Absolutely—I can generate an original comprehensive nursing practice exam.
A 150-question exam with detailed Rationales is too large to fit into a single
ChatGPT response. To keep the content complete and useful, I'll generate it in 5 parts
of 30 questions each.
We'll begin with Part 1 (Questions 1–30).
Comprehensive Nursing Final Practice Exam 7 (2026)
Part 1 (Questions 1–30)
Original NCLEX-Style Multiple-Choice Questions with Correct Answers and Detailed
Rationales
1. A nurse is assessing a client admitted with heart failure. Which assessment finding
requires immediate intervention?
A. Bilateral 2+ ankle edema
B. Crackles in both lower lung fields with oxygen saturation of 86%
C. Blood pressure of 142/86 mm Hg
D. Weight gain of 2 lb over one week
Answer: B
Rationale: Crackles with hypoxemia indicate pulmonary edema and impaired gas
exchange. Airway and oxygenation are the highest priorities.
2. A client with diabetes mellitus becomes diaphoretic, shaky, and confused. What is
the nurse's priority action?
A. Administer regular insulin.
B. Check the client's blood glucose level.
C. Encourage exercise.
D. Restrict carbohydrates.
Answer: B
https://www.stuvia.com/en-us/user/Lectdavian
,Rationale: These findings suggest hypoglycemia. The nurse should confirm the
blood glucose level and treat promptly according to protocol.
3. Which laboratory value should the nurse report immediately?
A. Potassium 6.2 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias and
requires immediate intervention.
4. A nurse is caring for a client receiving heparin. Which laboratory test is monitored to
evaluate therapy?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Troponin
Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is monitored during
unfractionated heparin therapy.
5. Which client should the nurse assess first?
A. Client with pneumonia and oxygen saturation of 88%
B. Client requesting pain medication
C. Client awaiting discharge instructions
D. Client needing assistance with breakfast
Answer: A
https://www.stuvia.com/en-us/user/Lectdavian
,Rationale: Using ABC priorities, impaired oxygenation is the most urgent
concern.
6. Which finding is expected in a client with left-sided heart failure?
A. Jugular venous distention
B. Pulmonary crackles and dyspnea
C. Ascites
D. Hepatomegaly
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, resulting in
dyspnea and crackles.
7. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
8 breaths/min. Which medication should the nurse anticipate?
A. Protamine sulfate
B. Naloxone
C. Vitamin K
D. Flumazenil
Answer: B
Rationale: Naloxone reverses opioid-induced respiratory depression.
8. Which electrolyte imbalance places the client at greatest risk for ventricular
dysrhythmias?
A. Potassium 2.9 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.5 mg/dL
D. Chloride 102 mEq/L
Answer: A
https://www.stuvia.com/en-us/user/Lectdavian
, Rationale: Hypokalemia significantly increases the risk for ventricular
arrhythmias.
9. Which intervention helps prevent ventilator-associated pneumonia (VAP)?
A. Keep the head of the bed elevated 30–45 degrees.
B. Limit oral care.
C. Place the client supine.
D. Increase sedation.
Answer: A
Rationale: Elevating the head of the bed reduces aspiration risk and helps
prevent VAP.
10. Which client is at greatest risk for developing pressure injuries?
A. Independent client recovering from appendectomy
B. Bedridden client with spinal cord injury
C. Ambulatory client with hypertension
D. Client receiving outpatient antibiotics
Answer: B
Rationale: Immobility is the greatest risk factor for pressure injuries.
11. A nurse is teaching a client taking warfarin. Which statement indicates
understanding?
A. "I'll use an electric razor."
B. "I'll double my dose if I miss one."
C. "I'll stop the medication when I feel better."
D. "I'll avoid all green vegetables."
Answer: A
https://www.stuvia.com/en-us/user/Lectdavian
A 150-question exam with detailed Rationales is too large to fit into a single
ChatGPT response. To keep the content complete and useful, I'll generate it in 5 parts
of 30 questions each.
We'll begin with Part 1 (Questions 1–30).
Comprehensive Nursing Final Practice Exam 7 (2026)
Part 1 (Questions 1–30)
Original NCLEX-Style Multiple-Choice Questions with Correct Answers and Detailed
Rationales
1. A nurse is assessing a client admitted with heart failure. Which assessment finding
requires immediate intervention?
A. Bilateral 2+ ankle edema
B. Crackles in both lower lung fields with oxygen saturation of 86%
C. Blood pressure of 142/86 mm Hg
D. Weight gain of 2 lb over one week
Answer: B
Rationale: Crackles with hypoxemia indicate pulmonary edema and impaired gas
exchange. Airway and oxygenation are the highest priorities.
2. A client with diabetes mellitus becomes diaphoretic, shaky, and confused. What is
the nurse's priority action?
A. Administer regular insulin.
B. Check the client's blood glucose level.
C. Encourage exercise.
D. Restrict carbohydrates.
Answer: B
https://www.stuvia.com/en-us/user/Lectdavian
,Rationale: These findings suggest hypoglycemia. The nurse should confirm the
blood glucose level and treat promptly according to protocol.
3. Which laboratory value should the nurse report immediately?
A. Potassium 6.2 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A
Rationale: Hyperkalemia can cause life-threatening cardiac dysrhythmias and
requires immediate intervention.
4. A nurse is caring for a client receiving heparin. Which laboratory test is monitored to
evaluate therapy?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Troponin
Answer: B
Rationale: Activated partial thromboplastin time (aPTT) is monitored during
unfractionated heparin therapy.
5. Which client should the nurse assess first?
A. Client with pneumonia and oxygen saturation of 88%
B. Client requesting pain medication
C. Client awaiting discharge instructions
D. Client needing assistance with breakfast
Answer: A
https://www.stuvia.com/en-us/user/Lectdavian
,Rationale: Using ABC priorities, impaired oxygenation is the most urgent
concern.
6. Which finding is expected in a client with left-sided heart failure?
A. Jugular venous distention
B. Pulmonary crackles and dyspnea
C. Ascites
D. Hepatomegaly
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, resulting in
dyspnea and crackles.
7. A client receiving morphine becomes difficult to arouse and has a respiratory rate of
8 breaths/min. Which medication should the nurse anticipate?
A. Protamine sulfate
B. Naloxone
C. Vitamin K
D. Flumazenil
Answer: B
Rationale: Naloxone reverses opioid-induced respiratory depression.
8. Which electrolyte imbalance places the client at greatest risk for ventricular
dysrhythmias?
A. Potassium 2.9 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.5 mg/dL
D. Chloride 102 mEq/L
Answer: A
https://www.stuvia.com/en-us/user/Lectdavian
, Rationale: Hypokalemia significantly increases the risk for ventricular
arrhythmias.
9. Which intervention helps prevent ventilator-associated pneumonia (VAP)?
A. Keep the head of the bed elevated 30–45 degrees.
B. Limit oral care.
C. Place the client supine.
D. Increase sedation.
Answer: A
Rationale: Elevating the head of the bed reduces aspiration risk and helps
prevent VAP.
10. Which client is at greatest risk for developing pressure injuries?
A. Independent client recovering from appendectomy
B. Bedridden client with spinal cord injury
C. Ambulatory client with hypertension
D. Client receiving outpatient antibiotics
Answer: B
Rationale: Immobility is the greatest risk factor for pressure injuries.
11. A nurse is teaching a client taking warfarin. Which statement indicates
understanding?
A. "I'll use an electric razor."
B. "I'll double my dose if I miss one."
C. "I'll stop the medication when I feel better."
D. "I'll avoid all green vegetables."
Answer: A
https://www.stuvia.com/en-us/user/Lectdavian
