Comprehensive
Predictor and NCLEX-
RN Final Readiness
### Question 1
The nurse is caring for a patient who is 24 hours post-operative following a total hip arthroplasty. Which
intervention should the nurse prioritize to prevent complications?
A. Encouraging the patient to sit in a low chair
B. Keeping the patient's legs adducted with a pillow between the knees
C. Placing the patient in a supine position with the hips flexed
,D. Ambulating the patient with a walker on the first post-operative day
💫RATIONALE✔️✔️: Keeping the patient's legs adducted with an abduction pillow or pillow between
the knees prevents dislocation of the new hip joint. The patient should avoid hip flexion greater than 90
degrees, adduction past midline, and internal rotation.
💫ANSWER✔️✔️: B. Keeping the patient's legs adducted with a pillow between the knees
---
### Question 2
A patient with chronic kidney disease is scheduled for hemodialysis. The nurse notes that the patient's
arteriovenous (AV) fistula has a palpable thrill and audible bruit. Which action should the nurse take?
A. Notify the healthcare provider of the findings
B. Document the findings and continue with dialysis preparation
C. Apply a warm compress to the AV fistula site
D. Restrict fluids to prevent fluid overload
💫RATIONALE✔️✔️: A palpable thrill and audible bruit indicate that the AV fistula is patent and
functioning properly. The nurse should document these findings and continue with dialysis preparation.
Absence of thrill or bruit indicates occlusion and requires immediate intervention.
💫ANSWER✔️✔️: B. Document the findings and continue with dialysis preparation
---
,### Question 3
The nurse is caring for a patient with a diagnosis of acute pancreatitis. Which laboratory finding is most
consistent with this condition?
A. Elevated serum amylase and lipase
B. Decreased serum calcium
C. Elevated white blood cell count
D. All of the above
💫RATIONALE✔️✔️: Acute pancreatitis is characterized by elevated serum amylase and lipase,
decreased serum calcium (due to saponification), and elevated white blood cell count (due to
inflammation). All of these findings may be present in acute pancreatitis.
💫ANSWER✔️✔️: D. All of the above
---
### Question 4
The nurse is assessing a patient who has been diagnosed with major depressive disorder. Which finding
is most indicative of a risk for suicide?
A. The patient reports feeling sad and hopeless
B. The patient has a history of previous suicide attempts
C. The patient has difficulty sleeping and eating
, D. The patient reports a lack of interest in activities
💫RATIONALE✔️✔️: A history of previous suicide attempts is the strongest predictor of future suicide
attempts and completed suicide. While other symptoms of depression (sadness, hopelessness, sleep
disturbances, anhedonia) are concerning, a history of attempts requires immediate intervention and
close monitoring.
💫ANSWER✔️✔️: B. The patient has a history of previous suicide attempts
---
### Question 5
A patient with heart failure is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which
finding requires the nurse to withhold the medication and notify the healthcare provider?
A. Blood pressure of 110/70 mmHg
B. Heart rate of 72 beats per minute
C. Serum potassium of 5.8 mEq/L
D. Serum creatinine of 1.2 mg/dL
💫RATIONALE✔️✔️: A serum potassium of 5.8 mEq/L is significantly elevated and may indicate
hyperkalemia, a potential side effect of ACE inhibitors. The nurse should withhold the medication and
notify the healthcare provider. Renal function should also be monitored.
💫ANSWER✔️✔️: C. Serum potassium of 5.8 mEq/L
---
Predictor and NCLEX-
RN Final Readiness
### Question 1
The nurse is caring for a patient who is 24 hours post-operative following a total hip arthroplasty. Which
intervention should the nurse prioritize to prevent complications?
A. Encouraging the patient to sit in a low chair
B. Keeping the patient's legs adducted with a pillow between the knees
C. Placing the patient in a supine position with the hips flexed
,D. Ambulating the patient with a walker on the first post-operative day
💫RATIONALE✔️✔️: Keeping the patient's legs adducted with an abduction pillow or pillow between
the knees prevents dislocation of the new hip joint. The patient should avoid hip flexion greater than 90
degrees, adduction past midline, and internal rotation.
💫ANSWER✔️✔️: B. Keeping the patient's legs adducted with a pillow between the knees
---
### Question 2
A patient with chronic kidney disease is scheduled for hemodialysis. The nurse notes that the patient's
arteriovenous (AV) fistula has a palpable thrill and audible bruit. Which action should the nurse take?
A. Notify the healthcare provider of the findings
B. Document the findings and continue with dialysis preparation
C. Apply a warm compress to the AV fistula site
D. Restrict fluids to prevent fluid overload
💫RATIONALE✔️✔️: A palpable thrill and audible bruit indicate that the AV fistula is patent and
functioning properly. The nurse should document these findings and continue with dialysis preparation.
Absence of thrill or bruit indicates occlusion and requires immediate intervention.
💫ANSWER✔️✔️: B. Document the findings and continue with dialysis preparation
---
,### Question 3
The nurse is caring for a patient with a diagnosis of acute pancreatitis. Which laboratory finding is most
consistent with this condition?
A. Elevated serum amylase and lipase
B. Decreased serum calcium
C. Elevated white blood cell count
D. All of the above
💫RATIONALE✔️✔️: Acute pancreatitis is characterized by elevated serum amylase and lipase,
decreased serum calcium (due to saponification), and elevated white blood cell count (due to
inflammation). All of these findings may be present in acute pancreatitis.
💫ANSWER✔️✔️: D. All of the above
---
### Question 4
The nurse is assessing a patient who has been diagnosed with major depressive disorder. Which finding
is most indicative of a risk for suicide?
A. The patient reports feeling sad and hopeless
B. The patient has a history of previous suicide attempts
C. The patient has difficulty sleeping and eating
, D. The patient reports a lack of interest in activities
💫RATIONALE✔️✔️: A history of previous suicide attempts is the strongest predictor of future suicide
attempts and completed suicide. While other symptoms of depression (sadness, hopelessness, sleep
disturbances, anhedonia) are concerning, a history of attempts requires immediate intervention and
close monitoring.
💫ANSWER✔️✔️: B. The patient has a history of previous suicide attempts
---
### Question 5
A patient with heart failure is prescribed an angiotensin-converting enzyme (ACE) inhibitor. Which
finding requires the nurse to withhold the medication and notify the healthcare provider?
A. Blood pressure of 110/70 mmHg
B. Heart rate of 72 beats per minute
C. Serum potassium of 5.8 mEq/L
D. Serum creatinine of 1.2 mg/dL
💫RATIONALE✔️✔️: A serum potassium of 5.8 mEq/L is significantly elevated and may indicate
hyperkalemia, a potential side effect of ACE inhibitors. The nurse should withhold the medication and
notify the healthcare provider. Renal function should also be monitored.
💫ANSWER✔️✔️: C. Serum potassium of 5.8 mEq/L
---
