NCLEX-RN 2025/2026 ULTIMATE TEST BANK
ACTUAL HIGH-YIELD QUESTIONS AND ANSWERS
WITH FULL RATIONALES
This premium 200-question NCLEX-RN test bank is meticulously
designed for 2025/2026 nursing students looking to master high-
yield clinical judgment concepts. Each multiple-choice question
features an explicit, italicized correct answer followed by a
comprehensive, bold-italicized scientific rationale to guarantee
deep conceptual understanding. It covers critical testing
categories including safety, pharmacology, and physiological
adaptation, making it the ultimate tool to boost your exam
scores.
1. A nurse reviews the lab results of a patient
receiving spironolactone. Which result requires
immediate intervention?
A) Sodium 138 mEq/L
B) Potassium 5.6 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mEq/L
Answer: B
Rationale: Spironolactone is a potassium-
sparing diuretic. A potassium level of 5.6 mEq/L
, indicates hyperkalemia, which risks cardiac
dysrhythmias. Normal potassium is 3.5–5.0
mEq/L.
2. A patient with a chest tube becomes suddenly
short of breath. The nurse notes continuous
bubbling in the water seal chamber. What does
this indicate?
A) The lung has fully re-expanded.
B) The system is functioning normally.
C) There is an air leak in the system.
D) The suction pressure is too high.
Answer: C
Rationale: Continuous bubbling in the water
seal chamber indicates an air leak. Intermittent
bubbling is normal during coughing or
exhalation, but continuous bubbling requires
troubleshooting the connections.
3. Which medication should the nurse withhold for
a patient scheduled for an electroconvulsive
therapy (ECT) session in two hours?
A) Lorazepam
B) Metoprolol
C) Omeprazole
D) Atorvastatin
, Answer: A
Rationale: Benzodiazepines like lorazepam
raise the seizure threshold and can prevent the
therapeutic seizure required during ECT.
Anticonvulsants should also be held.
4. A nurse cares for a client with Addison's
disease. Which metabolic imbalance is most
expected?
A) Hypernatremia and hypokalemia
B) Hyponatremia and hyperkalemia
C) Hyperglycemia and hypernatremia
D) Hypokalemia and hyperglycemia
Answer: B
Rationale: Addison's disease involves
hyposecretion of adrenal corticoids. Deficient
aldosterone leads to sodium wasting
(hyponatremia) and potassium retention
(hyperkalemia).
5. What is the priority nursing action for a patient
presenting with an absolute neutrophil count
(ANC) of 450/mm³?
A) Administer a scheduled measles vaccine.
B) Place the patient in a negative-pressure
room.
, C) Implement protective (reverse) isolation
precautions.
D) Check the patient's rectal temperature every
4 hours.
Answer: C
Rationale: An ANC under 500/mm³ indicates
severe neutropenia and high risk for life-
threatening infection. Protective isolation is
mandatory. Rectal temperatures are
contraindicated due to infection risk via
mucosal trauma.
6. A client presents with a rigid, board-like
abdomen and severe pain after a peptic ulcer
flare-up. What should the nurse suspect?
A) Gastrointestinal hemorrhage
B) Intestinal obstruction
C) Perforation and peritonitis
D) Splenic rupture
Answer: C
Rationale: A rigid, board-like abdomen
combined with severe pain is a classic sign of
peritonitis, which typically follows a
gastrointestinal perforation.
ACTUAL HIGH-YIELD QUESTIONS AND ANSWERS
WITH FULL RATIONALES
This premium 200-question NCLEX-RN test bank is meticulously
designed for 2025/2026 nursing students looking to master high-
yield clinical judgment concepts. Each multiple-choice question
features an explicit, italicized correct answer followed by a
comprehensive, bold-italicized scientific rationale to guarantee
deep conceptual understanding. It covers critical testing
categories including safety, pharmacology, and physiological
adaptation, making it the ultimate tool to boost your exam
scores.
1. A nurse reviews the lab results of a patient
receiving spironolactone. Which result requires
immediate intervention?
A) Sodium 138 mEq/L
B) Potassium 5.6 mEq/L
C) Calcium 9.2 mg/dL
D) Magnesium 2.0 mEq/L
Answer: B
Rationale: Spironolactone is a potassium-
sparing diuretic. A potassium level of 5.6 mEq/L
, indicates hyperkalemia, which risks cardiac
dysrhythmias. Normal potassium is 3.5–5.0
mEq/L.
2. A patient with a chest tube becomes suddenly
short of breath. The nurse notes continuous
bubbling in the water seal chamber. What does
this indicate?
A) The lung has fully re-expanded.
B) The system is functioning normally.
C) There is an air leak in the system.
D) The suction pressure is too high.
Answer: C
Rationale: Continuous bubbling in the water
seal chamber indicates an air leak. Intermittent
bubbling is normal during coughing or
exhalation, but continuous bubbling requires
troubleshooting the connections.
3. Which medication should the nurse withhold for
a patient scheduled for an electroconvulsive
therapy (ECT) session in two hours?
A) Lorazepam
B) Metoprolol
C) Omeprazole
D) Atorvastatin
, Answer: A
Rationale: Benzodiazepines like lorazepam
raise the seizure threshold and can prevent the
therapeutic seizure required during ECT.
Anticonvulsants should also be held.
4. A nurse cares for a client with Addison's
disease. Which metabolic imbalance is most
expected?
A) Hypernatremia and hypokalemia
B) Hyponatremia and hyperkalemia
C) Hyperglycemia and hypernatremia
D) Hypokalemia and hyperglycemia
Answer: B
Rationale: Addison's disease involves
hyposecretion of adrenal corticoids. Deficient
aldosterone leads to sodium wasting
(hyponatremia) and potassium retention
(hyperkalemia).
5. What is the priority nursing action for a patient
presenting with an absolute neutrophil count
(ANC) of 450/mm³?
A) Administer a scheduled measles vaccine.
B) Place the patient in a negative-pressure
room.
, C) Implement protective (reverse) isolation
precautions.
D) Check the patient's rectal temperature every
4 hours.
Answer: C
Rationale: An ANC under 500/mm³ indicates
severe neutropenia and high risk for life-
threatening infection. Protective isolation is
mandatory. Rectal temperatures are
contraindicated due to infection risk via
mucosal trauma.
6. A client presents with a rigid, board-like
abdomen and severe pain after a peptic ulcer
flare-up. What should the nurse suspect?
A) Gastrointestinal hemorrhage
B) Intestinal obstruction
C) Perforation and peritonitis
D) Splenic rupture
Answer: C
Rationale: A rigid, board-like abdomen
combined with severe pain is a classic sign of
peritonitis, which typically follows a
gastrointestinal perforation.
