NEW!!! Saunders Adult Health Practice Real
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Exam: =
NCLEX-RN QUESTION Bank – = = =
Verified Questions &
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Answers with Rationales for Medical-Surgical = = = = =
Nursing Success = =
2026/2027
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SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
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Question 1: = =
A 64-year-
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old man with a history of hypertension and hyperlipidemia arrives
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at the emergency department with 90 minutes of substernal chest p
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ressure, diaphoresis, and left arm numbness. Vital signs: BP 150/88
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, HR 98, SpO2 96% on room air. ECG shows ST elevation in leads II,
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III, and aVF. Which action should the nurse perform first?
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A) Administer chewable aspirin 325 mg PO = = = = = =
,B) Prepare the client for emergent PCI (activate cath lab)
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C) Give sublingual nitroglycerin
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D) Start a peripheral IV and give morphine
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Answer: B) Prepare the client for emergent PCI (activate cath lab)
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Rationale: The key goal for STEMI is reperfusion—door-
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toballoon time is critical. Activating the cath lab is the highest priorit
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y to minimize myocardial damage . Aspirin is essential (antiplatelet
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), but activation of the PCI team is time-
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sensitive and should occur immediately while aspirin is given concur
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rently. Nitroglycerin may relieve ischemia but is contraindicated if r
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ight ventricular infarct or hypotension is suspected. Morphine is not t
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he priority over reperfusion .
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Question 2: = =
A client with chronic heart failure (HFrEF, EF 32%) is discharged on li
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sinopril, carvedilol, furosemide, and spironolactone. The client calls
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asking why his potassium was low (3.1 mEq/L) last week and wheth
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er to take extra potassium. What is the nurse's best response?
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A) "You should take a potassium supplement daily as ordered by y
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our provider."
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B) "This is normal; you don't need to worry about it."
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,C) "Spironolactone is potassium-sparing, so we need to check = = = = = = = =
with your provider before you take extra potassium."
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D) "Stop taking the furosemide until your potassium returns to norm
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al." =
Answer: C) "Spironolactone is potassium-
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sparing, so we need to check with your provider before you take
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extra potassium."
= =
Rationale: Furosemide causes potassium loss, but spironolactone is
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potassium-
sparing . Adding extra potassium without provider guidance could
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cause hyperkalemia, especially with spironolactone on board. The
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provider should be consulted before any potassium supplementatio
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n is initiated .
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=
Question 3: = =
A 72-year-
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old woman with new atrial fibrillation is discharged on warfarin. W
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hich instructions should the nurse include? (Select all that apply)
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A) Have INR checked regularly as scheduled
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B) Stop leafy green vegetables while on warfarin
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, C) Report any unusual bleeding or bruising
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D) Use an electric razor for shaving
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E) Begin aspirin 81 mg daily if you miss a dose
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Answer: A, C, D = = = =
Rationale: INR monitoring is essential for warfarin therapy. Clients
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should not stop eating green vegetables; instead, they should maint
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ain consistent vitamin K intake to avoid INR fluctuations . Bleeding is
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a major adverse effect and must be reported. Electric razors reduc
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e the risk of cuts and bleeding . Aspirin should not be added without
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a provider's order as it increases bleeding risk .
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Question 4: = =
The nurse is preparing to administer furosemide (Lasix) to a client wi
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th heart failure. Which laboratory test result is most important to ch
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eck before administering this medication?
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A) Blood urea nitrogen = = =
B) Cholesterol level = =
C) Potassium level = =
D) Creatinine level = =
Answer: C) Potassium level = = = =
== = = = = =
Exam: =
NCLEX-RN QUESTION Bank – = = =
Verified Questions &
= = = =
Answers with Rationales for Medical-Surgical = = = = =
Nursing Success = =
2026/2027
=
SECTION 1: CARDIOVASCULAR DISORDERS (Questions 1-35)
= = = = = =
=
Question 1: = =
A 64-year-
=
old man with a history of hypertension and hyperlipidemia arrives
= = = = = = = = = =
at the emergency department with 90 minutes of substernal chest p
= = = = = = = = = =
ressure, diaphoresis, and left arm numbness. Vital signs: BP 150/88
= = = = = = = = =
, HR 98, SpO2 96% on room air. ECG shows ST elevation in leads II,
= = = = = = = = = = = = = =
III, and aVF. Which action should the nurse perform first?
= = = = = = = = = = =
A) Administer chewable aspirin 325 mg PO = = = = = =
,B) Prepare the client for emergent PCI (activate cath lab)
= = = = = = = = =
C) Give sublingual nitroglycerin
= = =
D) Start a peripheral IV and give morphine
= = = = = = =
Answer: B) Prepare the client for emergent PCI (activate cath lab)
= = = = = = = = = = =
Rationale: The key goal for STEMI is reperfusion—door-
= = = = = = =
toballoon time is critical. Activating the cath lab is the highest priorit
= = = = = = = = = = =
y to minimize myocardial damage . Aspirin is essential (antiplatelet
= = = = = = = = =
), but activation of the PCI team is time-
= = = = = = = =
sensitive and should occur immediately while aspirin is given concur
= = = = = = = = =
rently. Nitroglycerin may relieve ischemia but is contraindicated if r
= = = = = = = = =
ight ventricular infarct or hypotension is suspected. Morphine is not t
= = = = = = = = = =
he priority over reperfusion .
= = = = =
=
Question 2: = =
A client with chronic heart failure (HFrEF, EF 32%) is discharged on li
= = = = = = = = = = = =
sinopril, carvedilol, furosemide, and spironolactone. The client calls
= = = = = = = =
asking why his potassium was low (3.1 mEq/L) last week and wheth
= = = = = = = = = = =
er to take extra potassium. What is the nurse's best response?
= = = = = = = = = = =
A) "You should take a potassium supplement daily as ordered by y
= = = = = = = = = =
our provider."
= =
B) "This is normal; you don't need to worry about it."
= = = = = = = = = =
,C) "Spironolactone is potassium-sparing, so we need to check = = = = = = = =
with your provider before you take extra potassium."
= = = = = = = =
D) "Stop taking the furosemide until your potassium returns to norm
= = = = = = = = =
al." =
Answer: C) "Spironolactone is potassium-
= = = =
sparing, so we need to check with your provider before you take
= = = = = = = = = = = =
extra potassium."
= =
Rationale: Furosemide causes potassium loss, but spironolactone is
= = = = = = = =
potassium-
sparing . Adding extra potassium without provider guidance could
= = = = = = = = =
cause hyperkalemia, especially with spironolactone on board. The
= = = = = = = =
provider should be consulted before any potassium supplementatio
= = = = = = =
n is initiated .
= = = =
=
Question 3: = =
A 72-year-
=
old woman with new atrial fibrillation is discharged on warfarin. W
= = = = = = = = = =
hich instructions should the nurse include? (Select all that apply)
= = = = = = = = = =
A) Have INR checked regularly as scheduled
= = = = = =
B) Stop leafy green vegetables while on warfarin
= = = = = = =
, C) Report any unusual bleeding or bruising
= = = = = =
D) Use an electric razor for shaving
= = = = = =
E) Begin aspirin 81 mg daily if you miss a dose
= = = = = = = = = =
Answer: A, C, D = = = =
Rationale: INR monitoring is essential for warfarin therapy. Clients
= = = = = = = = =
should not stop eating green vegetables; instead, they should maint
= = = = = = = = =
ain consistent vitamin K intake to avoid INR fluctuations . Bleeding is
= = = = = = = = = = = =
a major adverse effect and must be reported. Electric razors reduc
= = = = = = = = = =
e the risk of cuts and bleeding . Aspirin should not be added without
= = = = = = = = = = = = =
a provider's order as it increases bleeding risk .
= = = = = = = = = =
=
Question 4: = =
The nurse is preparing to administer furosemide (Lasix) to a client wi
= = = = = = = = = = =
th heart failure. Which laboratory test result is most important to ch
= = = = = = = = = = =
eck before administering this medication?
= = = = =
A) Blood urea nitrogen = = =
B) Cholesterol level = =
C) Potassium level = =
D) Creatinine level = =
Answer: C) Potassium level = = = =
