REx-PN Nursing Certification Exam
Prep: Comprehensive Question Bank
Practice Exam 2026–2027| Complete
Test Prep Practice Questions With
Answers & Detailed Rationales |clinical
Judgment &Safety |A+ Rated
1.
A client with pneumonia has a respiratory rate of 30/min, oxygen
saturation of 88% on room air, and increasing confusion. Which
action should the nurse take first?
A. Encourage oral fluids
B. Obtain a sputum specimen
C. Apply oxygen as prescribed
D. Assist the client to ambulate
Answer: C. Apply oxygen as prescribed
Rationale: Hypoxemia and altered mental status indicate impaired
oxygenation. Supporting oxygenation is the immediate priority.
2.
A nurse is caring for a client with heart failure who has bilateral
crackles and severe dyspnea. Which position is most appropriate?
A. Supine
B. Trendelenburg
C. High-Fowler's
D. Left lateral
,Answer: C. High-Fowler's
Rationale: Upright positioning promotes lung expansion and
decreases venous return, helping reduce pulmonary congestion.
3.
A client receiving insulin becomes shaky, diaphoretic, and confused.
What should the nurse do first?
A. Administer rapid-acting insulin
B. Check the client's blood glucose
C. Encourage exercise
D. Restrict oral intake
Answer: B. Check the client's blood glucose
Rationale: These are classic manifestations of hypoglycemia. Blood
glucose should be assessed promptly, followed by appropriate
treatment.
4.
Which finding in a client with a urinary tract infection requires the
most immediate attention?
A. Urinary frequency
B. Burning with urination
C. Temperature of 39.4°C
D. Mild suprapubic discomfort
Answer: C. Temperature of 39.4°C
Rationale: A high fever may indicate systemic infection or progression
toward sepsis and requires prompt assessment.
5.
A client taking warfarin reports black, tarry stools. What is the
priority nursing action?
,A. Document the expected effect
B. Encourage increased fiber intake
C. Notify the healthcare provider
D. Administer the next dose early
Answer: C. Notify the healthcare provider
Rationale: Melena can indicate gastrointestinal bleeding. Warfarin
increases bleeding risk and requires immediate evaluation.
6.
A client with COPD is receiving oxygen. Which oxygen saturation is
generally an appropriate target unless otherwise prescribed?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
Answer: C. 88–92%
Rationale: Many clients with COPD are managed with a target
saturation around 88–92%, although individualized orders take
priority.
7.
A postoperative client suddenly develops dyspnea, chest pain, and
tachycardia. Which complication should the nurse suspect?
A. Constipation
B. Pulmonary embolism
C. Urinary retention
D. Wound infection
Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea, pleuritic chest pain, and tachycardia are
concerning for pulmonary embolism.
, 8.
Which assessment finding is most concerning in a client with
asthma?
A. Mild wheezing
B. Productive cough
C. Inability to speak full sentences
D. Respiratory rate of 20/min
Answer: C. Inability to speak full sentences
Rationale: Inability to speak normally indicates significant respiratory
distress and possible severe airway obstruction.
9.
A client with suspected stroke arrives at the emergency department.
Which information is most important to establish?
A. Last meal
B. Time symptoms began
C. Usual sleep pattern
D. Childhood illnesses
Answer: B. Time symptoms began
Rationale: The time the client was last known well is critical when
determining eligibility for time-sensitive stroke interventions.
10.
A client with a suspected spinal injury should be moved using which
technique?
A. Pulling by the arms
B. Logrolling while maintaining alignment
C. Sitting the client upright
D. Flexing the neck during transfer
Answer: B. Logrolling while maintaining alignment
Prep: Comprehensive Question Bank
Practice Exam 2026–2027| Complete
Test Prep Practice Questions With
Answers & Detailed Rationales |clinical
Judgment &Safety |A+ Rated
1.
A client with pneumonia has a respiratory rate of 30/min, oxygen
saturation of 88% on room air, and increasing confusion. Which
action should the nurse take first?
A. Encourage oral fluids
B. Obtain a sputum specimen
C. Apply oxygen as prescribed
D. Assist the client to ambulate
Answer: C. Apply oxygen as prescribed
Rationale: Hypoxemia and altered mental status indicate impaired
oxygenation. Supporting oxygenation is the immediate priority.
2.
A nurse is caring for a client with heart failure who has bilateral
crackles and severe dyspnea. Which position is most appropriate?
A. Supine
B. Trendelenburg
C. High-Fowler's
D. Left lateral
,Answer: C. High-Fowler's
Rationale: Upright positioning promotes lung expansion and
decreases venous return, helping reduce pulmonary congestion.
3.
A client receiving insulin becomes shaky, diaphoretic, and confused.
What should the nurse do first?
A. Administer rapid-acting insulin
B. Check the client's blood glucose
C. Encourage exercise
D. Restrict oral intake
Answer: B. Check the client's blood glucose
Rationale: These are classic manifestations of hypoglycemia. Blood
glucose should be assessed promptly, followed by appropriate
treatment.
4.
Which finding in a client with a urinary tract infection requires the
most immediate attention?
A. Urinary frequency
B. Burning with urination
C. Temperature of 39.4°C
D. Mild suprapubic discomfort
Answer: C. Temperature of 39.4°C
Rationale: A high fever may indicate systemic infection or progression
toward sepsis and requires prompt assessment.
5.
A client taking warfarin reports black, tarry stools. What is the
priority nursing action?
,A. Document the expected effect
B. Encourage increased fiber intake
C. Notify the healthcare provider
D. Administer the next dose early
Answer: C. Notify the healthcare provider
Rationale: Melena can indicate gastrointestinal bleeding. Warfarin
increases bleeding risk and requires immediate evaluation.
6.
A client with COPD is receiving oxygen. Which oxygen saturation is
generally an appropriate target unless otherwise prescribed?
A. 70–75%
B. 80–84%
C. 88–92%
D. 98–100%
Answer: C. 88–92%
Rationale: Many clients with COPD are managed with a target
saturation around 88–92%, although individualized orders take
priority.
7.
A postoperative client suddenly develops dyspnea, chest pain, and
tachycardia. Which complication should the nurse suspect?
A. Constipation
B. Pulmonary embolism
C. Urinary retention
D. Wound infection
Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea, pleuritic chest pain, and tachycardia are
concerning for pulmonary embolism.
, 8.
Which assessment finding is most concerning in a client with
asthma?
A. Mild wheezing
B. Productive cough
C. Inability to speak full sentences
D. Respiratory rate of 20/min
Answer: C. Inability to speak full sentences
Rationale: Inability to speak normally indicates significant respiratory
distress and possible severe airway obstruction.
9.
A client with suspected stroke arrives at the emergency department.
Which information is most important to establish?
A. Last meal
B. Time symptoms began
C. Usual sleep pattern
D. Childhood illnesses
Answer: B. Time symptoms began
Rationale: The time the client was last known well is critical when
determining eligibility for time-sensitive stroke interventions.
10.
A client with a suspected spinal injury should be moved using which
technique?
A. Pulling by the arms
B. Logrolling while maintaining alignment
C. Sitting the client upright
D. Flexing the neck during transfer
Answer: B. Logrolling while maintaining alignment
