -
,,,,,answer,,,,..B. In the two-examiner technique for detecting a pulse deficit, the
nurse and a colleague count the radial and apical pulses simultaneously and then
compare the rates. The difference between the apical and radial pulse rates is the
pulse deficit. If the client has an apical heart rate of 90 beats/min and a radial rate of
76 beats/min, the pulse deficit is 14 beats. The nurse would document this finding.
The nurse would also report the finding to the primary health care provider. Although
the nurse would continue to check for a pulse deficit, it would not be necessary to do
for NCLEX-RN Preparation
Study guide
This comprehensive study document is a targeted resource for nursing students
preparing for the critical Kaplan Exit Exam. It features 160 verified practice questions and
answers aligned with the NCLEX-RN test plan blueprint. The content is designed to
assess and reinforce core competencies in areas such as pharmacology, patient safety,
management of care, and physiological adaptation. By simulating the exam environment
and providing rationales for answers, this document serves as an effective tool for
identifying knowledge gaps, building test-taking confidence, and ensuring academic
progression toward RN licensure.
The nurse is delegating to nursing assistive personnel (NAP) the administration of an
enema for an older adult patient who is recovering from a stroke. The enema order
reads, "Enemas until clear." Which statement made by NAP requires the nurse to
follow-up?
A. "I'll need help to turn her onto her side."
B. "It may take three or four enemas to achieve a clear return."
C. "I'll test the water temperature on the inside of my own wrist."
D. "The enema will wear her out, so I'll wait until after she ambulates." -
,,,,,answer,,,,..B. Stating it may take three or four enemas to achieve a clear return
requires follow-up, since administering more than three enemas can cause fluid and
electrolyte imbalance, especially in an older adult patient. The health care provider
should be notified if the bowel has not been evacuated after three enemas. This
requires no follow-up, since more than one person may be required to turn a patient
onto her side. Testing the water temperature on the wrist is appropriate, so this
,statement requires no follow-up. Stating that the enema will wear her out reflects
appropriate concern for the patient and requires no follow-up.
The nurse has delegated administration of a standard enema for a 72-year-old
patient with constipation. Which statement made by nursing assistive personnel
(NAP) requires the nurse to follow-up?
A. "I'll warm up the solution before instilling it."
B. "I'll place the patient in the left side-lying position with the right knee bent."
C. "I'll put a waterproof pad under the patient before I start."
D. "I'll instill the solution and then check in on my other patients until I get the call
signal." - ,,,,,answer,,,,..D. After instilling the solution, NAP should remain with the
patient until he or she is ready to defecate, this statement requires follow-up.
Warming the solution is appropriate. The patient is placed in a left side-lying position
to allow the solution to flow downward by gravity along the natural curve of the
sigmoid colon and rectum. A waterproof pad may be placed under the patient if
necessary.
Which action would the nurse take to reduce the risk of infection among patients and
staff when administering an enema to an older adult patient with dementia?
A. Lubricate the tip of the rectal tube.
B. Pad the patient's bed thoroughly.
C. Perform hand hygiene before donning gloves.
D. Help the patient onto a bedpan to expel the enema fluid and stool. -
,,,,,answer,,,,..C.
Performing hand hygiene before donning gloves and after removing them is
appropriate in order to reduce the risk of infection among patients and staff. While
lubricating the tip of the rectal tube is appropriate, it pertains to instillation of the
,enema, not to reducing the risk of infection. Padding the patient's bed thoroughly is
appropriate; it pertains to the patient's comfort, not to reducing the risk of infection.
While helping the patient onto a bedpan is appropriate, it pertains to the procedure
itself, not to reducing the risk of infection.
The nurse interprets a client's temperature reading, knowing that certain factors can
affect body temperature. Which statements regarding body temperature are
accurate? Select all that apply.
a. Stress can cause a decrease in body temperature.
b. Body temperature increases just before ovulation.
c. Body temperature increases when the client has an infection.
d. Body temperature is usually higher in the afternoon than in the morning.
e. Body temperature may be lower than the true temperature if the temperature in the
client's room is cool. - ,,,,,answer,,,,..C, D, E
Emotions (stress) increase hormone secretion, leading to increased heat production
and a higher-than-normal temperature. Body temperature decreases slightly just
before ovulation and usually increases by 1° F above normal during ovulation.
Infective agents and the inflammatory response may cause an increase in
temperature. Afternoon body temperature may be high normal as a result of the
metabolic process, activity, and environmental temperature. Body temperature is
lower in cold weather and higher in warm weather.
The nurse is caring for a client who has undergone surgery. The client is anxious and
complains of incision pain. The nurse conducts a pain assessment, checks the
client's vital signs, and notes that the client's blood pressure and pulse rate have
increased. On the basis of these findings, which action by the nurse is most
appropriate?
a. Contacting the primary health care provider
, b. Preparing to administer pain medication
c. Checking for signs/symptoms of postoperative hemorrhage
d. Consulting with the primary health care provider about administering an
antianxiety medication - ,,,,,answer,,,,..B. Because increases in pulse and blood
pressure are expected in a client who is anxious and in pain, most appropriate action
by the nurse would be to prepare and administer pain medication. Anxiety, fear, pain,
and emotional stress all result in sympathetic stimulation, which increases the heart
rate, cardiac output, and peripheral vascular resistance. Sympathetic stimulation
also increases the blood pressure. There is no reason to contact the primary health
care provider at this time. Hemorrhage would result in a decrease in blood pressure.
Although a prescription for an antianxiety medication may be an option, it is not the
most appropriate action to take on the basis of the information in the question.
The nurse asks a colleague to assist in counting a client's pulse to determine whether
the client with a dysrhythmia has a pulse deficit. The nurse's colleague counts the
client's apical heart rate while the nurse counts the client's radial rate. The nurse's
colleague reports an apical heart rate of 90 beats/min, and the nurse obtains a radial
rate of 76 beats/min. Which nursing action is most appropriate?
a. Reassessing the client for a pulse deficit in 15 minutes
b. Documenting that the client has a pulse deficit of 14 beats
c. Asking another colleague to count the apical rate to verify the findings
d. Asking the client to ambulate and then reassess the apical and radial rate -
,,,,,answer,,,,..B. In the two-examiner technique for detecting a pulse deficit, the
nurse and a colleague count the radial and apical pulses simultaneously and then
compare the rates. The difference between the apical and radial pulse rates is the
pulse deficit. If the client has an apical heart rate of 90 beats/min and a radial rate of
76 beats/min, the pulse deficit is 14 beats. The nurse would document this finding.
The nurse would also report the finding to the primary health care provider. Although
the nurse would continue to check for a pulse deficit, it would not be necessary to do
