NCLEX EXAM PREP 2026/2027 | COMPLETE QUESTIONS
AND ANSWERS (VERIFIED ANSWERS) | EXAM PREP |
COMPREHENSIVE EXAM GUIDE 2026&2027
1. A nurse is assessing a client who received IV morphine 20 minutes ago. Which finding
requires the nurse to intervene first?
A. Pain rating of 5/10
B. Respiratory rate of 8/min
C. Blood pressure of 108/68 mm Hg
D. Mild nausea
Answer: B
A respiratory rate of 8/min indicates significant opioid-induced respiratory depression.
Airway and breathing take priority, so the nurse should immediately assess the client and
provide appropriate intervention.
2. A client with heart failure reports increasing shortness of breath and has bilateral
crackles. Which action should the nurse take first?
A. Place the client in high-Fowler position
B. Encourage oral fluids
C. Obtain the client's daily weight
D. Teach the client about sodium restriction
Answer: A
High-Fowler positioning improves lung expansion and can reduce pulmonary congestion while
the nurse continues assessment and treatment.
3. A nurse is caring for a client with type 1 diabetes who is conscious, diaphoretic, and
trembling. The blood glucose level is 48 mg/dL. Which action is appropriate?
A. Administer scheduled insulin
B. Give the client 15 g of rapid-acting carbohydrate
C. Administer glucagon intramuscularly immediately
D. Restrict oral intake until the glucose is rechecked
Answer: B
A conscious client with symptomatic hypoglycemia should receive approximately 15 g of
rapid-acting carbohydrate, followed by reassessment of glucose according to protocol.
4. A client with a suspected stroke develops sudden facial drooping and difficulty speaking.
What is the nurse's priority action?
A. Give the client oral fluids
,B. Place the client in Trendelenburg position
C. Determine the time the symptoms began
D. Administer an oral antiplatelet medication
Answer: C
Determining the time of symptom onset is critical because eligibility for time-sensitive stroke
therapies depends on when symptoms began or when the client was last known well.
5. A postoperative client suddenly develops dyspnea, chest pain, tachycardia, and oxygen
saturation of 86%. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Hypoglycemia
D. Fluid overload
Answer: B
Sudden dyspnea, pleuritic chest discomfort, tachycardia, and hypoxemia are classic findings
associated with pulmonary embolism and require immediate evaluation.
6. A nurse is preparing to administer digoxin to an adult client. Which finding should cause
the nurse to withhold the medication and notify the provider?
A. Apical pulse of 54/min
B. Blood pressure of 138/76 mm Hg
C. Potassium level of 4.2 mEq/L
D. Respiratory rate of 18/min
Answer: A
Digoxin can slow the heart rate. An adult apical pulse below the commonly accepted
threshold of 60/min warrants withholding the medication and further evaluation.
7. A client taking warfarin asks which laboratory test is used to monitor therapeutic
effectiveness. Which response is correct?
A. aPTT
B. Platelet count
C. INR
D. Troponin
Answer: C
The international normalized ratio is used to monitor the anticoagulant effect of warfarin and
guide dosage adjustments.
,8. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What should the nurse do first?
A. Slow the transfusion rate
B. Stop the transfusion
C. Administer acetaminophen
D. Obtain a urine specimen
Answer: B
The transfusion should be stopped immediately when an acute transfusion reaction is
suspected. The nurse should then maintain IV access with appropriate solution and follow the
facility's reaction protocol.
9. A client with chronic obstructive pulmonary disease is receiving oxygen. Which finding
requires the most immediate attention?
A. Oxygen saturation of 90%
B. Productive cough with clear sputum
C. Respiratory rate of 24/min
D. Increasing somnolence and difficulty arousing
Answer: D
Increasing somnolence and difficulty arousing may indicate worsening hypercapnia or
respiratory failure and require immediate assessment and intervention.
10. A nurse is teaching a client prescribed subcutaneous enoxaparin. Which instruction is
appropriate?
A. Massage the injection site after administration
B. Inject the medication into the abdomen as prescribed
C. Aspirate before injecting
D. Expel the entire contents of a prefilled syringe before injection
Answer: B
Enoxaparin is commonly administered subcutaneously in the abdominal area. The site should
not be massaged because doing so can increase bruising and bleeding.
11. A client with potassium level of 2.8 mEq/L is prescribed IV potassium chloride. Which
action is essential?
A. Administer it by IV push
B. Dilute the medication and administer it using an infusion pump
C. Mix it with an intramuscular anesthetic
D. Give it rapidly through a peripheral IV
Answer: B
, IV potassium must be diluted and administered at a controlled rate using an infusion pump.
IV push administration can cause fatal cardiac dysrhythmias.
12. A nurse is assessing a client with increased intracranial pressure. Which finding is most
concerning?
A. Mild headache
B. Increasing level of consciousness
C. New unequal pupils
D. Mild nausea
Answer: C
New unequal pupils can indicate worsening intracranial pressure and possible neurologic
deterioration, requiring immediate intervention.
13. A client with pneumonia has an oxygen saturation of 84% despite receiving oxygen.
Which action should the nurse take first?
A. Document the finding
B. Assess airway and respiratory status
C. Offer oral fluids
D. Encourage ambulation
Answer: B
Airway and breathing are immediate priorities. The nurse should rapidly reassess respiratory
status, oxygen delivery, and the client's response to therapy.
14. A client receiving a heparin infusion has an aPTT significantly above the prescribed
therapeutic range. What should the nurse anticipate?
A. Increasing the infusion rate
B. Holding or adjusting the infusion according to protocol
C. Administering vitamin K
D. Giving an additional anticoagulant
Answer: B
An excessively prolonged aPTT indicates increased anticoagulant effect and bleeding risk. The
infusion should be held or adjusted according to the prescribed protocol.
15. A nurse is caring for a client after thyroidectomy. Which finding requires immediate
intervention?
A. Hoarse voice
B. Incisional discomfort
C. Tingling around the mouth
D. Respiratory stridor
AND ANSWERS (VERIFIED ANSWERS) | EXAM PREP |
COMPREHENSIVE EXAM GUIDE 2026&2027
1. A nurse is assessing a client who received IV morphine 20 minutes ago. Which finding
requires the nurse to intervene first?
A. Pain rating of 5/10
B. Respiratory rate of 8/min
C. Blood pressure of 108/68 mm Hg
D. Mild nausea
Answer: B
A respiratory rate of 8/min indicates significant opioid-induced respiratory depression.
Airway and breathing take priority, so the nurse should immediately assess the client and
provide appropriate intervention.
2. A client with heart failure reports increasing shortness of breath and has bilateral
crackles. Which action should the nurse take first?
A. Place the client in high-Fowler position
B. Encourage oral fluids
C. Obtain the client's daily weight
D. Teach the client about sodium restriction
Answer: A
High-Fowler positioning improves lung expansion and can reduce pulmonary congestion while
the nurse continues assessment and treatment.
3. A nurse is caring for a client with type 1 diabetes who is conscious, diaphoretic, and
trembling. The blood glucose level is 48 mg/dL. Which action is appropriate?
A. Administer scheduled insulin
B. Give the client 15 g of rapid-acting carbohydrate
C. Administer glucagon intramuscularly immediately
D. Restrict oral intake until the glucose is rechecked
Answer: B
A conscious client with symptomatic hypoglycemia should receive approximately 15 g of
rapid-acting carbohydrate, followed by reassessment of glucose according to protocol.
4. A client with a suspected stroke develops sudden facial drooping and difficulty speaking.
What is the nurse's priority action?
A. Give the client oral fluids
,B. Place the client in Trendelenburg position
C. Determine the time the symptoms began
D. Administer an oral antiplatelet medication
Answer: C
Determining the time of symptom onset is critical because eligibility for time-sensitive stroke
therapies depends on when symptoms began or when the client was last known well.
5. A postoperative client suddenly develops dyspnea, chest pain, tachycardia, and oxygen
saturation of 86%. Which complication should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Hypoglycemia
D. Fluid overload
Answer: B
Sudden dyspnea, pleuritic chest discomfort, tachycardia, and hypoxemia are classic findings
associated with pulmonary embolism and require immediate evaluation.
6. A nurse is preparing to administer digoxin to an adult client. Which finding should cause
the nurse to withhold the medication and notify the provider?
A. Apical pulse of 54/min
B. Blood pressure of 138/76 mm Hg
C. Potassium level of 4.2 mEq/L
D. Respiratory rate of 18/min
Answer: A
Digoxin can slow the heart rate. An adult apical pulse below the commonly accepted
threshold of 60/min warrants withholding the medication and further evaluation.
7. A client taking warfarin asks which laboratory test is used to monitor therapeutic
effectiveness. Which response is correct?
A. aPTT
B. Platelet count
C. INR
D. Troponin
Answer: C
The international normalized ratio is used to monitor the anticoagulant effect of warfarin and
guide dosage adjustments.
,8. A client receiving a blood transfusion develops chills, fever, and low back pain 15
minutes after the transfusion begins. What should the nurse do first?
A. Slow the transfusion rate
B. Stop the transfusion
C. Administer acetaminophen
D. Obtain a urine specimen
Answer: B
The transfusion should be stopped immediately when an acute transfusion reaction is
suspected. The nurse should then maintain IV access with appropriate solution and follow the
facility's reaction protocol.
9. A client with chronic obstructive pulmonary disease is receiving oxygen. Which finding
requires the most immediate attention?
A. Oxygen saturation of 90%
B. Productive cough with clear sputum
C. Respiratory rate of 24/min
D. Increasing somnolence and difficulty arousing
Answer: D
Increasing somnolence and difficulty arousing may indicate worsening hypercapnia or
respiratory failure and require immediate assessment and intervention.
10. A nurse is teaching a client prescribed subcutaneous enoxaparin. Which instruction is
appropriate?
A. Massage the injection site after administration
B. Inject the medication into the abdomen as prescribed
C. Aspirate before injecting
D. Expel the entire contents of a prefilled syringe before injection
Answer: B
Enoxaparin is commonly administered subcutaneously in the abdominal area. The site should
not be massaged because doing so can increase bruising and bleeding.
11. A client with potassium level of 2.8 mEq/L is prescribed IV potassium chloride. Which
action is essential?
A. Administer it by IV push
B. Dilute the medication and administer it using an infusion pump
C. Mix it with an intramuscular anesthetic
D. Give it rapidly through a peripheral IV
Answer: B
, IV potassium must be diluted and administered at a controlled rate using an infusion pump.
IV push administration can cause fatal cardiac dysrhythmias.
12. A nurse is assessing a client with increased intracranial pressure. Which finding is most
concerning?
A. Mild headache
B. Increasing level of consciousness
C. New unequal pupils
D. Mild nausea
Answer: C
New unequal pupils can indicate worsening intracranial pressure and possible neurologic
deterioration, requiring immediate intervention.
13. A client with pneumonia has an oxygen saturation of 84% despite receiving oxygen.
Which action should the nurse take first?
A. Document the finding
B. Assess airway and respiratory status
C. Offer oral fluids
D. Encourage ambulation
Answer: B
Airway and breathing are immediate priorities. The nurse should rapidly reassess respiratory
status, oxygen delivery, and the client's response to therapy.
14. A client receiving a heparin infusion has an aPTT significantly above the prescribed
therapeutic range. What should the nurse anticipate?
A. Increasing the infusion rate
B. Holding or adjusting the infusion according to protocol
C. Administering vitamin K
D. Giving an additional anticoagulant
Answer: B
An excessively prolonged aPTT indicates increased anticoagulant effect and bleeding risk. The
infusion should be held or adjusted according to the prescribed protocol.
15. A nurse is caring for a client after thyroidectomy. Which finding requires immediate
intervention?
A. Hoarse voice
B. Incisional discomfort
C. Tingling around the mouth
D. Respiratory stridor
