**Ultimate Nursing Exam Prep Guide | 2025/2026 Edition – Complete
Study Pack for NCLEX Success**
*Your student-created resource for mastering Fundamentals, Med-
Surg, Pediatrics, and more – over 120 practice questions with detailed
rationales.*
Compiled from student notes and practice resources — not an official
exam.
---
**💫QUESTION 1:**
A client with heart failure is prescribed digoxin (Lanoxin). Which finding indicates early digoxin toxicity?
A) Heart rate of 98 beats/min
B) Serum potassium of 4.2 mEq/L
C) Anorexia, nausea, and blurred vision
D) Blood pressure of 140/90 mmHg
💫ANSWER✔️✔️: C) Anorexia, nausea, and blurred vision
💫RATIONALE✔️✔️: Early signs of digoxin toxicity include GI symptoms (anorexia, nausea, vomiting) and
visual disturbances (yellow-green halos, blurred vision). Bradycardia (not tachycardia) is also a sign –
option A is elevated. Option B is a normal potassium; hypokalemia increases risk of toxicity. Option D is
an elevated BP but not a sign of toxicity. *My tip: "Dig toxicity – think GI and eyes."* This nursing exam
prep question is crucial for pharmacology review. *(SEO: nursing exam prep, study guide, practice
questions, pharmacology)*
---
,**💫QUESTION 2:**
A postpartum client reports a sudden onset of chest pain and shortness of breath. The nurse notes a
heart rate of 120 bpm and an SpO₂ of 88% on room air. What is the nurse's priority action?
A) Administer oxygen via non-rebreather mask and notify the provider
B) Encourage the client to cough and deep breathe
C) Place the client in a supine position with legs elevated
D) Administer a PRN dose of morphine sulfate
💫ANSWER✔️✔️: A) Administer oxygen via non-rebreather mask and notify the provider
💫RATIONALE✔️✔️: These symptoms are concerning for a pulmonary embolism (PE), a leading cause of
maternal mortality. The priority is to correct hypoxemia with high-flow oxygen and immediately notify
the provider. Option B delays emergency care; Option C is wrong because a semi-Fowler's or left lateral
position is preferred to improve perfusion; Option D might be given later but not before oxygen and
provider notification. *I learned in clinicals: "Sudden SOB + chest pain in postpartum = think PE first."*
This maternal-newborn/critical care question is vital for nursing exam prep. *(SEO: maternal-newborn,
nursing exam prep, student success)*
---
**💫QUESTION 3:**
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has an order for
oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the oxygen therapy is effective?
A) Respiratory rate decreases from 28 to 18 breaths/min
B) SpO₂ increases from 86% to 94%
C) PaCO₂ increases from 48 to 56 mmHg
D) Client reports less anxiety and drowsiness
💫ANSWER✔️✔️: B) SpO₂ increases from 86% to 94%
💫RATIONALE✔️✔️: The goal of oxygen therapy is to maintain SpO₂ ≥ 88–92% in COPD clients (to avoid
suppressing the hypoxic drive). An increase from 86% to 94% shows effectiveness. Option A indicates
,improvement but isn't as specific; Option C shows worsening CO₂ retention (bad); Option D is subjective.
*I remember: "Target 88–92 – that's the COPD view."* This med-surg/respiratory question is a must-
know for nursing exam prep. *(SEO: med-surg, practice questions, study guide)*
---
**💫QUESTION 4:**
A client with schizophrenia is experiencing severe extrapyramidal symptoms (EPS) from haloperidol
(Haldol). Which medication should the nurse anticipate administering?
A) Diphenhydramine (Benadryl)
B) Flumazenil
C) Naloxone
D) Protamine sulfate
💫ANSWER✔️✔️: A) Diphenhydramine (Benadryl)
💫RATIONALE✔️✔️: Diphenhydramine or benztropine (Cogentin) are anticholinergic medications used to
treat acute EPS symptoms (dystonia, akathisia, pseudoparkinsonism). Flumazenil is for benzodiazepine
overdose; naloxone for opioids; protamine for heparin reversal. *My mnemonic: "Benadryl for the
shakes and aches."* This mental health/pharmacology question is essential for nursing exam prep.
*(SEO: mental health, pharmacology, nursing exam prep)*
---
**💫QUESTION 5:**
A 3-year-old child is admitted with dehydration. Which assessment finding is most indicative of severe
dehydration?
A) Dry mucous membranes and sunken eyes
B) Capillary refill of 3 seconds
C) Skin turgor that returns slowly (> 2 seconds)
, D) Irritability and thirst
💫ANSWER✔️✔️: C) Skin turgor that returns slowly (> 2 seconds)
💫RATIONALE✔️✔️: In pediatric dehydration, decreased skin turgor (tenting) is a sensitive sign of severe
dehydration (≥ 10% body weight loss). Option A is moderate, Option B is normal (< 2 sec is normal), and
Option D is mild to moderate. *I remember: "Skin tents = fluid vents."* This pediatric/nutrition question
is key for nursing exam prep. *(SEO: pediatrics, study guide, practice questions)*
---
**💫QUESTION 6:**
The nurse is calculating the intake for a client from 0700 to 1500. The client consumed 6 oz of water, 8
oz of juice, and 4 oz of broth. The IV infusion of 100 mL/hr was running continuously. What is the total
intake in milliliters?
A) 540 mL
B) 780 mL
C) 960 mL
D) 1340 mL
💫ANSWER✔️✔️: D) 1340 mL
💫RATIONALE✔️✔️: Convert ounces to mL (1 oz = 30 mL): 6 × 30 = 180; 8 × 30 = 240; 4 × 30 = 120. Total
PO = 180 + 240 + 120 = 540 mL. IV over 8 hours = 100 × 8 = 800 mL. Total = 540 + 800 = 1340 mL. *I
double-check: "Always convert ounces to mL and add IV time."* This dosage calculation question is a
staple in nursing exam prep. *(SEO: dosage calculations, nursing exam prep, revision notes)*
---
**💫QUESTION 7:**
A client with a terminal illness tells the nurse, "I don't want any more aggressive treatment. I just want
to be comfortable." Which action by the nurse is most appropriate?
Study Pack for NCLEX Success**
*Your student-created resource for mastering Fundamentals, Med-
Surg, Pediatrics, and more – over 120 practice questions with detailed
rationales.*
Compiled from student notes and practice resources — not an official
exam.
---
**💫QUESTION 1:**
A client with heart failure is prescribed digoxin (Lanoxin). Which finding indicates early digoxin toxicity?
A) Heart rate of 98 beats/min
B) Serum potassium of 4.2 mEq/L
C) Anorexia, nausea, and blurred vision
D) Blood pressure of 140/90 mmHg
💫ANSWER✔️✔️: C) Anorexia, nausea, and blurred vision
💫RATIONALE✔️✔️: Early signs of digoxin toxicity include GI symptoms (anorexia, nausea, vomiting) and
visual disturbances (yellow-green halos, blurred vision). Bradycardia (not tachycardia) is also a sign –
option A is elevated. Option B is a normal potassium; hypokalemia increases risk of toxicity. Option D is
an elevated BP but not a sign of toxicity. *My tip: "Dig toxicity – think GI and eyes."* This nursing exam
prep question is crucial for pharmacology review. *(SEO: nursing exam prep, study guide, practice
questions, pharmacology)*
---
,**💫QUESTION 2:**
A postpartum client reports a sudden onset of chest pain and shortness of breath. The nurse notes a
heart rate of 120 bpm and an SpO₂ of 88% on room air. What is the nurse's priority action?
A) Administer oxygen via non-rebreather mask and notify the provider
B) Encourage the client to cough and deep breathe
C) Place the client in a supine position with legs elevated
D) Administer a PRN dose of morphine sulfate
💫ANSWER✔️✔️: A) Administer oxygen via non-rebreather mask and notify the provider
💫RATIONALE✔️✔️: These symptoms are concerning for a pulmonary embolism (PE), a leading cause of
maternal mortality. The priority is to correct hypoxemia with high-flow oxygen and immediately notify
the provider. Option B delays emergency care; Option C is wrong because a semi-Fowler's or left lateral
position is preferred to improve perfusion; Option D might be given later but not before oxygen and
provider notification. *I learned in clinicals: "Sudden SOB + chest pain in postpartum = think PE first."*
This maternal-newborn/critical care question is vital for nursing exam prep. *(SEO: maternal-newborn,
nursing exam prep, student success)*
---
**💫QUESTION 3:**
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has an order for
oxygen at 2 L/min via nasal cannula. Which assessment finding indicates the oxygen therapy is effective?
A) Respiratory rate decreases from 28 to 18 breaths/min
B) SpO₂ increases from 86% to 94%
C) PaCO₂ increases from 48 to 56 mmHg
D) Client reports less anxiety and drowsiness
💫ANSWER✔️✔️: B) SpO₂ increases from 86% to 94%
💫RATIONALE✔️✔️: The goal of oxygen therapy is to maintain SpO₂ ≥ 88–92% in COPD clients (to avoid
suppressing the hypoxic drive). An increase from 86% to 94% shows effectiveness. Option A indicates
,improvement but isn't as specific; Option C shows worsening CO₂ retention (bad); Option D is subjective.
*I remember: "Target 88–92 – that's the COPD view."* This med-surg/respiratory question is a must-
know for nursing exam prep. *(SEO: med-surg, practice questions, study guide)*
---
**💫QUESTION 4:**
A client with schizophrenia is experiencing severe extrapyramidal symptoms (EPS) from haloperidol
(Haldol). Which medication should the nurse anticipate administering?
A) Diphenhydramine (Benadryl)
B) Flumazenil
C) Naloxone
D) Protamine sulfate
💫ANSWER✔️✔️: A) Diphenhydramine (Benadryl)
💫RATIONALE✔️✔️: Diphenhydramine or benztropine (Cogentin) are anticholinergic medications used to
treat acute EPS symptoms (dystonia, akathisia, pseudoparkinsonism). Flumazenil is for benzodiazepine
overdose; naloxone for opioids; protamine for heparin reversal. *My mnemonic: "Benadryl for the
shakes and aches."* This mental health/pharmacology question is essential for nursing exam prep.
*(SEO: mental health, pharmacology, nursing exam prep)*
---
**💫QUESTION 5:**
A 3-year-old child is admitted with dehydration. Which assessment finding is most indicative of severe
dehydration?
A) Dry mucous membranes and sunken eyes
B) Capillary refill of 3 seconds
C) Skin turgor that returns slowly (> 2 seconds)
, D) Irritability and thirst
💫ANSWER✔️✔️: C) Skin turgor that returns slowly (> 2 seconds)
💫RATIONALE✔️✔️: In pediatric dehydration, decreased skin turgor (tenting) is a sensitive sign of severe
dehydration (≥ 10% body weight loss). Option A is moderate, Option B is normal (< 2 sec is normal), and
Option D is mild to moderate. *I remember: "Skin tents = fluid vents."* This pediatric/nutrition question
is key for nursing exam prep. *(SEO: pediatrics, study guide, practice questions)*
---
**💫QUESTION 6:**
The nurse is calculating the intake for a client from 0700 to 1500. The client consumed 6 oz of water, 8
oz of juice, and 4 oz of broth. The IV infusion of 100 mL/hr was running continuously. What is the total
intake in milliliters?
A) 540 mL
B) 780 mL
C) 960 mL
D) 1340 mL
💫ANSWER✔️✔️: D) 1340 mL
💫RATIONALE✔️✔️: Convert ounces to mL (1 oz = 30 mL): 6 × 30 = 180; 8 × 30 = 240; 4 × 30 = 120. Total
PO = 180 + 240 + 120 = 540 mL. IV over 8 hours = 100 × 8 = 800 mL. Total = 540 + 800 = 1340 mL. *I
double-check: "Always convert ounces to mL and add IV time."* This dosage calculation question is a
staple in nursing exam prep. *(SEO: dosage calculations, nursing exam prep, revision notes)*
---
**💫QUESTION 7:**
A client with a terminal illness tells the nurse, "I don't want any more aggressive treatment. I just want
to be comfortable." Which action by the nurse is most appropriate?
