NCLEX-RN: Reduction of Risk Potential (2026 Update) BSN
UPDATED ACTUAL Exam Questions and CORRECT Answers
1. A nurse is reviewing the lab results of a patient receiving heparin via
continuous IV infusion. Which value should the nurse monitor to adjust the
dosage?
A. Prothrombin time (PT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Activated partial thromboplastin time (aPTT)
Answer: D
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effect of heparin. PT and INR are used for warfarin.
2. Which of the following laboratory findings is most indicative of a myocardial
infarction?
A. Decreased BNP
B. Elevated Creatinine
C. Elevated Troponin I
D. Decreased C-reactive protein
Answer: C
Rationale: Troponin I is a highly specific cardiac marker that rises within 3-6 hours of
myocardial injury.
,3. A patient with chronic kidney disease has a serum potassium level of 6.2
mEq/L. Which EKG change should the nurse expect?
A. Prominent U waves
B. ST segment depression
C. Inverted P waves
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves. U waves are seen in
hypokalemia.
4. A nurse is caring for a patient who underwent a liver biopsy 1 hour ago. How
should the patient be positioned?
A. Left side-lying with a pillow under the abdomen
B. Right side-lying with a pillow under the biopsy site
C. Semi-Fowler’s with legs elevated
D. Supine with the head of bed flat
Answer: B
Rationale: Positioning the patient on the right side applies pressure to the liver, which
helps prevent post-procedure bleeding.
5. Which lab value is the most sensitive indicator of a patient’s renal function?
A. Blood urea nitrogen (BUN)
B. Serum creatinine
C. Urine specific gravity
D. Serum uric acid
Answer: B
Rationale: Serum creatinine is more specific to kidney function than BUN, as BUN can be
affected by dehydration, diet, and stress.
, 6. A patient is scheduled for an intravenous pyelogram (IVP). What is the
priority nursing assessment?
A. History of claustrophobia
B. Allergy to shellfish or iodine
C. Last bowel movement
D. Baseline heart rate
Answer: B
Rationale: IVP uses radiopaque contrast media. Assessment for iodine or shellfish allergies
is critical to prevent anaphylaxis.
7. The nurse notes a patient’s glycosylated hemoglobin (HbA1c) is 8.5%. This
indicates which of the following?
A. The patient is currently hypoglycemic
B. The patient’s blood glucose is well-controlled
C. The patient has been fasting effectively
D. Poor glucose control over the past 3 months
Answer: D
Rationale: An HbA1c above 7% usually indicates suboptimal long-term glucose
management in diabetic patients.
8. A patient has been taking warfarin for atrial fibrillation. The nurse notes an
INR of 5.5. What is the priority action?
A. Administer Vitamin K as prescribed
B. Administer the next dose as scheduled
C. Encourage a diet high in leafy greens
D. Prepare for a blood transfusion
Answer: A
Rationale: An INR of 5.5 is critically high (therapeutic range is 2-3). Vitamin K is the
antidote for warfarin.
UPDATED ACTUAL Exam Questions and CORRECT Answers
1. A nurse is reviewing the lab results of a patient receiving heparin via
continuous IV infusion. Which value should the nurse monitor to adjust the
dosage?
A. Prothrombin time (PT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Activated partial thromboplastin time (aPTT)
Answer: D
Rationale: Activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effect of heparin. PT and INR are used for warfarin.
2. Which of the following laboratory findings is most indicative of a myocardial
infarction?
A. Decreased BNP
B. Elevated Creatinine
C. Elevated Troponin I
D. Decreased C-reactive protein
Answer: C
Rationale: Troponin I is a highly specific cardiac marker that rises within 3-6 hours of
myocardial injury.
,3. A patient with chronic kidney disease has a serum potassium level of 6.2
mEq/L. Which EKG change should the nurse expect?
A. Prominent U waves
B. ST segment depression
C. Inverted P waves
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves. U waves are seen in
hypokalemia.
4. A nurse is caring for a patient who underwent a liver biopsy 1 hour ago. How
should the patient be positioned?
A. Left side-lying with a pillow under the abdomen
B. Right side-lying with a pillow under the biopsy site
C. Semi-Fowler’s with legs elevated
D. Supine with the head of bed flat
Answer: B
Rationale: Positioning the patient on the right side applies pressure to the liver, which
helps prevent post-procedure bleeding.
5. Which lab value is the most sensitive indicator of a patient’s renal function?
A. Blood urea nitrogen (BUN)
B. Serum creatinine
C. Urine specific gravity
D. Serum uric acid
Answer: B
Rationale: Serum creatinine is more specific to kidney function than BUN, as BUN can be
affected by dehydration, diet, and stress.
, 6. A patient is scheduled for an intravenous pyelogram (IVP). What is the
priority nursing assessment?
A. History of claustrophobia
B. Allergy to shellfish or iodine
C. Last bowel movement
D. Baseline heart rate
Answer: B
Rationale: IVP uses radiopaque contrast media. Assessment for iodine or shellfish allergies
is critical to prevent anaphylaxis.
7. The nurse notes a patient’s glycosylated hemoglobin (HbA1c) is 8.5%. This
indicates which of the following?
A. The patient is currently hypoglycemic
B. The patient’s blood glucose is well-controlled
C. The patient has been fasting effectively
D. Poor glucose control over the past 3 months
Answer: D
Rationale: An HbA1c above 7% usually indicates suboptimal long-term glucose
management in diabetic patients.
8. A patient has been taking warfarin for atrial fibrillation. The nurse notes an
INR of 5.5. What is the priority action?
A. Administer Vitamin K as prescribed
B. Administer the next dose as scheduled
C. Encourage a diet high in leafy greens
D. Prepare for a blood transfusion
Answer: A
Rationale: An INR of 5.5 is critically high (therapeutic range is 2-3). Vitamin K is the
antidote for warfarin.
