RN Comprehensive
Predictor 2026 v2
,SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-30)
1. A nurse is caring for a client who is receiving warfarin and has an INR of 3.3. Which of the
following actions should the nurse take?
A) Administer vitamin K immediately
,B) Continue to monitor the client
C) Hold the next dose of warfarin
D) Notify the provider of the result
Correct Answer: B – Continue to monitor the client
*Rationale: The therapeutic INR range for most indications (atrial fibrillation, DVT treatment) is
2.0-3.0. An INR of 3.3 is slightly elevated but not critical unless bleeding occurs. The nurse
should continue monitoring and report to the provider, but this does not require immediate
reversal with vitamin K unless there is active bleeding .*
2. A nurse is caring for a client who has deep-vein thrombosis of the left lower extremity.
Which of the following actions should the nurse take? (Select all that apply)
A) Massage the affected extremity
B) Administer acetaminophen for pain
C) Withhold heparin IV infusion if bleeding occurs
D) Position the client with the affected extremity elevated
E) Apply compression stockings as prescribed
Correct Answer: B, D, E – Administer acetaminophen, elevate extremity, apply compression
stockings
Rationale: DVT management includes pain management (acetaminophen is safe; NSAIDs
increase bleeding risk), elevation of the affected extremity to promote venous return, and
graduated compression stockings. Massaging the affected extremity is contraindicated because
it can dislodge the clot .
3. A nurse is reviewing a client's laboratory results prior to surgery. Which of the following
findings should the nurse report to the provider?
A) WBC count 9,800/mm³
B) Creatinine 0.9 mg/dL
C) Fasting blood glucose 108 mg/dL
D) Potassium 5.2 mEq/L
Correct Answer: D – Potassium 5.2 mEq/L
*Rationale: Normal potassium range is 3.5-5.0 mEq/L. A potassium level of 5.2 mEq/L indicates
hyperkalemia, which increases the risk for cardiac dysrhythmias during and after surgery. This
finding requires provider notification before proceeding with surgery .*
4. A nurse is caring for a client who has a sealed radiation implant and is to remain in the
hospital for 1 week. Which of the following should the nurse include in the plan of care?
A) Wear a dosimeter film badge while in the client's room
B) Ensure family members remain at least 3 feet from the client
, C) Limit each visitor to 1 hour per day
D) Remove dirty linens after double bagging
Correct Answer: A – Wear a dosimeter film badge while in the client's room
Rationale: Staff caring for clients with sealed radiation implants must wear dosimeter badges to
monitor cumulative radiation exposure. Visitors should remain at least 6 feet from the client and
limit visits to 30 minutes per day. Linens should be kept in the room until the implant is
removed .
5. A nurse is developing a nutritional care plan for a client who has COPD with severe
dyspnea. To promote intake, which of the following instructions is appropriate to include?
A) Administer a bronchodilator after meals
B) Ambulate the client before each meal
C) Offer the client three large meals each day
D) Limit fluid intake with meals
Correct Answer: D – Limit fluid intake with meals
Rationale: Limiting fluids with meals prevents early satiety and reduces the risk of aspiration.
Small, frequent meals are better tolerated than large meals. Bronchodilators should be
administered before meals to improve breathing during eating .
6. A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of
the following places the client at risk for aspiration?
A) History of GERD
B) NPO status
C) Supine positioning during feeding
D) Continuous feeding pump
Correct Answer: A – History of GERD
*Rationale: Gastroesophageal reflux disease (GERD) increases the risk of regurgitation and
aspiration during enteral feedings. The head of the bed should be elevated to 30-45 degrees
during and for 30-60 minutes after feedings .*
7. A nurse is reviewing assessment data from several clients. For which of the following
clients should the nurse recommend referral to a dietitian?
A) Client with non-healing leg ulcer
B) Client with BMI of 22
C) Client with controlled hypertension
D) Client with occasional constipation
Correct Answer: A – Client with non-healing leg ulcer
Predictor 2026 v2
,SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-30)
1. A nurse is caring for a client who is receiving warfarin and has an INR of 3.3. Which of the
following actions should the nurse take?
A) Administer vitamin K immediately
,B) Continue to monitor the client
C) Hold the next dose of warfarin
D) Notify the provider of the result
Correct Answer: B – Continue to monitor the client
*Rationale: The therapeutic INR range for most indications (atrial fibrillation, DVT treatment) is
2.0-3.0. An INR of 3.3 is slightly elevated but not critical unless bleeding occurs. The nurse
should continue monitoring and report to the provider, but this does not require immediate
reversal with vitamin K unless there is active bleeding .*
2. A nurse is caring for a client who has deep-vein thrombosis of the left lower extremity.
Which of the following actions should the nurse take? (Select all that apply)
A) Massage the affected extremity
B) Administer acetaminophen for pain
C) Withhold heparin IV infusion if bleeding occurs
D) Position the client with the affected extremity elevated
E) Apply compression stockings as prescribed
Correct Answer: B, D, E – Administer acetaminophen, elevate extremity, apply compression
stockings
Rationale: DVT management includes pain management (acetaminophen is safe; NSAIDs
increase bleeding risk), elevation of the affected extremity to promote venous return, and
graduated compression stockings. Massaging the affected extremity is contraindicated because
it can dislodge the clot .
3. A nurse is reviewing a client's laboratory results prior to surgery. Which of the following
findings should the nurse report to the provider?
A) WBC count 9,800/mm³
B) Creatinine 0.9 mg/dL
C) Fasting blood glucose 108 mg/dL
D) Potassium 5.2 mEq/L
Correct Answer: D – Potassium 5.2 mEq/L
*Rationale: Normal potassium range is 3.5-5.0 mEq/L. A potassium level of 5.2 mEq/L indicates
hyperkalemia, which increases the risk for cardiac dysrhythmias during and after surgery. This
finding requires provider notification before proceeding with surgery .*
4. A nurse is caring for a client who has a sealed radiation implant and is to remain in the
hospital for 1 week. Which of the following should the nurse include in the plan of care?
A) Wear a dosimeter film badge while in the client's room
B) Ensure family members remain at least 3 feet from the client
, C) Limit each visitor to 1 hour per day
D) Remove dirty linens after double bagging
Correct Answer: A – Wear a dosimeter film badge while in the client's room
Rationale: Staff caring for clients with sealed radiation implants must wear dosimeter badges to
monitor cumulative radiation exposure. Visitors should remain at least 6 feet from the client and
limit visits to 30 minutes per day. Linens should be kept in the room until the implant is
removed .
5. A nurse is developing a nutritional care plan for a client who has COPD with severe
dyspnea. To promote intake, which of the following instructions is appropriate to include?
A) Administer a bronchodilator after meals
B) Ambulate the client before each meal
C) Offer the client three large meals each day
D) Limit fluid intake with meals
Correct Answer: D – Limit fluid intake with meals
Rationale: Limiting fluids with meals prevents early satiety and reduces the risk of aspiration.
Small, frequent meals are better tolerated than large meals. Bronchodilators should be
administered before meals to improve breathing during eating .
6. A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of
the following places the client at risk for aspiration?
A) History of GERD
B) NPO status
C) Supine positioning during feeding
D) Continuous feeding pump
Correct Answer: A – History of GERD
*Rationale: Gastroesophageal reflux disease (GERD) increases the risk of regurgitation and
aspiration during enteral feedings. The head of the bed should be elevated to 30-45 degrees
during and for 30-60 minutes after feedings .*
7. A nurse is reviewing assessment data from several clients. For which of the following
clients should the nurse recommend referral to a dietitian?
A) Client with non-healing leg ulcer
B) Client with BMI of 22
C) Client with controlled hypertension
D) Client with occasional constipation
Correct Answer: A – Client with non-healing leg ulcer
