Review & Practice Questions
2026 Exam All Answers and
Illustrations Given
(Tattoo These on Your Brain) - ANSWER ✔✔ABCs override
everything
Maslow's Hierarchy
Unstable = intervene
,Assessment only applies if patient is stable
Safety = least restrictive
NGN = recognize → analyze → act → evaluate
A nurse enters a client's room and notes the following findings:
Respiratory rate: 28/min
Oxygen saturation: 90% on room air
Client is sitting upright and using accessory muscles
Blood pressure: 136/82 mm Hg
Heart rate: 104 bpm
Which action should the nurse take first?
A. Obtain a STAT chest x-ray
B. Apply supplemental oxygen
C. Notify the provider
,D. Obtain a full set of vital signs - ANSWER ✔✔✅ Correct Answer: B.
Apply supplemental oxygen
Rationale
-Breathing is compromised (tachypnea, accessory muscle use,
borderline SpO₂).
-The nurse does not delay intervention to collect more data when
oxygenation is threatened.
-Applying oxygen is within nursing scope and addresses immediate
safety.
Why the others are wrong:
-A: Diagnostic tests come after stabilization.
-C: The nurse intervenes before calling.
-D: Enough data already shows a breathing problem.
NCLEX Insight: If breathing is impaired, intervene immediately —
assessment is already complete.
COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, A nurse is caring for a client who reports dizziness when standing. What
should the nurse do first?
A. Assist the client to the rest room
B. Obtain orthostatic vital signs
C. Notify the provider
D. Administer IV fluids - ANSWER ✔✔✅ Correct Answer: B. Obtain
orthostatic vital signs
Rationale:
-Nursing Process = Assess before Act
-Orthostatic vitals gather data to determine cause.
-Interventions and provider notification come after assessment.
Test-Taking Tip:
If you haven't collected data yet, the answer is usually ASSESS.
Which client should the nurse assess first?