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KAPLAN NCLEX-RN DIAGNOSTIC TEST 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NCLEX-RN
Prepare for the Kaplan NCLEX Diagnostic Test with a focused study resource designed
to evaluate and reinforce essential nursing knowledge across key NCLEX content
areas. It supports review of clinical judgment, prioritization, patient safety, nursing
interventions, and core concepts commonly assessed on the NCLEX. Use the material
to identify knowledge gaps, target your study efforts, and build confidence in test-
taking skills. This resource is best suited for NCLEX candidates and nursing students
using a diagnostic assessment to guide their exam preparation.
MULTIPLE CHOICE.
1. The nurse is caring for a client with a new diagnosis of type 1 diabetes.
Which statement by the client indicates a correct understanding of
insulin therapy?
• A) "I will rotate my injection sites to prevent lipodystrophy."
• B) "I will administer my insulin only when my blood sugar is high."
• C) "I can use the same insulin syringe for up to 3 days."
• D) "I will inject my insulin into the same site each time for consistency."
Answer: A
Rationale: Rotating insulin injection sites prevents lipodystrophy (atrophy
or hypertrophy of subcutaneous tissue) and ensures consistent
absorption. Insulin should be given as prescribed, not only when blood sugar
is high. Syringes are single-use only. Rotating sites, not using the same one, is
correct.
2. A client is admitted with a suspected pulmonary embolism. Which
assessment finding is most consistent with this diagnosis?
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• A) Hemoptysis and fever
• B) Sudden onset of pleuritic chest pain, dyspnea, and tachycardia
• C) Productive cough with green sputum
• D) Bradycardia and hypotension
Answer: B
Rationale: Pulmonary embolism (PE) classically presents with sudden
onset pleuritic chest pain, dyspnea, tachypnea, tachycardia, and
sometimes hemoptysis. Fever and productive cough suggest infection;
bradycardia is not typical.
3. The nurse is preparing to administer a blood transfusion. Which
solution is safe to infuse with packed red blood cells?
• A) 0.9% normal saline
• B) 5% dextrose in water (D5W)
• C) Lactated Ringer's solution
• D) 0.45% normal saline
Answer: A
Rationale: 0.9% normal saline is the only IV solution that should be used
with blood products. D5W and hypotonic solutions cause hemolysis.
Lactated Ringer's contains calcium, which can cause clotting in the IV
line.
4. A client with chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 88%. The nurse should initially:
• A) Apply oxygen at 2 L/min via nasal cannula
• B) Apply oxygen at 6 L/min via nasal cannula
• C) Place the client in a supine position
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• D) Encourage the client to cough and deep breathe
Answer: A
Rationale: Oxygen should be initiated at a low flow rate (1–2 L/min) in
clients with COPD to avoid suppressing the hypoxic drive. The goal is to
maintain SpO₂ between 88–92%. 6 L/min is too high; supine worsens
ventilation; coughing/deep breathing may not raise SpO₂ quickly enough.
5. The nurse is assessing a client who had a myocardial infarction 24
hours ago. Which finding indicates a complication requiring immediate
action?
• A) Heart rate of 90 bpm
• B) Blood pressure of 110/70 mmHg
• C) New onset of S3 heart sound and crackles in the lung bases
• D) Mild chest discomfort rated 3/10
Answer: C
Rationale: An S3 heart sound with crackles indicates left-sided heart
failure (pulmonary edema), a serious complication post-MI requiring
immediate intervention. Mild chest discomfort may be expected; HR 90
and BP 110/70 are not immediately life-threatening.
6. The nurse is caring for a client receiving continuous enteral tube
feeding. Which action is most important to prevent aspiration?
• A) Elevate the head of the bed to 30–45 degrees
• B) Flush the tube with 50 mL of water every 4 hours
• C) Check gastric residual volume every 8 hours
• D) Change the feeding tubing every 24 hours
Answer: A
Rationale: Elevating the head of the bed (HOB) to 30–45 degrees during
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and for 1 hour after enteral feeding is the most effective intervention to
prevent aspiration. Checking residual volumes is also important but
positioning is the priority.
7. A client is receiving IV vancomycin. Which adverse effect requires the
nurse to slow the infusion rate?
• A) Phlebitis
• B) Red man syndrome (flushing, rash, hypotension)
• C) Ototoxicity
• D) Nephrotoxicity
Answer: B
Rationale: Red man syndrome is a histamine-release reaction associated
with rapid vancomycin infusion. It is managed by slowing the infusion rate
to at least 60 minutes. Phlebitis is a local site reaction; ototoxicity and
nephrotoxicity are dose-related and not immediately affected by rate.
8. A 72-year-old client is hospitalized for pneumonia. The nurse notes that
the client is confused and disoriented. Which is the best initial nursing
action?
• A) Apply restraints to prevent injury
• B) Reorient the client and assess for possible causes of delirium
• C) Notify the provider for a psychiatric consult
• D) Administer a PRN sedative
Answer: B
Rationale: Acute confusion in an older hospitalized client is often
delirium caused by infection, medications, dehydration, or hypoxia. The
nurse should reorient, assess for underlying causes, and provide a calm
environment. Restraints and sedatives are last resorts.
KAPLAN NCLEX-RN DIAGNOSTIC TEST 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
NCLEX-RN
Prepare for the Kaplan NCLEX Diagnostic Test with a focused study resource designed
to evaluate and reinforce essential nursing knowledge across key NCLEX content
areas. It supports review of clinical judgment, prioritization, patient safety, nursing
interventions, and core concepts commonly assessed on the NCLEX. Use the material
to identify knowledge gaps, target your study efforts, and build confidence in test-
taking skills. This resource is best suited for NCLEX candidates and nursing students
using a diagnostic assessment to guide their exam preparation.
MULTIPLE CHOICE.
1. The nurse is caring for a client with a new diagnosis of type 1 diabetes.
Which statement by the client indicates a correct understanding of
insulin therapy?
• A) "I will rotate my injection sites to prevent lipodystrophy."
• B) "I will administer my insulin only when my blood sugar is high."
• C) "I can use the same insulin syringe for up to 3 days."
• D) "I will inject my insulin into the same site each time for consistency."
Answer: A
Rationale: Rotating insulin injection sites prevents lipodystrophy (atrophy
or hypertrophy of subcutaneous tissue) and ensures consistent
absorption. Insulin should be given as prescribed, not only when blood sugar
is high. Syringes are single-use only. Rotating sites, not using the same one, is
correct.
2. A client is admitted with a suspected pulmonary embolism. Which
assessment finding is most consistent with this diagnosis?
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• A) Hemoptysis and fever
• B) Sudden onset of pleuritic chest pain, dyspnea, and tachycardia
• C) Productive cough with green sputum
• D) Bradycardia and hypotension
Answer: B
Rationale: Pulmonary embolism (PE) classically presents with sudden
onset pleuritic chest pain, dyspnea, tachypnea, tachycardia, and
sometimes hemoptysis. Fever and productive cough suggest infection;
bradycardia is not typical.
3. The nurse is preparing to administer a blood transfusion. Which
solution is safe to infuse with packed red blood cells?
• A) 0.9% normal saline
• B) 5% dextrose in water (D5W)
• C) Lactated Ringer's solution
• D) 0.45% normal saline
Answer: A
Rationale: 0.9% normal saline is the only IV solution that should be used
with blood products. D5W and hypotonic solutions cause hemolysis.
Lactated Ringer's contains calcium, which can cause clotting in the IV
line.
4. A client with chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 88%. The nurse should initially:
• A) Apply oxygen at 2 L/min via nasal cannula
• B) Apply oxygen at 6 L/min via nasal cannula
• C) Place the client in a supine position
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• D) Encourage the client to cough and deep breathe
Answer: A
Rationale: Oxygen should be initiated at a low flow rate (1–2 L/min) in
clients with COPD to avoid suppressing the hypoxic drive. The goal is to
maintain SpO₂ between 88–92%. 6 L/min is too high; supine worsens
ventilation; coughing/deep breathing may not raise SpO₂ quickly enough.
5. The nurse is assessing a client who had a myocardial infarction 24
hours ago. Which finding indicates a complication requiring immediate
action?
• A) Heart rate of 90 bpm
• B) Blood pressure of 110/70 mmHg
• C) New onset of S3 heart sound and crackles in the lung bases
• D) Mild chest discomfort rated 3/10
Answer: C
Rationale: An S3 heart sound with crackles indicates left-sided heart
failure (pulmonary edema), a serious complication post-MI requiring
immediate intervention. Mild chest discomfort may be expected; HR 90
and BP 110/70 are not immediately life-threatening.
6. The nurse is caring for a client receiving continuous enteral tube
feeding. Which action is most important to prevent aspiration?
• A) Elevate the head of the bed to 30–45 degrees
• B) Flush the tube with 50 mL of water every 4 hours
• C) Check gastric residual volume every 8 hours
• D) Change the feeding tubing every 24 hours
Answer: A
Rationale: Elevating the head of the bed (HOB) to 30–45 degrees during
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and for 1 hour after enteral feeding is the most effective intervention to
prevent aspiration. Checking residual volumes is also important but
positioning is the priority.
7. A client is receiving IV vancomycin. Which adverse effect requires the
nurse to slow the infusion rate?
• A) Phlebitis
• B) Red man syndrome (flushing, rash, hypotension)
• C) Ototoxicity
• D) Nephrotoxicity
Answer: B
Rationale: Red man syndrome is a histamine-release reaction associated
with rapid vancomycin infusion. It is managed by slowing the infusion rate
to at least 60 minutes. Phlebitis is a local site reaction; ototoxicity and
nephrotoxicity are dose-related and not immediately affected by rate.
8. A 72-year-old client is hospitalized for pneumonia. The nurse notes that
the client is confused and disoriented. Which is the best initial nursing
action?
• A) Apply restraints to prevent injury
• B) Reorient the client and assess for possible causes of delirium
• C) Notify the provider for a psychiatric consult
• D) Administer a PRN sedative
Answer: B
Rationale: Acute confusion in an older hospitalized client is often
delirium caused by infection, medications, dehydration, or hypoxia. The
nurse should reorient, assess for underlying causes, and provide a calm
environment. Restraints and sedatives are last resorts.
