Predictor Practice Exam &
Review Guide (150-
Question Bank)
This high-yield practice question bank features
150 comprehensive multiple-choice questions
modeled closely after professional nursing
licensure and exit exams. Each item contains a
clear question, structured options, bold-italic
answers, and detailed rationales covering core
competencies such as pharmacology, med-surg,
pediatrics, and nursing prioritization. It is
formatted explicitly to meet online study
platform guidelines, providing an efficient, plug-
and-play resource for students preparing for
high-stakes exit assessments.
,1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take to prevent
dislocation of the prosthesis?
A) Place an abduction pillow between the client's legs while in bed.
B) Encourage the client to cross their legs at the ankles when sitting.
C) Maintain the head of the bed at a 90-degree angle during meals.
D) Instruct the client to turn their toes inward when transferring.
Correct Answer: A) Place an abduction pillow between the client's legs while in
bed.
Rationale: An abduction pillow maintains the surgical hip in an abducted position, which
prevents adduction and subsequent dislocation of the new prosthesis. Crossing the
legs, flexing the hip past 90 degrees, and internal rotation (turning toes inward) all
increase the risk of dislocation and must be strictly avoided.
2. A nurse is reviewing the laboratory results of a client who is receiving a
continuous intravenous heparin infusion for a deep vein thrombosis. Which of
the following laboratory values indicates that the therapy is effective?
A) Prothrombin time (PT) of 12 seconds
B) International Normalized Ratio (INR) of 3.0
C) Activated partial thromboplastin time (aPTT) of 65 seconds
D) Platelet count of 95,000/mm³
Correct Answer: C) Activated partial thromboplastin time (aPTT) of 65 seconds
Rationale: The continuous therapeutic effectiveness of heparin is monitored using the
aPTT, with a target therapeutic range typically being 1.5 to 2.5 times the normal
reference value (normal is roughly 30 to 40 seconds). PT and INR are used to monitor
oral warfarin therapy. A platelet count below 100,000/mm³ indicates a potential adverse
effect called heparin-induced thrombocytopenia (HIT).
3. A nurse is assessing a client who has a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal
chamber. How should the nurse interpret this finding?
A) The system is functioning normally and evacuating air.
B) There is an air leak present somewhere in the drainage system.
C) The suction pressure applied to the system is too high.
D) The client's lung has fully re-expanded.
,Correct Answer: B) There is an air leak present somewhere in the drainage
system.
Rationale: Continuous bubbling in the water-seal chamber strongly indicates an air leak
within the system or at the insertion site. Intermittent bubbling is normal during
expiration, coughing, or sneezing if air is leaving the pleural space. Suction pressure is
monitored in the suction control chamber, not the water-seal chamber. Fully re-
expanded lungs result in cessation of bubbling and tidaling.
4. A nurse is preparing to administer digoxin to a client who has heart failure.
Which of the following actions should the nurse take prior to administration?
A) Assess the client's apical pulse for 1 full minute.
B) Monitor the client's blood pressure in both arms.
C) Administer an antacid to maximize medication absorption.
D) Check the client's serum calcium level.
Correct Answer: A) Assess the client's apical pulse for 1 full minute.
Rationale: Digoxin is a cardiac glycoside that decreases the heart rate while increasing
contractility. The nurse must assess the apical pulse for 1 full minute and withhold the
medication if the pulse is below 60 beats/min in an adult to avoid severe bradycardia.
Antacids decrease digoxin absorption, and potassium levels (not calcium) must be
carefully monitored due to risk of hypokalemia-induced toxicity.
5. A nurse is caring for a client who is experiencing an acute panic attack. Which
of the following interventions should the nurse implement first?
A) Instruct the client to practice deep imagery techniques.
B) Administer an oral dose of an anti-anxiety medication.
C) Stay with the client and speak using short, simple sentences.
D) Ask the client to explain what triggered the panic episode.
Correct Answer: C) Stay with the client and speak using short, simple sentences.
Rationale: During an acute panic attack, the client's cognitive processing is severely
impaired. The immediate nursing priority is to ensure safety and reduce anxiety by
remaining physically present and communicating with short, clear, and direct phrases.
Complex imagery or exploring psychological triggers cannot be processed until the
panic state subsides.
, 6. A nurse is teaching a client who has a new prescription for sublingual
nitroglycerin tablets for the management of angina pectoris. Which of the
following instructions should the nurse include?
A) Swallow the tablet with a full glass of water.
B) Take up to five tablets at 5-minute intervals if pain persists.
C) Store the medication in its original dark glass bottle.
D) Discard the tablets if they produce a tingling sensation under the tongue.
Correct Answer: C) Store the medication in its original dark glass bottle.
Rationale: Nitroglycerin is highly sensitive to light, heat, and moisture, and must be
stored in its original dark glass container with a tight lid to preserve potency. Sublingual
tablets must dissolve under the tongue instead of being swallowed. A maximum of three
doses spaced 5 minutes apart can be taken, and a tingling sensation indicates that the
medication is active.
7. A nurse is caring for a client who has type 1 diabetes mellitus and is
unresponsive, diaphoretic, and has a blood glucose level of 42 mg/dL. Which of
the following actions should the nurse take?
A) Administer 15 g of simple carbohydrates orally.
B) Inject 1 mg of glucagon subcutaneously or intramuscularly.
C) Give 4 oz of regular fruit juice through a straw.
D) Administer 10 units of regular insulin intravenously.
Correct Answer: B) Inject 1 mg of glucagon subcutaneously or intramuscularly.
Rationale: Because the client is unresponsive, oral administration of fluids or
carbohydrates poses a severe aspiration risk and is strictly contraindicated. The nurse
should immediately administer glucagon or IV dextrose (D50) to rapidly raise blood
glucose. Oral carbohydrates are appropriate only for a conscious, cooperative client.
8. A nurse is preparing to administer an intramuscular injection to an infant who
is 6 months old. Which of the following injection sites should the nurse select?
A) Dorsogluteal muscle
B) Deltoid muscle
C) Ventrogluteal muscle
D) Vastus lateralis muscle
Correct Answer: D) Vastus lateralis muscle