NCLEX Study Questions

The nurse is providing information to a 28 year-old female, who is a type 1 diabetic and planning a pregnancy. The nurse is assessing the client's understanding of insulin therapy during pregnancy. Which statement, made by the client, indicates a need for more teaching? 1) "I will need to increase my insulin dosage during the first three months of pregnancy." 2) "I will probably need to give myself more insulin during the second and third trimesters of my pregnancy." 3) "I may be more likely to experience hypoglycemia during the first three months of pregnancy." 4) "If I bottle-feed my baby, my insulin needs should return to normal within 7 to 10 days after birth."

1) "I will need to increase my insulin dosage during the first three months of pregnancy."

The client, who is four days post-op for a transverse colostomy and is scheduled for discharge tomorrow, asks the nurse to empty the colostomy pouch. What is the best response by the nurse? 1) "Show me what you have learned about emptying your pouch." 2) "Let me demonstrate to you how to empty the pouch." 3) "What have you learned about emptying your pouch?" 4) "You should be emptying the pouch yourself."

1) "Show me what you have learned about emptying your pouch."

A nurse manager suspects a staff nurse of substance use disorder (SUD). Which approach would be the best initial action by the nurse manager? 1) Consult with human resources personnel about the issue and needed actions. 2) Schedule a staff conference, without the nurse present, to collect information. 3) Counsel the employee to resign to avoid investigation and rumors. 4) Confront the nurse about the suspicions in a private meeting.

1) Consult with human resources personnel about the issue and needed actions.

A client diagnosed with diabetes mellitus has a blood glucose of 175 this morning. After the nurse reports this lab result along with the client's findings of being hungry and thirsty, what type of insulin should the nurse expect the health care provider to order? 1) Humulin-R insulin. 2) Mixture of insulin aspart (NovoLog) and insulin glargine (Lantus). 3) Insulin glargine (Lantus). 4) NPH insulin (Humulin-N).

1) Humulin-R insulin.

The nurse receives an order for several medications for a client. Which combination of medications would require the nurse to contact the provider to discuss the orders? (Select all that apply.) 1) Lithium (Eskalith, Lithobid). 2) Furosemide (Lasix). 3) Amlodipine (Norvasc). 4) Verapamil (Calan, Covera, Isoptin, Verelan). 5) Finasteride (Propecia, Proscar).6) Insulin.

1) Lithium (Eskalith, Lithobid). 2) Furosemide (Lasix).

The health care team is planning discharge for a 90 year-old client diagnosed with musculoskeletal weakness. Which intervention would be the priority to help prevent falls in the home? 1) Place night lights in the bedroom and bathroom. 2) Take calcium and vitamin D supplements. 3) Begin therapy for muscle strengthening and balance. 4) Wear eyeglasses and hearing aid.

1) Place night lights in the bedroom and bathroom.

The client, who is 12-hours post gastric bypass surgery, is restless and reports increasing back and shoulder pain unrelieved by pain medication. What action should the nurse take first? 1) Report the complaint to the surgeon immediately. 2) Place the client in Trendelenburg position. 3) Check the nasogastric (NG) tube for patency and reposition the tube. 4) Roll the client to side-lying position to ensure the epidural analgesia catheter is still in place.

1) Report the complaint to the surgeon immediately.

The registered nurse (RN) and the unlicensed assistive person (UAP) are caring for clients on a surgical unit. Which action(s) by the UAP warrant immediate intervention? (Select all that apply.) 1) The UAP assists a client, who received an IV narcotic analgesic 30 minutes ago, to ambulate in the hall. 2) The UAP applies moisture barrier cream to the client's excoriated perianal area. 3) The UAP assists a client, who had a total knee replacement two days ago, to shave using a straight-edge razor. 4) The UAP empties the indwelling catheter bag for the client who had a transurethral resection of the prostate (TURP) yesterday. 5) The UAP applies a fingertip pulse oximeter on a client's finger with dark blue nail polish.

1) The UAP assists a client, who received an IV narcotic analgesic 30 minutes ago, to ambulate in the hall. 3) The UAP assists a client, who had a total knee replacement two days ago, to shave using a straight-edge razor. 5) The UAP applies a fingertip pulse oximeter on a client's finger with dark blue nail polish.

A 62 year-old client is admitted to the emergency department. The client has a history of anemia and peptic ulcer disease and is now experiencing chest pain, nausea and dizziness. The nurse anticipates which laboratory tests to be ordered right away? (Select all that apply.) 1) Complete blood count (CBC). 2) Cardiac enzymes. 3) Lipid panel. 4) Toxicology screen. 5) Helicobactor pylori (H. pylori).

1-2 are correct.

The nurse listens to report about a newly admitted client who has a skin ulcer that's tested positive for MRSA (methicillin-resistant Staphylococcus aureus). What precautions must be taken for this hospitalized client? (Select all that apply.) 1) Perform hand hygiene after direct contact with the client and before leaving the room. 2) Place the client in a single room. 3) Keep the door to the room closed, with a notice for visitors. 4) Keep all equipment in the client's room for his/her sole use. Wear mask when providing routine care to the client.

1-2-3-4 are all correct.

A client asks the nurse for information about a living will. Which statement made by the client demonstrates an understanding of a living will? (Select all that apply.) 1) "I will need to identify someone to be my health care proxy." 2) "I should sit down and discuss my wishes for end of life care with my loved ones." 3) "My wishes for end of life treatment are stated in writing." 4) "It lists all my assets and how they should be divided among my family after I die." 5 ) "A living will must be renewed by a designated family member each time I am hospitalized." 6) "A living will is a legal document that becomes a permanent part of my health care record."

1-2-3-6 are all correct.

The oncology nurse is preparing to administer the initial dose of vincristine to a child diagnosed with acute lymphocytic leukemia (ALL). Which intervention is most appropriate to add to the plan of care? (Select all that apply.) 1) Monitor for numbness or tingling in the fingers and toes. 2) Verify blood return before, during and after intravenous administration. 3) Select appropriate catheter for intrathecal administration. 4) Apply ice to the injection site if extravasation occurs. 5) Monitor liver enzyme tests.

1-2-5 are all correct.

The nurse is caring for a young adult client with an acute attack of inflammatory bowel disease. Which of the following findings indicates a potential complication? (Select all that apply) 1) Chills and fever. 2) Frequent diarrhea. 3) Abdominal distention. 4) Visible blood and mucus in the stool. 5) Abdominal pain and tenderness.

1-3 re correct.

The nurse recognizes that obtaining accurate post anesthesia vital signs is extremely important. Which of the following client conditions are not appropriate for electronic blood pressure measurement? (Select all that apply.) 1) Shivering. 2) Blood pressure greater than 140 mm Hg systolic. 3) Peripheral vascular obstruction. 4) Irregular heart rate.

1-3-4 all correct.

The client is admitted to the hospital with a diagnosis of exacerbation of right ventricular heart failure. Which of the following findings would the nurse expect with right-sided heart failure? (Select all that apply.) 1) Abdominal discomfort. 2) Cough. 3) Peripheral edema. Anorexia and nausea.

1-3-4 are all correct.

The interdisciplinary team is reviewing charts for potential candidates for hospice care. Which of the following clients meet the criteria for hospice care? (Select all that apply.) 1) 91 year-old with Alzheimer's disease, who is no longer able to eat or drink oral fluids. 2) 53 year-old client with chronic, unrelieved pain, who is addicted to narcotics following a back injury. 3) 72 year-old with prostate cancer metastasized to the bone, who is receiving palliative radiation therapy. 4) 8 year-old client with acute myelogenous leukemia, for whom all treatment options have failed. 5) 46 year-old with end stage liver disease, on a wait list for a donor organ.

1-3-4 are all correct.

The health care provider has ordered a vanillylmandelic acid test and catecholamine test for a middle-aged client. Which of the following points should the nurse discuss with the client prior to these tests? (Select all that apply.) 1) Identify and minimize factors contributing to stress and anxiety. 2) Continue taking all prescribed medications. 3) Avoid excessive physical exercise several days prior to the test. 4) Avoid caffeinated beverages, bananas, chocolate, cocoa, licorice and citrus fruit. 5) A 24-hour urine collection procedure is required.

1-3-4-5 are all correct.

A client, who is receiving a blood transfusion, reports having a headache and low back pain. What are the nurse's actions? (Select all that apply.) 1) Stop the blood transfusion. 2) Administer acetaminophen (Tylenol) 1000 mg. 3) Obtain first voided urine (within one hour of reaction). 4) Flush the line with saline. 5) Establish a saline lock or patent IV. 6) Send the tubing and bag to the blood bank.

1-3-5-6 are all correct.

The charge nurse sends a nursing assistant to help an RN with admission of a client with multiple health problems. Which of the following tasks would be appropriate to delegate to the nursing assistant? (Select all that apply.) 1) Observe and document the client's responses to ambulation to the bathroom. 2) Assist the client to change into a gown. 3) Collect a urine specimen. 4) Obtain routine vital signs (temperature, pulse, respirations, blood pressure, oxygen saturations). 5) Orient the client to the room.

2) Assist the client to change into a gown. 3) Collect a urine specimen. 4) Obtain routine vital signs (temperature, pulse, respirations, blood pressure, oxygen saturations). 5) Orient the client to the room.

The client is 48 hours post-insertion of an abdominal catheter for peritoneal dialysis and is currently undergoing a fluid exchange. The nurse understands that which of these findings needs to be reported to the health care provider immediately? 1) Muscle weakness. 2) Cloudy drainage. 3) Abdominal discomfort. 4) Slight pink-tinged drainage.

2) Cloudy drainage.

A registered nurse (RN) works for a visiting nurse agency (VNA) and makes a home visit to admit a client newly diagnosed with type 1 diabetes. The client has a small foot ulcer that was debrided and needs daily wound care. Which of the following options is the most important intervention to ensure a successful outcome? 1) Refer to a local diabetes support group. 2) Involve the client in making health care decisions. 3) Schedule daily RN visits to the client. 4) Arrange for a friend or relative to visit daily.

2) Involve the client in making health care decisions.

A nurse is assessing an 8 month-old infant with a malfunctioning ventriculoperitoneal shunt. Which of these findings should the nurse anticipate the infant might exhibit? 1) Lethargy. 2) Irritability. 3) Negative Moro reflex. 4) Sunken anterior fontanelle.

2) Irritability.

The nurse is caring for a client with a pressure ulcer on the heel that is covered with black hard tissue. Which would be an appropriate goal in planning the care of this client? 1) Protection for the granulation tissue. 2) Keep the tissue intact. 3) Heal the infection. 4) Debride the eschar.

2) Keep the tissue intact.

A nurse is anticipating providing guidance to parents of a toddler about readiness for toilet training. Which statement describes what the nurse should know in order to provide such guidance? 1) The toddler can understand cause and effect. 2) Myelination of the spinal cord is completed by this age. 3) Neuronal impulses are interrupted at the base of the ganglia. 4) The child learns voluntary sphincter control through repetition.

2) Myelination of the spinal cord is completed by this age.

The health care provider orders an osmotic diuretic for a client diagnosed with a traumatic brain injury (TBI). Why is this medication ordered? 1) Prevent electrolyte imbalance. 2) Reduce intracranial pressure. 3) Reduce pulmonary edema. 4) Prevent seizures.

2) Reduce intracranial pressure.

A nurse has been assigned to four clients in the emergency department, with each client experiencing one of these conditions. Which client should the nurse check first? 1) Acute asthma with episodes of bronchospasm. 2) Tension pneumothorax with slight tracheal deviation to the right. 3) Viral pneumonia with atelectasis. 4) Spontaneous pneumothorax with a respiratory rate of 38.

2) Tension pneumothorax with slight tracheal deviation to the right.

The nurse, who is caring for a client with complex and unique health needs, describes the nature of the illness in an online social forum for nurses. Neither the client's real name nor any other personal identifiers are used. What, if any, consequence could result from posting this information online? 1) There won't be any consequences because the client's real name was not used. 2) The nurse could be fired for breach of confidentiality. 3) The nurse could be reprimanded for not clearing the information first with hospital administration. 4) There won't be any consequences because the information was posted on a website for nursing professionals.

2) The nurse could be fired for breach of confidentiality.

A client is to receive three doses of potassium chloride 10 mEq in 100 mL of 0.9% normal saline to infuse over 30 minutes each. Which action is a priority assessment to perform before the nurse gives this medication? 1) Bowel sounds. 2) Urine output. 3) Oral fluid intake. 4) Grip strength.

2) Urine output.

The nurse is caring for a newly admitted client with a diagnosis of hyperosmolar hyperglycemic nonketotic state (HHNS). Which interventions would the nurse expect the health care provider to order? (Select all that apply.) 1) NPH insulin as IV bolus and then titrated by weight. 2) Rapid infusion of intravenous fluids. 3) Check blood glucose levels every four hours. 4) BUN and creatinine levels.

2-4 are correct.

The nurse is preparing a speech to a local service organization about clinical trials in cancer care. Which of the following statements would be correct to include? (Select all that apply.) 1) There is a clinical trial protocol for all types of people with cancer. 2) Clinical trials require approval of a human subjects review board. 3)A clinical trial is one of the first steps in the research process. 4) Clinical trials have led to improved cancer prevention and treatment.

2-4 are correct.

A female client is admitted for a breast biopsy. She says, tearfully to a nurse, "If this turns out to be cancer and I have to have my breast removed, my partner will never come near me." Which of these statements would be the best response by the nurse? 1) "I hear you saying that you have a fear for the loss of love." 2) "Are you wondering about the effects on your sexuality?" 3) "Are you worried that the surgery will lead to changes?" 4) "You sound concerned that your partner will reject you."

3) "Are you worried that the surgery will lead to changes?"

A client frequently admitted to the locked psychiatric unit repeatedly compliments and then invites one of the nurses to go out on a date. The nurse should take which of these approaches? 1) Tell the client that such behavior is inappropriate and unethical. 2) Ask to not be assigned to this client or request to work on another unit. 3) Discuss the boundaries of a therapeutic relationship with the client. 4) Inform the client that the hospital policy prohibits staff to date clients.

3) Discuss the boundaries of a therapeutic relationship with the client.

A nurse is caring for a client with chronic renal failure who is treated with hemodialysis three times a week. The client becomes confused and irritable six hours before the next treatment. Which of these physiologic changes might explain the reason for the client's behavior? 1) Calcium depletion. 2) Metabolic alkalosis. 3) Elevated blood urea nitrogen (BUN). 4) Potassium loss.

3) Elevated blood urea nitrogen (BUN)

A client who is HIV-positive is diagnosed with a herpes simplex type 1 (HSV-1) infection. The nurse understands that which issue is the most likely reason for the HSV-1 infection in this client? 1) The client has a history unprotected sexual activities. 2) The client has experienced emotional stress. 3) The client is immunosuppressed. 4) The client had contact with saliva.

3) The client is immunosuppressed.

Mass casualty survivors are brought to the emergency department (ED) after a disaster. The nurse is assigned to four clients who were triaged in the field and have just arrived in the ED. Which client will the nurse care for first? 1) The person with an undisplaced fracture of the radius. 2) The person with multiple wounds and an open fracture. 3) The person with hypotension and a sucking chest wound. 4) The person with head trauma requiring mechanical ventilation.

3) The person with hypotension and a sucking chest wound.

A client with hepatitis A (HAV) is newly admitted to the unit. Which action would be the priority to include in this client's plan of care within the initial 24 hours? 1) Use disposable utensils and plates for meals. 2) Provide soft easily digested food with frequent snacks. 3) Wear gown and gloves during client contact. 4) Wear masks with shields if there is potential for fluid splash.

3) Wear gown and gloves during client contact.

The client with newly diagnosed irritable bowel syndrome (IBS) states: "All this fiber I have to eat now is making me full of gas! It makes me want to stop taking it." What instruction by the nurse will help the client manage this side effect and increase compliance with the diet? (Select all that apply.)1) Eat a balanced and nutritious variety of foods. 2) Eat three regularly scheduled meals every day. 3) Discuss a work-up for lactose intolerance with the health care provider. 4) Reduce intake of gas-forming foods. 5) Cut back on fiber and then add it again slowly to the diet.

3-4-5 are all correct.

After working with a client, an unlicensed assistive personnel (UAP) tells the nurse, "I have had it with that demanding client. I just can't do anything that pleases him. I'm not going in there again." The nurse should respond with which statement? 1) "Ignore him and get the rest of your work done. Someone else can care for him the rest of the day." 2) "I will talk with him and try to figure out what to do or what the problem is." 3) "He has a lot of problems. You need to have patience with him." 4) "He may be scared and taking it out on you. Let's talk to figure out what to do next."

4) "He may be scared and taking it out on you. Let's talk to figure out what to do next."

Which of these clients should the nurse assess and monitor for Clostridium difficile (C. difficile) diarrhea? 1) An older adult client living in a retirement center taking prednisone. 2) An adolescent taking tetracycline for acne. 3) A young adult at home taking a prescribed aminoglycoside. 4) A hospitalized middle-aged client receiving IV cephalexin (Reflex).

4) A hospitalized middle-aged client receiving IV cephalexin (Reflex). Cephalexin is an Antibiotic.

A client arrives in the emergency department after a radiologic accident at a local factory. After placing the client in a decontamination room, the nurse gives priority to which intervention? 1) Begin decontamination procedures for the client. 2) Double bag the client's contaminated clothing. 3) Wrap the client in blankets to minimize staff contamination. 4) Ensure physiologic stability of the client.

4) Ensure physiologic stability of the client.

The nurse is assessing a client in the labor and delivery unit. Which of the following actions is correct when using palpation to assess the characteristics and pattern of uterine contractions? 1) Place a hand on abdomen below the umbilicus and palpate uterine tone with fingertips. 2) Determine frequency by timing the end of one contraction until the end of the next contraction. 3) Assess uterine contractions every 30 minutes throughout the first stage of labor. 4) Evaluate intensity by pressing fingertips into the uterine funds.

4) Evaluate intensity by pressing fingertips into the uterine funds.

A client was just taken off the ventilator after surgery and has a nasogastric tube draining bile-colored liquids. Which nursing intervention would provide the most comfort to the client? 1) Provide mints to freshen the breath. 2) Swab the mouth with glycerin swabs. 3) Allow the client to melt ice chips in the mouth. 4) Perform frequent oral care using a tooth sponge.

4) Perform frequent oral care using a tooth sponge.

A client takes 20 mg of furosemide by mouth at 10 am. What information would be essential for the nurse to include at the change of shift report at 3 pm? 1) The client is to receive another dose of furosemide at 10 pm. 2) The client lost two pounds in the last 24 hours. 3) The client's potassium level is 4 mEq/L prior to medication administration. 4) The client's urine output was 1500 mL in five hours.

4) The client's urine output was 1500 mL in five hours.

The nurse is assessing a 28 year-old female for risk factors contributing to osteoporosis. Which statement reported by the client should alert the nurse that additional teaching about this disease is indicated? (Select all that apply.) 1) "I'm just started following the Mediterranean diet and already feel more energized." 2) "I get sun exposure daily and always use sunblock protection." 3) "I consume only skim milk, never whole milk." 4) "I take 1000 mg OsCal (calcium carbonate) every morning with breakfast." 5) "I'm a professional dancer and train 8 to 10 hours a day."

4-5 are correct.