NCLEX-RN Comprehensive Practice Exam
2026/2027 – Verified Q&As with Detailed
Rationales (Test Bank Bundle - 76 Questions)
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**QUESTION 1:**
A nurse is assessing a client who has just returned from the operating room following a thyroidectomy.
Which of the following findings is the priority to report to the surgeon?
A) Pain of 4 on a 0-10 scale
B) Heart rate of 112/min
C) Serosanguinous drainage on dressing
D) Hoarse voice
> 🎯 **CORRECT ANSWER:** B) Heart rate of 112/min
> 💡 **CLINICAL RATIONALE:** Tachycardia post-thyroidectomy indicates possible thyroid storm or
hemorrhage, requiring immediate intervention.
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**QUESTION 2:**
A client with heart failure is prescribed furosemide. Which laboratory value should the nurse monitor
most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum glucose
> 🎯 **CORRECT ANSWER:** B) Serum potassium
> 💡 **CLINICAL RATIONALE:** Furosemide is a loop diuretic that causes potassium wasting, increasing
hypokalemia risk.
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,**QUESTION 3:**
A nurse is providing teaching to a client with a new colostomy. Which food should the client avoid to
prevent blockage?
A) Applesauce
B) Cooked carrots
C) Corn
D) White bread
> 🎯 **CORRECT ANSWER:** C) Corn
> 💡 **CLINICAL RATIONALE:** Corn and other high-fiber foods with skins are difficult to digest and may
cause obstruction.
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**QUESTION 4:**
A client is admitted with suspected acute pancreatitis. Which laboratory finding is most indicative of this
condition?
A) Elevated serum amylase
B) Elevated serum bilirubin
C) Decreased serum calcium
D) Increased white blood cell count
> 🎯 **CORRECT ANSWER:** A) Elevated serum amylase
> 💡 **CLINICAL RATIONALE:** Serum amylase and lipase rise significantly in acute pancreatitis due to
pancreatic inflammation.
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**QUESTION 5:**
A nurse is caring for a client with a chest tube. Which observation indicates the system is functioning
correctly?
A) Continuous bubbling in the water seal chamber
B) Tidaling in the water seal chamber with respiration
C) Lack of drainage in the collection chamber
, D) Suction pressure set to -10 cm H2O
> 🎯 **CORRECT ANSWER:** B) Tidaling in the water seal chamber with respiration
> 💡 **CLINICAL RATIONALE:** Tidaling reflects normal respiratory pressure changes and pleural
integrity.
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**QUESTION 6:**
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via nasal
cannula. What is the primary reason for this low flow rate?
A) To prevent oxygen toxicity
B) To preserve the hypoxic drive
C) To reduce drying of mucous membranes
D) To minimize the risk of infection
> 🎯 **CORRECT ANSWER:** B) To preserve the hypoxic drive
> 💡 **CLINICAL RATIONALE:** COPD clients depend on hypoxic drive; high oxygen may suppress
respiratory effort.
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**QUESTION 7:**
A nurse is preparing to administer a blood transfusion. Which intravenous solution should be used to
prime the tubing?
A) Lactated Ringer's
B) Dextrose 5% in water
C) 0.9% sodium chloride
D) Dextrose 5% in 0.45% saline
> 🎯 **CORRECT ANSWER:** C) 0.9% sodium chloride
> 💡 **CLINICAL RATIONALE:** Normal saline is the only compatible solution for blood products to
prevent hemolysis.
---
2026/2027 – Verified Q&As with Detailed
Rationales (Test Bank Bundle - 76 Questions)
---
**QUESTION 1:**
A nurse is assessing a client who has just returned from the operating room following a thyroidectomy.
Which of the following findings is the priority to report to the surgeon?
A) Pain of 4 on a 0-10 scale
B) Heart rate of 112/min
C) Serosanguinous drainage on dressing
D) Hoarse voice
> 🎯 **CORRECT ANSWER:** B) Heart rate of 112/min
> 💡 **CLINICAL RATIONALE:** Tachycardia post-thyroidectomy indicates possible thyroid storm or
hemorrhage, requiring immediate intervention.
---
**QUESTION 2:**
A client with heart failure is prescribed furosemide. Which laboratory value should the nurse monitor
most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum glucose
> 🎯 **CORRECT ANSWER:** B) Serum potassium
> 💡 **CLINICAL RATIONALE:** Furosemide is a loop diuretic that causes potassium wasting, increasing
hypokalemia risk.
---
,**QUESTION 3:**
A nurse is providing teaching to a client with a new colostomy. Which food should the client avoid to
prevent blockage?
A) Applesauce
B) Cooked carrots
C) Corn
D) White bread
> 🎯 **CORRECT ANSWER:** C) Corn
> 💡 **CLINICAL RATIONALE:** Corn and other high-fiber foods with skins are difficult to digest and may
cause obstruction.
---
**QUESTION 4:**
A client is admitted with suspected acute pancreatitis. Which laboratory finding is most indicative of this
condition?
A) Elevated serum amylase
B) Elevated serum bilirubin
C) Decreased serum calcium
D) Increased white blood cell count
> 🎯 **CORRECT ANSWER:** A) Elevated serum amylase
> 💡 **CLINICAL RATIONALE:** Serum amylase and lipase rise significantly in acute pancreatitis due to
pancreatic inflammation.
---
**QUESTION 5:**
A nurse is caring for a client with a chest tube. Which observation indicates the system is functioning
correctly?
A) Continuous bubbling in the water seal chamber
B) Tidaling in the water seal chamber with respiration
C) Lack of drainage in the collection chamber
, D) Suction pressure set to -10 cm H2O
> 🎯 **CORRECT ANSWER:** B) Tidaling in the water seal chamber with respiration
> 💡 **CLINICAL RATIONALE:** Tidaling reflects normal respiratory pressure changes and pleural
integrity.
---
**QUESTION 6:**
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via nasal
cannula. What is the primary reason for this low flow rate?
A) To prevent oxygen toxicity
B) To preserve the hypoxic drive
C) To reduce drying of mucous membranes
D) To minimize the risk of infection
> 🎯 **CORRECT ANSWER:** B) To preserve the hypoxic drive
> 💡 **CLINICAL RATIONALE:** COPD clients depend on hypoxic drive; high oxygen may suppress
respiratory effort.
---
**QUESTION 7:**
A nurse is preparing to administer a blood transfusion. Which intravenous solution should be used to
prime the tubing?
A) Lactated Ringer's
B) Dextrose 5% in water
C) 0.9% sodium chloride
D) Dextrose 5% in 0.45% saline
> 🎯 **CORRECT ANSWER:** C) 0.9% sodium chloride
> 💡 **CLINICAL RATIONALE:** Normal saline is the only compatible solution for blood products to
prevent hemolysis.
---
