Download NCLEX-PN Review Questions with verified solutions 2025 latest update. Qs A patient is bei and more Exams Nursing in PDF only on Docsity!
NCLEX-PN Review Questions with verified
solutions 2025 latest update.
Qs A patient is being admitted to the ICU with a severe case of encephalitis. Which of these drugs would the nurse not be expected to be prescribed for this condition?
- Acyclovir (Zovirax)
- Mannitol (Osmitrol)
- Lactated Ringer's
- Phenytoin (Dilantin) 3. Lactated Ringer's Ans✔✔ - Lactated Ringer's solution is often used in fluid replacement therapy, which is not warranted if a patient is at risk for high ICP. . Qs The nurse is treating a patient who has Parkinson's Disease. Which of these practices would not be included in the care plan?
- Decrease the calorie content of daily meals to avoid weight gain
- Allow the patient extra time to respond to questions and do ADLs
- Use thickened liquids and a soft diet
- Encourage the patient to hold the spoon when eating 1. Decrease the calorie content of daily meals to avoid weight gain Ans✔✔ - Calorie content should be increased for patients with Parkinson's Disease because of dysphagia (difficulty swallowing), as well as calories burned due to muscle rigidity.
Qs A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The patient is living at home with her daughter. The nurse is most concerned about which side effect of ropinirole?
- Slurred speech
- Sudden dizziness
- Masklike facial expression
- Stooped Posture 2. Sudden dizziness Ans✔✔ - Dizziness and orthostatic hypotension are serious adverse effects of this drug that can lead to an increased risk of falls. Ropinirole's drug class is a dopamine agonist, which mimic dopamine in the brain (PD is characterized by a lack of dopamine). Qs The nurse is taking the health history of a patient being treated for Parkinson's Disease. After being told the patient has classic symptoms of Parkinson's, the nurse expects to note which assessment finding?
- Tremors
- Low Urine Output
- Exaggerated arm movements
- Risk for Falls 1. Tremors Ans✔✔ - Tremors is one of four cardinal signs of PD: the other three are rigidity, bradykinesia (slow movements), and postural instability Qs A nurse enters a patient's room and finds them unconscious with a rhythmic jerking of all four extremities. The patient is foaming heavily at the mouth. The patient was on seizure precautions and the bedrails are up and padded. What is the nurse's priority action?
- Connect and read an EKG2. Administer Normal Saline Ans✔✔ - The patient is entering neurogenic shock. Normal saline will replace fluid volume, treating the hypotension and bradycardia symptomatically. Atropine sulfate is also commonly used to increase the heart rate. Qs A nurse is caring for a patient who is suspected to have sustained a spinal cord injury. What best describes the overarching principles used to guide the care for this type of condition?
- Immobilize the cervical area to prevent further injury
- Monitor the patient's level of consciousness to prevent neurologic deterioration
- Help the patient with activities of daily living and provide emotional and physical support to help them adjust to their injury
- Facilitate tissue perfusion to the spinal cord while maintaining airway and breathing
- Facilitate tissue perfusion to the spinal cord while maintaining airway and breathing Ans✔✔ - Maintaining airway, breathing, and circulation is both essential and guides the overall plan of care for a patient with a spinal cord injury. Qs A 23-year-old woman is admitted to the infusion clinic after a Multiple Sclerosis Exacerbation. The physician orders methylprednisolone infusions (Solu-Medrol). The nurse would expect which of the following outcomes after administration of this medication?
- A decrease in muscle spasticity and involuntary movements
- A slowed progression of Multiple Sclerosis related plaques
- A decrease in the length of the exacerbation
- A stabilization of mood and sleep 3. A decrease in the length of the exacerbation
Ans✔✔ - A methylprednisolone infusion is the first line of treatment during an acute exacerbation and is used to decrease the length and severity of a relapse. Qs The nurse is taking the health history of a patient being treated for Emphysema and Chronic Bronchitis. After being told the patient has been smoking cigarettes for 30 years, the nurse expects to note which assessment finding?
- Increase in Forced Vital Capacity (FVC)
- A narrowed chest cavity
- Clubbed fingers
- An increased risk of cardiac failure 3. Clubbed fingers - Ans✔✔ Clubbed fingers are a sign of a long-term, or chronic, decrease in oxygen levels. Qs The nurse is taking the health history of a 70-year-old patient being treated for a Duodenal Ulcer. After being told the patient is complaining of epigastric pain, the nurse expects to note which assessment finding?
- Melena
- Nausea
- Hernia
- Hyperthermia 1. Melena - Ans✔✔ Melena is the finding that there are traces of blood in the stool which presents as black, tarry feces. This is a common manifestation of Duodenal Ulcers, since the Duodenum is further down the gastric anatomy. Qs A nurse is providing discharge teaching for a patient with severe Gastroesophogeal Reflux Disease. Which of these statements by the patient indicates a need for more teaching?
A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is critical and should be reported to the physician immediately?
- Hemoglobin 11 g/dl
- Platelet of 150,
- INR of 2.
- Potassium of 2.7 mEq/L 4. Potassium of 2.7 mEq/L ANS✔✔ - A potassium imbalance for a patient with a history of dysrhythmia can be life- threatening and can lead to cardiac distress. Qs While receiving normal saline infusions to treat a GI bleed, the nurse notes that the patient's lower legs have become edematous and auscultates crackles in the lungs. What should the nurse do first?
- Stop the saline infusion immediately
- Notify Physician
- Elevate the patient's legs
- Continue the infusion, since these are normal findings 1. Stop the saline infusion immediately ANS✔✔ - the patient has a fluid volume overload as a result of overly rapid fluid replacement. The nurse should stop the infusion and notify the physician. Qs The nurse is working in a support group for clients with HIV. Which point is most important for the nurse to stress?
- They must inform household members of their condition
- They must take their medications exactly as prescribed
- They must abstain from substance use
- They must avoid large crowds 2. They must take their medications exactly as prescribed ANS✔✔ - Antiretrovirals must be taken exactly as prescribed to prevent drug-resistant strains. Even missed doses can reduce the effectiveness of future treatment. Qs A nurse finds a 30-year-old woman experiencing anaphylaxis from a bee sting. Emergency personnel have been called. The nurse notes the woman is breathing but short of breath. Which of the following interventions should the nurse do first?
- Initiate cardiopulmonary resuscitation
- Check for a pulse
- Ask the woman if she carries an emergency medical kit
- Stay with the woman until help comes 3. Ask the woman if she carries an emergency medical kit ANS✔✔ - Many patients who have a known history of anaphylaxis carry epi-pens in their pockets or belongings. This is the best way to stop a hypersensitivity reaction before it becomes life-threatening. Qs A man is prescribed lithium to treat bipolar disorder. The nurse is most concerned about lithium toxicity when he notices which of these assessment findings?
- The patient states he had a manic episode a week ago
- The patient states he has been having diarrhea every day
- The patient has a rashy pruritis on his arms and legs
- The patient presents as severely depressed
A female patient is prescribed metformin for glucose control. The patient is on NPO status pending a diagnostic test. The nurse is most concerned about which side effect of metformin?
- Diarrhea and Vomiting
- Dizziness and Drowsiness
- Metallic taste
- Hypoglycemia 4. Hypoglycemia Ans✔✔ - The patient is at risk because she is on NPO status and continuing to take an anti-glycemic drug. Qs The nurse is reviewing the lab results of a patient taking lithium for schizoaffective disorder. The lab results show that the blood lithium value is 1.7 mcg/L. What would the nurse take as the priority action?
- Induce vomiting
- Hold the next dose of Lithium
- Administer an anti-emetic
- Give the next dose of Lithium 2. Hold the next dose of Lithium Ans✔✔ - Lithium's therapeutic range is 0.5-1.5mcg/L, and begins toxicity at 1.5mcg/L Qs A patient asks the nurse why they must have a heparin injection. What is the nurse's best response?
- "Heparin will dissolve clots that you have."
- "Heparin will reduce the platelets that make your blood clot"
- "Heparin will work better than warfarin."
- "Heparin will prevent new clots from developing." 4. "Heparin will prevent new clots from developing." Ans✔✔ -This is correct statement. Qs The nurse is reviewing the lab results of a patient who has presented in the Emergency Room. The lab results show that the troponin T value is at 5.3 ng/mL. Which of these interventions, if not completed already, would take priority over the others?
- Put the patient in a 90 degree position
- Check whether the patient is taking diuretics
- Obtain and attach defibrillator leads
- Check the patient's last ejection fraction 3. Obtain and attach defibrillator leads Ans✔✔ - This patient is undergoing an emergency cardiac event. Normal Troponin T levels are less than 0.2 ng/mL. Ventricular Fibrillation is the cause of death in most cases of deaths due to sudden cardiac arrest. Defibrillation is the most important action to take to prevent death. Qs A nurse is caring for a patient undergoing a stress test on a treadmill. The patient turns to talk to the nurse. Which of these statements would require the most immediate intervention?
- "I'm feeling extremely thirsty. I'm going to get some water after this."
- "I can feel my heart racing."
- "My shoulder and arm is hurting."
- "My blood pressure reading is 158/80" 3. "My shoulder and arm is hurting." Ans✔✔ - Unilateral arm and shoulder pain is one of the classic symptoms of myocardial ischemia. The stress test should be halted.
- Hypotension
- Palpitations
- Nagging, dry cough 2. Hypotension Ans✔✔ - The patient is particularly at risk for hypotension due to possible dehydration from fluid loss. Qs The nurse is taking the health history of a patient being treated for sickle cell disease. After being told the patient has severe generalized pain, the nurse expects to note which assessment finding?
- Severe and persistent diarrhea
- Intense pain in the toe
- Yellow-tinged sclera
- Headache 3. Yellow-tinged sclera Ans✔✔ - Jaundice is a common clinical finding of sickle cell disease, caused by bilirubin released from damaged or destroyed RBCs Qs A client with Multiple Sclerosis reports a constant, burning, tingling pain in the shoulders. The nurse anticipates that the physician will order which medication for this type of pain?
- alprazolam (Xanax)
- Corticosteroid injection
- gabapentin (Neurontin)
- hydrocodone/acetaminophen (Norco) 3. gabapentin (Neurontin) Ans✔✔ - Anticonvulsants like gabapentin are often the first line of treatment for nerve pain
Qs Which of these clients is likely to receive sublingual morphine?
- A 75-year-old woman in a hospice program
- A 40-year-old man who just had throat surgery
- A 20-year-old woman with trigeminal neuralgia
- A 60-year-old man who has a painful incision 1. A 75-year-old woman in a hospice program Ans✔✔ - Sublingual morphine is often used in hospice because the patients are unable to swallow, and intravenous access can be painful and not conducive to palliative care. Qs In educating clients on ways to manage pain, which topic can be appropriately delegated to a LPN/LVN who will continue under supervision?
- Acupuncture
- Guided Imagery
- Alternating Rest/Activity
- Over the counter medications 3. Alternating Rest/Activity Ans✔✔ - This is within the nursing scope of practice and within the training and education provided to all nurses. It is safe to use and a standard treatment. Qs The nurse assesses a patient suspected of having an asthma attack. Which of the following is a common clinical manifestation of this condition?
- Audible crackles and orthopnea
- An audible wheeze and use of accessory muscles
Ans✔✔ - Lethargy and drowsiness indicate a decreased level of consciousness, which is the cardinal sign of increased ICP (Intracranial Pressure), which can be life-threatening. Qs The nurse is caring for clients in the pediatric unit. A 6-year patient is admitted who has 2nd and 3rd degree burns on his arms. The nurse should assign the new patient to which of the following roommates?
- A 4-year old with sickle-cell disease
- A 12-year old with chickenpox
- A 6-year old undergoing chemotherapy
- A 7-year old with a high temperature 1. A 4-year old with sickle-cell disease Ans✔✔ - The nurse should be concerned about the burn patient's vulnerability to infection. Sickle cell disease is not a communicable disease. Qs A patient with Meningitis is being treated with Vancomycin intravenously 3 times per day. The nurse notes that the urine output during the last 8 hours was 200mL. What is the nurse's priority action?
- Check the patient's last BUN
- Ask the patient to increase their fluid intake
- Ask the physician to order a diuretic
- Notify the physician of this finding 4. Notify the physician of this finding Ans✔✔ - Vancomycin is a nephrotoxic drug and can cause impaired renal perfusion, which would cause a decreased urine output. This is a serious adverse effect and should be reported to the physician.
Qs A nurse knows that which of these patients are at greatest risk for a stroke?
- A 60-year old male who weighs 270 pounds, has atrial fibrillation, and has had a TIA in the past.
- A 75-year old male who has frequent migraines, drinks a glass of wine every day, and is Hispanic.
- A 40-year old female who has high cholesterol and uses oral contraceptives
- A 65-year old female who is African American, has sickle cell disease and smokes cigarettes. 1. A 60-year old male who weighs 270 pounds, has atrial fibrillation, and has had a TIA in the past. Ans✔✔ - Common risk factors for developing stroke include: Atrial fibrillation, arteriosclerosis, previous stroke or ischemic attack, heart surgery, valvular heart disease, diabetes, smoking, substance abuse,obesity, sedentary lifestyle, oral contraceptive use, genetic tendency, migraines, older age, male, African American/Hispanic/American Indian, Sickle Cell Anemia, and brain trauma. This man has the greatest risk based on these risk factors. Qs A nurse frequently treats patients in the 72-hour period after a stroke has occurred. The nurse would be most concerned about which of these assessment findings?
- INR is 3 seconds long
- Heart rate is 110 beats per minute
- Intracranial Pressure is 22 mm/Hg
- Blood pressure is 140/80 3. Intracranial Pressure is 22 mm/Hg
Ans✔✔ - Glaucoma cannot be cured, just treated. Treatment revolves around preventing further deterioration. Qs A patient with Glaucoma is verbalizing his daily medication routine to the nurse. He states he has two different eyedrop medications, both every twelve hours. He washes his hands, instills the drops, closes his eyes gently, and presses his finger to the corner of his eye nearest his nose. After waiting 1 minute with his eyes closed, he instills the other medication in the same way. What is the nurse's best response?
- "You should wait more than 1 minute between different medications."
- "Your routine is very good! Can you demonstrate it for me?"
- "It is actually not the best practice to close your eyes after instilling eyedrops."
- "You should actually be pressing your finger in the other corner of the eye." 1. "You should wait more than 1 minute between different medications." Ans✔✔ - It is recommended to wait 10-15 minutes between different eyedrop medications to give them time to absorb an avoid one medication washing another one out. Qs A nurse would evaluate which of these patients as appropriate candidates for a closed MRI without contrast, based on the information given?
- A 20-year old woman who has unexplained joint pain and a low BMI.
- A 35-year old woman with Multiple Sclerosis and has been trying to conceive.
- A 67-year old man who has had an open-heart surgery 4 years ago.
- A 40-year old woman who has been in a hypomanic state for the last 2 days. 1. A 20-year old woman who has unexplained joint pain and a low BMI. Ans✔✔ - MRI can be used to diagnose musculoskeletal disorders, and this patient has no contraindications to an MRI. Qs A nurse is caring for a patient in the cardiac care unit who is taking bumetanide (Bumex) and is diagnosed with Parkinson's Disease. An unlicensed assistive personnel is assisting with feeding the patient. Which of these foods would the nurse stress for the patient to eat most?
- Foods containing the least amount of salt
- Foods containing the most amount of potassium
- Foods containing the most amount of calories
- Foods containing the most amount of fiber 2. Foods containing the most amount of potassium Ans✔✔ - Bumex is a loop diuretic and can cause hypokalemia. Ensuring potassium is included in the diet is a priority and can directly avoid a hypokalemic crisis. information given, this is not the greatest priority. Qs A nurse knows that which of these patients are at greatest risk for a developing osteoporosis?
- An 80-year old man who has a thin build
- A 48-year old african american female who smokes cigarettes and drinks alcohol
- A 55-year old female with an estrogen deficiency
- A 70-year old caucasian female who takes oral corticosteroids 4. A 70-year old caucasian female who takes oral corticosteroids
