Comprehensive Nursing Predictor and
NCLEX Readiness Practice Exam questions
and correct answers– Updated 2026 (Graded
A+) instant download pdf
Subject: Nursing Comprehensive Review
Subtopic: Prioritization and Clinical Judgment
Question 1: A nurse receives report on four clients. Which client should the nurse assess first?
A) A client with chronic heart failure reporting fatigue after ambulation
B) A postoperative client with an oxygen saturation of 88% despite oxygen at 2 L/min by nasal
cannula
C) A client with diabetes requesting assistance with meal selection
D) A client awaiting discharge instructions for newly prescribed medications
Correct Answer: B - A postoperative client with an oxygen saturation of 88% despite
oxygen at 2 L/min by nasal cannula
Rationale: Using ABC prioritization, impaired oxygenation takes precedence. An oxygen
saturation of 88% despite supplemental oxygen suggests acute respiratory compromise requiring
immediate assessment. Fatigue, dietary teaching, and discharge education are important but not
urgent.
Question 2: A nurse caring for a client with acute chest pain should recognize which finding
requires immediate intervention?
A) Pain rating of 4/10 relieved by rest
B) Blood pressure of 138/84 mm Hg
C) New-onset ventricular tachycardia on telemetry
D) Heart rate of 92/min
Correct Answer: C - New-onset ventricular tachycardia on telemetry
Rationale: Ventricular tachycardia can rapidly progress to hemodynamic instability and cardiac
arrest, requiring immediate intervention. The remaining findings are not immediately life-
threatening.
Question 3: A nurse delegates obtaining vital signs to an assistive personnel (AP). Which client
should the nurse assess personally?
,A) A stable client scheduled for discharge
B) A client admitted with diabetic ketoacidosis receiving an insulin infusion
C) A client recovering from uncomplicated cataract surgery
D) A client awaiting transportation home
Correct Answer: B - A client admitted with diabetic ketoacidosis receiving an insulin
infusion
Rationale: Unstable clients and those requiring ongoing assessment should be managed directly
by the RN. Stable clients may appropriately be delegated to AP.
Question 4: A nurse notes a medication dosage that appears unusually high. What is the nurse's
priority action?
A) Administer the medication as prescribed
B) Clarify the prescription with the provider before administration
C) Ask another nurse to administer the medication
D) Document refusal to administer without further action
Correct Answer: B - Clarify the prescription with the provider before administration
Rationale: Nurses are responsible for verifying questionable prescriptions before administration.
Clarification promotes client safety and professional accountability.
Question 5: A nurse caring for a client receiving opioid analgesics should monitor primarily for:
A) Hypertension
B) Respiratory depression
C) Polyuria
D) Hyperglycemia
Correct Answer: B - Respiratory depression
Rationale: Opioids may suppress respiratory drive, making respiratory assessment a priority.
The other findings are less commonly associated with opioid administration.
Subtopic: Infection Prevention and Safety
Question 6: Which action by a nurse demonstrates appropriate infection-control practice?
A) Wearing the same gloves between clients if no visible soil is present
B) Performing hand hygiene before and after client contact
C) Recapping contaminated needles before disposal
D) Placing used sharps in regular waste containers
Correct Answer: B - Performing hand hygiene before and after client contact
,Rationale: Hand hygiene remains the most effective measure for preventing healthcare-
associated infections. Recapping needles and improper sharps disposal increase injury risk.
Question 7: A client with active pulmonary tuberculosis should be placed in:
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Protective isolation
Correct Answer: C - Airborne precautions
Rationale: Tuberculosis is transmitted via airborne particles. Airborne precautions require a
negative-pressure room and appropriate respiratory protection.
Question 8: Which client is at greatest risk for falls?
A) A 25-year-old postoperative client receiving IV fluids
B) A 45-year-old client with controlled hypertension
C) An 82-year-old client receiving sedative medications
D) A 34-year-old client awaiting discharge
Correct Answer: C - An 82-year-old client receiving sedative medications
Rationale: Advanced age combined with sedative use significantly increases fall risk.
Question 9: A nurse identifies a fire in a client's room. According to the RACE protocol, the
nurse should first:
A) Activate the alarm
B) Remove individuals from immediate danger
C) Close doors and windows
D) Extinguish the fire
Correct Answer: B - Remove individuals from immediate danger
Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish/Evacuate. Client safety is the
first priority.
Question 10: Which action best protects client confidentiality?
A) Discussing client information in the hallway
B) Logging off electronic records when leaving a workstation
C) Sharing passwords with coworkers during emergencies
D) Leaving charts open at the nurses' station
, Correct Answer: B - Logging off electronic records when leaving a workstation
Rationale: Securing access to electronic records protects confidentiality and complies with
privacy standards.
Subtopic: Pharmacology and Medication Administration
Question 11: Before administering digoxin, the nurse should assess the client's:
A) Deep tendon reflexes
B) Apical pulse
C) Pupillary response
D) Blood glucose level
Correct Answer: B - Apical pulse
Rationale: Digoxin can cause bradycardia. Assessing the apical pulse helps determine whether
administration is safe.
Question 12: A nurse administers insulin to a client. Which finding indicates possible
hypoglycemia?
A) Polyuria and thirst
B) Warm, dry skin
C) Diaphoresis and confusion
D) Fruity breath odor
Correct Answer: C - Diaphoresis and confusion
Rationale: Sweating, confusion, tremors, and tachycardia are common manifestations of
hypoglycemia.
Question 13: Which laboratory value should the nurse review before administering warfarin?
A) Serum sodium
B) INR
C) Serum calcium
D) Hemoglobin A1C
Correct Answer: B - INR
Rationale: INR assesses anticoagulation status and guides warfarin therapy.
Question 14: A client receiving furosemide is at greatest risk for:
NCLEX Readiness Practice Exam questions
and correct answers– Updated 2026 (Graded
A+) instant download pdf
Subject: Nursing Comprehensive Review
Subtopic: Prioritization and Clinical Judgment
Question 1: A nurse receives report on four clients. Which client should the nurse assess first?
A) A client with chronic heart failure reporting fatigue after ambulation
B) A postoperative client with an oxygen saturation of 88% despite oxygen at 2 L/min by nasal
cannula
C) A client with diabetes requesting assistance with meal selection
D) A client awaiting discharge instructions for newly prescribed medications
Correct Answer: B - A postoperative client with an oxygen saturation of 88% despite
oxygen at 2 L/min by nasal cannula
Rationale: Using ABC prioritization, impaired oxygenation takes precedence. An oxygen
saturation of 88% despite supplemental oxygen suggests acute respiratory compromise requiring
immediate assessment. Fatigue, dietary teaching, and discharge education are important but not
urgent.
Question 2: A nurse caring for a client with acute chest pain should recognize which finding
requires immediate intervention?
A) Pain rating of 4/10 relieved by rest
B) Blood pressure of 138/84 mm Hg
C) New-onset ventricular tachycardia on telemetry
D) Heart rate of 92/min
Correct Answer: C - New-onset ventricular tachycardia on telemetry
Rationale: Ventricular tachycardia can rapidly progress to hemodynamic instability and cardiac
arrest, requiring immediate intervention. The remaining findings are not immediately life-
threatening.
Question 3: A nurse delegates obtaining vital signs to an assistive personnel (AP). Which client
should the nurse assess personally?
,A) A stable client scheduled for discharge
B) A client admitted with diabetic ketoacidosis receiving an insulin infusion
C) A client recovering from uncomplicated cataract surgery
D) A client awaiting transportation home
Correct Answer: B - A client admitted with diabetic ketoacidosis receiving an insulin
infusion
Rationale: Unstable clients and those requiring ongoing assessment should be managed directly
by the RN. Stable clients may appropriately be delegated to AP.
Question 4: A nurse notes a medication dosage that appears unusually high. What is the nurse's
priority action?
A) Administer the medication as prescribed
B) Clarify the prescription with the provider before administration
C) Ask another nurse to administer the medication
D) Document refusal to administer without further action
Correct Answer: B - Clarify the prescription with the provider before administration
Rationale: Nurses are responsible for verifying questionable prescriptions before administration.
Clarification promotes client safety and professional accountability.
Question 5: A nurse caring for a client receiving opioid analgesics should monitor primarily for:
A) Hypertension
B) Respiratory depression
C) Polyuria
D) Hyperglycemia
Correct Answer: B - Respiratory depression
Rationale: Opioids may suppress respiratory drive, making respiratory assessment a priority.
The other findings are less commonly associated with opioid administration.
Subtopic: Infection Prevention and Safety
Question 6: Which action by a nurse demonstrates appropriate infection-control practice?
A) Wearing the same gloves between clients if no visible soil is present
B) Performing hand hygiene before and after client contact
C) Recapping contaminated needles before disposal
D) Placing used sharps in regular waste containers
Correct Answer: B - Performing hand hygiene before and after client contact
,Rationale: Hand hygiene remains the most effective measure for preventing healthcare-
associated infections. Recapping needles and improper sharps disposal increase injury risk.
Question 7: A client with active pulmonary tuberculosis should be placed in:
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Protective isolation
Correct Answer: C - Airborne precautions
Rationale: Tuberculosis is transmitted via airborne particles. Airborne precautions require a
negative-pressure room and appropriate respiratory protection.
Question 8: Which client is at greatest risk for falls?
A) A 25-year-old postoperative client receiving IV fluids
B) A 45-year-old client with controlled hypertension
C) An 82-year-old client receiving sedative medications
D) A 34-year-old client awaiting discharge
Correct Answer: C - An 82-year-old client receiving sedative medications
Rationale: Advanced age combined with sedative use significantly increases fall risk.
Question 9: A nurse identifies a fire in a client's room. According to the RACE protocol, the
nurse should first:
A) Activate the alarm
B) Remove individuals from immediate danger
C) Close doors and windows
D) Extinguish the fire
Correct Answer: B - Remove individuals from immediate danger
Rationale: RACE stands for Rescue, Alarm, Contain, Extinguish/Evacuate. Client safety is the
first priority.
Question 10: Which action best protects client confidentiality?
A) Discussing client information in the hallway
B) Logging off electronic records when leaving a workstation
C) Sharing passwords with coworkers during emergencies
D) Leaving charts open at the nurses' station
, Correct Answer: B - Logging off electronic records when leaving a workstation
Rationale: Securing access to electronic records protects confidentiality and complies with
privacy standards.
Subtopic: Pharmacology and Medication Administration
Question 11: Before administering digoxin, the nurse should assess the client's:
A) Deep tendon reflexes
B) Apical pulse
C) Pupillary response
D) Blood glucose level
Correct Answer: B - Apical pulse
Rationale: Digoxin can cause bradycardia. Assessing the apical pulse helps determine whether
administration is safe.
Question 12: A nurse administers insulin to a client. Which finding indicates possible
hypoglycemia?
A) Polyuria and thirst
B) Warm, dry skin
C) Diaphoresis and confusion
D) Fruity breath odor
Correct Answer: C - Diaphoresis and confusion
Rationale: Sweating, confusion, tremors, and tachycardia are common manifestations of
hypoglycemia.
Question 13: Which laboratory value should the nurse review before administering warfarin?
A) Serum sodium
B) INR
C) Serum calcium
D) Hemoglobin A1C
Correct Answer: B - INR
Rationale: INR assesses anticoagulation status and guides warfarin therapy.
Question 14: A client receiving furosemide is at greatest risk for:
