KAPLAN SECURE PREDICTOR B PRACTICE TEST QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*
Safe and Effective Care Environment
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Adaptation
Management of Care
Pharmacological Therapies
*
Introduction
*
This practice assessment is designed to evaluate comprehensive nursing knowledge and clinical decision-making skills essential for successful
NCLEX-RN licensure. The exam assesses critical competencies across multiple domains including patient safety, pharmacological interventions,
therapeutic communication, disease management, and ethical professional standards. The multiple-choice and scenario-based structure
emphasizes real-world application of nursing principles, requiring candidates to prioritize care, analyze clinical data, and make sound clinical
judgments. This assessment mirrors the rigor and content distribution of the actual predictor examination, providing an accurate measure of
readiness for professional nursing practice and licensure.
*
Section One: Questions 1–100
Question 1
A nurse is caring for a patient with end-stage renal disease who refuses dialysis treatment. The patient is alert, oriented, and clearly understands the
consequences of refusal. What is the nurse's most appropriate initial action?
,A. Contact the healthcare provider to report the refusal
B. Document the patient's refusal and the assessment of decision-making capacity
C. Ask the family to intervene and persuade the patient to accept treatment
D. Initiate emergency dialysis to prevent life-threatening complications
🟢 B. Document the patient's refusal and the assessment of decision-making capacity
🔴 RATIONALE: Competent adults have the legal right to refuse medical treatment, even if life-sustaining. The nurse must first document the
refusal and confirm the patient has decision-making capacity. Contacting the provider is important but documentation is the priority initial action.
Question 2
Which medication should the nurse avoid administering to a patient with a known history of sulfonamide allergy?
A. Hydrochlorothiazide
B. Ampicillin
C. Metformin
D. Lisinopril
🟢 A. Hydrochlorothiazide
🔴 RATIONALE: Hydrochlorothiazide is a sulfonamide-derived diuretic and can cause severe allergic reactions in patients with sulfonamide allergy.
Ampicillin, metformin, and lisinopril do not contain sulfonamide components.
Question 3
A postoperative patient complains of sudden chest pain and shortness of breath 24 hours after knee arthroplasty. The nurse notes tachycardia and
decreased oxygen saturation. What is the most likely complication?
,A. Pneumonia
B. Pulmonary embolism
C. Wound infection
D. Atelectasis
🟢 B. Pulmonary embolism
🔴 RATIONALE: Sudden chest pain, shortness of breath, tachycardia, and hypoxia 24 hours postoperatively are classic signs of pulmonary
embolism, especially after orthopedic surgery. Pneumonia typically develops more gradually with fever and productive cough.
Question 4
The nurse is teaching a patient about new prescription warfarin therapy. Which statement by the patient indicates understanding of the medication?
A. "I will take aspirin for headaches instead of ibuprofen."
B. "I will use a soft toothbrush and avoid flossing."
C. "I need to maintain consistent intake of green leafy vegetables."
D. "I will stop the medication if I notice bruising."
🟢 C. "I need to maintain consistent intake of green leafy vegetables."
🔴 RATIONALE: Warfarin works by interfering with vitamin K, which is found in green leafy vegetables. Consistent intake prevents fluctuations in
warfarin effectiveness. Aspirin increases bleeding risk, soft toothbrushes are recommended but flossing isn't prohibited, and patients should never
stop warfarin without provider consultation.
Question 5
A 65-year-old patient with diabetes presents with blurred vision and floaters. Which complication should the nurse suspect?
, A. Retinal detachment
B. Diabetic retinopathy
C. Macular degeneration
D. Cataracts
🟢 B. Diabetic retinopathy
🔴 RATIONALE: Blurred vision and floaters in a diabetic patient are classic signs of diabetic retinopathy, caused by damage to retinal blood vessels.
Retinal detachment typically presents with sudden vision loss and flashes, while macular degeneration and cataracts develop more gradually.
Question 6
Which action by the nurse demonstrates proper infection control when caring for a patient with contact dermatitis?
A. Wearing a mask for all interactions
B. Using sterile gloves for wound care
C. Performing hand hygiene before and after patient contact
D. Placing the patient in negative pressure room
🟢 C. Performing hand hygiene before and after patient contact
🔴 RATIONALE: Hand hygiene is the most effective method for preventing infection transmission. Contact dermatitis is not infectious, so masks,
sterile gloves, and negative pressure rooms are unnecessary. Clean gloves are sufficient for wound care.
Question 7
A patient with heart failure is prescribed spironolactone. Which laboratory value requires immediate notification of the healthcare provider?
A. Sodium 138 mEq/L
B. Potassium 5.4 mEq/L
C. Creatinine 1.0 mg/dL
D. BUN 15 mg/dL
RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
*
Safe and Effective Care Environment
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Adaptation
Management of Care
Pharmacological Therapies
*
Introduction
*
This practice assessment is designed to evaluate comprehensive nursing knowledge and clinical decision-making skills essential for successful
NCLEX-RN licensure. The exam assesses critical competencies across multiple domains including patient safety, pharmacological interventions,
therapeutic communication, disease management, and ethical professional standards. The multiple-choice and scenario-based structure
emphasizes real-world application of nursing principles, requiring candidates to prioritize care, analyze clinical data, and make sound clinical
judgments. This assessment mirrors the rigor and content distribution of the actual predictor examination, providing an accurate measure of
readiness for professional nursing practice and licensure.
*
Section One: Questions 1–100
Question 1
A nurse is caring for a patient with end-stage renal disease who refuses dialysis treatment. The patient is alert, oriented, and clearly understands the
consequences of refusal. What is the nurse's most appropriate initial action?
,A. Contact the healthcare provider to report the refusal
B. Document the patient's refusal and the assessment of decision-making capacity
C. Ask the family to intervene and persuade the patient to accept treatment
D. Initiate emergency dialysis to prevent life-threatening complications
🟢 B. Document the patient's refusal and the assessment of decision-making capacity
🔴 RATIONALE: Competent adults have the legal right to refuse medical treatment, even if life-sustaining. The nurse must first document the
refusal and confirm the patient has decision-making capacity. Contacting the provider is important but documentation is the priority initial action.
Question 2
Which medication should the nurse avoid administering to a patient with a known history of sulfonamide allergy?
A. Hydrochlorothiazide
B. Ampicillin
C. Metformin
D. Lisinopril
🟢 A. Hydrochlorothiazide
🔴 RATIONALE: Hydrochlorothiazide is a sulfonamide-derived diuretic and can cause severe allergic reactions in patients with sulfonamide allergy.
Ampicillin, metformin, and lisinopril do not contain sulfonamide components.
Question 3
A postoperative patient complains of sudden chest pain and shortness of breath 24 hours after knee arthroplasty. The nurse notes tachycardia and
decreased oxygen saturation. What is the most likely complication?
,A. Pneumonia
B. Pulmonary embolism
C. Wound infection
D. Atelectasis
🟢 B. Pulmonary embolism
🔴 RATIONALE: Sudden chest pain, shortness of breath, tachycardia, and hypoxia 24 hours postoperatively are classic signs of pulmonary
embolism, especially after orthopedic surgery. Pneumonia typically develops more gradually with fever and productive cough.
Question 4
The nurse is teaching a patient about new prescription warfarin therapy. Which statement by the patient indicates understanding of the medication?
A. "I will take aspirin for headaches instead of ibuprofen."
B. "I will use a soft toothbrush and avoid flossing."
C. "I need to maintain consistent intake of green leafy vegetables."
D. "I will stop the medication if I notice bruising."
🟢 C. "I need to maintain consistent intake of green leafy vegetables."
🔴 RATIONALE: Warfarin works by interfering with vitamin K, which is found in green leafy vegetables. Consistent intake prevents fluctuations in
warfarin effectiveness. Aspirin increases bleeding risk, soft toothbrushes are recommended but flossing isn't prohibited, and patients should never
stop warfarin without provider consultation.
Question 5
A 65-year-old patient with diabetes presents with blurred vision and floaters. Which complication should the nurse suspect?
, A. Retinal detachment
B. Diabetic retinopathy
C. Macular degeneration
D. Cataracts
🟢 B. Diabetic retinopathy
🔴 RATIONALE: Blurred vision and floaters in a diabetic patient are classic signs of diabetic retinopathy, caused by damage to retinal blood vessels.
Retinal detachment typically presents with sudden vision loss and flashes, while macular degeneration and cataracts develop more gradually.
Question 6
Which action by the nurse demonstrates proper infection control when caring for a patient with contact dermatitis?
A. Wearing a mask for all interactions
B. Using sterile gloves for wound care
C. Performing hand hygiene before and after patient contact
D. Placing the patient in negative pressure room
🟢 C. Performing hand hygiene before and after patient contact
🔴 RATIONALE: Hand hygiene is the most effective method for preventing infection transmission. Contact dermatitis is not infectious, so masks,
sterile gloves, and negative pressure rooms are unnecessary. Clean gloves are sufficient for wound care.
Question 7
A patient with heart failure is prescribed spironolactone. Which laboratory value requires immediate notification of the healthcare provider?
A. Sodium 138 mEq/L
B. Potassium 5.4 mEq/L
C. Creatinine 1.0 mg/dL
D. BUN 15 mg/dL
