KAPLAN DIAGNOSTIC COMPLETE
EXAM NCLEX-RN PREPARATION 2026
1. The nurse is assigned to care for four clients. Which client should the nurse assess first?
A. A client with a fractured femur who is reporting sudden chest pain and dyspnea.
B. A client 2 days postoperative following a colon resection with no bowel sounds.
C. A client with a blood glucose level of 150 mg/dL who is requesting a snack.
D. A client with a history of asthma who is reporting shortness of breath after a breathing
treatment.
Answer: A
Conceptual Explanation: A client with a fractured femur is at high risk for a fat embolism.
Sudden chest pain and dyspnea are classic signs of pulmonary embolism, requiring
immediate intervention. Options A and B are expected findings in their respective
conditions but are not as urgent as a potential fat embolism.
,2. A nurse is caring for a client with a history of chronic alcoholism who is experiencing
alcohol withdrawal. Which of the following medications should the nurse anticipate the
provider to prescribe?
A. Disulfiram
B. Naloxone
C. Methadone
D. Chlordiazepoxide
Answer: D
Conceptual Explanation: Benzodiazepines like chlordiazepoxide are the gold standard for
managing acute alcohol withdrawal symptoms and preventing seizures/delirium tremens.
Disulfiram is for maintenance of sobriety, not acute withdrawal.
3. Which of the following instructions should a nurse provide to a client who has a new
prescription for lithium carbonate?
A. Limit your sodium intake to decrease the risk of toxicity.
B. Drink no more than 1 liter of fluid per day.
C. Maintain a consistent intake of sodium and fluids.
D. Take the medication on an empty stomach for better absorption.
Answer: C
, Conceptual Explanation: Lithium is a salt. Changes in sodium intake affect lithium
excretion. Low sodium levels lead to lithium retention and toxicity. Consistent sodium and
high fluid intake (2-3 L/day) are required.
4. A client in the third trimester of pregnancy is admitted with painless, bright red vaginal
bleeding. Which action should the nurse avoid?
A. Monitoring fetal heart rate
B. Performing a sterile vaginal examination
C. Assessing maternal blood pressure
D. Initiating intravenous access
Answer: B
Conceptual Explanation: Painless bright red bleeding suggests placenta previa. A vaginal
exam can stimulate the placenta and cause life-threatening hemorrhage. Ultrasound must
confirm placental location before any vaginal entry.
5. A nurse is evaluating a client’s understanding of dietary teaching for a low-purine diet to
manage gout. Which food choice indicates the client understands the teaching?
A. Poached eggs and toast
B. Steamed sardines
C. Grilled liver and onions
D. Lentil soup with bacon
EXAM NCLEX-RN PREPARATION 2026
1. The nurse is assigned to care for four clients. Which client should the nurse assess first?
A. A client with a fractured femur who is reporting sudden chest pain and dyspnea.
B. A client 2 days postoperative following a colon resection with no bowel sounds.
C. A client with a blood glucose level of 150 mg/dL who is requesting a snack.
D. A client with a history of asthma who is reporting shortness of breath after a breathing
treatment.
Answer: A
Conceptual Explanation: A client with a fractured femur is at high risk for a fat embolism.
Sudden chest pain and dyspnea are classic signs of pulmonary embolism, requiring
immediate intervention. Options A and B are expected findings in their respective
conditions but are not as urgent as a potential fat embolism.
,2. A nurse is caring for a client with a history of chronic alcoholism who is experiencing
alcohol withdrawal. Which of the following medications should the nurse anticipate the
provider to prescribe?
A. Disulfiram
B. Naloxone
C. Methadone
D. Chlordiazepoxide
Answer: D
Conceptual Explanation: Benzodiazepines like chlordiazepoxide are the gold standard for
managing acute alcohol withdrawal symptoms and preventing seizures/delirium tremens.
Disulfiram is for maintenance of sobriety, not acute withdrawal.
3. Which of the following instructions should a nurse provide to a client who has a new
prescription for lithium carbonate?
A. Limit your sodium intake to decrease the risk of toxicity.
B. Drink no more than 1 liter of fluid per day.
C. Maintain a consistent intake of sodium and fluids.
D. Take the medication on an empty stomach for better absorption.
Answer: C
, Conceptual Explanation: Lithium is a salt. Changes in sodium intake affect lithium
excretion. Low sodium levels lead to lithium retention and toxicity. Consistent sodium and
high fluid intake (2-3 L/day) are required.
4. A client in the third trimester of pregnancy is admitted with painless, bright red vaginal
bleeding. Which action should the nurse avoid?
A. Monitoring fetal heart rate
B. Performing a sterile vaginal examination
C. Assessing maternal blood pressure
D. Initiating intravenous access
Answer: B
Conceptual Explanation: Painless bright red bleeding suggests placenta previa. A vaginal
exam can stimulate the placenta and cause life-threatening hemorrhage. Ultrasound must
confirm placental location before any vaginal entry.
5. A nurse is evaluating a client’s understanding of dietary teaching for a low-purine diet to
manage gout. Which food choice indicates the client understands the teaching?
A. Poached eggs and toast
B. Steamed sardines
C. Grilled liver and onions
D. Lentil soup with bacon
