1
Page | 1
Saunders NCLEX-RN® 9th Edition Test
Bank 2025–2026 | 100+ Verified Questions
with Rationales | Real Exam Format | Grade
A+ Pass Guaranteed
, 2
1. A nurse is caring for a client with hypokalemia. Which assessment finding requires
immediate nursing intervention?
Page | 2
1. Muscle weakness
✔ 2. Irregular heart rhythm
2. Abdominal cramping
3. Generalized fatigue
ANS: 2
Rationale: Hypokalemia affects neuromuscular and cardiac function. While all listed
symptoms may occur, an irregular heart rhythm poses the most immediate risk due to the
potential for lethal arrhythmias like ventricular tachycardia or fibrillation. The heart's
conduction system is sensitive to potassium fluctuations, and low potassium can disrupt
repolarization, leading to ECG changes such as U waves, flattened T waves, and ST
depression. Prompt correction and ECG monitoring are critical.
Test-Taking Strategy: Look for life-threatening priorities. While all options are associated
with hypokalemia, use ABCs (Airway, Breathing, Circulation)—cardiac rhythm is a
circulatory issue and the most urgent.
PTS: 1
DIF: Analysis
REF: Silvestri, L.A. & Silvestri, A.E. (2022). Saunders Comprehensive Review for the
NCLEX-RN® Examination (9th ed.). Elsevier.
OBJ: Client Needs: Physiological Integrity – Reduction of Risk Potential
, 3
2. A nurse is caring for a client with heart failure who is receiving furosemide. Which finding
should the nurse report to the healthcare provider immediately?
Page | 3 1. Weight loss of 2 pounds in 2 days
✔ 2. Serum potassium level of 2.9 mEq/L
2. Decreased peripheral edema
3. Increase in urine output
ANS: 2
Rationale: Furosemide is a loop diuretic that promotes potassium loss. A serum potassium
level of 2.9 mEq/L is critically low and places the client at risk for cardiac dysrhythmias. This
requires immediate intervention. Weight loss, reduced edema, and increased urine output are
expected therapeutic outcomes. However, hypokalemia may lead to muscle weakness,
respiratory compromise, and ECG changes. Nurses must prioritize laboratory monitoring and
initiate potassium replacement protocols.
Test-Taking Strategy: Choose the response that identifies a life-threatening imbalance.
Potassium <3.0 mEq/L is an emergency due to cardiac risks. Always monitor electrolytes
with diuretics.
PTS: 1
DIF: Application
REF: Silvestri, L.A. & Silvestri, A.E. (2022). Saunders Comprehensive Review for the
NCLEX-RN®, 9th ed.
OBJ: Physiological Integrity – Pharmacological and Parenteral Therapies
, 4
3. A nurse is providing dietary education to a client taking warfarin. Which food should the
nurse instruct the client to avoid or maintain consistently in their diet?
Page | 4 ✔ 1. Spinach
2. Bananas
3. Carrots
4. Chicken breast
ANS: 1
Rationale: Spinach is high in vitamin K, which can interfere with the anticoagulant effects of
warfarin. Clients on warfarin should maintain a consistent intake of vitamin K-rich foods,
rather than avoiding them completely, to ensure INR remains in therapeutic range. Sudden
increases in vitamin K can reduce warfarin efficacy and increase clotting risk. Educating
clients on consistency, not avoidance, is essential for safe long-term therapy.
Test-Taking Strategy: Identify the food that directly counteracts warfarin. Green leafy
vegetables are rich in vitamin K—watch for these in similar questions.
PTS: 1
DIF: Understanding
REF: Silvestri, L.A. & Silvestri, A.E. (2022). Saunders Comprehensive Review, 9th ed.
OBJ: Physiological Integrity – Pharmacological and Parenteral Therapies
Page | 1
Saunders NCLEX-RN® 9th Edition Test
Bank 2025–2026 | 100+ Verified Questions
with Rationales | Real Exam Format | Grade
A+ Pass Guaranteed
, 2
1. A nurse is caring for a client with hypokalemia. Which assessment finding requires
immediate nursing intervention?
Page | 2
1. Muscle weakness
✔ 2. Irregular heart rhythm
2. Abdominal cramping
3. Generalized fatigue
ANS: 2
Rationale: Hypokalemia affects neuromuscular and cardiac function. While all listed
symptoms may occur, an irregular heart rhythm poses the most immediate risk due to the
potential for lethal arrhythmias like ventricular tachycardia or fibrillation. The heart's
conduction system is sensitive to potassium fluctuations, and low potassium can disrupt
repolarization, leading to ECG changes such as U waves, flattened T waves, and ST
depression. Prompt correction and ECG monitoring are critical.
Test-Taking Strategy: Look for life-threatening priorities. While all options are associated
with hypokalemia, use ABCs (Airway, Breathing, Circulation)—cardiac rhythm is a
circulatory issue and the most urgent.
PTS: 1
DIF: Analysis
REF: Silvestri, L.A. & Silvestri, A.E. (2022). Saunders Comprehensive Review for the
NCLEX-RN® Examination (9th ed.). Elsevier.
OBJ: Client Needs: Physiological Integrity – Reduction of Risk Potential
, 3
2. A nurse is caring for a client with heart failure who is receiving furosemide. Which finding
should the nurse report to the healthcare provider immediately?
Page | 3 1. Weight loss of 2 pounds in 2 days
✔ 2. Serum potassium level of 2.9 mEq/L
2. Decreased peripheral edema
3. Increase in urine output
ANS: 2
Rationale: Furosemide is a loop diuretic that promotes potassium loss. A serum potassium
level of 2.9 mEq/L is critically low and places the client at risk for cardiac dysrhythmias. This
requires immediate intervention. Weight loss, reduced edema, and increased urine output are
expected therapeutic outcomes. However, hypokalemia may lead to muscle weakness,
respiratory compromise, and ECG changes. Nurses must prioritize laboratory monitoring and
initiate potassium replacement protocols.
Test-Taking Strategy: Choose the response that identifies a life-threatening imbalance.
Potassium <3.0 mEq/L is an emergency due to cardiac risks. Always monitor electrolytes
with diuretics.
PTS: 1
DIF: Application
REF: Silvestri, L.A. & Silvestri, A.E. (2022). Saunders Comprehensive Review for the
NCLEX-RN®, 9th ed.
OBJ: Physiological Integrity – Pharmacological and Parenteral Therapies
, 4
3. A nurse is providing dietary education to a client taking warfarin. Which food should the
nurse instruct the client to avoid or maintain consistently in their diet?
Page | 4 ✔ 1. Spinach
2. Bananas
3. Carrots
4. Chicken breast
ANS: 1
Rationale: Spinach is high in vitamin K, which can interfere with the anticoagulant effects of
warfarin. Clients on warfarin should maintain a consistent intake of vitamin K-rich foods,
rather than avoiding them completely, to ensure INR remains in therapeutic range. Sudden
increases in vitamin K can reduce warfarin efficacy and increase clotting risk. Educating
clients on consistency, not avoidance, is essential for safe long-term therapy.
Test-Taking Strategy: Identify the food that directly counteracts warfarin. Green leafy
vegetables are rich in vitamin K—watch for these in similar questions.
PTS: 1
DIF: Understanding
REF: Silvestri, L.A. & Silvestri, A.E. (2022). Saunders Comprehensive Review, 9th ed.
OBJ: Physiological Integrity – Pharmacological and Parenteral Therapies
