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NCLEX NCLEX-PN Sample Questions

Question # 1

If your patient is acutely psychotic, which of the following independent nursing interventions would not be appropriate?

A. Conveying calmness with one on one interaction
B. Recognizing and dealing with your own feelings to prevent escalation of thepatient’s anxiety level
C. Encourage client participation in group therapy
D. Listen and identify causes of their behavior

Question # 2

Which of the following syndromes associated with incomplete lesions of the spinal cord is a result of damage to one-half of the spinal cord? 

A. Brown-Séquard syndrome
B. posterior cord syndrome
C. central cord syndrome
D. cauda equina syndrome

Question # 3

A client receiving preoperative instructions asks questions repeatedly about when to stop eating the night before the procedure. The nurse tries torefocus the client. The nurse notes that the client is frequently startled by noises in the hall. Assessment reveals rapid speech, trembling hands, tachypnea, tachycardia, and elevated blood pressure. The client admits to feeling nervous and having trouble sleeping. Based on the assessment, the nurse documents that the client has: 

A. mild anxiety.
B. moderate anxiety.
C. severe anxiety.
D. a panic attack.

Question # 4

A 64 year-old Alzheimer’s patient has exhibited excessive cognitive decline resulting in harmful behaviors. The physician orders restraints to be placed on the patient. Which of the following is the appropriate procedure?

A. Secure the restraints to the bed rails on all extremities.
B. Notify the physician that restraints have been placed properly.
C. Communicate with the patient and family the need for restraints.
D. Position the head of the bed at a 45 degree angle.

Question # 5

A client was involved in a motor vehicle accident in which the seat belt was not worn. The client is exhibiting crepitus, decreased breath sounds on the left, complains of shortness of breath, and has a respiratory rate of 34/min. Which of the following assessment findings should concern the nurse the most?

A. temperature of 102° F and a productive cough
B. arterial blood gases (ABGs) with a PaO2 of 92 and PaCO2 of 40 mmHg
C. trachea deviating to the right
D. barrel-chested appearance

Question # 6

Metformin (Glucophage) is administered to clients with type II diabetes mellitus. Metformin is an example of:

A. an antihyperglycemic agent.
B. a hypoglycemic agent.
C. an insulin analogue.
D. a pancreatic alpha cell stimulant.

Question # 7

An nurse is instructing a patient on the order of sensations with the application of an ice water bath for a swollen right ankle. Which of the following is the correct order of sensations experienced with an ice water bath?

A. cold, burning, aching, and numbness
B. burning, aching, cold, and numbness
C. aching, cold, burning and numbness
D. cold, aching, burning and numbness

Question # 8

A 20-year-old male client had a diving accident with subsequent paraplegia. He says to thenurse, “No woman will ever want to marry me now.” Which of the following responses bythe nurse is most therapeutic?

A. “Don’t worry. Maybe you’ll meet a paraplegic woman.”
B. “There is someone for everyone in this world.”
C. “You are still an attractive man, even though you can’t walk.”
D. “Tell me more about your feelings on this issue.”

Question # 9

A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS. Whichof the following side effects should the patient specifically watch out for?

A. Weakness and SOB
B. Fever and anemia
C. Hypertension and SOB
D. Fever and hypertension

Question # 10

A client reports that someone is in the room and trying to kill him. The nurse’s best response is:

A. “No one is in your room. Let’s get you more medicine.”
B. “I do not see anyone, but you seem to be very frightened.”
C. “No one can hurt you here.”
D. “Just tell the person to go away.”

Question # 11

A twenty-one year old man suffered a concussion and the MD ordered a MRI. The patientasks, “Will they allow me to sit up during the MRI?” The correct response by the nurseshould be.

A. “I will have to talk to the doctor about letting you sit upright during the test.”
B. “You will be positioned in the reverse Trendelenburg position to maximizethe view of thebrain.”
C. “The radiologist will let you know.”
D. “You will have to lie down on your back during the test.”

Question # 12

A thirty-seven year-old female in room 307 has a diagnosis of acquired immune deficiency syndrome (AIDS). Which of the following situations requires nurse intervention? 

A. A certified nursing assistant states, “The patient in 307 is not wearing glovesshaving her legs.” 
B. A nursing assistant at the nursing station states, “The patient in 307 has arespiratory rate of 16.”
C. A nursing student in the cafeteria states, “Dr.Jones told the patient in room307 that she was going to die.” 
D. A certified nursing assistant states, “Dr. Jones hasn’t made rounds thismorning.”

Question # 13

A nurse is reviewing a patient’s current Lithium levels. Which of the following values isoutside the therapeutic range?

A. 1.0 mEq/L
B. 1.1 mEq/L
C. 1.2 mEq/L
D. 1.3 mEq/L

Question # 14

A primigravida begins labor when her family is unavailable and she is alone. She is very upset that her family is not with her. Which approach can the nurse take to meet the client’s needs at this time?

A. asking whether another individual wants to be her support person
B. assuring her that the nursing triage group will be with her at all times
C. telling her you will try to locate her family
D. reinforcing the woman’s confidence in her own abilities to cope and maintain a sense of control

Question # 15

A nurse is caring for a patient in the step down unit. The patient has signs of increasedintracranial pressure. Which of the following is not a sign of increased intracranialpressure?

A. Bradycardia
B. Increased pupil size bilaterally
C. Change in LOC
D. Vomiting

Question # 16

A nurse has been assigned a patient who has recently been diagnosed with Guillain-Barre’Syndrome. Which of the following statements is the most applicable when discussing theimpairments with Guillain-Barre’ Syndrome with the patient?

A. Guillain-Barre’ Syndrome gets better after 5 years in almost all cases.
B. Guillain-Barre’ Syndrome causes limited sensation in the abdominal region.
C. Guillain-Barre’ Syndrome causes muscle weakness in the legs.
D. Guillain-Barre’ Syndrome does not effect breathing in severe cases.

Question # 17

In hanging a parenteral IV fluid that is to be infused by gravity, rather than with an infusion pump, the nurse notes that the IV tubing is available in different drop factors. Which tubing is a microdrop set?

A. 15 drops per milliliter
B. 60 drops per milliliter
C. 20 drops per milliliter
D. 10 drops per milliliter

Question # 18

Medical records indicate a patient has developed a condition of respiratory alkalosis. Which of the following clinical signs would not apply to a condition of respiratory alkalosis? 

A. Muscle tetany
B. Syncope
C. Numbness
D. Anxiety

Question # 19

The nurse sustains a needle puncture that requires HIV prophylaxis. Which of the followingmedication regimens should be used?

A. an antibiotic such as Metronidazole and a protease inhibitor (Saquinivir)
B. two non-nucleoside reverse transcriptase inhibitors
C. one protease inhibitor such as Nelfinavir
D. two protease inhibitors

Question # 20

How does the ANA define the psychiatric nursing role?

A. a specialized area of nursing practice that employs theories of human behavior as its science and the powerful use of self as its art
B. assisting the therapist to relieve the symptoms of clients
C. to solve clients’ problems and give them the answers
D. having a client committed to long-term therapy with the nurse

Question # 21

Signs of internal bleeding include all of the following except: 

A. painful or swollen extremities.s  
B. a tender, rigid abdomen.  
C. vomiting bile.  
D. bruising.  

Question # 22

A patient asks a nurse the following question. Exposure to TB can be identified best with which of the following procedures? Which of the following tests is the most definitive of TB?

A. Chest x-ray
B. Mantoux test
C. Breath sounds examination 
D. Sputum culture for gram-negative bacteria

Question # 23

A 64 year-old male who has been diagnosed with COPD, and CHF exhibits an increase intotal body weight of 10 lbs. over the last few days. The nurse should:

A. Contact the patient’s physician immediately.
B. Check the intake and output on the patient’s flow sheet.
C. Encourage the patient to ambulate to reduce lower extremity edema.
D. Check the patient’s vitals every 2 hours.

Question # 24

Which type of dressing is recommended to place over a site when a chest tube is removed by the physician?

A. transparent dressing
B. colloidal dressing
C. petrolatum gauze
D. nonadherent dressing

Question # 25

The physician wants to know if a client is tolerating his total parenteral nutrition. Which of the following laboratory tests is likely to be ordered?

A. triglyceride level
B. liver function tests
C. a glucose tolerance test
D. a complete blood count

Question # 26

A gastroenterologist should be consulted for clients suffering from:

A. digestive system diseases.
B. urinary system diseases.
C. female reproductive system diseases.
D. nervous system diseases.

Question # 27

A 24 year-old man has been admitted to the hospital due to work-related back injury. Thepatient’s wife would like to see the patient’s chart. The nurse should:

A. Provide the chart to the patient’s wife following verbal approval by the patient.
B. Provide the chart to the patient’s wife after consulting with the patient’s physician.
C. Get written approval from the patient prior to providing the wife with chart informationand call the MD about the patient’s request.
D. Tell the patient’ wife, a copy of the patient’s medical record is on-file with medicalrecords.

Question # 28

A 62 year-old female is being seen on a home visit by a nurse. The patient reports she has been taking Premarin for years. Which of the following would indicate an over-dosage?

A. Lower extremity edema  
B. Sensory changes in the upper extremities  
C. Increased occurrence of fractures  
D. Decreased peripheral blood flow  

Question # 29

A patient has been diagnosed with diabetes mellitus. Which of the following is not a clinical sign of diabetes mellitus?

A. Polyphagia
B. Polyuria
C. Metabolic acidosis
D. Lower extremity edema

Question # 30

A woman seeks assistance because she recently remembered childhood sexual abuse.The nurse should include which of the following goals for this client?

A. prosecuting the perpetrator
B. managing symptoms of anxiety and fear
C. determining if the memories are real
D. collaborating the client’s story

Question # 31

A paraplegic client is in the hospital to be treated for an electrolyte imbalance. Which level of care is the client currently receiving?

A. primary prevention
B. secondary prevention
C. tertiary prevention 
D. health promotion

Question # 32

After the client discusses her relationship with her father, the nurse says, “Tell me whether I am understanding your relationship with your father. You feel dominated and controlled by him?” This is an example of:

A. verbalizing the implied.  
B. seeking consensual validation.  
C. encouraging evaluation.  
D. suggesting collaboration.  

Question # 33

A 14 year-old boy has been admitted to a mental health unit for observation and treatment. The boy becomes agitated and starts yelling at nursing staff members. What should the nurse first response be? 

A. Create an atmosphere of seclusion for the boy according to procedures.
B. Remove other patients from the area via wheelchairs for added speed.
C. Ask the patient, “What is making you mad?”
D. Ask the patient, “Why are you doing this, have you thought about what yourparents might say?”

Question # 34

The nurse working with elderly clients should keep in mind that falls are most likely tohappen to elderly who are:

A. in their 80s.
B. living at home.
C. hospitalized.
D. living on only Social Security income.

Question # 35

A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else. Which of the following comments by the nurse to the physician is appropriate?

A. “Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain.”
B. “Often women become offended if asked about their safety in relationships.”  
C. “It is mandatory that all women be questioned about domestic violence.”  
D. “How would you feel to know that her partner is beating her and you didn’t ask?”  

Question # 36

A nurse working a surgical unit, notices a patient is experiencing SOB, calf pain, and warmth over the posterior calf. All of these may indicate which of the following medical conditions?

A. Patient may have a DVT. 
B. Patient may be exhibiting signs of dermatitis.
C. Patient may be in the late phases of CHF.
D. Patient may be experiencing anxiety after surgery.

Question # 37

A nurse is caring for a patient who has recently been diagnosed with fibromyalgia andCOPD. Which of the following tasks should the nurse delegate to a nursing assistant?

A. Transferring the patient to the shower.
B. Ambulating the patient for the first time.
C. Taking the patient’s breath sounds
D. Educating the patient on monitoring fatigue

Question # 38

A nurse is caring for a retired MD. The MD asks the question, “What type of cells secrete insulin?” The correct answer is: 

A. alpha cells
B. beta cells
C. CD4 cells
D. helper cells

Question # 39

Issues addressed in ethics committees include all of the following except: 

A. nonpayment of bills.  
B. euthanasia.  
C. starting or stopping treatment.  
D. use of feeding tubes.  

Question # 40

Which of the following symptoms is not indicative of autonomic dysreflexia in the client with a spinal cord injury? 

A. sudden onset of headache
B. flushed face
C. hypotension
D. nasal congestion

Question # 41

While admitting a client to an acute-care psychiatric unit, the nurse asks about substanceabuse based on knowledge that:

A. psychiatric illness is more prevalent in addicted populations.
B. people with psychiatric disorders are more prone to substance abuse.
C. substance disorders are easily detected and diagnosed in acute-care psychiatricsettings.
D. undetected substance problems have no real effect on treatment of psychiatricdisorders.

Question # 42

A client is 36 hours post-op a TKR surgery. 270 cc’s of sero-sanguinous accumulates in thesurgical drains. What action should the nurse take?

A. Notify the doctor
B. Empty the drain
C. Do nothing
D. Remove the drain

Question # 43

The home health nurse has made a visit to an 85-year-old female client’s home who has recently had surgery to replace her left knee. The client has been discharged from a rehab facility and has been able to walk on her own. The nurse assesses the need for teaching related to fall prevention. What should the nurse include in this teaching plan?

A. The client should remove all scatter rugs from the floor and minimize clutter.  
B. The client should not get up and move around the house.  
C. The client does not need to install a raised toilet and grab bar because she is able to walk on her own.
D. The client should wear a robe and socks while walking in the house.  

Question # 44

A nurse is working in a pediatric clinic and a 25 year-old mother comes in with a 4 week-old baby. The mother is stress out about loss of sleep and the baby exhibits signs of colic. Which of the following techniques should the nurse teach the mother?

A. Distraction of the infant with a red object
B. Prone positioning techniques
C. Tapping reflex techniques
D. Neural warmth techniques

Question # 45

A nurse working in a pediatric clinic observes bruises on the body of a four year-old boy. The parents report the boy fell riding his bike. The bruises are located on his posterior chest wall and gluteal region. The nurse should:

A. Suggest a script for counseling for the family to the doctor on duty.  
B. Recommend a warm bath for the boy to decrease healing time.  
B. Recommend a warm bath for the boy to decrease healing time.  
D. Recommend ROM to the patient’s spine to decrease healing time.  

Question # 46

The nurse is teaching a client about communicable diseases and explains that a portal of entry is:

A. a vector.
B. a source, like contaminated water.
C. food.
D. the respiratory system.

Question # 47

A nurse is caring for a retired MD. The MD asks the question, “What type of cells createexocrine secretions?” The correct answer is:

A. alpha cells
B. beta cells
C. acinar cells
D. plasma cells

Question # 48

A 26-year-old single woman is knocked down and robbed while walking her dog one evening. Three months later, she presents at the crisis clinic, stating that she cannot put this experience out of her mind. She complains of nightmares, extreme fear of being outside or alone, and difficulty eating and sleeping. What is the best response by the nurse?

A. “I will ask the physician to prescribe medication for you.”  
B. “That must have been a very difficult and frightening experience. It might be helpful to talk about it.
C. “In the future, you might walk your dog in a more populated area or hire someone else to take over this task.”  
D. “Have you thought of moving to a safer neighborhood?”  

Question # 49

A nurse suspects a patient is developing Bell’s Palsy. The nurse wants to test the function of cranial nerve VII. Which of the following would be the most appropriate testing procedures?

A. Test the taste sensation over the back of the tongue and activation of the facial muscles.
B. Test the taste sensation over the front of the tongue and activation of the facial muscles.
C. Test the sensation of the facial muscles and sensation of the back of the tongue.
D. Test the sensation of the facial muscles and sensation of the front of the tongue.

Question # 50

Following an automobile accident that caused a head injury to an adult client, the nurse observes that the client sleeps for long periods of time. The nurse determines that the client has experienced injury to the:

A. hypothalamus.
B. thalamus.
C. cortex.
D. medulla.

Question # 51

A small amount of bubbling is seen in the water seal of a pleural drainage system when aclient coughs. What should the nurse do?

A. Consider it a normal finding.
B. Check the system for leaks.
C. Clamp the chest tube.
D. Change the drainage system.

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