KAPLAN RN PREDICTOR EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A
|LATEST EXAM UPDATE 2026/2027..
*Core Domains*
*Medical-Surgical Nursing*
*Pharmacology and Parenteral Therapies*
*Management of Care and Safety*
*Pediatric Nursing*
*Maternity and Newborn Nursing*
*Mental Health and Psychiatric Nursing*
*Health Promotion and Maintenance*
*Basic Care and Comfort*
*Introduction*
The purpose of this examination is to evaluate the clinical readiness and critical thinking proficiency of nursing candidates. This assessment
measures essential knowledge across core nursing domains, ensuring the candidate can synthesize theoretical principles into safe,
evidence-based practice. Composed of challenging multiple-choice and complex scenario-based questions, the exam mirrors the cognitive
demands of real-world clinical environments. Candidates are tested on their ability to prioritize care, apply regulatory standards, and navigate
ethical dilemmas. Success on this predictor requires not only the recall of foundational theory but, more importantly, the application of sound
nursing judgment to achieve optimal patient outcomes.
SECTION ONE: QUESTIONS 1–100
A nurse is caring for a client with a suspected pheochromocytoma. Which assessment finding requires the most immediate
intervention?
A. Blood pressure of 180/110 mm Hg
B. Serum glucose level of 140 mg/dL
C. Client report of a severe pounding headache
D. 🟢 Blood pressure of 220/130 mm Hg
🔴 RATIONALE: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive catecholamines, leading to
,hypertensive crisis. A blood pressure of 220/130 mm Hg indicates a hypertensive emergency, which poses an immediate risk for stroke
or end-organ damage.
A client is receiving an intravenous infusion of potassium chloride. The nurse notes the IV site is cool, pale, and swollen. What is the
priority nursing action?
A. Slow the infusion rate
B. 🟢 Stop the infusion and remove the catheter
C. Apply a warm compress to the site
D. Aspirate for blood return
🔴 RATIONALE: The signs described (coolness, pallor, swelling) are indicative of infiltration. Because potassium chloride is a vesicant
that can cause tissue necrosis, the infusion must be stopped immediately to prevent further extravasation.
A nurse is reviewing discharge instructions for a client with newly diagnosed Addison's disease. Which statement by the client indicates
an understanding of the teaching?
A. I should limit my intake of sodium-rich foods
B. I will avoid taking my medication during stressful periods
C. 🟢 I will carry a medical alert identification card at all times
D. I will stop taking the medication if I experience nausea
🔴 RATIONALE: Addison’s disease requires lifelong glucocorticoid replacement. Due to the risk of adrenal crisis during stress or
illness, the client must wear medical identification to alert emergency providers of their condition and the need for steroids.
A nurse is caring for an adolescent client diagnosed with anorexia nervosa. Which nursing intervention is the highest priority?
A. Encouraging the client to talk about their feelings
B. Monitoring for signs of perfectionism
C. 🟢 Assessing cardiac rhythm via ECG
D. Providing a high-calorie diet
🔴 RATIONALE: Severe electrolyte imbalances and nutritional deficiencies in anorexia nervosa can cause cardiac dysrhythmias,
including prolonged QT intervals. Assessing cardiac status is the priority to ensure the client's physical safety.
A client at 34 weeks gestation presents with vaginal bleeding and a rigid, board-like abdomen. Which condition should the nurse
suspect?
A. 🟢 Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Preterm labor
, 🔴 RATIONALE: Abruptio placentae is characterized by the premature separation of the placenta, typically presenting with dark red
vaginal bleeding and a firm, tender, or board-like uterus due to concealed hemorrhage.
A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse is 58 beats per minute. What is the
correct action?
A. Administer the dose and notify the provider
B. 🟢 Withhold the dose and notify the provider
C. Administer half of the prescribed dose
D. Re-check the pulse in 30 minutes
🔴 RATIONALE: Digoxin toxicity is a significant risk. Standard nursing protocol dictates that digoxin should be withheld if the apical
pulse is less than 60 beats per minute in an adult, followed by notification of the healthcare provider.
A nurse observes a colleague violating a sterile technique during a dressing change. What is the most appropriate action?
A. Report the colleague to the ethics committee after the shift
B. 🟢 Intervene immediately to correct the technique
C. Wait until the procedure is finished to speak to the colleague
D. Document the incident in the client’s medical record
🔴 RATIONALE: The priority in nursing is patient safety. If a breach in sterile technique is observed, the nurse must intervene
immediately to prevent a potential healthcare-associated infection.
A client with type 1 diabetes mellitus is found unconscious and diaphoretic. The blood glucose level is 40 mg/dL. Which action should
the nurse take first?
A. Administer subcutaneous insulin
B. Start an IV bolus of 0.9% normal saline
C. 🟢 Administer glucagon intramuscularly
D. Give a glass of orange juice
🔴 RATIONALE: Because the client is unconscious, they cannot safely swallow oral glucose. Glucagon is the appropriate intervention
to rapidly increase blood glucose levels when oral intake is contraindicated due to altered consciousness.
A nurse is planning care for a client with a chest tube. Which action is appropriate to include in the plan of care?
A. 🟢 Keep the drainage system below the level of the client's chest
B. Clamp the chest tube if the client needs to be transported
C. Milk the chest tube every 2 hours to prevent clots
D. Change the dressing around the chest tube daily
🔴 RATIONALE: Gravity is used to drain fluid and air from the pleural space. Keeping the drainage system below the level of the chest
prevents backflow of fluid into the pleural cavity, which could cause a tension pneumothorax.
|LATEST EXAM UPDATE 2026/2027..
*Core Domains*
*Medical-Surgical Nursing*
*Pharmacology and Parenteral Therapies*
*Management of Care and Safety*
*Pediatric Nursing*
*Maternity and Newborn Nursing*
*Mental Health and Psychiatric Nursing*
*Health Promotion and Maintenance*
*Basic Care and Comfort*
*Introduction*
The purpose of this examination is to evaluate the clinical readiness and critical thinking proficiency of nursing candidates. This assessment
measures essential knowledge across core nursing domains, ensuring the candidate can synthesize theoretical principles into safe,
evidence-based practice. Composed of challenging multiple-choice and complex scenario-based questions, the exam mirrors the cognitive
demands of real-world clinical environments. Candidates are tested on their ability to prioritize care, apply regulatory standards, and navigate
ethical dilemmas. Success on this predictor requires not only the recall of foundational theory but, more importantly, the application of sound
nursing judgment to achieve optimal patient outcomes.
SECTION ONE: QUESTIONS 1–100
A nurse is caring for a client with a suspected pheochromocytoma. Which assessment finding requires the most immediate
intervention?
A. Blood pressure of 180/110 mm Hg
B. Serum glucose level of 140 mg/dL
C. Client report of a severe pounding headache
D. 🟢 Blood pressure of 220/130 mm Hg
🔴 RATIONALE: Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive catecholamines, leading to
,hypertensive crisis. A blood pressure of 220/130 mm Hg indicates a hypertensive emergency, which poses an immediate risk for stroke
or end-organ damage.
A client is receiving an intravenous infusion of potassium chloride. The nurse notes the IV site is cool, pale, and swollen. What is the
priority nursing action?
A. Slow the infusion rate
B. 🟢 Stop the infusion and remove the catheter
C. Apply a warm compress to the site
D. Aspirate for blood return
🔴 RATIONALE: The signs described (coolness, pallor, swelling) are indicative of infiltration. Because potassium chloride is a vesicant
that can cause tissue necrosis, the infusion must be stopped immediately to prevent further extravasation.
A nurse is reviewing discharge instructions for a client with newly diagnosed Addison's disease. Which statement by the client indicates
an understanding of the teaching?
A. I should limit my intake of sodium-rich foods
B. I will avoid taking my medication during stressful periods
C. 🟢 I will carry a medical alert identification card at all times
D. I will stop taking the medication if I experience nausea
🔴 RATIONALE: Addison’s disease requires lifelong glucocorticoid replacement. Due to the risk of adrenal crisis during stress or
illness, the client must wear medical identification to alert emergency providers of their condition and the need for steroids.
A nurse is caring for an adolescent client diagnosed with anorexia nervosa. Which nursing intervention is the highest priority?
A. Encouraging the client to talk about their feelings
B. Monitoring for signs of perfectionism
C. 🟢 Assessing cardiac rhythm via ECG
D. Providing a high-calorie diet
🔴 RATIONALE: Severe electrolyte imbalances and nutritional deficiencies in anorexia nervosa can cause cardiac dysrhythmias,
including prolonged QT intervals. Assessing cardiac status is the priority to ensure the client's physical safety.
A client at 34 weeks gestation presents with vaginal bleeding and a rigid, board-like abdomen. Which condition should the nurse
suspect?
A. 🟢 Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Preterm labor
, 🔴 RATIONALE: Abruptio placentae is characterized by the premature separation of the placenta, typically presenting with dark red
vaginal bleeding and a firm, tender, or board-like uterus due to concealed hemorrhage.
A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse is 58 beats per minute. What is the
correct action?
A. Administer the dose and notify the provider
B. 🟢 Withhold the dose and notify the provider
C. Administer half of the prescribed dose
D. Re-check the pulse in 30 minutes
🔴 RATIONALE: Digoxin toxicity is a significant risk. Standard nursing protocol dictates that digoxin should be withheld if the apical
pulse is less than 60 beats per minute in an adult, followed by notification of the healthcare provider.
A nurse observes a colleague violating a sterile technique during a dressing change. What is the most appropriate action?
A. Report the colleague to the ethics committee after the shift
B. 🟢 Intervene immediately to correct the technique
C. Wait until the procedure is finished to speak to the colleague
D. Document the incident in the client’s medical record
🔴 RATIONALE: The priority in nursing is patient safety. If a breach in sterile technique is observed, the nurse must intervene
immediately to prevent a potential healthcare-associated infection.
A client with type 1 diabetes mellitus is found unconscious and diaphoretic. The blood glucose level is 40 mg/dL. Which action should
the nurse take first?
A. Administer subcutaneous insulin
B. Start an IV bolus of 0.9% normal saline
C. 🟢 Administer glucagon intramuscularly
D. Give a glass of orange juice
🔴 RATIONALE: Because the client is unconscious, they cannot safely swallow oral glucose. Glucagon is the appropriate intervention
to rapidly increase blood glucose levels when oral intake is contraindicated due to altered consciousness.
A nurse is planning care for a client with a chest tube. Which action is appropriate to include in the plan of care?
A. 🟢 Keep the drainage system below the level of the client's chest
B. Clamp the chest tube if the client needs to be transported
C. Milk the chest tube every 2 hours to prevent clots
D. Change the dressing around the chest tube daily
🔴 RATIONALE: Gravity is used to drain fluid and air from the pleural space. Keeping the drainage system below the level of the chest
prevents backflow of fluid into the pleural cavity, which could cause a tension pneumothorax.
