VATI GREENLIGHT PREDICTOR VERSION A
Comprehensive Nursing Practice Exam (150
Questions)
Featuring 150 Clinical Judgment & NCLEX-Style Questions with
Detailed Rationales
Question 1 [Management of Care]
A charge nurse is planning client care assignments for a medical-
surgical unit. Which of the following clients should the nurse assign
to an assistive personnel (AP)?
A. A client who is 2 days postoperative following a total knee
arthroplasty and reports incisional pain of 6 on a 0-10 scale.
B. A client with type 1 diabetes mellitus who is scheduled for a
scheduled fingerstick blood glucose check before lunch.
C. A client who was admitted 3 hours ago with newly diagnosed heart
failure and is experiencing shortness of breath.
D. A client who is receiving continuous IV heparin infusion for deep
vein thrombosis and requires vital sign monitoring.
Rationale: Fingerstick blood glucose testing is within the scope of
practice for an assistive personnel (AP) who has received proper
training and competency verification. Assessing post-operative pain,
evaluating a newly admitted client with shortness of breath requiring
nursing judgment, and managing a client on continuous heparin
infusion requiring complex cardiovascular monitoring require
registered nurse (RN) assessment and clinical decision-making.
Correct Answer: B.
,Question 2 [Safety and Infection Control]
A nurse is caring for a client who has a diagnosis of active
pulmonary tuberculosis (TB) and is admitted to a negative-pressure
room. Which of the following personal protective equipment (PPE)
should the nurse don prior to entering the room?
A. Surgical mask
B. N95 respirator
C. Gown and face shield
D. Powered air-purifying respirator (PAPR) and sterile gloves
Rationale: Active pulmonary tuberculosis is transmitted via airborne
droplets requiring airborne precautions. Healthcare personnel must
don an N95 respirator (or higher-level particulate respirator) prior
to entering the client's room to prevent inhalation of mycobacterium
tuberculosis. Surgical masks do not filter small airborne droplet
nuclei. Gowns, gloves, and face shields are used for contact or
droplet precautions, or when splash/spray is anticipated. Correct
Answer: B.
Question 3 [Pharmacological and Parenteral Therapies]
A nurse is administering digoxin 0.25 mg PO daily to a client with
heart failure. Before administering the medication, which of the
following actions should the nurse take?
A. Check the client's radial pulse for 30 seconds and multiply by 2.
B. Auscultate the client's apical pulse for a full minute.
C. Measure the client's blood pressure while sitting and standing.
D. Assess the client's deep tendon reflexes.
, Rationale: When administering digoxin, the nurse must assess the
client's apical pulse for a full 60 seconds. If the pulse rate is less than
60/min in an adult client, the nurse should withhold the medication
and notify the provider. Measuring for a full minute ensures accuracy
in detecting bradycardia or arrhythmias, which are signs of digoxin
toxicity. Correct Answer: B.
Question 4 [Reduction of Risk Potential]
A nurse is caring for a client who is receiving a blood transfusion
(packed red blood cells). 15 minutes after the transfusion is initiated,
the client reports lower back pain, chills, and dyspnea. Which of the
following actions should the nurse take first?
A. Slow the rate of the blood transfusion.
B. Notify the primary healthcare provider immediately.
C. Stop the blood transfusion.
D. Administer diphenhydramine as prescribed.
Rationale: The client's symptoms (lower back pain, chills, dyspnea)
indicate an acute hemolytic transfusion reaction. According to the
nursing process and emergency transfusion protocols, the nurse's
first action is to immediately stop the transfusion and disconnect the
tubing, keeping the IV line open with 0.9% sodium chloride using new
tubing. Correct Answer: C.
Question 5 [Physiological Adaptation]
A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD) and is receiving oxygen via nasal
cannula at 2 L/min. The client reports increased shortness of breath.
Which of the following interventions should the nurse implement?
, A. Increase the oxygen flow rate to 5 L/min via nasal cannula.
B. Instruct the client in pursed-lip breathing techniques.
C. Place the client in a supine position.
D. Administer a rapid-acting opioid analgesic intravenously.
Rationale: Pursed-lip breathing helps clients with COPD prolong
exhalation, prevent airway collapse, and reduce air trapping, thereby
relieving shortness of breath. Increasing oxygen flow rate in COPD
clients can suppress the hypoxic respiratory drive, leading to carbon
dioxide retention and respiratory failure. Supine position worsens
dyspnea; upright or high-Fowler's position is indicated. Opioids
depress respiration and are contraindicated without careful provider
titration. Correct Answer: B.
Question 6 [Health Promotion and Maintenance]
A nurse in a prenatal clinic is providing education to a client who is
at 12 weeks of gestation regarding common discomforts of
pregnancy. Which of the following statements by the client indicates
an understanding of the teaching?
A. 'I should expect to experience severe headaches throughout my
second trimester.'
B. 'Experiencing urinary frequency is common during both the
first and third trimesters.'
C. 'Vaginal bleeding with cramping is a normal finding during weeks
12 to 14.'
D. 'I should restrict my fluid intake to prevent swelling in my ankles.'
Rationale: Urinary frequency is a common discomfort experienced
during the first trimester due to pressure from the enlarging uterus on
the bladder, and again in the third trimester as the presenting part
descends into the pelvis. Severe headaches can indicate gestational
Comprehensive Nursing Practice Exam (150
Questions)
Featuring 150 Clinical Judgment & NCLEX-Style Questions with
Detailed Rationales
Question 1 [Management of Care]
A charge nurse is planning client care assignments for a medical-
surgical unit. Which of the following clients should the nurse assign
to an assistive personnel (AP)?
A. A client who is 2 days postoperative following a total knee
arthroplasty and reports incisional pain of 6 on a 0-10 scale.
B. A client with type 1 diabetes mellitus who is scheduled for a
scheduled fingerstick blood glucose check before lunch.
C. A client who was admitted 3 hours ago with newly diagnosed heart
failure and is experiencing shortness of breath.
D. A client who is receiving continuous IV heparin infusion for deep
vein thrombosis and requires vital sign monitoring.
Rationale: Fingerstick blood glucose testing is within the scope of
practice for an assistive personnel (AP) who has received proper
training and competency verification. Assessing post-operative pain,
evaluating a newly admitted client with shortness of breath requiring
nursing judgment, and managing a client on continuous heparin
infusion requiring complex cardiovascular monitoring require
registered nurse (RN) assessment and clinical decision-making.
Correct Answer: B.
,Question 2 [Safety and Infection Control]
A nurse is caring for a client who has a diagnosis of active
pulmonary tuberculosis (TB) and is admitted to a negative-pressure
room. Which of the following personal protective equipment (PPE)
should the nurse don prior to entering the room?
A. Surgical mask
B. N95 respirator
C. Gown and face shield
D. Powered air-purifying respirator (PAPR) and sterile gloves
Rationale: Active pulmonary tuberculosis is transmitted via airborne
droplets requiring airborne precautions. Healthcare personnel must
don an N95 respirator (or higher-level particulate respirator) prior
to entering the client's room to prevent inhalation of mycobacterium
tuberculosis. Surgical masks do not filter small airborne droplet
nuclei. Gowns, gloves, and face shields are used for contact or
droplet precautions, or when splash/spray is anticipated. Correct
Answer: B.
Question 3 [Pharmacological and Parenteral Therapies]
A nurse is administering digoxin 0.25 mg PO daily to a client with
heart failure. Before administering the medication, which of the
following actions should the nurse take?
A. Check the client's radial pulse for 30 seconds and multiply by 2.
B. Auscultate the client's apical pulse for a full minute.
C. Measure the client's blood pressure while sitting and standing.
D. Assess the client's deep tendon reflexes.
, Rationale: When administering digoxin, the nurse must assess the
client's apical pulse for a full 60 seconds. If the pulse rate is less than
60/min in an adult client, the nurse should withhold the medication
and notify the provider. Measuring for a full minute ensures accuracy
in detecting bradycardia or arrhythmias, which are signs of digoxin
toxicity. Correct Answer: B.
Question 4 [Reduction of Risk Potential]
A nurse is caring for a client who is receiving a blood transfusion
(packed red blood cells). 15 minutes after the transfusion is initiated,
the client reports lower back pain, chills, and dyspnea. Which of the
following actions should the nurse take first?
A. Slow the rate of the blood transfusion.
B. Notify the primary healthcare provider immediately.
C. Stop the blood transfusion.
D. Administer diphenhydramine as prescribed.
Rationale: The client's symptoms (lower back pain, chills, dyspnea)
indicate an acute hemolytic transfusion reaction. According to the
nursing process and emergency transfusion protocols, the nurse's
first action is to immediately stop the transfusion and disconnect the
tubing, keeping the IV line open with 0.9% sodium chloride using new
tubing. Correct Answer: C.
Question 5 [Physiological Adaptation]
A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD) and is receiving oxygen via nasal
cannula at 2 L/min. The client reports increased shortness of breath.
Which of the following interventions should the nurse implement?
, A. Increase the oxygen flow rate to 5 L/min via nasal cannula.
B. Instruct the client in pursed-lip breathing techniques.
C. Place the client in a supine position.
D. Administer a rapid-acting opioid analgesic intravenously.
Rationale: Pursed-lip breathing helps clients with COPD prolong
exhalation, prevent airway collapse, and reduce air trapping, thereby
relieving shortness of breath. Increasing oxygen flow rate in COPD
clients can suppress the hypoxic respiratory drive, leading to carbon
dioxide retention and respiratory failure. Supine position worsens
dyspnea; upright or high-Fowler's position is indicated. Opioids
depress respiration and are contraindicated without careful provider
titration. Correct Answer: B.
Question 6 [Health Promotion and Maintenance]
A nurse in a prenatal clinic is providing education to a client who is
at 12 weeks of gestation regarding common discomforts of
pregnancy. Which of the following statements by the client indicates
an understanding of the teaching?
A. 'I should expect to experience severe headaches throughout my
second trimester.'
B. 'Experiencing urinary frequency is common during both the
first and third trimesters.'
C. 'Vaginal bleeding with cramping is a normal finding during weeks
12 to 14.'
D. 'I should restrict my fluid intake to prevent swelling in my ankles.'
Rationale: Urinary frequency is a common discomfort experienced
during the first trimester due to pressure from the enlarging uterus on
the bladder, and again in the third trimester as the presenting part
descends into the pelvis. Severe headaches can indicate gestational
