NCLEX-RN
Comprehensive
Readiness & Clinical
Judgment Examination
2026/2027
**Question 1**
The nurse is assessing a client with a diagnosis of acute kidney injury (AKI). Which laboratory finding is
most consistent with this condition?
,A. BUN 12 mg/dL, creatinine 0.8 mg/dL
B. BUN 45 mg/dL, creatinine 3.5 mg/dL
C. Serum potassium 3.5 mEq/L
D. Serum calcium 10.5 mg/dL
💫RATIONALE✔️✔️: Acute kidney injury is characterized by elevated BUN and creatinine levels
(azotemia). A BUN of 45 mg/dL and creatinine of 3.5 mg/dL are significantly elevated, indicating renal
impairment. Normal BUN is 7-20 mg/dL, and normal creatinine is 0.6-1.2 mg/dL. Hyperkalemia and
hyperphosphatemia may also occur.
💫ANSWER✔️✔️: B. BUN 45 mg/dL, creatinine 3.5 mg/dL
---
**Question 2**
The nurse is providing education to a client with a new diagnosis of heart failure. Which statement
indicates the client understands the importance of sodium restriction?
A. "I can eat canned soups as long as I drink extra water."
B. "I should avoid adding salt to my food at the table."
C. "I can use salt substitutes freely."
D. "I should limit my sodium intake to 3,000 mg per day."
💫RATIONALE✔️✔️: Avoiding adding salt to food at the table is an important part of sodium
restriction. Canned soups are high in sodium and should be avoided. Salt substitutes contain potassium
,and should be used cautiously. The recommended sodium intake for heart failure is typically 1,500-
2,000 mg per day.
💫ANSWER✔️✔️: B. "I should avoid adding salt to my food at the table."
---
**Question 3**
The nurse is assessing a client who has been diagnosed with borderline personality disorder. Which
behavior is most characteristic of this condition?
A. Grandiose sense of self-importance
B. Intense fear of abandonment
C. Lack of remorse for harming others
D. Preoccupation with orderliness and perfectionism
💫RATIONALE✔️✔️: Borderline personality disorder is characterized by intense fear of abandonment,
unstable relationships, impulsivity, and emotional dysregulation. Grandiosity is more characteristic of
narcissistic personality disorder, lack of remorse of antisocial personality disorder, and perfectionism of
obsessive-compulsive personality disorder.
💫ANSWER✔️✔️: B. Intense fear of abandonment
---
**Question 4**
, The nurse is caring for a client with a new tracheostomy. Which equipment should the nurse ensure is
always at the bedside?
A. An Ambu bag with a mask and the same size tracheostomy tube with obturator
B. A pulse oximeter and a nasal cannula
C. A suction catheter and a bag of normal saline
D. A sterile field and an extra inner cannula
💫RATIONALE✔️✔️: In case of accidental decannulation or obstruction, the nurse must be able to
immediately re-establish the airway. The essential equipment includes an Ambu bag (for ventilation)
and a spare tracheostomy tube of the same size with the obturator. This is a critical patient safety
measure.
💫ANSWER✔️✔️: A. An Ambu bag with a mask and the same size tracheostomy tube with obturator
---
**Question 5**
The nurse is assessing a client who is receiving a continuous infusion of IV fluids. The client develops
shortness of breath and crackles in the lung bases. Which action should the nurse take first?
A. Slow the IV infusion rate
B. Administer oxygen via nasal cannula
C. Notify the healthcare provider
D. Assess the client's oxygen saturation
Comprehensive
Readiness & Clinical
Judgment Examination
2026/2027
**Question 1**
The nurse is assessing a client with a diagnosis of acute kidney injury (AKI). Which laboratory finding is
most consistent with this condition?
,A. BUN 12 mg/dL, creatinine 0.8 mg/dL
B. BUN 45 mg/dL, creatinine 3.5 mg/dL
C. Serum potassium 3.5 mEq/L
D. Serum calcium 10.5 mg/dL
💫RATIONALE✔️✔️: Acute kidney injury is characterized by elevated BUN and creatinine levels
(azotemia). A BUN of 45 mg/dL and creatinine of 3.5 mg/dL are significantly elevated, indicating renal
impairment. Normal BUN is 7-20 mg/dL, and normal creatinine is 0.6-1.2 mg/dL. Hyperkalemia and
hyperphosphatemia may also occur.
💫ANSWER✔️✔️: B. BUN 45 mg/dL, creatinine 3.5 mg/dL
---
**Question 2**
The nurse is providing education to a client with a new diagnosis of heart failure. Which statement
indicates the client understands the importance of sodium restriction?
A. "I can eat canned soups as long as I drink extra water."
B. "I should avoid adding salt to my food at the table."
C. "I can use salt substitutes freely."
D. "I should limit my sodium intake to 3,000 mg per day."
💫RATIONALE✔️✔️: Avoiding adding salt to food at the table is an important part of sodium
restriction. Canned soups are high in sodium and should be avoided. Salt substitutes contain potassium
,and should be used cautiously. The recommended sodium intake for heart failure is typically 1,500-
2,000 mg per day.
💫ANSWER✔️✔️: B. "I should avoid adding salt to my food at the table."
---
**Question 3**
The nurse is assessing a client who has been diagnosed with borderline personality disorder. Which
behavior is most characteristic of this condition?
A. Grandiose sense of self-importance
B. Intense fear of abandonment
C. Lack of remorse for harming others
D. Preoccupation with orderliness and perfectionism
💫RATIONALE✔️✔️: Borderline personality disorder is characterized by intense fear of abandonment,
unstable relationships, impulsivity, and emotional dysregulation. Grandiosity is more characteristic of
narcissistic personality disorder, lack of remorse of antisocial personality disorder, and perfectionism of
obsessive-compulsive personality disorder.
💫ANSWER✔️✔️: B. Intense fear of abandonment
---
**Question 4**
, The nurse is caring for a client with a new tracheostomy. Which equipment should the nurse ensure is
always at the bedside?
A. An Ambu bag with a mask and the same size tracheostomy tube with obturator
B. A pulse oximeter and a nasal cannula
C. A suction catheter and a bag of normal saline
D. A sterile field and an extra inner cannula
💫RATIONALE✔️✔️: In case of accidental decannulation or obstruction, the nurse must be able to
immediately re-establish the airway. The essential equipment includes an Ambu bag (for ventilation)
and a spare tracheostomy tube of the same size with the obturator. This is a critical patient safety
measure.
💫ANSWER✔️✔️: A. An Ambu bag with a mask and the same size tracheostomy tube with obturator
---
**Question 5**
The nurse is assessing a client who is receiving a continuous infusion of IV fluids. The client develops
shortness of breath and crackles in the lung bases. Which action should the nurse take first?
A. Slow the IV infusion rate
B. Administer oxygen via nasal cannula
C. Notify the healthcare provider
D. Assess the client's oxygen saturation
