KAPLAN DIAGNOSTIC COMPLETE
EXAM NCLEX-RN PREPARATION
2026/2027
1. The nurse receives a hand-off report. Which client should the nurse assess first?
A. A client with a history of heart failure who is reporting a sudden onset of shortness of
breath and a cough productive of pink, frothy sputum.
B. A client who is 2 hours postoperative following a total hip replacement with a
hemoglobin of 10.5 g/dL.
C. A client with a chest tube for a pneumothorax who has 100 mL of serosanguineous
drainage in the collection chamber over 2 hours.
D. A client with chronic obstructive pulmonary disease (COPD) with an oxygen saturation
of 90%.
Answer: A
Conceptual Explanation: Pink, frothy sputum and sudden shortness of breath are
hallmark signs of acute pulmonary edema, which is a life-threatening emergency requiring
immediate intervention. The other options represent expected or less urgent findings.
,2. A client is prescribed lithium carbonate for bipolar disorder. Which statement by the client
indicates a need for further teaching?
A. I will make sure to drink at least 2 to 3 liters of water every day.
B. I should limit my salt intake while taking this medication to prevent swelling.
C. I need to have my blood levels checked regularly.
D. I will contact my doctor if I experience excessive thirst or tremors.
Answer: B
Conceptual Explanation: Sodium depletion can lead to lithium toxicity. Clients taking
lithium should maintain a consistent intake of dietary sodium rather than restricting it.
Adequate fluid intake is also necessary to prevent toxicity.
3. The nurse is caring for a client with a history of spinal cord injury at the T6 level. The client
reports a severe, throbbing headache and the blood pressure is 210/110 mmHg. Which action
should the nurse take first?
A. Administer the prescribed PRN antihypertensive medication.
B. Place the client in a high-Fowler’s position.
C. Check the client’s bladder for distension.
D. Assess the client for a fecal impaction.
Answer: B
, Conceptual Explanation: The client is exhibiting signs of autonomic dysreflexia. The
priority action is to sit the client up (high-Fowler’s) to help lower the blood pressure
through gravity before investigating the cause (like bladder distension or fecal impaction).
4. A client with type 1 diabetes mellitus is found unconscious. The nurse notes the client has a
fruity breath odor and rapid, deep respirations. Which laboratory result is most consistent
with this presentation?
A. Serum glucose of 65 mg/dL.
B. Negative urine ketones.
C. Serum bicarbonate of 26 mEq/L.
D. Arterial pH of 7.25.
Answer: D
Conceptual Explanation: The signs (fruity breath, Kussmaul respirations) indicate
Diabetic Ketoacidosis (DKA). DKA is characterized by metabolic acidosis, which results in a
low arterial pH (under 7.35).
5. A child is admitted with a diagnosis of acute epiglottitis. Which nursing intervention is
contraindicated?
A. Monitoring oxygen saturation via pulse oximetry.
B. Visualizing the throat with a tongue depressor.
C. Allowing the child to remain in a position of comfort.
EXAM NCLEX-RN PREPARATION
2026/2027
1. The nurse receives a hand-off report. Which client should the nurse assess first?
A. A client with a history of heart failure who is reporting a sudden onset of shortness of
breath and a cough productive of pink, frothy sputum.
B. A client who is 2 hours postoperative following a total hip replacement with a
hemoglobin of 10.5 g/dL.
C. A client with a chest tube for a pneumothorax who has 100 mL of serosanguineous
drainage in the collection chamber over 2 hours.
D. A client with chronic obstructive pulmonary disease (COPD) with an oxygen saturation
of 90%.
Answer: A
Conceptual Explanation: Pink, frothy sputum and sudden shortness of breath are
hallmark signs of acute pulmonary edema, which is a life-threatening emergency requiring
immediate intervention. The other options represent expected or less urgent findings.
,2. A client is prescribed lithium carbonate for bipolar disorder. Which statement by the client
indicates a need for further teaching?
A. I will make sure to drink at least 2 to 3 liters of water every day.
B. I should limit my salt intake while taking this medication to prevent swelling.
C. I need to have my blood levels checked regularly.
D. I will contact my doctor if I experience excessive thirst or tremors.
Answer: B
Conceptual Explanation: Sodium depletion can lead to lithium toxicity. Clients taking
lithium should maintain a consistent intake of dietary sodium rather than restricting it.
Adequate fluid intake is also necessary to prevent toxicity.
3. The nurse is caring for a client with a history of spinal cord injury at the T6 level. The client
reports a severe, throbbing headache and the blood pressure is 210/110 mmHg. Which action
should the nurse take first?
A. Administer the prescribed PRN antihypertensive medication.
B. Place the client in a high-Fowler’s position.
C. Check the client’s bladder for distension.
D. Assess the client for a fecal impaction.
Answer: B
, Conceptual Explanation: The client is exhibiting signs of autonomic dysreflexia. The
priority action is to sit the client up (high-Fowler’s) to help lower the blood pressure
through gravity before investigating the cause (like bladder distension or fecal impaction).
4. A client with type 1 diabetes mellitus is found unconscious. The nurse notes the client has a
fruity breath odor and rapid, deep respirations. Which laboratory result is most consistent
with this presentation?
A. Serum glucose of 65 mg/dL.
B. Negative urine ketones.
C. Serum bicarbonate of 26 mEq/L.
D. Arterial pH of 7.25.
Answer: D
Conceptual Explanation: The signs (fruity breath, Kussmaul respirations) indicate
Diabetic Ketoacidosis (DKA). DKA is characterized by metabolic acidosis, which results in a
low arterial pH (under 7.35).
5. A child is admitted with a diagnosis of acute epiglottitis. Which nursing intervention is
contraindicated?
A. Monitoring oxygen saturation via pulse oximetry.
B. Visualizing the throat with a tongue depressor.
C. Allowing the child to remain in a position of comfort.
