NCLEX exam 2026 UPDATED QUESTIONS AND ANSWERS
The nurse is caring for a client with heart failure. On assessment, the nurse notes that the client
is dyspneic, and crackles are audible on auscultation. What additional manifestations would the
nurse expect to note in this client if excess fluid volume is present? (Chapter 8)
a. weight loss and dry skin
b. flat neck and hand veins and decreased urinary output
c. an increase in blood pressure and increased respirations
d. weakness and decreased central venous pressure (CVP)
c. an increase in blood pressure and increased respirations
Assessment finding associated with FVE include cough, dyspnea, crackles, tachypnea,
tachycardia, elevated blood pressure, bouding pulse, elevated CVP, weigh gain, edema, neck and
hand vein distention, altered LOC, and decreased hematocrit.
The nurse reviews a client's record and determines that the client is at risk for developing a
potassium deficit if which situation is documented? (Chapter 8)
a. sustained tissue damage
b. requires nasogastric suction
c. has a history of Addison's disease
d. uric acid level of 9.4 mg/dL (557 mcmol/L)
b. requires nasogastric suction
,The nurse reviews a client's electrolyte laboratory report and notes that the potassium level is
2.5 mEq/L (2.5 mmol/L). Which patterns should the nurse watch for on the electrocardiogram
(ECG) as a result of the laboratory value? (SATA) (Chapter 8)
a. U waves
b. absent P waves
c. inverted T waves
d. depressed ST segment
e. widened QRS complex
a. U waves
c. inverted T waves
d. depressed ST segment
EKG changes for hypokalemia include shallow, flat, or inverted T waves; ST segment
depresssion; and prominent U waves
Potassium chloride intravenously is prescribed for a client with heart failure experiencing
hypokalemia. Which actions should the nurse take to plan for preparation and administration of
the potassium? (SATA) (Chapter 8)
a. obtain an IV infusion pump
b. monitor urine output during administration
c. prepare the medication for bolus administration
d. monitor the IV site for signs of infiltration or phlebitis
,e. ensure that the medication is diluted in the appropriate volume of fluid
f. ensure that the bag is labeled so that it reads the volume of potassium in the solution
a. obtain an IV infusion pump
b. monitor urine output during administration
d. monitor the IV site for signs of infiltration or phlebitis
e. ensure that the medication is diluted in the appropriate volume of fluid
f. ensure that the bag is labeled so that it reads the volume of potassium in the solution
Potassium chloride is never to be given IV push - this can result in cardiac arrest.
The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of
hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?
(Chapter 8)
a. twitching
b. hypoactive bowel sounds
c. negative Trousseau's sign
d. hypoactive deep tendon reflexes
a. twitching
Sings of hypocalcemia include paresthesias followed by numnbess, hyperactive deep tendon
reflexes, a positive Trousseau's or Chvosteks's sign, increased neuromuscular excitability, muscle
cramps, twitching, tetany, seizures, irritability, and anxiety. GI symptoms include increased
gastric motility, hyperactive bowel sounds, abdominal cramping, and diarrhea.
, The nurse is caring for a client with Crohn's disease who has a calcium level of 8mg/dL (2
mmol/L). Which patterns would the nurse watch for on the electrocardiogram? (SATA) (Chapter
8)
a. U waves
b. widened T wave
c. prominent U wave
d. prolonged QT interval
e. prolonged ST segment
d. prolonged QT interval
e. prolonged ST segment
EKG changes with hypocalcemia include a prolonged QT interval and prolonged ST segment.
With hypercalcemia, EKG changes are a shortened ST segment and a widened T wave. With
hypokalemia, EKG changes are ST depression and prominent U waves.
The nurse reviews the electrolyte results of a client with chronic kidney disease and notes that
the potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the
cardiac monitor as a result of the laboratory value? (SATA) (Chapter 8)
a. ST depression
b. prominent U wave
c. tall peaked T waves
d. prolonged ST segment
e. widened QRS complexes
c. tall peaked T waves
e. widened QRS complexes
The nurse is caring for a client with heart failure. On assessment, the nurse notes that the client
is dyspneic, and crackles are audible on auscultation. What additional manifestations would the
nurse expect to note in this client if excess fluid volume is present? (Chapter 8)
a. weight loss and dry skin
b. flat neck and hand veins and decreased urinary output
c. an increase in blood pressure and increased respirations
d. weakness and decreased central venous pressure (CVP)
c. an increase in blood pressure and increased respirations
Assessment finding associated with FVE include cough, dyspnea, crackles, tachypnea,
tachycardia, elevated blood pressure, bouding pulse, elevated CVP, weigh gain, edema, neck and
hand vein distention, altered LOC, and decreased hematocrit.
The nurse reviews a client's record and determines that the client is at risk for developing a
potassium deficit if which situation is documented? (Chapter 8)
a. sustained tissue damage
b. requires nasogastric suction
c. has a history of Addison's disease
d. uric acid level of 9.4 mg/dL (557 mcmol/L)
b. requires nasogastric suction
,The nurse reviews a client's electrolyte laboratory report and notes that the potassium level is
2.5 mEq/L (2.5 mmol/L). Which patterns should the nurse watch for on the electrocardiogram
(ECG) as a result of the laboratory value? (SATA) (Chapter 8)
a. U waves
b. absent P waves
c. inverted T waves
d. depressed ST segment
e. widened QRS complex
a. U waves
c. inverted T waves
d. depressed ST segment
EKG changes for hypokalemia include shallow, flat, or inverted T waves; ST segment
depresssion; and prominent U waves
Potassium chloride intravenously is prescribed for a client with heart failure experiencing
hypokalemia. Which actions should the nurse take to plan for preparation and administration of
the potassium? (SATA) (Chapter 8)
a. obtain an IV infusion pump
b. monitor urine output during administration
c. prepare the medication for bolus administration
d. monitor the IV site for signs of infiltration or phlebitis
,e. ensure that the medication is diluted in the appropriate volume of fluid
f. ensure that the bag is labeled so that it reads the volume of potassium in the solution
a. obtain an IV infusion pump
b. monitor urine output during administration
d. monitor the IV site for signs of infiltration or phlebitis
e. ensure that the medication is diluted in the appropriate volume of fluid
f. ensure that the bag is labeled so that it reads the volume of potassium in the solution
Potassium chloride is never to be given IV push - this can result in cardiac arrest.
The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of
hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?
(Chapter 8)
a. twitching
b. hypoactive bowel sounds
c. negative Trousseau's sign
d. hypoactive deep tendon reflexes
a. twitching
Sings of hypocalcemia include paresthesias followed by numnbess, hyperactive deep tendon
reflexes, a positive Trousseau's or Chvosteks's sign, increased neuromuscular excitability, muscle
cramps, twitching, tetany, seizures, irritability, and anxiety. GI symptoms include increased
gastric motility, hyperactive bowel sounds, abdominal cramping, and diarrhea.
, The nurse is caring for a client with Crohn's disease who has a calcium level of 8mg/dL (2
mmol/L). Which patterns would the nurse watch for on the electrocardiogram? (SATA) (Chapter
8)
a. U waves
b. widened T wave
c. prominent U wave
d. prolonged QT interval
e. prolonged ST segment
d. prolonged QT interval
e. prolonged ST segment
EKG changes with hypocalcemia include a prolonged QT interval and prolonged ST segment.
With hypercalcemia, EKG changes are a shortened ST segment and a widened T wave. With
hypokalemia, EKG changes are ST depression and prominent U waves.
The nurse reviews the electrolyte results of a client with chronic kidney disease and notes that
the potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the
cardiac monitor as a result of the laboratory value? (SATA) (Chapter 8)
a. ST depression
b. prominent U wave
c. tall peaked T waves
d. prolonged ST segment
e. widened QRS complexes
c. tall peaked T waves
e. widened QRS complexes
