NCLEX-PN Reduction of Risk Potential Practice Test
Vital signs and labs to report, procedure prep and post-procedure complications. Here are 10 NCLEX-PN reduction of risk potential questions, each with the answer and the reason.
Updated by the Tigertest team. Based on the NCSBN 2026 NCLEX-PN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.
- 1.
A client's urine specific gravity is 1.035. Which problem should the PN suspect?
- A.
Fluid volume excess
- B.
Diabetes insipidus
- C.
Fluid volume deficit
- D.
A urinary tract infection
Answer: C.A specific gravity above about 1.030 means the urine is concentrated because the body is holding on to water, which points to dehydration. Fluid excess and diabetes insipidus produce dilute urine with a low specific gravity.
- A.
- 2.
A client's troponin level is elevated. The PN understands that this result points to which problem?
- A.
A bacterial infection
- B.
Kidney damage
- C.
Liver injury
- D.
Heart muscle damage
Answer: D.Troponin is a protein released from injured heart muscle and is the main blood test for a heart attack. Infection raises the white count, kidney damage raises creatinine, and liver injury raises the liver enzymes.
- A.
- 3.
A client is scheduled for an MRI of the spine. Which question is most important for the PN to ask before the test?
- A.
"Do you have a pacemaker or any metal in your body?"
- B.
"Are you allergic to shellfish or iodine contrast dye?"
- C.
"When did you last have anything to eat or drink?"
- D.
"Do you have a latex allergy or any skin sensitivity?"
Answer: A.The MRI magnet can move or heat metal and disable a pacemaker, so implants, clips, fragments and devices must be identified before the client enters the room. Fasting, iodine contrast and latex questions matter for other procedures, but metal is the one question that can make an MRI itself dangerous.
- A.
- 4.
A client's morning potassium level is 2.9 mEq/L. Which finding should the PN watch for and report?
- A.
Muscle weakness and an irregular pulse
- B.
Tall, peaked T waves on the monitor
- C.
Twitching around the mouth
- D.
Watery diarrhea and cramping
Answer: A.Low potassium weakens skeletal muscle and makes the heart irritable, so weakness, leg cramps and an irregular pulse are the signs to report. Peaked T waves go with high potassium, twitching around the mouth suggests low calcium, and watery diarrhea is a cause of potassium loss rather than a sign of it, since low potassium slows the bowel and causes constipation.
- A.
- 5.
A client scheduled for surgery at 0800 tells the PN at 0700, "I had a piece of toast an hour ago." Which action should the PN take?
- A.
Document the intake and send the client to surgery
- B.
Notify the RN right away
- C.
Give an antacid and continue the preoperative checklist
- D.
Reschedule the surgery for the afternoon
Answer: B.Food within the fasting window raises the risk of aspiration during anesthesia, so the RN and surgical team must know before the client leaves the unit; they decide whether to delay. The PN reports the data and does not reschedule surgery or cover the problem with an antacid.
- A.
- 6.
A clinic client is scheduled for a colonoscopy. Which statement shows the client understands the reinforced preparation instructions?
- A.
"I can eat a light breakfast the morning of the test."
- B.
"I'll stop the bowel prep once I have diarrhea."
- C.
"I'll have only clear liquids the day before."
- D.
"Red gelatin is a good clear liquid to choose."
Answer: C.A clear liquid diet the day before and the full bowel preparation are what let the provider see the colon wall. Diarrhea means the prep is working and it is finished as directed, nothing is eaten the morning of the test, and red or purple liquids are avoided because they look like blood.
- A.
- 7.
A client takes warfarin after a deep vein thrombosis. Which laboratory value should the PN check before giving the dose?
- A.
aPTT
- B.
Platelet count
- C.
Hemoglobin
- D.
INR
Answer: D.Warfarin is monitored with the INR (goal usually 2.0 to 3.0). The aPTT monitors heparin, and platelets and hemoglobin do not show how much the blood is thinned.
- A.
- 8.
A client returned 1 hour ago from a cardiac catheterization through the right femoral artery. Which finding should the PN report to the RN immediately?
- A.
The right foot is cool and pale
- B.
A quarter-sized bruise at the puncture site
- C.
Pedal pulses equal on both feet
- D.
The client reports the urge to void
Answer: A.A cool, pale foot on the side of the puncture means blood flow to the leg is blocked by a clot or spasm and is an emergency. A small bruise, equal pulses and a full bladder are expected after the procedure and the fluids given with it.
- A.
- 9.
The RN started a blood transfusion 30 minutes ago and, per facility policy and state scope, asked the PN to help monitor the client. The client now reports chills and low back pain. Which action should the PN take first?
- A.
Slow the rate and continue to observe
- B.
Stop the transfusion and call the RN
- C.
Give the prescribed acetaminophen and continue
- D.
Document the complaint and recheck in 15 minutes
Answer: B.Chills and low back pain during a transfusion are classic signs of a hemolytic reaction, so the blood is stopped at once, the line is kept open with normal saline per policy, and the RN takes over. Slowing the rate or treating the symptoms lets more incompatible blood run in. The RN stays with the client for the first 15 minutes, when reactions are most likely; the PN helps monitor afterward only where policy and state scope allow.
- A.
- 10.
A client with a new forearm cast reports pain that is getting worse despite the prescribed analgesic, with numbness and tingling in the fingers. Which problem should the PN suspect and report?
- A.
Normal discomfort as the cast dries
- B.
Fat embolism
- C.
Compartment syndrome
- D.
Osteomyelitis
Answer: C.Pain out of proportion that medication does not relieve, with numbness and tingling, is compartment syndrome from pressure inside the cast and needs the RN and provider at once. Fat embolism causes breathing changes and confusion, and osteomyelitis develops over days with fever.
- A.
Drill every reduction of risk potential question in the NCLEX-PN Reduction of Risk Potential drill: questions you miss come back until you have mastered them. Then take a timed practice test with the NCLEX-PN section in it.
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