**Crush your nursing exams with this Ultimate 2026 Practice Question
Bank! Featuring 120 high-yield NCLEX-style questions with detailed
rationales covering Med-Surg, Leadership, and Pharmacology, this is
your comprehensive nursing exam guide for guaranteed success.**
---
# 🏆 2026 | NR 449 | HESI RN Comprehensive & ATI Leadership
Predictor | Complete NGN Questions with Rationales | V135-V141 |
Ultimate Nursing School Prep
---
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Placing the client in high-Fowler's position is the priority because it maximizes lung
expansion and facilitates breathing. This is a fundamental intervention for clients with respiratory
distress and is a key concept in NCLEX prep. Lying flat would worsen dyspnea. While oxygen and suction
may be needed, positioning is the immediate, independent nursing action that can be taken without an
order, a crucial skill for nursing exam guide success.
1. A nurse is caring for a client with pneumonia who is experiencing severe dyspnea. What is the priority
nursing intervention?
A. Administer oxygen at 2 L/min.
B. Encourage the client to cough and deep breathe.
C. Place the client in high-Fowler's position.
D. Suction the client's airway.
💫ANSWER✔️✔️: B
,💫RATIONALE✔️✔️: A patent AV fistula is confirmed by the presence of a bruit (auscultated) and a thrill
(palpated). These indicate good blood flow. A pulsating mass could be an aneurysm or pseudoaneurysm.
A cold, pale extremity indicates poor perfusion, which could mean the fistula is not functioning. This
assessment is critical for HESI Medical-Surgical Exam preparation.
2. A nurse is assessing a client's arteriovenous (AV) fistula in the right arm. Which of the following
findings indicates the fistula is functioning properly?
A. Absence of a bruit.
B. Presence of a thrill.
C. Coolness of the right hand.
D. A weak radial pulse.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The priority assessment for a client receiving magnesium sulfate is deep tendon
reflexes (DTRs). Loss of DTRs is the first sign of magnesium toxicity. The drug can cause central nervous
system depression, leading to respiratory arrest. This is a high-alert medication and a key topic for the
ATI Maternal Newborn Proctored Exam.
3. A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which of the following
assessments is the priority to monitor for toxicity?
A. Blood pressure
B. Temperature
C. Urine output
D. Deep tendon reflexes
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: A severe allergy to contrast dye or shellfish indicates a high risk for an anaphylactic
reaction to IV contrast. The nurse must notify the provider so that premedication protocols can be
initiated or alternative imaging ordered. A renal function test is also important but secondary to the
allergy concern. This is a safety concept emphasized in Chamberlain BSN programs.
4. A client scheduled for a CT scan with contrast tells the nurse they are allergic to shellfish. What is the
nurse's priority action?
,A. Administer diphenhydramine (Benadryl).
B. Notify the healthcare provider.
C. Cancel the CT scan.
D. Ensure the client is well-hydrated.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct action is to verify the medication order. This is the most crucial step in
safe medication administration and is a fundamental principle of nursing exam guide preparation.
Reconstituting or administering the medication without verifying the order could lead to a serious
medication error.
5. A nurse is preparing to administer a medication to a client. What is the most important action for the
nurse to take prior to administration?
A. Explain the purpose of the medication.
B. Verify the medication order.
C. Check the client's identification band.
D. Ask the client about allergies.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The client is exhibiting signs of hyperkalemia (nausea, diarrhea, ECG changes). The
priority is to remove potassium from the body. Sodium polystyrene sulfonate (Kayexalate) is a cation-
exchange resin that does this. This is a critical concept for the ATI Comprehensive Predictor.
6. A nurse is caring for a client with chronic kidney disease who has a potassium level of 6.8 mEq/L.
Which medication should the nurse anticipate administering?
A. Calcium gluconate
B. Sodium polystyrene sulfonate (Kayexalate)
C. Regular insulin with dextrose
D. Furosemide (Lasix)
💫ANSWER✔️✔️: C
, 💫RATIONALE✔️✔️: The first sign of a hemolytic transfusion reaction is often a subjective feeling of
impending doom, followed by chills and back pain. The priority is to stop the transfusion immediately to
prevent further complications. This is a life-threatening emergency and a must-know for NCLEX success.
7. A nurse is administering a blood transfusion. The client reports a sudden onset of chills, back pain,
and feels like "something is wrong." What is the nurse's priority action?
A. Slow the infusion rate.
B. Stop the transfusion.
C. Administer diphenhydramine (Benadryl).
D. Assess the client's temperature.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The priority is to place the client in a side-lying position to protect the airway and
allow secretions to drain. This prevents aspiration. Restraining the client or inserting anything into the
mouth is contraindicated. This is a critical intervention for the ATI Mental Health Proctored Exam.
8. A nurse is caring for a client who is having a generalized tonic-clonic seizure. What is the nurse's
priority action?
A. Insert a padded tongue blade.
B. Restrain the client's extremities.
C. Turn the client to the side.
D. Administer lorazepam (Ativan).
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The client is experiencing classic signs of a pulmonary embolism (sudden dyspnea,
chest pain, hemoptysis). The priority is to administer oxygen to correct hypoxemia. This is the
immediate, life-saving action. This is a high-yield topic for Med-Surg Nursing I Final Exam prep.
9. A nurse is caring for a client who is 2 days post-operative and suddenly develops dyspnea, chest pain,
and hemoptysis. What is the nurse's priority action?
A. Notify the healthcare provider.
B. Administer oxygen.
Bank! Featuring 120 high-yield NCLEX-style questions with detailed
rationales covering Med-Surg, Leadership, and Pharmacology, this is
your comprehensive nursing exam guide for guaranteed success.**
---
# 🏆 2026 | NR 449 | HESI RN Comprehensive & ATI Leadership
Predictor | Complete NGN Questions with Rationales | V135-V141 |
Ultimate Nursing School Prep
---
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Placing the client in high-Fowler's position is the priority because it maximizes lung
expansion and facilitates breathing. This is a fundamental intervention for clients with respiratory
distress and is a key concept in NCLEX prep. Lying flat would worsen dyspnea. While oxygen and suction
may be needed, positioning is the immediate, independent nursing action that can be taken without an
order, a crucial skill for nursing exam guide success.
1. A nurse is caring for a client with pneumonia who is experiencing severe dyspnea. What is the priority
nursing intervention?
A. Administer oxygen at 2 L/min.
B. Encourage the client to cough and deep breathe.
C. Place the client in high-Fowler's position.
D. Suction the client's airway.
💫ANSWER✔️✔️: B
,💫RATIONALE✔️✔️: A patent AV fistula is confirmed by the presence of a bruit (auscultated) and a thrill
(palpated). These indicate good blood flow. A pulsating mass could be an aneurysm or pseudoaneurysm.
A cold, pale extremity indicates poor perfusion, which could mean the fistula is not functioning. This
assessment is critical for HESI Medical-Surgical Exam preparation.
2. A nurse is assessing a client's arteriovenous (AV) fistula in the right arm. Which of the following
findings indicates the fistula is functioning properly?
A. Absence of a bruit.
B. Presence of a thrill.
C. Coolness of the right hand.
D. A weak radial pulse.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The priority assessment for a client receiving magnesium sulfate is deep tendon
reflexes (DTRs). Loss of DTRs is the first sign of magnesium toxicity. The drug can cause central nervous
system depression, leading to respiratory arrest. This is a high-alert medication and a key topic for the
ATI Maternal Newborn Proctored Exam.
3. A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which of the following
assessments is the priority to monitor for toxicity?
A. Blood pressure
B. Temperature
C. Urine output
D. Deep tendon reflexes
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: A severe allergy to contrast dye or shellfish indicates a high risk for an anaphylactic
reaction to IV contrast. The nurse must notify the provider so that premedication protocols can be
initiated or alternative imaging ordered. A renal function test is also important but secondary to the
allergy concern. This is a safety concept emphasized in Chamberlain BSN programs.
4. A client scheduled for a CT scan with contrast tells the nurse they are allergic to shellfish. What is the
nurse's priority action?
,A. Administer diphenhydramine (Benadryl).
B. Notify the healthcare provider.
C. Cancel the CT scan.
D. Ensure the client is well-hydrated.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The correct action is to verify the medication order. This is the most crucial step in
safe medication administration and is a fundamental principle of nursing exam guide preparation.
Reconstituting or administering the medication without verifying the order could lead to a serious
medication error.
5. A nurse is preparing to administer a medication to a client. What is the most important action for the
nurse to take prior to administration?
A. Explain the purpose of the medication.
B. Verify the medication order.
C. Check the client's identification band.
D. Ask the client about allergies.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: The client is exhibiting signs of hyperkalemia (nausea, diarrhea, ECG changes). The
priority is to remove potassium from the body. Sodium polystyrene sulfonate (Kayexalate) is a cation-
exchange resin that does this. This is a critical concept for the ATI Comprehensive Predictor.
6. A nurse is caring for a client with chronic kidney disease who has a potassium level of 6.8 mEq/L.
Which medication should the nurse anticipate administering?
A. Calcium gluconate
B. Sodium polystyrene sulfonate (Kayexalate)
C. Regular insulin with dextrose
D. Furosemide (Lasix)
💫ANSWER✔️✔️: C
, 💫RATIONALE✔️✔️: The first sign of a hemolytic transfusion reaction is often a subjective feeling of
impending doom, followed by chills and back pain. The priority is to stop the transfusion immediately to
prevent further complications. This is a life-threatening emergency and a must-know for NCLEX success.
7. A nurse is administering a blood transfusion. The client reports a sudden onset of chills, back pain,
and feels like "something is wrong." What is the nurse's priority action?
A. Slow the infusion rate.
B. Stop the transfusion.
C. Administer diphenhydramine (Benadryl).
D. Assess the client's temperature.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The priority is to place the client in a side-lying position to protect the airway and
allow secretions to drain. This prevents aspiration. Restraining the client or inserting anything into the
mouth is contraindicated. This is a critical intervention for the ATI Mental Health Proctored Exam.
8. A nurse is caring for a client who is having a generalized tonic-clonic seizure. What is the nurse's
priority action?
A. Insert a padded tongue blade.
B. Restrain the client's extremities.
C. Turn the client to the side.
D. Administer lorazepam (Ativan).
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: The client is experiencing classic signs of a pulmonary embolism (sudden dyspnea,
chest pain, hemoptysis). The priority is to administer oxygen to correct hypoxemia. This is the
immediate, life-saving action. This is a high-yield topic for Med-Surg Nursing I Final Exam prep.
9. A nurse is caring for a client who is 2 days post-operative and suddenly develops dyspnea, chest pain,
and hemoptysis. What is the nurse's priority action?
A. Notify the healthcare provider.
B. Administer oxygen.
