NCLEX-RN Predictor Exam 2025 Realistic Practice Tests with Answer
Explanations
Stuvia 5-Star Gold
May 2025
2025 NCLEX-RN Predictor Realistic Practice for Exam Mastery
This advanced NCLEX-RN predictor exam prepares you for the 2025 test with 30 realistic questions: 18 multiple-
choice (1 mark each, 18 marks), 6 select-all-that-apply (2 marks each, 12 marks), and 6 case-study-based (2 marks
each, 12 marks). Total: 42 marks. Detailed explanations and secret hints and helpers ensure Stuvia 5-star quality.
Aligns with NCSBNs 2025 test plan and NGN formats, emphasizing clinical judgment.
Key Concepts
Prioritize using ABCs and CJMM (Recognize Cues, Analyze, Prioritize, Evaluate). Memorize: SpO2 (95100
Section A: Multiple-Choice Questions (18 giene C) Notify the provider D) Administer a
marks) multivitamin
Secret Hint and Helper: Recall phenytoin side ef-
Answer all questions. Select the best answer. fects.
Correct Answer: C. Notify the provider.
1. A patient on vancomycin and gentamicin develops
Explanation: Gingival hyperplasia is a phenytoin
tinnitus. What is the priority action?
side effect; provider may adjust therapy. A, B, D)
A) Continue medications B) Check serum levels
These are insufficient or unrelated.
C) Administer an antiemetic D) Encourage fluids
Secret Hint and Helper: Consider ototoxicity risks. 5. A patient with OCD exhibits compulsive behaviors.
Correct Answer: B. Check serum levels. What is the best response?
Explanation: Tinnitus suggests aminoglycoside oto- A) Stop doing that. B) What triggers these ac-
toxicity; serum levels detect toxic gentamicin levels, tions? C) You need medication. D) Ignore the
per ISMP. A, C, D) Continuing, antiemetics, or flu- behavior
ids do not address toxicity. Secret Hint and Helper: Use therapeutic communi-
cation.
2. A patient with VRE is on contact precautions.
Correct Answer: B. What triggers these actions?
Which practice prevents transmission?
Explanation: Exploring triggers aids assessment
A) Using a surgical mask B) Dedicated equip-
and coping, per ANA. A, C, D) These are non-
ment C) N95 respirator D) Routine glove
therapeutic or premature.
changes
Secret Hint and Helper: Recall VRE precautions. 6. A patient with a new tracheostomy needs teaching.
Correct Answer: B. Dedicated equipment. What is the priority topic?
Explanation: Dedicated equipment prevents VRE A) Dietary changes B) Suctioning technique C)
spread, per CDC. A, C) Masks are for respiratory Speech therapy D) Activity limits
pathogens. D) Glove changes are standard but in- Secret Hint and Helper: Prioritize airway safety.
sufficient alone. Correct Answer: B. Suctioning technique.
Explanation: Suctioning maintains airway patency,
3. A patient with chest pain has ST elevation. What
per ATS guidelines. A, C, D) These are secondary
is the priority action?
to airway management.
A) Administer nitroglycerin B) Notify the cath
lab C) Obtain a 12-lead ECG D) Assess pain 7. A nurse administers TPN. Which finding indicates
scale a complication?
Secret Hint and Helper: Suspect STEMI protocol. A) Stable weight B) Blood glucose 250 mg/dL
Correct Answer: B. Notify the cath lab. C) Clear urine D) Normal BP
Explanation: ST elevation indicates STEMI; cath Secret Hint and Helper: Recall TPN metabolic
lab notification is urgent, per AHA. A, C, D) These risks.
are supportive or already confirmed. Correct Answer: B. Blood glucose 250 mg/dL.
Explanation: Hyperglycemia is a TPN complica-
4. A patient on phenytoin has gingival hyperplasia.
tion, requiring insulin adjustment. A, C, D) These
What is the nurses best action?
are normal or unrelated.
A) Continue the medication B) Teach oral hy-
1
Explanations
Stuvia 5-Star Gold
May 2025
2025 NCLEX-RN Predictor Realistic Practice for Exam Mastery
This advanced NCLEX-RN predictor exam prepares you for the 2025 test with 30 realistic questions: 18 multiple-
choice (1 mark each, 18 marks), 6 select-all-that-apply (2 marks each, 12 marks), and 6 case-study-based (2 marks
each, 12 marks). Total: 42 marks. Detailed explanations and secret hints and helpers ensure Stuvia 5-star quality.
Aligns with NCSBNs 2025 test plan and NGN formats, emphasizing clinical judgment.
Key Concepts
Prioritize using ABCs and CJMM (Recognize Cues, Analyze, Prioritize, Evaluate). Memorize: SpO2 (95100
Section A: Multiple-Choice Questions (18 giene C) Notify the provider D) Administer a
marks) multivitamin
Secret Hint and Helper: Recall phenytoin side ef-
Answer all questions. Select the best answer. fects.
Correct Answer: C. Notify the provider.
1. A patient on vancomycin and gentamicin develops
Explanation: Gingival hyperplasia is a phenytoin
tinnitus. What is the priority action?
side effect; provider may adjust therapy. A, B, D)
A) Continue medications B) Check serum levels
These are insufficient or unrelated.
C) Administer an antiemetic D) Encourage fluids
Secret Hint and Helper: Consider ototoxicity risks. 5. A patient with OCD exhibits compulsive behaviors.
Correct Answer: B. Check serum levels. What is the best response?
Explanation: Tinnitus suggests aminoglycoside oto- A) Stop doing that. B) What triggers these ac-
toxicity; serum levels detect toxic gentamicin levels, tions? C) You need medication. D) Ignore the
per ISMP. A, C, D) Continuing, antiemetics, or flu- behavior
ids do not address toxicity. Secret Hint and Helper: Use therapeutic communi-
cation.
2. A patient with VRE is on contact precautions.
Correct Answer: B. What triggers these actions?
Which practice prevents transmission?
Explanation: Exploring triggers aids assessment
A) Using a surgical mask B) Dedicated equip-
and coping, per ANA. A, C, D) These are non-
ment C) N95 respirator D) Routine glove
therapeutic or premature.
changes
Secret Hint and Helper: Recall VRE precautions. 6. A patient with a new tracheostomy needs teaching.
Correct Answer: B. Dedicated equipment. What is the priority topic?
Explanation: Dedicated equipment prevents VRE A) Dietary changes B) Suctioning technique C)
spread, per CDC. A, C) Masks are for respiratory Speech therapy D) Activity limits
pathogens. D) Glove changes are standard but in- Secret Hint and Helper: Prioritize airway safety.
sufficient alone. Correct Answer: B. Suctioning technique.
Explanation: Suctioning maintains airway patency,
3. A patient with chest pain has ST elevation. What
per ATS guidelines. A, C, D) These are secondary
is the priority action?
to airway management.
A) Administer nitroglycerin B) Notify the cath
lab C) Obtain a 12-lead ECG D) Assess pain 7. A nurse administers TPN. Which finding indicates
scale a complication?
Secret Hint and Helper: Suspect STEMI protocol. A) Stable weight B) Blood glucose 250 mg/dL
Correct Answer: B. Notify the cath lab. C) Clear urine D) Normal BP
Explanation: ST elevation indicates STEMI; cath Secret Hint and Helper: Recall TPN metabolic
lab notification is urgent, per AHA. A, C, D) These risks.
are supportive or already confirmed. Correct Answer: B. Blood glucose 250 mg/dL.
Explanation: Hyperglycemia is a TPN complica-
4. A patient on phenytoin has gingival hyperplasia.
tion, requiring insulin adjustment. A, C, D) These
What is the nurses best action?
are normal or unrelated.
A) Continue the medication B) Teach oral hy-
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