# NCLEX-RN (NGN) Pretest 2023 Latest Exam –
Over 145 Questions Collection (60 Shown) – 100%
Accurate for 2024/2025 Exam Success
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**01.** A nurse in the emergency department is assessing a client who reports chest pain and shortness
of breath. The client’s vital signs are: BP 160/90 mm Hg, HR 110 bpm, RR 24/min, SpO2 91% on room air.
Which action should the nurse take first?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead ECG
C) Apply oxygen via nasal cannula at 2 L/min
D) Draw blood for cardiac enzymes
🔍 RATIONALE💡-- Airway and breathing come first. SpO2 91% indicates hypoxemia; applying oxygen is
the priority to improve oxygenation before further assessment or interventions.
ANSWER💫✔️-- C) Apply oxygen via nasal cannula at 2 L/min
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**02.** A nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an insulin
infusion. Which laboratory finding indicates that treatment is effective?
A) Serum potassium 5.5 mEq/L
B) Serum glucose decreasing from 450 mg/dL to 200 mg/dL per hour
C) Serum bicarbonate increasing from 12 to 18 mEq/L
D) Serum sodium 135 mEq/L
,🔍 RATIONALE💡-- In DKA, the anion gap metabolic acidosis improves as bicarbonate levels rise. Insulin
stops ketogenesis and allows bicarbonate to regenerate. Glucose should fall no faster than 50-70 mg/dL
per hour to avoid cerebral edema.
ANSWER💫✔️-- C) Serum bicarbonate increasing from 12 to 18 mEq/L
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**03.** A nurse is assessing a client who is 2 days post‑operative following a bowel resection. The client
has a nasogastric (NG) tube to low intermittent suction. The nurse notes that the NG tube drainage is
bright red. What is the priority action?
A) Irrigate the NG tube with 30 mL of normal saline
B) Clamp the NG tube for 30 minutes
C) Assess the client’s vital signs and notify the provider
D) Document the finding as expected
🔍 RATIONALE💡-- Bright red drainage indicates active bleeding, possibly from the surgical anastomosis.
The nurse should assess vital signs for signs of hypovolemia and notify the provider immediately.
ANSWER💫✔️-- C) Assess the client’s vital signs and notify the provider
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**04.** A nurse is teaching a client with a new prescription for phenelzine (Nardil), an MAOI. Which
food should the client be instructed to avoid?
A) Fresh apples
B) Aged cheddar cheese
C) Boiled potatoes
D) White rice
, 🔍 RATIONALE💡-- MAOIs interact with tyramine in aged cheeses, cured meats, fermented foods, and
some beers, leading to hypertensive crisis. Aged cheddar cheese is high in tyramine.
ANSWER💫✔️-- B) Aged cheddar cheese
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**05.** A nurse is assessing a client with a suspected pulmonary embolism (PE). Which finding is most
consistent with this condition?
A) Bradycardia and hypotension
B) Hemoptysis and fever
C) Sudden onset of dyspnea and tachypnea
D) Productive cough with green sputum
🔍 RATIONALE💡-- The classic presentation of PE is sudden dyspnea, tachypnea, and often pleuritic
chest pain. Tachycardia, not bradycardia, is typical. Hemoptysis occurs in some cases but is less
common.
ANSWER💫✔️-- C) Sudden onset of dyspnea and tachypnea
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**06.** A nurse is caring for a client who has a central line and suddenly develops dyspnea,
hypotension, and desaturation to 80% during an infusion. The nurse suspects air embolism. What is the
priority action?
A) Place the client in left lateral Trendelenburg position
B) Clamp the central line
C) Administer 100% oxygen via non‑rebreather mask
D) Notify the provider
Over 145 Questions Collection (60 Shown) – 100%
Accurate for 2024/2025 Exam Success
---
**01.** A nurse in the emergency department is assessing a client who reports chest pain and shortness
of breath. The client’s vital signs are: BP 160/90 mm Hg, HR 110 bpm, RR 24/min, SpO2 91% on room air.
Which action should the nurse take first?
A) Administer sublingual nitroglycerin
B) Obtain a 12-lead ECG
C) Apply oxygen via nasal cannula at 2 L/min
D) Draw blood for cardiac enzymes
🔍 RATIONALE💡-- Airway and breathing come first. SpO2 91% indicates hypoxemia; applying oxygen is
the priority to improve oxygenation before further assessment or interventions.
ANSWER💫✔️-- C) Apply oxygen via nasal cannula at 2 L/min
---
**02.** A nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an insulin
infusion. Which laboratory finding indicates that treatment is effective?
A) Serum potassium 5.5 mEq/L
B) Serum glucose decreasing from 450 mg/dL to 200 mg/dL per hour
C) Serum bicarbonate increasing from 12 to 18 mEq/L
D) Serum sodium 135 mEq/L
,🔍 RATIONALE💡-- In DKA, the anion gap metabolic acidosis improves as bicarbonate levels rise. Insulin
stops ketogenesis and allows bicarbonate to regenerate. Glucose should fall no faster than 50-70 mg/dL
per hour to avoid cerebral edema.
ANSWER💫✔️-- C) Serum bicarbonate increasing from 12 to 18 mEq/L
---
**03.** A nurse is assessing a client who is 2 days post‑operative following a bowel resection. The client
has a nasogastric (NG) tube to low intermittent suction. The nurse notes that the NG tube drainage is
bright red. What is the priority action?
A) Irrigate the NG tube with 30 mL of normal saline
B) Clamp the NG tube for 30 minutes
C) Assess the client’s vital signs and notify the provider
D) Document the finding as expected
🔍 RATIONALE💡-- Bright red drainage indicates active bleeding, possibly from the surgical anastomosis.
The nurse should assess vital signs for signs of hypovolemia and notify the provider immediately.
ANSWER💫✔️-- C) Assess the client’s vital signs and notify the provider
---
**04.** A nurse is teaching a client with a new prescription for phenelzine (Nardil), an MAOI. Which
food should the client be instructed to avoid?
A) Fresh apples
B) Aged cheddar cheese
C) Boiled potatoes
D) White rice
, 🔍 RATIONALE💡-- MAOIs interact with tyramine in aged cheeses, cured meats, fermented foods, and
some beers, leading to hypertensive crisis. Aged cheddar cheese is high in tyramine.
ANSWER💫✔️-- B) Aged cheddar cheese
---
**05.** A nurse is assessing a client with a suspected pulmonary embolism (PE). Which finding is most
consistent with this condition?
A) Bradycardia and hypotension
B) Hemoptysis and fever
C) Sudden onset of dyspnea and tachypnea
D) Productive cough with green sputum
🔍 RATIONALE💡-- The classic presentation of PE is sudden dyspnea, tachypnea, and often pleuritic
chest pain. Tachycardia, not bradycardia, is typical. Hemoptysis occurs in some cases but is less
common.
ANSWER💫✔️-- C) Sudden onset of dyspnea and tachypnea
---
**06.** A nurse is caring for a client who has a central line and suddenly develops dyspnea,
hypotension, and desaturation to 80% during an infusion. The nurse suspects air embolism. What is the
priority action?
A) Place the client in left lateral Trendelenburg position
B) Clamp the central line
C) Administer 100% oxygen via non‑rebreather mask
D) Notify the provider
