NCLEX-RN PRACTICE QUESTIONS AND RATIONALES 2026
1. A nurse is caring for a client with acute kidney injury. Which laboratory value
requires immediate notification of the provider?
A. Serum potassium 5.1 mEq/L
B. Serum potassium 6.2 mEq/L
C. Serum sodium 135 mEq/L
D. Serum creatinine 1.2 mg/dL
Correct answer: B
Rationale: Hyperkalemia >5.0 mEq/L can cause life‑threatening dysrhythmias. 6.2 is
critically high and requires immediate intervention.
2. A client post‑op day 1 reports sudden chest pain and dyspnea. O2 saturation
88%. What is the priority action?
A. Obtain a stat ECG
B. Apply oxygen and notify rapid response team
C. Administer morphine IV
D. Elevate the head of bed to 30 degrees
Correct answer: B
Rationale: Suspected pulmonary embolism requires immediate oxygenation and
advanced evaluation. Oxygen and rapid response are the first steps.
, 3. Which finding indicates effective treatment for diabetic ketoacidosis (DKA)?
A. Serum glucose 250 mg/dL
B. Serum bicarbonate increasing toward 22 mEq/L
C. Serum potassium 3.0 mEq/L
D. Urine output 20 mL/hr
Correct answer: B
Rationale: Rising bicarbonate indicates resolution of metabolic acidosis. Glucose may
still be elevated; hypokalemia and low urine output are complications.
4. A nurse delegates vital signs to an LPN. Which client should the LPN assess
first?
A. Client with new‑onset confusion and hypotension
B. Client requesting pain medication
C. Client ready for discharge teaching
D. Client with a scheduled dressing change
Correct answer: A
Rationale: Unstable clients require RN assessment. Confusion + hypotension suggests
deterioration; delegation must match stability.
1. A nurse is caring for a client with acute kidney injury. Which laboratory value
requires immediate notification of the provider?
A. Serum potassium 5.1 mEq/L
B. Serum potassium 6.2 mEq/L
C. Serum sodium 135 mEq/L
D. Serum creatinine 1.2 mg/dL
Correct answer: B
Rationale: Hyperkalemia >5.0 mEq/L can cause life‑threatening dysrhythmias. 6.2 is
critically high and requires immediate intervention.
2. A client post‑op day 1 reports sudden chest pain and dyspnea. O2 saturation
88%. What is the priority action?
A. Obtain a stat ECG
B. Apply oxygen and notify rapid response team
C. Administer morphine IV
D. Elevate the head of bed to 30 degrees
Correct answer: B
Rationale: Suspected pulmonary embolism requires immediate oxygenation and
advanced evaluation. Oxygen and rapid response are the first steps.
, 3. Which finding indicates effective treatment for diabetic ketoacidosis (DKA)?
A. Serum glucose 250 mg/dL
B. Serum bicarbonate increasing toward 22 mEq/L
C. Serum potassium 3.0 mEq/L
D. Urine output 20 mL/hr
Correct answer: B
Rationale: Rising bicarbonate indicates resolution of metabolic acidosis. Glucose may
still be elevated; hypokalemia and low urine output are complications.
4. A nurse delegates vital signs to an LPN. Which client should the LPN assess
first?
A. Client with new‑onset confusion and hypotension
B. Client requesting pain medication
C. Client ready for discharge teaching
D. Client with a scheduled dressing change
Correct answer: A
Rationale: Unstable clients require RN assessment. Confusion + hypotension suggests
deterioration; delegation must match stability.
