RN Comprehensive Predictor 2026 Exit Ultimate
Study Guide and Practice Test Comprehensive
150-Question Practice Examination for NCLEX-RN
Readiness
Difficulty Level: Advanced/Hard/Mixed | Target Audience: Nursing Students preparing for RN
Comprehensive Predictor Exit Exam and NCLEX-RN
SECTION 1: MANAGEMENT OF CARE – Prioritization, Delegation, & Leadership (Questions 1–
20)
1. The charge nurse is making shift assignments on a medical-surgical unit. Which patient
should be assigned to the most experienced RN?
• A. A 45-year-old patient with diabetes mellitus requiring insulin administration
• B. A 68-year-old patient 2 days post-hip replacement with stable vital signs
• C. A 72-year-old patient with acute exacerbation of COPD receiving continuous BiPAP
• D. A 38-year-old patient with pneumonia receiving IV antibiotics
Correct Answer: C. A 72-year-old patient with acute exacerbation of COPD receiving
continuous BiPAP
Rationale: The patient requiring continuous BiPAP is the most unstable and requires the most
,experienced nurse due to the potential for rapid deterioration and the complexity of respiratory
management. Stable patients with routine care can be assigned to less experienced nurses.
2. An RN is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
• A. Administering a PRN analgesic medication
• B. Performing a sterile wound dressing change
• C. Assisting a stable patient with ambulation using a gait belt
• D. Assessing a patient's lung sounds
Correct Answer: C. Assisting a stable patient with ambulation using a gait belt
Rationale: Assisting with ambulation is within the scope of UAP when the patient is stable and
the UAP has been trained. Tasks requiring nursing judgment, assessment, or sterile technique
cannot be delegated to UAP.
3. A nurse receives a telephone order from a provider. Which action is most appropriate?
• A. Implement the order immediately and document it later
• B. Write the order, read it back, and obtain verification from the provider
• C. Ask the provider to fax the order instead
, • D. Have another nurse listen to the order for confirmation
Correct Answer: B. Write the order, read it back, and obtain verification from the
provider
Rationale: Telephone orders must be written down, read back to the provider for verification,
and signed by the provider within a specified time frame per facility policy. This reduces the risk
of errors.
4. A nurse is caring for four patients. Which patient should the nurse assess first?
• A. A patient with a new-onset atrial fibrillation with a heart rate of 140 bpm
• B. A patient scheduled for discharge who needs teaching
• C. A patient requesting pain medication
• D. A patient with a newly inserted nasogastric tube
Correct Answer: A. A patient with a new-onset atrial fibrillation with a heart rate of 140
bpm
Rationale: A new-onset atrial fibrillation with a rapid ventricular response can lead to
hemodynamic instability, decreased cardiac output, and stroke. This patient requires immediate
assessment and intervention. Prioritize based on stability and potential for deterioration.
, 5. A charge nurse is evaluating a new graduate nurse's performance. Which action by the new
graduate requires immediate intervention?
• A. Using two patient identifiers before medication administration
• B. Documenting a patient's blood pressure of 180/100 mmHg and notifying the provider
• C. Administering IV push morphine over 2 minutes as prescribed
• D. Delegating vital signs assessment to UAP for a stable patient
Correct Answer: C. Administering IV push morphine over 2 minutes as prescribed
Rationale: IV push morphine should be administered over 4-5 minutes to prevent respiratory
depression and severe hypotension. A 2-minute administration is too rapid and requires
immediate intervention and education.
6. A nurse is preparing to discharge a patient who speaks a different language. Which action
best demonstrates culturally competent care?
• A. Providing written discharge instructions in English only
• B. Using a certified medical interpreter to provide discharge teaching
• C. Asking a family member to translate the instructions
• D. Giving the patient a list of medications without explanation
Correct Answer: B. Using a certified medical interpreter to provide discharge teaching
Rationale: Using a certified medical interpreter ensures accurate communication and
Study Guide and Practice Test Comprehensive
150-Question Practice Examination for NCLEX-RN
Readiness
Difficulty Level: Advanced/Hard/Mixed | Target Audience: Nursing Students preparing for RN
Comprehensive Predictor Exit Exam and NCLEX-RN
SECTION 1: MANAGEMENT OF CARE – Prioritization, Delegation, & Leadership (Questions 1–
20)
1. The charge nurse is making shift assignments on a medical-surgical unit. Which patient
should be assigned to the most experienced RN?
• A. A 45-year-old patient with diabetes mellitus requiring insulin administration
• B. A 68-year-old patient 2 days post-hip replacement with stable vital signs
• C. A 72-year-old patient with acute exacerbation of COPD receiving continuous BiPAP
• D. A 38-year-old patient with pneumonia receiving IV antibiotics
Correct Answer: C. A 72-year-old patient with acute exacerbation of COPD receiving
continuous BiPAP
Rationale: The patient requiring continuous BiPAP is the most unstable and requires the most
,experienced nurse due to the potential for rapid deterioration and the complexity of respiratory
management. Stable patients with routine care can be assigned to less experienced nurses.
2. An RN is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
• A. Administering a PRN analgesic medication
• B. Performing a sterile wound dressing change
• C. Assisting a stable patient with ambulation using a gait belt
• D. Assessing a patient's lung sounds
Correct Answer: C. Assisting a stable patient with ambulation using a gait belt
Rationale: Assisting with ambulation is within the scope of UAP when the patient is stable and
the UAP has been trained. Tasks requiring nursing judgment, assessment, or sterile technique
cannot be delegated to UAP.
3. A nurse receives a telephone order from a provider. Which action is most appropriate?
• A. Implement the order immediately and document it later
• B. Write the order, read it back, and obtain verification from the provider
• C. Ask the provider to fax the order instead
, • D. Have another nurse listen to the order for confirmation
Correct Answer: B. Write the order, read it back, and obtain verification from the
provider
Rationale: Telephone orders must be written down, read back to the provider for verification,
and signed by the provider within a specified time frame per facility policy. This reduces the risk
of errors.
4. A nurse is caring for four patients. Which patient should the nurse assess first?
• A. A patient with a new-onset atrial fibrillation with a heart rate of 140 bpm
• B. A patient scheduled for discharge who needs teaching
• C. A patient requesting pain medication
• D. A patient with a newly inserted nasogastric tube
Correct Answer: A. A patient with a new-onset atrial fibrillation with a heart rate of 140
bpm
Rationale: A new-onset atrial fibrillation with a rapid ventricular response can lead to
hemodynamic instability, decreased cardiac output, and stroke. This patient requires immediate
assessment and intervention. Prioritize based on stability and potential for deterioration.
, 5. A charge nurse is evaluating a new graduate nurse's performance. Which action by the new
graduate requires immediate intervention?
• A. Using two patient identifiers before medication administration
• B. Documenting a patient's blood pressure of 180/100 mmHg and notifying the provider
• C. Administering IV push morphine over 2 minutes as prescribed
• D. Delegating vital signs assessment to UAP for a stable patient
Correct Answer: C. Administering IV push morphine over 2 minutes as prescribed
Rationale: IV push morphine should be administered over 4-5 minutes to prevent respiratory
depression and severe hypotension. A 2-minute administration is too rapid and requires
immediate intervention and education.
6. A nurse is preparing to discharge a patient who speaks a different language. Which action
best demonstrates culturally competent care?
• A. Providing written discharge instructions in English only
• B. Using a certified medical interpreter to provide discharge teaching
• C. Asking a family member to translate the instructions
• D. Giving the patient a list of medications without explanation
Correct Answer: B. Using a certified medical interpreter to provide discharge teaching
Rationale: Using a certified medical interpreter ensures accurate communication and
