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National Council Licensure Examination(NCLEX-RN)

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NCLEX NCLEX-RN Sample Questions

Question # 1

A 25-year-old client believes she may be pregnant with her first child. She schedules an obstetric examination with the nurse practitioner to determine the status of her possible pregnancy. Her last menstrual period began May 20, and her estimated date of confinement using Nägele’s rule is:

A. March 27
B. February 1
C. February 27
D. January 3

Question # 2

A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would expect which of the following to be present in relation to his blood sugar level?

A. A normal blood sugar level
B. A decreased blood sugar level
C. An increased blood sugar level
D. Fluctuating levels with a predawn increase

Question # 3

The therapeutic blood-level range for lithium is: 

A. 0.25–1.0 mEq/L
B. 0.5–1.5 mEq/L
C. 1.0–2.0 mEq/L
D. 2.0–2.5 mEq/L

Question # 4

The usual treatment for diabetes insipidus is with IM or SC injection of vasopressin tannate in oil. Nursing care related to the client receiving IM vasopressin tannate would include: 

A. Weigh once a week and report to the physician any weight gain of10 lb.
B. Limit fluid intake to 500 mL/day.
C. Store the medication in a refrigerator and allow to stand at room temperature for 30 minutes prior to administration
D. Hold the vial under warm water for 10–15 minutes and shake vigorously before drawing medication into the syringe.

Question # 5

When the nurse is evaluating lab data for a client 18–24 hours after a major thermal burn, the expected physiological changes would include which of the following?

A. Elevated serum sodium
B. Elevated serum calcium
C. Elevated serum protein
D. Elevated hematocrit

Question # 6

Which of the following findings would be abnormal in a postpartal woman? 

A. Chills shortly after delivery
B. Pulse rate of 60 bpm in morning on first postdelivery day
C. Urinary output of 3000 mL on the second day after delivery
D. An oral temperature of 101F (38.3C) on the third day after delivery

Question # 7

The nurse practitioner determines that a client is approximately 9 weeks’ gestation. During the visit, the practitioner informs the client about symptoms of physical changes that she will experience during her first trimester, such as:

A. Nausea and vomiting
B. Quickening
C. A 6–8 lb weight gain
D. Abdominal enlargement

Question # 8

When teaching a sex education class, the nurse identifies the most common STDs in the United States as: 

A. Chlamydia
B. Herpes genitalis
C. Syphilis
D. Gonorrhea

Question # 9

What is the most effective method to identify early breast cancer lumps?

A. Mammograms every 3 years
B. Yearly checkups performed by physician
C. Ultrasounds every 3 years
D. Monthly breast self-examination

Question # 10

A 27-year-old man was diagnosed with type I diabetes 3 months ago. Two weeks ago he complained of pain, redness, and tenderness in his right lower leg. He is admitted to the hospital with a slight elevation of temperature and vague complaints of “not feeling well.” At 4:30 PM on the day of his admission, his blood glucose level is 50 mg; dinner will be served at 5:00 PM. The best nursing action would be to: 

A. Give him 3 tbsp of sugar dissolved in 4 oz of grape juice to drink
B. Ask him to dissolve three pieces of hard candy in his mouth
C. Have him drink 4 oz of orange juice
D. Monitor him closely until dinner arrives

Question # 11

As the nurse assesses a male adolescent with chlamydia, the nurse determines that a sign of chlamydia is:

A. Enlarged penis
B. Secondary lymphadenitis
C. Epididymitis
D. Hepatomegaly

Question # 12

The initial treatment for a client with a liquid chemical burn injury is to: 

A. Irrigate the area with neutralizing solutions
B. Flush the exposed area with large amounts of water
C. Inject calcium chloride into the burned area
D. Apply lanolin ointment to the area

Question # 13

A client with a C-3–4 fracture has just arrived in the emergency room. The primary nursing intervention is: 

A. Stabilization of the cervical spine
B. Airway assessment and stabilization
C. Confirmation of spinal cord injury

Question # 14

To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with which of the following?

A. Positive inotropic therapy
B. Negative chronotropic therapy
C. Increase in balance of myocardial O2 supply and demand
D. Afterload reduction therapy

Question # 15

Which of the following procedures is necessary to establish a definitive diagnosis of breast cancer? 

A. Diaphanography
B. Mammography
C. Thermography
D. Breast tissue biopsy

Question # 16

A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy of fluid resuscitation in the burned child?

A. Blood pressure
B. Serum potassium level
C. Urine output
D. Pulse rate

Question # 17

Three weeks following discharge, a male client is readmitted to the psychiatric unit for depression. His wifestated that he had threatened to kill himself with a handgun. As the nurse admits him to the unit, he says, “Iwish I were dead because I am worthless to everyone; I guess I am just no good.” Which response by the nurseis most appropriate at this time?

A. “I don’t think you are worthless. I’m glad to see you, and we will help you.”
B. “Don’t you think this is a sign of your illness?”
C. “I know with your wife and new baby that you do have a lot to live for.”
D. “You’ve been feeling sad and alone for some time now?”

Question # 18

Which of the following activities would be most appropriate during occupational therapy for a client with bipolar disorder?

A. Playing cards with other clients
B. Working crossword puzzles
C. Playing tennis with a staff member
D. Sewing beads on a leather belt

Question # 19

Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?

A. Ventilation-perfusion (V./Q.) mismatch
B. Hypoxemia and respiratory acidosis
C. Mediastinal tissue and organ shifting
D. Decreased tidal volume and tachypnea

Question # 20

A client has been diagnosed as being preeclamptic. The physician orders magnesium sulfate. Magnesium sulfate (MgSO4) is used in the management of preeclampsia for:

A. Prevention of seizures
B. Prevention of uterine contractions
C. Sedation
D. Fetal lung protection

Question # 21

Which of the following statements relevant to a suicidal client is correct? 

A. The more specific a client’s plan, the more likely he or she is to attempt suicide.
B. A client who is unsuccessful at a first suicide attempt is not likely to make future attempts.
C. A client who threatens suicide is just seeking attention and is not likely to attempt suicide.
D. Nurses who care for a client who has attempted suicide should not make any reference to the word “suicide” in order to protect the client’s ego.

Question # 22

Provide the 1-minute Apgar score for an infant born with the following findings: Heart rate: Above 100 Respiratory effort: Slow, irregular Muscle tone: Some flexion of extremities Reflex irritability: Vigorous cry Color: Body pink, blue extremities 

A. 7
B. 10
C. 8
D. 9

Question # 23

Hematotympanum and otorrhea are associated with which of the following head injuries? 

A. Basilar skull fracture
B. Subdural hematoma
C. Epidural hematoma
D. Frontal lobe fracture

Question # 24

When teaching a mother of a 4-month-old with diarrhea about the importance of preventing dehydration, the nurse would inform the mother about the importance of feeding her child: 

A. Fruit juices
B. Diluted carbonated drinks
C. Soy-based, lactose-free formula
D. Regular formulas mixed with electrolyte solutions

Question # 25

The most commonly known vectors of Lyme disease are: 

A. Mites
B. Fleas
C. Ticks
D. Mosquitoes

Question # 26

The nurse assists a client with advanced emphysema to the bathroom. The client becomes extremely short of breath while returning to bed. The nurse should: 

A. Increase his nasal O2 to 6 L/min
B. Increase his nasal O2 to 6 L/min
C. Encourage pursed-lip breathing
D. Have him breathe into a paper bag

Question # 27

A 55-year-old man is admitted to the hospital with complaints of fatigue, jaundice, anorexia, and clay-coloredstools. His admitting diagnosis is “rule out hepatitis.” Laboratory studies reveal elevated liver enzymes andbilirubin. In obtaining his health history, the nurse should assess his potential for exposure to hepatitis.Which of the following represents a high-risk group for contracting this disease?

A. Heterosexual males
B. Heterosexual males
C. American Indians
D. Jehovah’s Witnesses

Question # 28

A male client receives 10 U of regular human insulin SC at 9:00 AM. The nurse would expect peak action from this injection to occur at: 

A. 9:30 AM
B. 10:30 AM
C. 12 noon
D. 4:00 PM

Question # 29

The nurse would expect to include which of the following when planning the management of the client with Lyme disease?

A. Complete bed rest for 6–8 weeks
B. Complete bed rest for 6–8 weeks
C. IV amphotericin B
D. High-protein diet with limited fluids

Question # 30

To ensure proper client education, the nurse should teach the client taking SL nitroglycerin to expect which ofthe following responses with administration?

A. Stinging, burning when placed under the tongue
B. Temporary blurring of vision
C. Generalized urticaria with prolonged use
D. Urinary frequency

Question # 31

When a client questions the nurse as to the purpose of exercise electrocardiography (ECG) in the diagnosis of cardiovascular disorders, the nurse’s response should be based on the fact that:

A. The test provides a baseline for further tests
B. The procedure simulates usual daily activity and myocardial performance
C. The client can be monitored while cardiac conditioning and heart toning are done
D. Ischemia can be diagnosed because exercise increasesO2 consumption and demand

Question # 32

A 38-year-old pregnant woman visits her nurse practitioner for her regular prenatal checkup. She is 30 weeks’ gestation. The nurse should be alert to which condition related to her age?

A. Iron-deficiency anemia
B. Sexually transmitted disease (STD)
C. Intrauterine growth retardation
D.  Pregnancy-induced hypertension (PIH)

Question # 33

When assessing fetal heart rate status during labor, the monitor displays late decelerations with tachycardia and decreasing variability. What action should the nurse take?

A. Continue monitoring because this is a normal occurrence.
B. Turn client on right side.
C. Decrease IV fluids.
D. Report to physician or midwife.

Question # 34

During burn therapy, morphine is primarily administered IV for pain management because this route: 

A. Delays absorption to provide continuous pain relief
B. Facilitates absorption because absorption from muscles is not dependable
C. Allows for discontinuance of the medication if respiratory depression develops
D. Avoids causing additional pain from IM injections

Question # 35

The nurse notes hyperventilation in a client with a thermal injury. She recognizes that this may be a reaction to which of the following medications if applied in large amounts?

A. Neosporin sulfate
B. Mafenide acetate
C. Silver sulfadiazine
D. Povidone-iodine

Question # 36

The physician recommends immediate hospital admission for a client with PIH. She says to the nurse, “It’s notso easy for me to just go right to the hospital like that.” After acknowledging her feelings, which of theseapproaches by the nurse would probably be best?

A. Stress to the client that her husband would want her to do what is best for her health.
B. Stress to the client that her husband would want her to do what is best for her health.
C. Repeat the physician’s reasons for advising immediate hospitalization.
D. Explain to the client that she is ultimately responsible for her own welfare and that of her baby.

Question # 37

Clinical manifestations seen in left-sided rather than in right-sided heart failure are: 

A. Elevated central venous pressure and peripheral edema
B. Dyspnea and jaundice
C. Hypotension and hepatomegaly
D. Decreased peripheral perfusion and rales

Question # 38

A child is admitted to the emergency room with her mother. Her mother states that she has been exposed to chickenpox. During the assessment, the nurse would note a characteristic rash:

A. That is covered with vesicular scabs all in the macular stage
B. That appears profusely on the trunk and sparsely on the extremities
C. That first appears on the neck and spreads downward
D. That appears especially on the cheeks, which gives a“slapped-cheek” appearance

Question # 39

The child with iron poisoning is given IV deforoxamine mesylate (Desferal). Following administration, the child suffers hypotension, facial flushing, and urticaria. The initial nursing intervention would be to:

A. Discontinue the IV
B. Stop the medication, and begin a normal saline infusion
C. Take all vital signs, and report to the physician
D. Assess urinary output, and if it is 30 mL an hour, maintain current treatment

Question # 40

When assessing a child with diabetes insipidus, the nurse should be aware of the cardinal signs of: 

A. Anemia and vomiting
B. Polyuria and polydipsia
C. Irritability relieved by feeding formula
D. Hypothermia and azotemia

Question # 41

Which of the following would the nurse expect to find following respiratory assessment of a client with advanced emphysema?

A. Distant breath sounds
B. Increased heart sounds
C. Decreased anteroposterior chest diameter
D. Collapsed neck veins

Question # 42

The most important reason to closely assess circumferential burns at least every hour is that they may result in: 

A. Hypovolemia
B. Renal damage
C. Ventricular arrhythmias
D. Loss of peripheral pulses

Question # 43

Assessment of the client with pericarditis may reveal which of the following? 

A. Ventricular gallop and substernal chest pain
B. Ventricular gallop and substernal chest pain
C. Pericardial friction rub and pain on deep inspiration
D. Pericardial tamponade and widened pulse pressure