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RN COMPREHENSIVE ONLINE PRACTICE
2026 B WITH NGN REAL EXAM REVIEW –
250 QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES RN COMPREHENSIVE
PREDICTOR PRACTICE EXAM
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1–30)
1. A nurse is caring for a client who has a new diagnosis of methicillin-
resistant Staphylococcus aureus (MRSA) in a wound. Which of the following actions
should the nurse take?
A) Place the client in a room with a client who has MRSA
B) Remove gloves first when removing PPE
C) Wear an N95 respirator during wound care
D) Use a dedicated stethoscope that remains in the room
Answer: D
Rationale: A dedicated stethoscope that remains in the room reduces transmission of
MRSA to other clients. Contact precautions (gloves, gown) are required, not airborne
precautions (N95). Gloves are removed last (contaminated), not first.
2. A charge nurse is observing a newly licensed nurse perform a sterile dressing change.
Which action requires intervention?
A) Opens the sterile drape away from the body
B) Places the sterile field at waist level
C) Holds the sterile gauze with sterile forceps
D) Pours sterile solution onto the field from a height of 10 cm (4 in)
Answer: D
*Rationale: Sterile solution should be poured from a height of 4-6 inches (10-15 cm) to
prevent splashing onto the sterile field. 10 cm is acceptable. The issue may be that the
question implies a pour height of 10 cm is wrong? Actually, 4-6 inches = 10-15 cm. Wait —
check: 4 inches = 10 cm correct. However, common NCLEX error: pouring from too low
(touches edge) or too high (splashes). The correct action is ✅. But if the question intends
to test a wrong action: if the nurse pours from a height of 10 cm that is actually correct.
Many NCLEX questions use wrong heights like 2 in or 12 in. Given standard teaching: 4-6
,2|Page
inches (10-15 cm). So D is likely correct. But if they say 10 cm = correct. If the question
says "which requires intervention" and D says 10 cm — that is correct, not wrong. Possibly
a trick. To align with NCLEX: pouring from too low (touching edge) is wrong; pouring
from too high (splashes) is wrong. 10 cm is fine. I will adjust: A common wrong action is
pouring solution while holding the bottle directly over the field (drops fall). But here,
none of these are clearly wrong except possibly if the nurse pours without removing the
cap properly. Given standard Answer: The correct intervention is when the nurse pours
from a height of 2 inches — not listed. So in this set, the wrong action is: opens drape
away from body? No, that is correct. Places field at waist? Correct. Holds gauze with
forceps? Correct. So none are wrong — not possible. Let me redesign this item for
accuracy.
Revised 2: A nurse is setting up a sterile field. Which action indicates a break in sterile
technique?
A) Opens the sterile drape away from the body
B) Places the sterile field at waist level
C) Holds sterile gauze with sterile forceps
D) Reaches across the sterile field to obtain an item
Answer: D
Rationale: Reaching across the sterile field contaminates it. The nurse should walk around
the field. Opening away, waist level, and using forceps are correct.
3. A nurse is providing discharge instructions to a client who has a new colostomy. Which
statement by the client indicates understanding?
A) "I will change the pouch whenever it becomes one-third full."
B) "I will apply stoma adhesive paste directly to the stoma."
C) "I will cut the flange opening to the exact size of the stoma."
D) "I will empty the pouch when it is completely full."
Answer: C
*Rationale: The flange opening should be cut to the exact size of the stoma to prevent
skin breakdown. Pouch should be emptied when 1/3 to 1/2 full. Adhesive paste goes on
the skin, not stoma.*
4. A nurse is preparing to administer a blood transfusion. Which IV solution should be
used as a compatible fluid?
A) Lactated Ringer's
B) 5% dextrose in water (D5W)
C) 0.9% sodium chloride (normal saline)
D) 0.45% sodium chloride (half normal saline)
,3|Page
Answer: C
Rationale: Normal saline (0.9% NaCl) is the only compatible IV solution for blood
transfusions. Dextrose solutions can cause hemolysis; hypotonic and LR solutions can
cause clotting or hemolysis.
5. A nurse is caring for a client who has a chest tube following a thoracotomy. The chest
tube accidentally disconnects from the drainage system. What should the nurse do first?
A) Clamp the chest tube
B) Place the end of the tube in sterile water
C) Apply an occlusive dressing over the insertion site
D) Reconnect the tube to the drainage system
Answer: B
Rationale: The priority is to prevent air from entering the pleural space. Placing the end
of the tube in sterile water creates a water seal. Clamping can cause tension
pneumothorax.
6. A nurse is caring for a client who has a nasogastric (NG) tube set to low intermittent
suction. The nurse assesses the tube and notes it is not draining. Which action should the
nurse take first?
A) Irrigate the tube with 30 mL of sterile water
B) Reposition the client
C) Notify the provider
D) Check the suction device and tubing connections
Answer: D
Rationale: The nurse should first check equipment (suction device, connections, tubing)
for malfunction before repositioning or irrigating. Notify provider after assessment.
7. A charge nurse is observing a nurse prepare a client for an indwelling urinary catheter
insertion. Which action requires intervention?
A) The nurse places the sterile drape on the overbed table
B) The nurse opens the catheter kit on the clean bedside table
C) The nurse uses clean gloves to perform perineal cleaning before sterile gloving
D) The nurse attaches the collection bag to the bed frame below the level of the bladder
Answer: A
Rationale: The sterile drape should be placed on the client's perineal area, not the
overbed table. The overbed table is for the sterile field. The other actions are correct.
8. A nurse is caring for a client on fall precautions. Which nursing action is most
important?
, 4|Page
A) Keep the call light within reach
B) Raise all four side rails
C) Place the bed in the lowest position
D) Lock the wheels of the bed
Answer: C
Rationale: Placing the bed in the lowest position reduces fall risk if the client attempts to
get out of bed. Side rails can be a restraint; only raise if indicated.
9. A nurse is preparing to administer enoxaparin (Lovenox) subcutaneously. Which action
is correct?
A) Aspirate before injection
B) Massage the injection site after administration
C) Administer in the abdomen while pinching a skin fold
D) Expel the air bubble from the prefilled syringe before injection
Answer: C
Rationale: Enoxaparin is given subcutaneously in the abdomen (pinched skin fold). Do
not aspirate, do not massage (risk of bruising/hematoma), do not expel the air bubble (it
ensures full dose).
10. A nurse is caring for a client who has a new tracheostomy. Which action should the
nurse take when providing tracheostomy care?
A) Use sterile technique when suctioning
B) Replace the inner cannula every 24 hours
C) Clean the stoma with alcohol-based wipes
D) Change the tracheostomy ties only when soiled
Answer: A
*Rationale: Sterile technique is required for suctioning. Inner cannula is cleaned more
often (8-12 hours). Alcohol dries skin. Tracheostomy ties are changed when soiled or wet,
not only when soiled.*
11. A nurse is preparing to transfer a client from the bed to a stretcher. Which action by
the nurse indicates correct body mechanics?
A) Places feet together before lifting
B) Keeps the back straight and knees bent
C) Twists at the waist while moving the client
D) Positions the stretcher at knee level
RN COMPREHENSIVE ONLINE PRACTICE
2026 B WITH NGN REAL EXAM REVIEW –
250 QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES RN COMPREHENSIVE
PREDICTOR PRACTICE EXAM
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1–30)
1. A nurse is caring for a client who has a new diagnosis of methicillin-
resistant Staphylococcus aureus (MRSA) in a wound. Which of the following actions
should the nurse take?
A) Place the client in a room with a client who has MRSA
B) Remove gloves first when removing PPE
C) Wear an N95 respirator during wound care
D) Use a dedicated stethoscope that remains in the room
Answer: D
Rationale: A dedicated stethoscope that remains in the room reduces transmission of
MRSA to other clients. Contact precautions (gloves, gown) are required, not airborne
precautions (N95). Gloves are removed last (contaminated), not first.
2. A charge nurse is observing a newly licensed nurse perform a sterile dressing change.
Which action requires intervention?
A) Opens the sterile drape away from the body
B) Places the sterile field at waist level
C) Holds the sterile gauze with sterile forceps
D) Pours sterile solution onto the field from a height of 10 cm (4 in)
Answer: D
*Rationale: Sterile solution should be poured from a height of 4-6 inches (10-15 cm) to
prevent splashing onto the sterile field. 10 cm is acceptable. The issue may be that the
question implies a pour height of 10 cm is wrong? Actually, 4-6 inches = 10-15 cm. Wait —
check: 4 inches = 10 cm correct. However, common NCLEX error: pouring from too low
(touches edge) or too high (splashes). The correct action is ✅. But if the question intends
to test a wrong action: if the nurse pours from a height of 10 cm that is actually correct.
Many NCLEX questions use wrong heights like 2 in or 12 in. Given standard teaching: 4-6
,2|Page
inches (10-15 cm). So D is likely correct. But if they say 10 cm = correct. If the question
says "which requires intervention" and D says 10 cm — that is correct, not wrong. Possibly
a trick. To align with NCLEX: pouring from too low (touching edge) is wrong; pouring
from too high (splashes) is wrong. 10 cm is fine. I will adjust: A common wrong action is
pouring solution while holding the bottle directly over the field (drops fall). But here,
none of these are clearly wrong except possibly if the nurse pours without removing the
cap properly. Given standard Answer: The correct intervention is when the nurse pours
from a height of 2 inches — not listed. So in this set, the wrong action is: opens drape
away from body? No, that is correct. Places field at waist? Correct. Holds gauze with
forceps? Correct. So none are wrong — not possible. Let me redesign this item for
accuracy.
Revised 2: A nurse is setting up a sterile field. Which action indicates a break in sterile
technique?
A) Opens the sterile drape away from the body
B) Places the sterile field at waist level
C) Holds sterile gauze with sterile forceps
D) Reaches across the sterile field to obtain an item
Answer: D
Rationale: Reaching across the sterile field contaminates it. The nurse should walk around
the field. Opening away, waist level, and using forceps are correct.
3. A nurse is providing discharge instructions to a client who has a new colostomy. Which
statement by the client indicates understanding?
A) "I will change the pouch whenever it becomes one-third full."
B) "I will apply stoma adhesive paste directly to the stoma."
C) "I will cut the flange opening to the exact size of the stoma."
D) "I will empty the pouch when it is completely full."
Answer: C
*Rationale: The flange opening should be cut to the exact size of the stoma to prevent
skin breakdown. Pouch should be emptied when 1/3 to 1/2 full. Adhesive paste goes on
the skin, not stoma.*
4. A nurse is preparing to administer a blood transfusion. Which IV solution should be
used as a compatible fluid?
A) Lactated Ringer's
B) 5% dextrose in water (D5W)
C) 0.9% sodium chloride (normal saline)
D) 0.45% sodium chloride (half normal saline)
,3|Page
Answer: C
Rationale: Normal saline (0.9% NaCl) is the only compatible IV solution for blood
transfusions. Dextrose solutions can cause hemolysis; hypotonic and LR solutions can
cause clotting or hemolysis.
5. A nurse is caring for a client who has a chest tube following a thoracotomy. The chest
tube accidentally disconnects from the drainage system. What should the nurse do first?
A) Clamp the chest tube
B) Place the end of the tube in sterile water
C) Apply an occlusive dressing over the insertion site
D) Reconnect the tube to the drainage system
Answer: B
Rationale: The priority is to prevent air from entering the pleural space. Placing the end
of the tube in sterile water creates a water seal. Clamping can cause tension
pneumothorax.
6. A nurse is caring for a client who has a nasogastric (NG) tube set to low intermittent
suction. The nurse assesses the tube and notes it is not draining. Which action should the
nurse take first?
A) Irrigate the tube with 30 mL of sterile water
B) Reposition the client
C) Notify the provider
D) Check the suction device and tubing connections
Answer: D
Rationale: The nurse should first check equipment (suction device, connections, tubing)
for malfunction before repositioning or irrigating. Notify provider after assessment.
7. A charge nurse is observing a nurse prepare a client for an indwelling urinary catheter
insertion. Which action requires intervention?
A) The nurse places the sterile drape on the overbed table
B) The nurse opens the catheter kit on the clean bedside table
C) The nurse uses clean gloves to perform perineal cleaning before sterile gloving
D) The nurse attaches the collection bag to the bed frame below the level of the bladder
Answer: A
Rationale: The sterile drape should be placed on the client's perineal area, not the
overbed table. The overbed table is for the sterile field. The other actions are correct.
8. A nurse is caring for a client on fall precautions. Which nursing action is most
important?
, 4|Page
A) Keep the call light within reach
B) Raise all four side rails
C) Place the bed in the lowest position
D) Lock the wheels of the bed
Answer: C
Rationale: Placing the bed in the lowest position reduces fall risk if the client attempts to
get out of bed. Side rails can be a restraint; only raise if indicated.
9. A nurse is preparing to administer enoxaparin (Lovenox) subcutaneously. Which action
is correct?
A) Aspirate before injection
B) Massage the injection site after administration
C) Administer in the abdomen while pinching a skin fold
D) Expel the air bubble from the prefilled syringe before injection
Answer: C
Rationale: Enoxaparin is given subcutaneously in the abdomen (pinched skin fold). Do
not aspirate, do not massage (risk of bruising/hematoma), do not expel the air bubble (it
ensures full dose).
10. A nurse is caring for a client who has a new tracheostomy. Which action should the
nurse take when providing tracheostomy care?
A) Use sterile technique when suctioning
B) Replace the inner cannula every 24 hours
C) Clean the stoma with alcohol-based wipes
D) Change the tracheostomy ties only when soiled
Answer: A
*Rationale: Sterile technique is required for suctioning. Inner cannula is cleaned more
often (8-12 hours). Alcohol dries skin. Tracheostomy ties are changed when soiled or wet,
not only when soiled.*
11. A nurse is preparing to transfer a client from the bed to a stretcher. Which action by
the nurse indicates correct body mechanics?
A) Places feet together before lifting
B) Keeps the back straight and knees bent
C) Twists at the waist while moving the client
D) Positions the stretcher at knee level
