NCLEX NURSING SCHOOL SURVIVAL
KIT - COMPREHENSIVE HIGH-
DIFFICULTY STUDY GUIDE QUESTIONS
AND ANSWERS
1. A patient presents with arterial blood gas (ABG) results: pH 7.26, PaCO2 54 mmHg, and
HCO3 24 mEq/L. Which condition is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), and the PaCO2 is high (respiratory
origin), while the HCO3 is within normal range, indicating uncompensated respiratory
acidosis.
,2. Which clinical manifestation should a nurse prioritize in a patient diagnosed with
autonomic dysreflexia?
A. Tachycardia and hypotension
B. Flaccid paralysis below the level of injury
C. Severe pounding headache and hypertension
D. Extreme thirst and polyuria
Answer: C
Conceptual Explanation: Autonomic dysreflexia is a medical emergency characterized by
sudden, severe hypertension and a pounding headache, usually triggered by a noxious
stimulus below a T6 spinal cord injury.
3. A client is prescribed Digoxin 0.125 mg daily. Which assessment finding would indicate the
nurse should withhold the medication and notify the provider?
A. Report of yellow-green halos around lights
B. Potassium level of 4.8 mEq/L
C. Blood pressure 110/70 mmHg
D. Heart rate of 78 beats per minute
Answer: A
Conceptual Explanation: Visual disturbances such as yellow-green halos are classic signs
of digoxin toxicity. The nurse must hold the drug and assess serum levels.
, 4. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG change is
most characteristic of this finding?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged QT interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves. Prominent
U waves are associated with hypokalemia.
5. Which of the following tasks is most appropriate for a nurse to delegate to an unlicensed
assistive personnel (UAP)?
A. Assessing a patient’s pain level after medication
B. Recording intake and output for a stable patient
C. Feeding a patient with new-onset dysphagia
D. Educating a patient on insulin administration
Answer: B
Conceptual Explanation: UAPs can perform routine tasks on stable patients, such as
measuring intake and output. Assessment, feeding high-risk patients, and education
require the expertise of an RN.
KIT - COMPREHENSIVE HIGH-
DIFFICULTY STUDY GUIDE QUESTIONS
AND ANSWERS
1. A patient presents with arterial blood gas (ABG) results: pH 7.26, PaCO2 54 mmHg, and
HCO3 24 mEq/L. Which condition is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis), and the PaCO2 is high (respiratory
origin), while the HCO3 is within normal range, indicating uncompensated respiratory
acidosis.
,2. Which clinical manifestation should a nurse prioritize in a patient diagnosed with
autonomic dysreflexia?
A. Tachycardia and hypotension
B. Flaccid paralysis below the level of injury
C. Severe pounding headache and hypertension
D. Extreme thirst and polyuria
Answer: C
Conceptual Explanation: Autonomic dysreflexia is a medical emergency characterized by
sudden, severe hypertension and a pounding headache, usually triggered by a noxious
stimulus below a T6 spinal cord injury.
3. A client is prescribed Digoxin 0.125 mg daily. Which assessment finding would indicate the
nurse should withhold the medication and notify the provider?
A. Report of yellow-green halos around lights
B. Potassium level of 4.8 mEq/L
C. Blood pressure 110/70 mmHg
D. Heart rate of 78 beats per minute
Answer: A
Conceptual Explanation: Visual disturbances such as yellow-green halos are classic signs
of digoxin toxicity. The nurse must hold the drug and assess serum levels.
, 4. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which ECG change is
most characteristic of this finding?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Prolonged QT interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves. Prominent
U waves are associated with hypokalemia.
5. Which of the following tasks is most appropriate for a nurse to delegate to an unlicensed
assistive personnel (UAP)?
A. Assessing a patient’s pain level after medication
B. Recording intake and output for a stable patient
C. Feeding a patient with new-onset dysphagia
D. Educating a patient on insulin administration
Answer: B
Conceptual Explanation: UAPs can perform routine tasks on stable patients, such as
measuring intake and output. Assessment, feeding high-risk patients, and education
require the expertise of an RN.
