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NCLEX-RN Reduction of Risk Potential
Questions And Well Graded Solutions
With Rationales Updated 2026-2027
1. A client is scheduled for a cardiac catheterization. Which pre-procedure assessment
is most important for the nurse to report?
A) Allergies to shellfish
B) Serum creatinine of 2.5 mg/dL
C) Blood pressure of 150/90 mmHg
D) Heart rate of 88 beats per minute
Correct Answer: B
Rationale: The contrast dye used in cardiac catheterization is nephrotoxic. A
serum creatinine of 2.5 mg/dL indicates renal impairment and increases the risk
for contrast-induced nephropathy. Shellfish allergy (A) is a concern but
creatinine elevation is more critical. BP (C) is elevated but stable.
2. A client is 24 hours post-thyroidectomy. Which assessment finding requires
immediate action?
A) Hoarseness
B) Difficulty swallowing
C) Respiratory distress and stridor
D) Neck pain
Correct Answer: C
Rationale: Respiratory distress and stridor after thyroidectomy indicate
laryngeal edema or hematoma causing airway obstruction. This is a life-
threatening emergency requiring immediate intervention (e.g., tracheostomy).
Hoarseness (A) and difficulty swallowing (B) are expected temporary findings.
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3. A client is scheduled for a colonoscopy. Which instruction should the nurse provide
regarding bowel preparation?
A) "Drink clear liquids only for 24 hours before the procedure."
B) "Drink the bowel preparation solution quickly to avoid nausea."
C) "Take the bowel preparation solution with milk to improve taste."
D) "You can eat a light breakfast on the morning of the procedure."
Correct Answer: A
Rationale: Clear liquids only for 24 hours before the procedure (A) is standard
for colonoscopy prep. The solution should be sipped slowly (B), not quickly. It
should not be mixed with milk (C). Nothing by mouth after midnight (D) for
most procedures.
4. A client is scheduled for an intravenous pyelogram (IVP). Which assessment finding
should the nurse report to the provider?
A) Allergy to iodine
B) Serum creatinine of 1.0 mg/dL
C) Blood pressure of 130/80 mmHg
D) Heart rate of 72 beats per minute
Correct Answer: A
Rationale: Iodine-based contrast is used in IVP. An allergy to iodine (A)
increases the risk of anaphylaxis. Serum creatinine of 1.0 (B) is normal. BP (C)
and HR (D) are normal.
5. A client is post-operative from an abdominal hysterectomy. Which finding indicates a
potential complication?
A) Serosanguineous drainage on the dressing
B) Temperature of 100.4°F (38°C) on the first post-op day
C) Absent bowel sounds
D) Urine output of 30 mL/hr
Correct Answer: C
Rationale: Absent bowel sounds (C) after abdominal surgery may indicate ileus
or obstruction. Serosanguineous drainage (A) is normal. Low-grade fever (B) is
common on the first post-op day. Urine output of 30 mL/hr (D) is adequate.
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6. A client is scheduled for an MRI. Which question is most important for the nurse to
ask?
A) "Do you have any metal implants?"
B) "Are you allergic to any medications?"
C) "When did you last eat or drink?"
D) "Do you have a history of claustrophobia?"
Correct Answer: A
Rationale: Metal implants (A) can be pulled by the MRI magnet, causing serious
injury. Allergies (B) are important but not the priority for MRI. NPO status (C) is
not required for MRI. Claustrophobia (D) is important but not life-threatening.
7. A client is post-operative from a knee replacement. Which intervention should the
nurse implement to prevent a deep vein thrombosis (DVT)?
A) Apply sequential compression devices
B) Encourage bed rest
C) Place pillows under the knees
D) Keep the legs in a dependent position
Correct Answer: A
Rationale: Sequential compression devices (A) promote venous return and
prevent DVT. Bed rest (B) and pillows under the knees (C) increase DVT risk.
Dependent position (D) is not appropriate.
8. A client is scheduled for a lumbar puncture. Which position should the nurse place
the client in?
A) Supine position
B) Prone position
C) Lateral recumbent position with knees drawn to chest
D) High-Fowler's position
Correct Answer: C
Rationale: The lateral recumbent position with knees drawn to chest (C) flexes
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the spine and widens the intervertebral spaces. Supine (A), prone (B), and High-
Fowler's (D) are not appropriate for lumbar puncture.
9. A client is post-operative from a cholecystectomy. Which finding requires immediate
notification of the provider?
A) Nausea and vomiting
B) Pain at the incision site
C) Jaundice
D) Temperature of 99.0°F (37.2°C)
Correct Answer: C
Rationale: Jaundice (C) after cholecystectomy may indicate bile duct injury or
obstruction. Nausea (A) and pain (B) are common post-op. Low-grade fever (D)
is expected.
10. A client is scheduled for a bronchoscopy. Which instruction should the nurse
provide?
A) "You will be able to eat immediately after the procedure."
B) "You will receive sedation and your throat will be numbed."
C) "You will be awake and alert during the procedure."
D) "You will need to drink plenty of fluids before the procedure."
Correct Answer: B
Rationale: Bronchoscopy requires sedation and local anesthetic to numb the
throat (B). The client should be NPO (A) before and after until the gag reflex
returns. General anesthesia is not always used (C). Fluids are restricted before
the procedure (D).
11. A client is scheduled for a paracentesis. Which pre-procedure action should the nurse
take?
A) Have the client void
B) Administer a sedative
NCLEX-RN Reduction of Risk Potential
Questions And Well Graded Solutions
With Rationales Updated 2026-2027
1. A client is scheduled for a cardiac catheterization. Which pre-procedure assessment
is most important for the nurse to report?
A) Allergies to shellfish
B) Serum creatinine of 2.5 mg/dL
C) Blood pressure of 150/90 mmHg
D) Heart rate of 88 beats per minute
Correct Answer: B
Rationale: The contrast dye used in cardiac catheterization is nephrotoxic. A
serum creatinine of 2.5 mg/dL indicates renal impairment and increases the risk
for contrast-induced nephropathy. Shellfish allergy (A) is a concern but
creatinine elevation is more critical. BP (C) is elevated but stable.
2. A client is 24 hours post-thyroidectomy. Which assessment finding requires
immediate action?
A) Hoarseness
B) Difficulty swallowing
C) Respiratory distress and stridor
D) Neck pain
Correct Answer: C
Rationale: Respiratory distress and stridor after thyroidectomy indicate
laryngeal edema or hematoma causing airway obstruction. This is a life-
threatening emergency requiring immediate intervention (e.g., tracheostomy).
Hoarseness (A) and difficulty swallowing (B) are expected temporary findings.
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3. A client is scheduled for a colonoscopy. Which instruction should the nurse provide
regarding bowel preparation?
A) "Drink clear liquids only for 24 hours before the procedure."
B) "Drink the bowel preparation solution quickly to avoid nausea."
C) "Take the bowel preparation solution with milk to improve taste."
D) "You can eat a light breakfast on the morning of the procedure."
Correct Answer: A
Rationale: Clear liquids only for 24 hours before the procedure (A) is standard
for colonoscopy prep. The solution should be sipped slowly (B), not quickly. It
should not be mixed with milk (C). Nothing by mouth after midnight (D) for
most procedures.
4. A client is scheduled for an intravenous pyelogram (IVP). Which assessment finding
should the nurse report to the provider?
A) Allergy to iodine
B) Serum creatinine of 1.0 mg/dL
C) Blood pressure of 130/80 mmHg
D) Heart rate of 72 beats per minute
Correct Answer: A
Rationale: Iodine-based contrast is used in IVP. An allergy to iodine (A)
increases the risk of anaphylaxis. Serum creatinine of 1.0 (B) is normal. BP (C)
and HR (D) are normal.
5. A client is post-operative from an abdominal hysterectomy. Which finding indicates a
potential complication?
A) Serosanguineous drainage on the dressing
B) Temperature of 100.4°F (38°C) on the first post-op day
C) Absent bowel sounds
D) Urine output of 30 mL/hr
Correct Answer: C
Rationale: Absent bowel sounds (C) after abdominal surgery may indicate ileus
or obstruction. Serosanguineous drainage (A) is normal. Low-grade fever (B) is
common on the first post-op day. Urine output of 30 mL/hr (D) is adequate.
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6. A client is scheduled for an MRI. Which question is most important for the nurse to
ask?
A) "Do you have any metal implants?"
B) "Are you allergic to any medications?"
C) "When did you last eat or drink?"
D) "Do you have a history of claustrophobia?"
Correct Answer: A
Rationale: Metal implants (A) can be pulled by the MRI magnet, causing serious
injury. Allergies (B) are important but not the priority for MRI. NPO status (C) is
not required for MRI. Claustrophobia (D) is important but not life-threatening.
7. A client is post-operative from a knee replacement. Which intervention should the
nurse implement to prevent a deep vein thrombosis (DVT)?
A) Apply sequential compression devices
B) Encourage bed rest
C) Place pillows under the knees
D) Keep the legs in a dependent position
Correct Answer: A
Rationale: Sequential compression devices (A) promote venous return and
prevent DVT. Bed rest (B) and pillows under the knees (C) increase DVT risk.
Dependent position (D) is not appropriate.
8. A client is scheduled for a lumbar puncture. Which position should the nurse place
the client in?
A) Supine position
B) Prone position
C) Lateral recumbent position with knees drawn to chest
D) High-Fowler's position
Correct Answer: C
Rationale: The lateral recumbent position with knees drawn to chest (C) flexes
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the spine and widens the intervertebral spaces. Supine (A), prone (B), and High-
Fowler's (D) are not appropriate for lumbar puncture.
9. A client is post-operative from a cholecystectomy. Which finding requires immediate
notification of the provider?
A) Nausea and vomiting
B) Pain at the incision site
C) Jaundice
D) Temperature of 99.0°F (37.2°C)
Correct Answer: C
Rationale: Jaundice (C) after cholecystectomy may indicate bile duct injury or
obstruction. Nausea (A) and pain (B) are common post-op. Low-grade fever (D)
is expected.
10. A client is scheduled for a bronchoscopy. Which instruction should the nurse
provide?
A) "You will be able to eat immediately after the procedure."
B) "You will receive sedation and your throat will be numbed."
C) "You will be awake and alert during the procedure."
D) "You will need to drink plenty of fluids before the procedure."
Correct Answer: B
Rationale: Bronchoscopy requires sedation and local anesthetic to numb the
throat (B). The client should be NPO (A) before and after until the gag reflex
returns. General anesthesia is not always used (C). Fluids are restricted before
the procedure (D).
11. A client is scheduled for a paracentesis. Which pre-procedure action should the nurse
take?
A) Have the client void
B) Administer a sedative
