NCLEX Practice Questions — Set 52
How to use this set
Run it as a timed block rather than dipping in and out. 100 items at roughly a minute each is close to the pace the real exam asks for, and pacing is a skill that only improves under a clock. Answer every item before you open a single rationale — checking as you go turns a test into a reading exercise and hides the questions you were unsure about.
These sets are numbered rather than sorted by subject. The questions come from a general NCLEX bank that carries no topic field, and labelling them by eye would put a share of them under the wrong heading, so they are presented as mixed sets — which is how the exam itself arrives.
The 100 questions
A client with suspected myasthenias gravis has been administered the drug edrophonium chloride (Tensilon). Which effect would the nurse expect the client to exhibit after administration?
Show answer and rationale
Correct answer: A. Increased muscle strength
Clients with myasthenia gravis have a decrease in muscular strength because of a lack of acetylcholine. Tensilon administration halts the breakdown of acetylcholine, causing an increase in muscular strength that confirms the diagnosis. Answer A would indicate that the client does not have myasthenias gravis. Answers B and D are not an effect of the drug Tensilon.
A client is admitted with hypothyroidism. Which clinical manifestation would the nurse expect the client to exhibit?
Show answer and rationale
Correct answer: D. Intolerance to cold
These clients have a subnormal temperature and pulse rate, causing them to have a decreased tolerance of cold. Answers A, C, and D are symptoms of hyperthyroidism, so they are incorrect.
The nurse caring for a client with Alzheimer’s disease should initiate which of the following when requesting an action by the client?
Show answer and rationale
Correct answer: C. Give one direction at a time
The nurse should give only one direction or step at a time when communicating to clients with Alzheimer’s disease. Clients cannot comprehend when too much detailed information or too many instructions are given at one time, making answers A and D incorrect. Answer C forces the Alzheimer’s client to make a choice and a decision, which is difficult for clients with this disorder.
A nurse would expect a newly diagnosed insulin-dependent diabetic to exhibit which clinical manifestations?
Show answer and rationale
Correct answer: B. Increased urination and thirst
The three main symptoms of diabetes are increased urination, increased thirst, and increased appetite. Answer A is incorrect because the client’s appetite would be increased. Diabetics experience weight loss, which makes answer B incorrect. Answer C is not associated with diabetes.
A nurse is working in a nursing home and evaluating temperatures that have been recorded by the nurse’s assistant. A temperature of 100.4�F is noted. Which of these responses should the nurse take?
Show answer and rationale
Correct answer: A. Retake the client’s temperature in 30 minutes to assess for an increase
Any abnormal temperature should be reassessed in 30 minutes. A temperature above 101�F requires that the physician be notified, which makes answer D incorrect. Answer A would be done, but it would not be the only action. Answer C is incorrect because the nurse should wait 5 minutes after food or liquids to retake the temperature, for an accurate recording.
Which of these tasks would it be most appropriate to assign to a nursing assistant?
Show answer and rationale
Correct answer: A. Assisting a client 2 days post-operative abdominal surgery
It is appropriate for the nursing assistant to perform activity orders for stable clients. It is beyond the role of the nurse’s assistant to perform blood sugars and obtain vital signs on unstable clients, as in answers A and B. A client with a stroke might have dysphasia, which makes answer C inappropriate for the assistant, especially because the client is new and has not been evaluated.
Which action by the nurse would be most effective in relieving phantom limb pain on a client with an above-the-knee amputation?
Show answer and rationale
Correct answer: B. Applying ordered transcutaneous nerve stimulator (TENS) unit
The TENS unit is applied for pain relief. A TENS unit is a batteryoperated unit applied to the skin that stimulates non-pain receptors in the same areas that transmit the pain. This is the only answer that actually does anything about the pain the client is experiencing. Answer A is a psychosocial acknowledgment. Answers B and D might help the pain, but answer C would help more.
Acetaminophen (Tylenol) 240mg is ordered for an infant who weighs 12 pounds. The usual dose for an infant is 10-15mg per kilogram of body weight. A nurse should take which action?
Show answer and rationale
Correct answer: A. Discuss the order with the physician
The dose of medication is too high, so the nurse should contact the physician. The infant weighs 5.45kg; the dose should be between 54.5 and 81.75. Answer A would be an incorrect dose. Answer B would require a new prescription. The action in answer C is not necessary and inappropriate to the situation.
Which comment made by a client with congestive heart failure should cause a need for nursing follow-up?
Show answer and rationale
Correct answer: B. "I have gained 3 pounds since yesterday."
This statement indicates that the client is retaining fluid and the condition is deteriorating. Answers A and B are normal and require no need for followup. Answer C indicates that the client is diuresing, which is a positive outcome of treatment.
The nurse is discussing pain from cholecystitis with a client. Which statement made by the client most accurately describes the typical pain of this disorder?
Show answer and rationale
Correct answer: B. "The pain gets worse after I eat fatty foods."
Clients with gallbladder (GB) disease complain of colicky pain usually after intake of fatty foods. The pain is located in the right upper quadrant of the abdomen or the right shoulder, so answer A is incorrect. Food intake causes more pain because of GB stimulation, so answer B is incorrect. Answer D is an incorrect statement because the gallbladder function is not associated with diarrhea or constipation.
A client with end stage cirrhosis can sometimes develop mental changes. What is the most likely cause?
Show answer and rationale
Correct answer: C. Elevated blood ammonia
The liver fails to convert protein for excretion; therefore, protein converts to ammonia, which then builds up in the blood stream, causing mental changes and sometimes coma. An increased WBC and high blood sugar are not associated with liver cirrhosis, so answers C and D are incorrect. The protein levels are elevated, as evidenced by elevated ammonia in the serum, so answer B is incorrect.
The nurse is caring for a client after a liver biopsy. The nurse should carefully monitor the client for the development of which of the following?
Show answer and rationale
Correct answer: B. Pneumothorax
The lung could be punctured inadvertently by the liver biopsy procedure, causing a pneumothorax. The nurse should also be alert for hemorrhage. Answers A, B, and D are not associated risks with a liver biopsy.
The LPN/LVN is assisting a client immediately after a paracentesis. Which of the following actions is the priority?
Show answer and rationale
Correct answer: D. Obtaining vital signs
The client is at risk for a loss of fluid volume and shock, so obtaining the vital signs to assess for complications would be the priority. Answers B, C, and D can all be implemented, but they are not the priority so they are incorrect.
A client has a subtotal thyroidectomy. The nurse is observed requesting that the client state her name frequently. The primary reason for this assessment is to monitor for which of the following?
Show answer and rationale
Correct answer: B. Laryngeal nerve damage
The nurse would monitor the client for hoarseness or a voice change, which could indicate damage to the laryngeal nerve during the surgical procedure. Although the nurse would monitor for edema, bleeding, and tetany, assessment of these problems would not be performed by asking the client to speak.
The nurse is caring for a client with hyperthyroidism. Which clinical manifestation should be reported to the physician immediately?
Show answer and rationale
Correct answer: D. Heart failure
Heart failure can be life threatening and would be a priority for reporting. These clients are hyperactive and restless, making answers C and D incorrect. Urinary retention, as in answer A, is not a clinical manifestation of hyperthyroidism.
The LPN/LVN is caring for a client with a diagnosis of diabetes insipidus. Which of the following clinical manifestations is expected?
Show answer and rationale
Correct answer: D. Polyuria
Symptoms of diabetes insipidus include excretion of large amounts of dilute urine and extreme thirst. The clinical manifestations listed in options B, C, and D are not associated with diabetes insipidus so they are incorrect.
The influenza vaccine cannot be given to clients in which age group?
Show answer and rationale
Correct answer: A. Less than 6 months of age
The flu vaccine has not been found to be safe in children younger than 6 months; therefore, is not recommended for them. It is especially important that the vaccine be given in the age groups in answers B and D because they are high-risk groups. The age group in C is not a high-risk group, but flu vaccine administration is not contraindicated.
The physician is about to remove a chest tube. Which client instruction is appropriate?
Show answer and rationale
Correct answer: B. Take a deep breath, exhale, and bear down
This procedure prevents air entrance while the chest tube is being removed. Answer B is incorrect because it requires a lack of ventilation for too long of a period and exhalation is not allowed. Answers C and D allow air to enter the thoracic cavity during removal, so they are incorrect.
A client with diagnosed diabetes visits the clinic complaining of shakiness and tingling sensations. Which of the following questions is most important for the LPN/LVN to ask?
Show answer and rationale
Correct answer: A. What was your blood glucose and when was it checked?
The client is exhibiting symptoms of hypoglycemia. The LPN needs to gather information related to the client’s diagnosis. The questions in A, B, and D are appropriate. But the priority would be to find out the problem and treat it.
A client is to undergo insertion of an esophageal gastric balloon tube. Which instruction would the nurse include in teaching aboutthe purpose of the device?
Show answer and rationale
Correct answer: A. "The device applies pressure to the veins in the esophagus and stomach."
An esophageal gastric balloon tube is inserted for bleeding esophageal varices by placing direct pressure and stopping the bleeding. It cannot be used to prevent fluid build-up in the peritoneal cavity, as in answer B. The bleeding is a venous backup of blood, not an arterial one, so answer C is incorrect. Sclerotherapy is done by endoscopic procedure, so answer D is incorrect.
A client has an order to remove the nasogastric tube. Which is the correct nursing action to remove the tube?
Show answer and rationale
Correct answer: A. Pull the tube out steadily and smoothly while keeping it pinched
The nurse should also ask the client to hold his breath to prevent aspiration, which is the correct procedure for discontinuing an NG tube. Clean gloves should be used for this procedure, making answer A incorrect. The tube should be removed continuously without pause, so answer B is incorrect. An amount of 30mL of air�not normal saline�can be inserted before removal, so answer C is incorrect.
The nurse is preparing a client with cirrhosis for a paracentesis. How will the nurse position the client for this procedure?
Show answer and rationale
Correct answer: A. Sitting position
Placing the client in the sitting position for a paracentesis is recommended. The side-lying and head-down positions in answers A, B, and C are not recommended for a paracentesis.
The nurse working on a surgical unit would identify which client as having the highest risk for pulmonary complications after surgery?
Show answer and rationale
Correct answer: D. A 45-year-old with an open cholecystectomy
The risk factors for pulmonary complications increase with abdominal surgery for clients over age 40, and for those with prolonged periods in bed. Answer B includes two risk factors, an age of more than 40 years and abdominal surgery in an area under the diaphragm. Answers A and C have one risk factor each, which makes them incorrect. Answer D involves a risk factor for deep vein thrombosis, so it is incorrect.
Which medication should the nurse have available in case a client has an anaphylactic reaction to penicillin G benzathine (Bicillin)?
Show answer and rationale
Correct answer: D. Epinephrine
Epinephrine, antihistamines, and resuscitation equipment should be available in case of a reaction to penicillin. Epinephrine is used for allergic reactions. Answer B is an antianxiety agent, and answer D is used for high blood pressure. The anti-ulcer agent in answer C is not used for allergic reactions.
A client is admitted with benign prostatic hypertrophy. Which clinical manifestation should the nurse expect?
Show answer and rationale
Correct answer: D. Frequent urge to void
The person with benign prostatic hypertrophy (BPH) has clinical manifestations that are caused by the obstruction. Symptoms of BPH include frequency of urination, difficulty in starting the urine flow, and a frequent urge to void. If the client develops a urinary tract infection, the urine might smell, but it is not directly related to the BPH, so answer B is incorrect. Urinary retention also occurs, making answer C incorrect. Pain with urination is not a symptom of BPH, so answer D is incorrect.
The nurse is preparing to administer promethazine hydrochloride (Phenergan). This drug should produce which therapeutic effect?
Show answer and rationale
Correct answer: A. Decreased nausea
Phenergan is used for prevention and treatment of nausea and vomiting, sedation, adjunct to pain and anesthesia medications, and allergic reactions. Answers A, C, and D are not desired effects of the drug Phenergan, which makes them incorrect.
Which of the following would the nurse perform when giving medication via an NG tube?
Show answer and rationale
Correct answer: D. Ascertain tube patency and placement.
Making sure that the tube is in the right location is an important first step. Clients should be positioned with the head elevated, the medication should be administered slowly, and the NG tube should be clamped for 20-30 minutes after medication administration; therefore, options B, C, and D are incorrect.
An infant in the nursery is 48 hours old and has not passed meconium. The nurse suspects which of the following?
Show answer and rationale
Correct answer: A. Cystic fibrosis
A newborn who has not passed meconium in the first 24 hours could have cystic fibrosis. This is due to the thick secretions preventing passage of the meconium, resulting in obstruction of the bowel. Answers A and B are both cardiovascular problems that are not associated with meconium passage, so these are incorrect. Answer C is not associated with meconium and is evidenced by a yellow skin tone and an elevated serum bilirubin level.
The nurse has an order to administer meperidine (Demerol) 75 mg IM for pain. The drug available is Demerol 100mg in 2 mLs. How many mL(S) will the nurse administer?
Show answer and rationale
Correct answer: C. 1.5 mL
The correct calculation is 1.5 mL, which is calculated as follows: 75 mg?= 2mL/100mg= 150/100= 1.5 mL Answers A, B, and D are incorrect calculations, so they are wrong.
A client who is complaining of nausea, has an order for hydroxyzine hydrochloride (Vistaril) 75mg every 3-4 hours IM p.r.n. for nausea. The vial contains 100mg per 2mL. How many milliliters will you give?
Show answer and rationale
Correct answer: D. 1.5mL
The desired dose is 75mg. The dose on hand is 100mg in 2mL, making the correct dose 1.5mL. The answers in A, C, and D are incorrect calculations.
The nurse is giving instructions on the removal of ticks at a Girl Scout meeting. Which information is proper procedure for tick removal?
Show answer and rationale
Correct answer: D. "Use tweezers to remove the tick, disinfecting the area before and after removal."
The recommended procedure is to use tweezers to remove the tick, using a slow steady force, and to disinfect the area before and after doing so. Answers B, C, and D are not the correct procedure to safely remove a tick
The nurse recognizes that which of the following protective equipment is most appropriate to wear when suctioning a client with a tracheostomy?
Show answer and rationale
Correct answer: C. Gown, goggles, and gloves
Standard precautions require that goggles, a gown, and gloves be worn when there is a danger of contamination by splashing. Answers B and C are not adequate for the suctioning procedure. A gown is not an adequate precaution and shoe covers are not required, making answer D incorrect.
Which statement made by a client’s son signifies abnormal grieving by the client?
Show answer and rationale
Correct answer: C. "Mother has not been saddened at all by Daddy’s death. She acts like nothing has happened."
Abnormal grieving occurs when someone acts as if nothing has happened. Answers A, B, and C are normal parts of the grieving process, so they are incorrect.
A nurse would expect a client admitted with congestive heart failure to be treated with which drug?
Show answer and rationale
Correct answer: A. Furosemide (Lasix)
Clients with congestive heart failure are usually treated with a diuretic, such as Lasix and Digoxin. Answer B is a hematologic, and answer C is an anticoagulant. Skelaxin, in answer D, is a muscle relaxer. These drugs are not used to decrease fluid or improve cardiac output necessary for the treatment of congestive heart failure, so they are incorrect
The nurse is assessing the chart of a client admitted for surgery when an order is noted to administer Atropine 2mg IM as a pre-operative medication to a 40-year-old client. What initial nursing action is most appropriate?
Show answer and rationale
Correct answer: A. Clarifying the order with the physician
The usual dosage of atropine as a preoperative medication is 0.4-0.6mg. The ordered dosage is too high, so the order requires clarification. Answer B is incorrect because of the ordered dosage. Answers C and D will be required, but not before getting a correct dosage order
The LPN/LVN is caring for a client with Clostidium difficile (C difficile). Which of the following observations indicates to the nurse that the client’s condition is improving?
Show answer and rationale
Correct answer: D. Moist mucous membranes
Dehydration is associated with C difficile due to the diarrhea and temperature elevation. Moist mucous membranes would indicate adequate hydration showing an improved patient outcome. Answers A, B, and D are manifestations of the condition and do not indicate an improvement, so they are incorrect
The LPN/LVN is describing a 24 hour urine collection to a client. Which of the following explanations is most accurate?
Show answer and rationale
Correct answer: D. Empty the bladder at the end of the collection period and save this urine
Proper procedure is to empty the bladder and save the urine at the end of the collection period. Clients should void and discard the urine at the beginning of the collection period so answer A is incorrect. Answer B is utilized when collecting a mid stream (clean catch) specimen so it is incorrect. The urine doesn’t have to be collected in a sterile container, therefore C is incorrect.
A client who has had thoracic surgery has been instructed in arm and shoulder exercises. The nurse recognizes which of the following as the primary reason for these exercises?
Show answer and rationale
Correct answer: A. Restore movement
The reasons for these exercises are to restore movement, prevent stiffening of the shoulder area, and improve the client’s muscle power. Answer B is not prevented by the exercises utilized. Although the answers in C and D might have a positive outcome from performing these exercises, they are not the primary reason the exercises are done.
For the drugs Tamiflu and Relenza to be the most effective in eliminating the influenza virus, they should be administered within which time period?
Show answer and rationale
Correct answer: B. 3 days of the client becoming ill
The best effect of the medications occurs if given within 2-3 days of illness with the influenza virus. Answers B, C, and D are not within the allotted time period for the drugs to be effective in eliminating the influenza virus.
A 22-year-old female is being discharged after an admission for bipolar disorder. Discharge medications include valproate (Depakote). Which statement by the client would cause the nurse concern because of the prescription?
Show answer and rationale
Correct answer: D. "I am trying to get pregnant."
Depakote can cause neural tube defects in pregnant women, so the client should be on birth control or should not take this drug. A client’s career, exercise level, and diet will not affect the dose or prescription for this drug, so answers B, C, and D are incorrect.
A tuberculin test has been administered to an elderly client in preparation for nursing home placement. Which of these skin reactions at the site of the test could indicate a positive result?
Show answer and rationale
Correct answer: A. Induration
The hardening or induration could indicate a positive test result. A reaction of 0-4mm is not significant. A larger-size induration could indicate exposure to tuberculosis. Answers B, C, and D without induration are nonsignificant, so they are incorrect.
The influenza vaccine is contraindicated in clients with allergies to which of the following?
Show answer and rationale
Correct answer: D. Eggs
The vaccine is made from eggs, so clients with allergies to eggs should not receive the vaccine. Shellfish and iodine are associated with the dye used for intravenous pyelograms, so answers B and C are incorrect. An allergy to pork, as in answer D, does not indicate a need to avoid the influenza virus.
The nurse identifies which of the following as a side effect of the influenza vaccine?
Show answer and rationale
Correct answer: A. Febrile reaction
The client, especially a child, could experience a febrile reaction. This makes hypothermia or a decreased temperature, as in answer B, incorrect. Another side effect is soreness at the injection site. A generalized rash and difficulty breathing are not side effects of the vaccine; therefore, answers C and D are incorrect.
A client is admitted with cholethiasis and has obstructive jaundice. Which clinical manifestations does the LPN/LVN expect to observe?
Show answer and rationale
Correct answer: B. Clay colored stool
The obstruction decreases the elimination of bile causing the collection of bilirubin in the blood instead of it being removed by the urinary and Gastrointestinal system. This leads to a lack of normal color of the stool and urine. Answers A, B, and D do not occur with obstructive jaundice so they are incorrect.
A client has an order for Codeine 60 mg IM. An available vial contains Codeine 30 mg/mL. What volume of drug would the nurse administer?
Show answer and rationale
Correct answer: D. 2.0mL
The dose to administer is 2mL, which is calculated as follows: 60 mg?= 1 mL/30 mg=60/30 = 2.0 mL Answers A, B, and C are incorrect calculations.
A client at the clinic reports to the nurse, "I have trouble seeing signs at a distance, but no trouble seeing things close up." The nurse identifies the correct term for this vision problem as:
Show answer and rationale
Correct answer: C. Myopia
Myopia is nearsightedness due to the cornea being too steep or the eye being too long. This causes light to come into focus in front of the retina, resulting in blurred distant vision. Answer B is normal vision. Farsightedness is blurred near and often distant vision, as in answer C. Astigmatism occurs when light rays focus in multiple points, causing blurred vision not related to near or far vision; thus, answer D is incorrect.
The LPN/LVN is working on a team that includes an RN and a nursing assistant. The LPN/LVN should be assigned which of the following clients?
Show answer and rationale
Correct answer: A. A client with peripheral vascular disease requiring a dressing change
The LPN should be assigned the client requiring a dressing change. This client is the one most correlated to the LPN’s scope of practice. The clients described in answer options A and D are more appropriate to the RN. The nursing assistant should care for the client needing ambulatory assistance as described in answer C because this relates to the nurses assistants standards and practices.
The nurse is caring for a client with a basilar skull fracture. Fluid is assessed leaking from the ear. What is the nurse’s first action?
Show answer and rationale
Correct answer: B. Test the drainage for glucose
Testing the drainage for glucose could indicate the presence of cerebrospinal fluid, making this the best initial action. The next action would be to notify the physician, as in answer B. Answers A and D would be contraindicated, so they are incorrect.
A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct.
Show answer and rationale
Correct answer: C. Coumadin ,Finasteride
both contraindicated with pregnancy.
A nurse is reviewing a patient’s PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct.
Show answer and rationale
Correct answer: D. Nitrodur
All of the others have can cause photosensitivity reactions.
A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient’s medication does not cause urine discoloration?
Show answer and rationale
Correct answer: A. Aspirin
All of the others can cause urine discoloration.
You are responsible for reviewing the nursing unit’s refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator’s contents?
Show answer and rationale
Correct answer: D. Corgard
Corgard could be removed from the refigerator
A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb
Show answer and rationale
Correct answer: A. IgG
IgG is the only immunoglobulin that can cross the placental barrier.
A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?
Show answer and rationale
Correct answer: D. Start prophylactic AZT treatment
AZT treatment is the most critical innervention.
A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?
Show answer and rationale
Correct answer: D. Autonomic neuropathy
Autonomic neuropathy can cause inability to urinate.
You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?
Show answer and rationale
Correct answer: A. Anorexia nervosa
All of the clinical signs and systems point to a condition of anorexia nervosa.
A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?
Show answer and rationale
Correct answer: A. Hypercalcaemia
Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.
Rho gam is most often used to treat____ mothers that have a ____ infant.
Show answer and rationale
Correct answer: B. RH negative, RH positive
Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.
A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU?
Show answer and rationale
Correct answer: C. The effects of PKU are reversible.
The effects of PKU stay with the infant throughout their life.
A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?
Show answer and rationale
Correct answer: A. Parkinson’s disease type symptoms
Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.
A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is?
Show answer and rationale
Correct answer: A. Provide a secure environment for the patient.
This patient’s safety is your primary concern.
A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient?
Show answer and rationale
Correct answer: A. Cough following bronchodilator utilization
The bronchodilator will allow a more productive cough.
A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?
Show answer and rationale
Correct answer: A. Weight gain
Weight gain is associated with CHF and congenital heart deficits.
A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?
Show answer and rationale
Correct answer: A. Oily skin
The skin would be dry and not oily.
A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered?
Show answer and rationale
Correct answer: A. Streptokinase
Streptokinase is a clot busting drug and the best choice in this situation.
A patient asks a nurse, "My doctor recommended I increase my intake of folic acid. What type of foods contain folic acids?"
Show answer and rationale
Correct answer: C. Green vegetables and liver
Green vegetables and liver are a great source of folic acid.
A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?
Show answer and rationale
Correct answer: A. Cl. difficile
Cl. difficile has not been linked to meningitis.
A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is.
Show answer and rationale
Correct answer: D. The life span of RBC is 120 days.
RBC’s last for 120 days in the body
A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning begin for this patient?.
Show answer and rationale
Correct answer: B. Upon admit
Discharge education begins upon admit.
A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?
Show answer and rationale
Correct answer: C. Initiative vs. guilt
Initiative vs. guilt- 3-6 years old
A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?
Show answer and rationale
Correct answer: B. Trust vs. mistrust
Trust vs. Mistrust- 12-18 months old
A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in?
Show answer and rationale
Correct answer: A. Intimacy vs. isolation
Intimacy vs. isolation- 18-35 years old
A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?
Show answer and rationale
Correct answer: D. 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg
HR and Respirations are slightly increased. BP is down.
When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?
Show answer and rationale
Correct answer: A. Elavil
Elavil is a tricyclic antidepressant.
Which of the following conditions would a nurse not administer erythromycin?
Show answer and rationale
Correct answer: A. Multiple Sclerosis
Erythromycin is used to treat conditions A-C.
A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?
Show answer and rationale
Correct answer: A. Migranes
Answer choices A-C were symptoms of acute hyperkalemia
A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?
Show answer and rationale
Correct answer: A. Weight gain
Weight loss would be expected.
A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?
Show answer and rationale
Correct answer: B. Increased appetite
Loss of appetite would be expected.
A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?
Show answer and rationale
Correct answer: B. Hemophilus aegyptius
Choice A is linked to Plague, Choice B is linked to peptic ulcers, Choice C is linked to Cholera.
A nurse if reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition?
Show answer and rationale
Correct answer: C. Borrelia burgdorferi
Choice B is linked to Rheumatic fever, Choice C is linked to Anthrax, Choice D is linked to Endocarditis.
A fragile 87 year-old female has recently been admitted to the hospital with increased confusion and falls over last 2 weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?
Show answer and rationale
Correct answer: A. CT scan
A CT scan would be performed for further investigation of the hemiparesis.
A 84 year-old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?
Show answer and rationale
Correct answer: D. Thyroid function tests
Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function.
A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?
Show answer and rationale
Correct answer: B. Blood cultures
Blood cultures would be performed to investigate the fever and rash symptoms.
A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?
Show answer and rationale
Correct answer: B. CT scan
With a history of diabetes, the first response should be to check blood sugar levels.
A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?
Show answer and rationale
Correct answer: B. The overall mental and physical abilities of the child.
Age is not the greatest factor in potty training. The overall mental and physical abilities of the child is the most important factor.
A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 20 minutes. Which of the following is the most important instruction the nurse can give the parent?
Show answer and rationale
Correct answer: B. Contact the Poison Control Center quickly
The poison control center will have an exact plan of action for this child.
A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate?
Show answer and rationale
Correct answer: B. Vastus lateralis
Vastus lateralis is the most appropriate location.
A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 year-old boy who is non-verbal. This child does not have on any identification. What should the nurse do?
Show answer and rationale
Correct answer: C. Ask the father who is in the room the child’s name.
In this case you are able to determine the name of the child by the father’s statement, moreover you should not withhold the medication from the child following identification.
A nurse is observing a child’s motor, sensory and speech development. The child is 7 months old. Which of the following tasks would generally not be observed?
Show answer and rationale
Correct answer: C. Child plays patty-cake and imitates.
These skills generally develop between 10-15 months.
A nurse is observing a child’s motor, sensory and speech development. The child is 5 months old. Which of the following tasks would generally not be observed?
Show answer and rationale
Correct answer: D. Child transfers objects between hands.
Transferring objects between hands is a 8-9 month skill.
A nurse is caring for an adult that has recently been diagnosed with renal failure. Which of the following clinical signs would most likely not be present?
Show answer and rationale
Correct answer: A. Hypotension
Hypertension is often related renal failure.
A nurse is caring for an adult that has recently been diagnosed with hypokalemia. Which of the following clinical signs would most likely not be present?
Show answer and rationale
Correct answer: D. Flaccid paralysis
Flaccid paralysis is an indication of Hyperkalemia.
A nurse is caring for an adult that has recently been diagnosed with metabolic acidosis. Which of the following clinical signs would most likely not be present?
Show answer and rationale
Correct answer: B. Dysrhythmias
Dysrhythmias are associated with metabolic alkalosis.
A nurse is caring for an adult that has recently been diagnosed with metabolic alkalosis. Which of the following clinical signs would most likely not be present?
Show answer and rationale
Correct answer: D. Hyperventilation
Hyperventilation occurs with metabolic acidosis. Hypoventilation occurs with metabolic alkalosis.
A nurse is caring for an adult that has recently been diagnosed with respiratory acidosis. Which of the following clinical signs would most likely not be present?
Show answer and rationale
Correct answer: B. Tachypnea
Tachypnea is associated with respiratory alkalosis.
A nurse is caring for an adult that has recently been diagnosed with respiratory alkalosis. Which of the following clinical signs would most likely not be present?
Show answer and rationale
Correct answer: A. Hyperventilation cyanosis
Hyperventilation cyanosis is associated with respiratory acidosis.
A nurse is reviewing a patient’s medication list. The drug Pentoxifylline is present on the list. Which of the following conditions is commonly treated with this medication?
Show answer and rationale
Correct answer: D. PVD
This drug is a hemorheological agent that helps blood viscosity.
A patient has been on long-term management for CHF. Which of the following drugs is considered a loop dieuretic that could be used to treat CHF symptoms?
Show answer and rationale
Correct answer: C. Bumex
Bumex is considered a loop dieuretic.
A patient has recently been diagnosed with polio and has questions about the diagnosis. Which of the following systems is most affected by polio?
Show answer and rationale
Correct answer: B. PNS
Polio is caused by a virus that attacks the CNS.
A nurse is educating a patient about right-sided heart deficits. Which of the following clinical signs is not associated with right-sided heart deficits?
Show answer and rationale
Correct answer: B. Orthopnea
Orthopnea is a left- sided heart failure clinical symptom.
What to do with your score
Score the set, then spend longer on the review than you did on the questions. For every item you missed, decide which of three things went wrong: you did not know the fact, you misread what the item was asking, or you knew the fact and still chose second-best. Those need three different fixes — content review, slower reading, and priority-framework practice — and lumping them together is why question banks stop working for people.
Read the rationale on the items you got right as well. Arriving at the correct option for the wrong reason is common, and it does not survive a harder version of the same question.
More NCLEX practice and review
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