NCLEX-RN Readiness and Comprehensive Review 2026 |Chamberlain
College
1. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate for the nurse to delegate?
A. Performing a sterile dressing change on a post-operative wound
B. Evaluating the effectiveness of pain medication administered 30 minutes ago
C. Assisting a stable patient with ambulation for the first time post-surgery
D. Measuring and recording vital signs for a client who is hemodynamically stable
Answer: D
Rationale: The UAP’s scope of practice includes routine tasks such as taking vital signs on
stable patients. Dressing changes, evaluations, and first-time ambulations require nursing
judgment.
2. A client is admitted with a diagnosis of Tuberculosis (TB). Which type of
isolation precautions should the nurse implement?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective environment
Answer: C
Rationale: TB is transmitted via small droplets that remain suspended in the air; therefore,
airborne precautions, including a private negative-pressure room and N95 respirator, are
required.
,3. A nurse is caring for a client with a potassium level of 3.2 mEq/L. Which of the
following assessment findings is most consistent with this lab value?
A. T-wave peaking on the EKG
B. Hyperactive bowel sounds
C. Muscle weakness and leg cramps
D. Positive Trousseau sign
Answer: C
Rationale: Hypokalemia (potassium < 3.5 mEq/L) commonly causes muscle weakness,
cramps, and cardiac arrhythmias (U-waves). Peaked T-waves are associated with
hyperkalemia.
4. The nurse is preparing to administer Digoxin to a client. Which of the
following findings would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Apical heart rate of 52 beats per minute
C. Potassium level of 5.2 mEq/L
D. Respiratory rate of 22 breaths per minute
Answer: B
Rationale: Digoxin should be held if the apical pulse is less than 60 bpm in adults because
it slows the heart rate (negative chronotropic effect).
5. A client in the third trimester of pregnancy is receiving Magnesium Sulfate for
preeclampsia. The nurse notes absent deep tendon reflexes (DTRs). What is the
priority action?
A. Increase the infusion rate to prevent seizures
B. Notify the provider and continue monitoring
C. Check the client’s blood pressure immediately
D. Stop the infusion and prepare to administer Calcium Gluconate
Answer: D
, Rationale: Absent DTRs are a sign of magnesium toxicity. The infusion must be stopped,
and the antidote, calcium gluconate, should be available.
6. A nurse is reviewing a client’s arterial blood gas (ABG) results: pH 7.30, PaCO2
50 mmHg, and HCO3 24 mEq/L. The nurse interprets these results as:
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Rationale: The low pH (<7.35) indicates acidosis. The high PaCO2 (>45 mmHg) indicates a
respiratory cause, while the normal HCO3 indicates no compensation yet.
7. A nurse is caring for a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. How should the nurse interpret this
finding?
A. This is a normal finding during the expiratory phase
B. The chest tube is functioning correctly and removing air
C. There is an air leak in the drainage system
D. The lung has fully re-expanded
Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling is normal during coughing or exhalation if there is a pneumothorax.
College
1. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which
task is appropriate for the nurse to delegate?
A. Performing a sterile dressing change on a post-operative wound
B. Evaluating the effectiveness of pain medication administered 30 minutes ago
C. Assisting a stable patient with ambulation for the first time post-surgery
D. Measuring and recording vital signs for a client who is hemodynamically stable
Answer: D
Rationale: The UAP’s scope of practice includes routine tasks such as taking vital signs on
stable patients. Dressing changes, evaluations, and first-time ambulations require nursing
judgment.
2. A client is admitted with a diagnosis of Tuberculosis (TB). Which type of
isolation precautions should the nurse implement?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective environment
Answer: C
Rationale: TB is transmitted via small droplets that remain suspended in the air; therefore,
airborne precautions, including a private negative-pressure room and N95 respirator, are
required.
,3. A nurse is caring for a client with a potassium level of 3.2 mEq/L. Which of the
following assessment findings is most consistent with this lab value?
A. T-wave peaking on the EKG
B. Hyperactive bowel sounds
C. Muscle weakness and leg cramps
D. Positive Trousseau sign
Answer: C
Rationale: Hypokalemia (potassium < 3.5 mEq/L) commonly causes muscle weakness,
cramps, and cardiac arrhythmias (U-waves). Peaked T-waves are associated with
hyperkalemia.
4. The nurse is preparing to administer Digoxin to a client. Which of the
following findings would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Apical heart rate of 52 beats per minute
C. Potassium level of 5.2 mEq/L
D. Respiratory rate of 22 breaths per minute
Answer: B
Rationale: Digoxin should be held if the apical pulse is less than 60 bpm in adults because
it slows the heart rate (negative chronotropic effect).
5. A client in the third trimester of pregnancy is receiving Magnesium Sulfate for
preeclampsia. The nurse notes absent deep tendon reflexes (DTRs). What is the
priority action?
A. Increase the infusion rate to prevent seizures
B. Notify the provider and continue monitoring
C. Check the client’s blood pressure immediately
D. Stop the infusion and prepare to administer Calcium Gluconate
Answer: D
, Rationale: Absent DTRs are a sign of magnesium toxicity. The infusion must be stopped,
and the antidote, calcium gluconate, should be available.
6. A nurse is reviewing a client’s arterial blood gas (ABG) results: pH 7.30, PaCO2
50 mmHg, and HCO3 24 mEq/L. The nurse interprets these results as:
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
Answer: B
Rationale: The low pH (<7.35) indicates acidosis. The high PaCO2 (>45 mmHg) indicates a
respiratory cause, while the normal HCO3 indicates no compensation yet.
7. A nurse is caring for a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. How should the nurse interpret this
finding?
A. This is a normal finding during the expiratory phase
B. The chest tube is functioning correctly and removing air
C. There is an air leak in the drainage system
D. The lung has fully re-expanded
Answer: C
Rationale: Continuous bubbling in the water seal chamber indicates an air leak.
Intermittent bubbling is normal during coughing or exhalation if there is a pneumothorax.
