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2025/2026 NCLEX RN (NEXT GENERATION FORMAT)
Page | 1
ACTUAL Qs&As WITH RATIONALES|TEST BANK OF
REAL QUESTIONS & CORRECT DETAILED
ANSWERS WITH RATIONALES NCLEX 2025
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Q1. A nurse is caring for a postoperative patient who suddenly becomes restless, short of
breath, and has chest pain. Which is the priority action?
Page | 2 A. Notify the healthcare provider
B. Check oxygen saturation levels ✅✅✅
C. Administer morphine for pain
D. Encourage coughing and deep breathing
Rationale: The patient’s symptoms suggest a possible pulmonary embolism. The nurse
should first assess oxygenation by checking O2 saturation to determine the need for
immediate oxygen or advanced interventions.
Q2. A client with heart failure is receiving furosemide. Which laboratory value requires
priority nursing action?
A. Sodium 135 mEq/L
B. Potassium 2.8 mEq/L ✅✅✅
C. Magnesium 1.9 mg/dL
D. Creatinine 1.0 mg/dL
Rationale: A potassium level of 2.8 mEq/L is critically low, increasing the risk for
arrhythmias. This is a priority concern when using loop diuretics like furosemide.
Q3. A nurse is delegating tasks on a busy med-surg unit. Which task is appropriate to
delegate to a UAP (unlicensed assistive personnel)?
A. Teaching a diabetic patient how to check blood sugar
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B. Administering a routine insulin injection
C. Assisting a stable client to ambulate in the hallway ✅✅✅
D. Assessing a post-op patient’s surgical dressing
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Rationale: UAPs can assist with non-invasive, routine, and predictable tasks such as
ambulation of a stable client. Teaching, assessments, and medication administration are
outside their scope.
Q4. A nurse is reviewing lab results for a patient on warfarin. Which result indicates the
medication is within therapeutic range?
A. INR 1.0
B. INR 2.5 ✅✅✅
C. INR 4.5
D. INR 0.8
Rationale: The therapeutic INR range for most patients on warfarin is 2.0 to 3.0. An INR of
2.5 is ideal and indicates effective anticoagulation.
Q5. A newly admitted patient with pneumonia has the following vitals: RR 28, O2 Sat 88%,
HR 110, Temp 39.2°C. What is the first intervention?
A. Administer IV antibiotics
B. Obtain sputum culture
C. Apply oxygen via nasal cannula ✅✅✅
D. Start IV fluids
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Rationale: With an O2 saturation of 88%, oxygen therapy is the immediate priority to
correct hypoxia before initiating other treatments.
Page | 4
Q6. (SATA) A nurse is educating a patient with chronic kidney disease on dietary
restrictions. Which foods should the patient avoid? (Select all that apply)
A. Bananas ✅✅✅
B. Broccoli
C. Baked potato ✅✅✅
D. Chicken breast
E. Orange juice ✅✅✅
Rationale: Patients with CKD should avoid foods high in potassium like bananas, potatoes,
and orange juice. Protein (chicken) may be limited but is not automatically restricted.
Q7. A nurse assesses a client with hypocalcemia. Which finding is expected?
A. Negative Chvostek’s sign
B. Muscle weakness
C. Numbness and tingling around the mouth ✅✅✅
D. Hypoactive reflexes
Rationale: Paresthesia (numbness/tingling) is a classic symptom of hypocalcemia. Positive
Chvostek and Trousseau signs may also be present.
2025/2026 NCLEX RN (NEXT GENERATION FORMAT)
Page | 1
ACTUAL Qs&As WITH RATIONALES|TEST BANK OF
REAL QUESTIONS & CORRECT DETAILED
ANSWERS WITH RATIONALES NCLEX 2025
, 2
Q1. A nurse is caring for a postoperative patient who suddenly becomes restless, short of
breath, and has chest pain. Which is the priority action?
Page | 2 A. Notify the healthcare provider
B. Check oxygen saturation levels ✅✅✅
C. Administer morphine for pain
D. Encourage coughing and deep breathing
Rationale: The patient’s symptoms suggest a possible pulmonary embolism. The nurse
should first assess oxygenation by checking O2 saturation to determine the need for
immediate oxygen or advanced interventions.
Q2. A client with heart failure is receiving furosemide. Which laboratory value requires
priority nursing action?
A. Sodium 135 mEq/L
B. Potassium 2.8 mEq/L ✅✅✅
C. Magnesium 1.9 mg/dL
D. Creatinine 1.0 mg/dL
Rationale: A potassium level of 2.8 mEq/L is critically low, increasing the risk for
arrhythmias. This is a priority concern when using loop diuretics like furosemide.
Q3. A nurse is delegating tasks on a busy med-surg unit. Which task is appropriate to
delegate to a UAP (unlicensed assistive personnel)?
A. Teaching a diabetic patient how to check blood sugar
, 3
B. Administering a routine insulin injection
C. Assisting a stable client to ambulate in the hallway ✅✅✅
D. Assessing a post-op patient’s surgical dressing
Page | 3
Rationale: UAPs can assist with non-invasive, routine, and predictable tasks such as
ambulation of a stable client. Teaching, assessments, and medication administration are
outside their scope.
Q4. A nurse is reviewing lab results for a patient on warfarin. Which result indicates the
medication is within therapeutic range?
A. INR 1.0
B. INR 2.5 ✅✅✅
C. INR 4.5
D. INR 0.8
Rationale: The therapeutic INR range for most patients on warfarin is 2.0 to 3.0. An INR of
2.5 is ideal and indicates effective anticoagulation.
Q5. A newly admitted patient with pneumonia has the following vitals: RR 28, O2 Sat 88%,
HR 110, Temp 39.2°C. What is the first intervention?
A. Administer IV antibiotics
B. Obtain sputum culture
C. Apply oxygen via nasal cannula ✅✅✅
D. Start IV fluids
, 4
Rationale: With an O2 saturation of 88%, oxygen therapy is the immediate priority to
correct hypoxia before initiating other treatments.
Page | 4
Q6. (SATA) A nurse is educating a patient with chronic kidney disease on dietary
restrictions. Which foods should the patient avoid? (Select all that apply)
A. Bananas ✅✅✅
B. Broccoli
C. Baked potato ✅✅✅
D. Chicken breast
E. Orange juice ✅✅✅
Rationale: Patients with CKD should avoid foods high in potassium like bananas, potatoes,
and orange juice. Protein (chicken) may be limited but is not automatically restricted.
Q7. A nurse assesses a client with hypocalcemia. Which finding is expected?
A. Negative Chvostek’s sign
B. Muscle weakness
C. Numbness and tingling around the mouth ✅✅✅
D. Hypoactive reflexes
Rationale: Paresthesia (numbness/tingling) is a classic symptom of hypocalcemia. Positive
Chvostek and Trousseau signs may also be present.
