**THE ULTIMATE NURSING EXAM VAULT:
2026 COMPREHENSIVE PREDICTOR**
---
**Question 1**
A nurse is caring for a patient with acute pancreatitis. Which laboratory finding is most consistent with
this diagnosis?
A) Elevated serum amylase and lipase
B) Decreased serum calcium
C) Elevated blood urea nitrogen
D) Decreased white blood cell count
---
💫RATIONALE✔️✔️: Amylase and lipase rise within 24-48 hours of pancreatitis onset; lipase is more
specific and remains elevated longer.
💫ANSWER✔️✔️: A) Elevated serum amylase and lipase
---
**Question 2**
A client with chronic kidney disease has a hemoglobin of 8.2 g/dL. The nurse anticipates a prescription
for which medication?
A) Ferrous sulfate
B) Epoetin alfa
C) Folic acid
D) Cyanocobalamin
---
💫RATIONALE✔️✔️: Epoetin alfa (erythropoietin) stimulates red blood cell production and treats anemia
of chronic kidney disease due to deficient erythropoietin production.
,💫ANSWER✔️✔️: B) Epoetin alfa
---
**Question 3**
A patient is admitted with exacerbation of multiple sclerosis. The nurse notes new-onset scanning
speech and nystagmus. Which medication does the nurse expect to administer?
A) Interferon beta-1a
B) Methylprednisolone
C) Baclofen
D) Donepezil
---
💫RATIONALE✔️✔️: Acute exacerbations of MS are treated with high-dose corticosteroids like
methylprednisolone to reduce inflammation and shorten relapse duration.
💫ANSWER✔️✔️: B) Methylprednisolone
---
**Question 4**
A nurse is assessing a patient with Addison’s disease. Which finding requires immediate intervention?
A) Blood pressure 90/60 mmHg
B) Serum sodium 132 mEq/L
C) Blood glucose 55 mg/dL
D) Skin hyperpigmentation
---
💫RATIONALE✔️✔️: Hypoglycemia in Addison’s indicates adrenal crisis with cortisol deficiency; it requires
immediate IV dextrose and hydrocortisone.
💫ANSWER✔️✔️: C) Blood glucose 55 mg/dL
, ---
**Question 5**
A client with a new prescription for isoniazid for latent TB asks about side effects. The nurse should
instruct the client to report:
A) Orange discoloration of urine
B) Numbness and tingling in the hands
C) Dry mouth and constipation
D) Blurred vision at night
---
💫RATIONALE✔️✔️: Isoniazid can cause peripheral neuropathy due to pyridoxine (vitamin B6) depletion;
report paresthesias for possible B6 supplementation.
💫ANSWER✔️✔️: B) Numbness and tingling in the hands
---
**Question 6**
A nurse is caring for a patient with a chest tube following a thoracotomy. The drainage collection
chamber has 150 mL of sanguineous drainage in the first 2 hours. What is the priority action?
A) Document the drainage as expected
B) Milk the chest tube to ensure patency
C) Notify the healthcare provider immediately
D) Increase the suction pressure
---
💫RATIONALE✔️✔️: Drainage >100 mL/hr post-thoracotomy suggests hemorrhage; notify the provider
immediately for potential return to surgery.
💫ANSWER✔️✔️: C) Notify the healthcare provider immediately
---
2026 COMPREHENSIVE PREDICTOR**
---
**Question 1**
A nurse is caring for a patient with acute pancreatitis. Which laboratory finding is most consistent with
this diagnosis?
A) Elevated serum amylase and lipase
B) Decreased serum calcium
C) Elevated blood urea nitrogen
D) Decreased white blood cell count
---
💫RATIONALE✔️✔️: Amylase and lipase rise within 24-48 hours of pancreatitis onset; lipase is more
specific and remains elevated longer.
💫ANSWER✔️✔️: A) Elevated serum amylase and lipase
---
**Question 2**
A client with chronic kidney disease has a hemoglobin of 8.2 g/dL. The nurse anticipates a prescription
for which medication?
A) Ferrous sulfate
B) Epoetin alfa
C) Folic acid
D) Cyanocobalamin
---
💫RATIONALE✔️✔️: Epoetin alfa (erythropoietin) stimulates red blood cell production and treats anemia
of chronic kidney disease due to deficient erythropoietin production.
,💫ANSWER✔️✔️: B) Epoetin alfa
---
**Question 3**
A patient is admitted with exacerbation of multiple sclerosis. The nurse notes new-onset scanning
speech and nystagmus. Which medication does the nurse expect to administer?
A) Interferon beta-1a
B) Methylprednisolone
C) Baclofen
D) Donepezil
---
💫RATIONALE✔️✔️: Acute exacerbations of MS are treated with high-dose corticosteroids like
methylprednisolone to reduce inflammation and shorten relapse duration.
💫ANSWER✔️✔️: B) Methylprednisolone
---
**Question 4**
A nurse is assessing a patient with Addison’s disease. Which finding requires immediate intervention?
A) Blood pressure 90/60 mmHg
B) Serum sodium 132 mEq/L
C) Blood glucose 55 mg/dL
D) Skin hyperpigmentation
---
💫RATIONALE✔️✔️: Hypoglycemia in Addison’s indicates adrenal crisis with cortisol deficiency; it requires
immediate IV dextrose and hydrocortisone.
💫ANSWER✔️✔️: C) Blood glucose 55 mg/dL
, ---
**Question 5**
A client with a new prescription for isoniazid for latent TB asks about side effects. The nurse should
instruct the client to report:
A) Orange discoloration of urine
B) Numbness and tingling in the hands
C) Dry mouth and constipation
D) Blurred vision at night
---
💫RATIONALE✔️✔️: Isoniazid can cause peripheral neuropathy due to pyridoxine (vitamin B6) depletion;
report paresthesias for possible B6 supplementation.
💫ANSWER✔️✔️: B) Numbness and tingling in the hands
---
**Question 6**
A nurse is caring for a patient with a chest tube following a thoracotomy. The drainage collection
chamber has 150 mL of sanguineous drainage in the first 2 hours. What is the priority action?
A) Document the drainage as expected
B) Milk the chest tube to ensure patency
C) Notify the healthcare provider immediately
D) Increase the suction pressure
---
💫RATIONALE✔️✔️: Drainage >100 mL/hr post-thoracotomy suggests hemorrhage; notify the provider
immediately for potential return to surgery.
💫ANSWER✔️✔️: C) Notify the healthcare provider immediately
---
