Kaplan Predictor Exam (Versions A, B & C)
2026: Complete NGN Real Questions with
Verified Answers & Detailed Rationales
Section 1: Priority & Clinical Judgment (Questions 1-20)
Q1: A nurse is caring for a client who reports sudden, sharp chest pain that
increases with inspiration. The client is restless and has an SpO₂ of 89% on room
air. Which action should the nurse take first?
A. Administer oxygen at 2 L/min via nasal cannula
B. Position the client in high-Fowler’s position
C. Assess lung sounds
D. Notify the provider immediately
A1: B. Position the client in high-Fowler’s position
Rationale: High-Fowler’s position maximizes lung expansion and oxygenation.
While oxygen administration is important, positioning is a non-invasive,
immediate action that can improve breathing. Airway and breathing are the
priority.
Q2: A client with a history of seizures begins to have a generalized tonic-clonic
seizure. What is the nurse’s priority action?
A. Restrain the client’s limbs to prevent injury
B. Insert a padded tongue blade
C. Lower the client to the floor and protect the head
D. Administer IV lorazepam immediately
A2: C. Lower the client to the floor and protect the head
Rationale: The priority during a seizure is to prevent injury. The nurse should ease
the client to the floor, clear the area, and protect the head. Never restrain or
insert anything into the mouth.
,Q3: A postoperative client’s vital signs are: BP 88/50, HR 120, RR 24. The surgical
incision site has moderate serosanguineous drainage. What is the nurse’s priority
action?
A. Document the findings
B. Increase the IV fluid rate
C. Notify the healthcare provider
D. Apply pressure to the incision site
A3: C. Notify the healthcare provider
Rationale: The client is showing signs of hypovolemic shock (hypotension,
tachycardia). Notification is essential for rapid intervention. Increasing IV fluids
may be ordered, but the provider must be notified first.
Q4: A client who is 2 days post-mastectomy has a Jackson-Pratt drain in place. The
nurse notes that the drain is not compressed and the bulb is fully expanded.
Which action should the nurse take?
A. Remove the drain
B. Compress the bulb to re-establish suction
C. Irrigate the drain with normal saline
D. Document the finding as normal
A4: B. Compress the bulb to re-establish suction
Rationale: A Jackson-Pratt drain functions by suction created when the bulb is
compressed. If expanded, suction is lost. The nurse should compress the bulb to
restore function.
Q5: A nurse is assessing a client receiving a blood transfusion. Fifteen minutes
after initiation, the client reports low back pain and chills. What is the priority
action?
A. Slow the infusion rate
B. Administer acetaminophen
C. Stop the transfusion
D. Notify the blood bank
,A5: C. Stop the transfusion
Rationale: Low back pain and chills are signs of a hemolytic transfusion reaction.
The transfusion must be stopped immediately to prevent further complications.
Q6: A client with a tracheostomy tube has a sudden onset of respiratory distress.
The nurse attempts to pass a suction catheter but cannot advance it. What should
the nurse do first?
A. Hyperoxygenate the client
B. Deflate the cuff
C. Remove the inner cannula
D. Call a rapid response team
A6: C. Remove the inner cannula
Rationale: A blocked inner cannula is a common cause of obstruction. Removing
it may immediately restore airway patency. After removal, the nurse can attempt
to suction the outer cannula.
Q7: A client is receiving continuous enteral feedings via nasogastric tube. The
nurse checks the residual and obtains 350 mL. What is the appropriate action?
A. Discard the residual and continue the feeding
B. Hold the feeding and notify the provider
C. Return the residual and continue the feeding
D. Flush the tube with 50 mL of water
A7: C. Return the residual and continue the feeding
Rationale: Returning residual prevents electrolyte loss. Holding feeding is typically
indicated for residuals >500 mL or other signs of intolerance. 350 mL alone does
not require holding unless facility protocol states otherwise.
Q8: A client with a history of falls is admitted. Which intervention is most
effective to prevent falls?
A. Raise all four side rails
B. Place the bed in the lowest position
, C. Apply a wrist restraint at night
D. Keep the call light out of reach to prevent confusion
A8: B. Place the bed in the lowest position
Rationale: Low beds reduce injury risk if the client attempts to get out unassisted.
Side rails should not be fully raised unless ordered as restraints. Call light must be
within reach.
Q9: A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires withholding the medication?
A. Heart rate 58 bpm
B. Blood pressure 110/70
C. Respiratory rate 18
D. Serum potassium 4.0 mEq/L
A9: A. Heart rate 58 bpm
Rationale: Digoxin is held for adults if the apical pulse is <60 bpm (or <70 in
children). Bradycardia increases the risk of digoxin toxicity.
Q10: A client with diabetes mellitus is found unconscious. Which action should
the nurse take first?
A. Administer glucagon IM
B. Check blood glucose level
C. Administer IV dextrose
D. Provide orange juice
A10: B. Check blood glucose level
Rationale: The nurse must first confirm hypoglycemia or hyperglycemia before
administering treatment. Unconscious clients should not receive oral fluids.
Q11: A nurse is caring for a client with a chest tube. The drainage system is
accidentally knocked over and cracks. What is the priority action?
A. Clamp the chest tube
B. Place the end of the tube in sterile water
2026: Complete NGN Real Questions with
Verified Answers & Detailed Rationales
Section 1: Priority & Clinical Judgment (Questions 1-20)
Q1: A nurse is caring for a client who reports sudden, sharp chest pain that
increases with inspiration. The client is restless and has an SpO₂ of 89% on room
air. Which action should the nurse take first?
A. Administer oxygen at 2 L/min via nasal cannula
B. Position the client in high-Fowler’s position
C. Assess lung sounds
D. Notify the provider immediately
A1: B. Position the client in high-Fowler’s position
Rationale: High-Fowler’s position maximizes lung expansion and oxygenation.
While oxygen administration is important, positioning is a non-invasive,
immediate action that can improve breathing. Airway and breathing are the
priority.
Q2: A client with a history of seizures begins to have a generalized tonic-clonic
seizure. What is the nurse’s priority action?
A. Restrain the client’s limbs to prevent injury
B. Insert a padded tongue blade
C. Lower the client to the floor and protect the head
D. Administer IV lorazepam immediately
A2: C. Lower the client to the floor and protect the head
Rationale: The priority during a seizure is to prevent injury. The nurse should ease
the client to the floor, clear the area, and protect the head. Never restrain or
insert anything into the mouth.
,Q3: A postoperative client’s vital signs are: BP 88/50, HR 120, RR 24. The surgical
incision site has moderate serosanguineous drainage. What is the nurse’s priority
action?
A. Document the findings
B. Increase the IV fluid rate
C. Notify the healthcare provider
D. Apply pressure to the incision site
A3: C. Notify the healthcare provider
Rationale: The client is showing signs of hypovolemic shock (hypotension,
tachycardia). Notification is essential for rapid intervention. Increasing IV fluids
may be ordered, but the provider must be notified first.
Q4: A client who is 2 days post-mastectomy has a Jackson-Pratt drain in place. The
nurse notes that the drain is not compressed and the bulb is fully expanded.
Which action should the nurse take?
A. Remove the drain
B. Compress the bulb to re-establish suction
C. Irrigate the drain with normal saline
D. Document the finding as normal
A4: B. Compress the bulb to re-establish suction
Rationale: A Jackson-Pratt drain functions by suction created when the bulb is
compressed. If expanded, suction is lost. The nurse should compress the bulb to
restore function.
Q5: A nurse is assessing a client receiving a blood transfusion. Fifteen minutes
after initiation, the client reports low back pain and chills. What is the priority
action?
A. Slow the infusion rate
B. Administer acetaminophen
C. Stop the transfusion
D. Notify the blood bank
,A5: C. Stop the transfusion
Rationale: Low back pain and chills are signs of a hemolytic transfusion reaction.
The transfusion must be stopped immediately to prevent further complications.
Q6: A client with a tracheostomy tube has a sudden onset of respiratory distress.
The nurse attempts to pass a suction catheter but cannot advance it. What should
the nurse do first?
A. Hyperoxygenate the client
B. Deflate the cuff
C. Remove the inner cannula
D. Call a rapid response team
A6: C. Remove the inner cannula
Rationale: A blocked inner cannula is a common cause of obstruction. Removing
it may immediately restore airway patency. After removal, the nurse can attempt
to suction the outer cannula.
Q7: A client is receiving continuous enteral feedings via nasogastric tube. The
nurse checks the residual and obtains 350 mL. What is the appropriate action?
A. Discard the residual and continue the feeding
B. Hold the feeding and notify the provider
C. Return the residual and continue the feeding
D. Flush the tube with 50 mL of water
A7: C. Return the residual and continue the feeding
Rationale: Returning residual prevents electrolyte loss. Holding feeding is typically
indicated for residuals >500 mL or other signs of intolerance. 350 mL alone does
not require holding unless facility protocol states otherwise.
Q8: A client with a history of falls is admitted. Which intervention is most
effective to prevent falls?
A. Raise all four side rails
B. Place the bed in the lowest position
, C. Apply a wrist restraint at night
D. Keep the call light out of reach to prevent confusion
A8: B. Place the bed in the lowest position
Rationale: Low beds reduce injury risk if the client attempts to get out unassisted.
Side rails should not be fully raised unless ordered as restraints. Call light must be
within reach.
Q9: A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires withholding the medication?
A. Heart rate 58 bpm
B. Blood pressure 110/70
C. Respiratory rate 18
D. Serum potassium 4.0 mEq/L
A9: A. Heart rate 58 bpm
Rationale: Digoxin is held for adults if the apical pulse is <60 bpm (or <70 in
children). Bradycardia increases the risk of digoxin toxicity.
Q10: A client with diabetes mellitus is found unconscious. Which action should
the nurse take first?
A. Administer glucagon IM
B. Check blood glucose level
C. Administer IV dextrose
D. Provide orange juice
A10: B. Check blood glucose level
Rationale: The nurse must first confirm hypoglycemia or hyperglycemia before
administering treatment. Unconscious clients should not receive oral fluids.
Q11: A nurse is caring for a client with a chest tube. The drainage system is
accidentally knocked over and cracks. What is the priority action?
A. Clamp the chest tube
B. Place the end of the tube in sterile water
