Page 1 of 209
NCLEX-PN TYPE QUESTIONS FOR EXAM WITH CORRECT
ANSWERS,RATIONALES AND WHY THE OTHERS ARE NOT
CORRECT NEWEST 2026 QUESTIONS WITH ANSWERS
EXAM 2026 LATEST EDITION SOLVED QUESTIONS &
ANSWERS VERIFIED
NCLEX Practice Test questions for exam 3
The community health nurse is assigned to a client who recently was
discharged from the hospital with resolving hypernatremia. During the initial
assessment interview, what information would be of critical importance in
determining a plan of care for this client?
1. The client lives on the second floor of an apartment building that has an
elevator.
2. The client needs to walk 100 feet each day to reach the mailbox for the
apartment building.
3. The client performs self- monitoring of blood glucose once a day.
4. The client uses Alka- Seltzer on a frequent basis for gastrointestinal
complaints.
Answer 4
Why the Correct Option Is Right
• 4. The client uses Alka-Seltzer on a frequent basis for gastrointestinal
complaints.
o Pathophysiology: Hypernatremia indicates an excess concentration of
sodium in the blood.
o The Hidden Danger: Effervescent antacids like Alka-Seltzer contain an
extremely high amount of sodium bicarbonate (often exceeding 500
mg of sodium per tablet).
o Clinical Impact: Frequent use of this over-the-counter medication
introduces massive, hidden amounts of dietary sodium into the body.
This can completely undo the hospital's treatment and trigger a severe,
dangerous recurrence of hypernatremia. Identifying and stopping this
habit is critical to creating a safe plan of care.
, Page 2 of 209
Why the Other Options Are Wrong
• ❌ 1. The client lives on the second floor of an apartment building that
has an elevator.
o Knowing the client's home layout and mobility access is a standard part
of a home health environmental assessment, but it does not present an
immediate, physiological threat to their fluid and electrolyte balance.
• ❌ 2. The client needs to walk 100 feet each day to reach the mailbox for
the apartment building.
o While physical activity can increase fluid loss through sweat, walking a
short distance of 100 feet inside or near an apartment building is light
exertion and unlikely to cause severe dehydration or alter sodium
levels.
• ❌ 3. The client performs self-monitoring of blood glucose once a day.
o Tracking blood sugar is essential for managing diabetes. While severe
hyperglycemia can cause osmotic diuresis and secondary dehydration,
a client who is already stable and actively tracking their blood glucose
once a day does not pose the immediate, hidden electrolyte risk that
frequent Alka-Seltzer use does.
The nurse is caring for a client who has sustained partial and full thickness
burns over 30% of his body 18 hours ago. The nurse assesses for which fluid
and electrolyte imbalances at this time? Select all that apply.
1. Hyperkalemia
2. Hypokalemia
3. Hypervolemia
4. Hypercalcemia
5. Hypovolemia
Answer 1, 5
Why the Correct Options Are Right
• 1. Hyperkalemia
o Pathophysiology: The patient is in the emergent/resuscitation phase
of a burn injury (the first 24 to 48 hours post-burn).
o The Mechanism: Massive thermal trauma causes extensive cellular
destruction. Because potassium (\(K^{+}\)) is the primary intracellular
cation, the ruptured and damaged cells instantly spill their potassium
stores into the extracellular fluid and bloodstream. This causes serum
potassium levels to spike dramatically. [1, 2, 3, 4]
• 5. Hypovolemia
o Pathophysiology: Severe burns cause a massive inflammatory
response that damages capillary integrity.
o The Mechanism: Capillaries become highly permeable, causing a
dramatic "capillary leak." Intravascular plasma, fluids, and proteins
rapidly escape from the bloodstream and shift into the surrounding
interstitial tissues (causing extensive third-spacing and edema).
, Page 3 of 209
Without aggressive fluid resuscitation, this profound fluid volume deficit
rapidly progresses to life-threatening hypovolemic shock. [1, 2, 3, 4]
Why the Other Options Are Wrong
• ❌ 2. Hypokalemia
o Hypokalemia (low potassium) is not an expected finding during the first
24 hours of a burn injury. Low potassium typically occurs later during
the acute/diuretic phase (after 48 to 72 hours), as fluid shifts back into
the intravascular space and the kidneys begin excreting large amounts
of water and potassium. [1]
• ❌ 3. Hypervolemia
o Hypervolemia (fluid volume excess) does not occur spontaneously in
the early emergent phase of a burn. The patient is losing fluids from
their blood vessels at an alarming rate. Hypervolemia is only a risk later
if fluid resuscitation volume is miscalculated or over-administered. [1, 2,
3, 4]
• ❌ 4. Hypercalcemia
o Hypercalcemia (high calcium) is not associated with early burn trauma.
Instead, clients are much more vulnerable to hypocalcemia (low
calcium) because calcium binds to the albumin that is leaking out of the
damaged capillaries into the tissues
The nurse concludes that a history of which condition places a client at risk
for possible hypokalemia?
1. Chronic obstructive pulmonary disease (COPD)
2. Cirrhosis
3. Addison's disease
4. Chronic renal failure (CRF)
Answer 2
Why the Correct Option Is Right
• 2. Cirrhosis
o Pathophysiology: Clients with cirrhosis of the liver commonly develop
severe fluid retention, resulting in ascites (fluid accumulation in the
abdomen) and peripheral edema.
o The Mechanism: To manage this fluid overload, these clients are
routinely prescribed potassium-wasting loop or thiazide diuretics
(such as furosemide). Furthermore, cirrhosis often triggers a secondary
state of hyperaldosteronism (where the body produces too much
aldosterone), which causes the kidneys to retain sodium and excrete
massive amounts of potassium into the urine. This combination puts
the client at high risk for developing hypokalemia (low serum
potassium).
, Page 4 of 209
Why the Other Options Are Wrong
• ❌ 1. Chronic obstructive pulmonary disease (COPD)
o Clients with COPD frequently suffer from respiratory acidosis due to
chronic carbon dioxide (\(CO_{2}\)) retention. When the blood is acidic,
the body tries to compensate by shifting excess hydrogen ions
(\(H^{+}\)) into the cells. To maintain electrical balance, potassium
shifts out of the cells and into the bloodstream, which typically
causes hyperkalemia (high potassium), not hypokalemia.
• ❌ 3. Addison's disease
o Addison's disease features an absolute deficiency in adrenal
hormones, specifically aldosterone. Because aldosterone normally
excretes potassium, a lack of it means the kidneys cannot dump
potassium. This results in potassium retention and hyperkalemia.
• ❌ 4. Chronic renal failure (CRF)
o The kidneys are the primary organ responsible for excreting potassium
from the body. In chronic renal failure, the damaged kidneys lose their
ability to filter and excrete waste, leading to a dangerous accumulation
of potassium in the blood (hyperkalemia)
Which health care provider order for potassium chloride ( KCl) should the
nurse question regarding a client with severe hypokalemia?
1. Infuse 1000 mL normal saline with 20 mEq KCl IV over 8 hours.
2. Give KCl 20 mEq PO daily after meals.
3. Infuse 1000 mL normal saline with 40 mEq KCl IV at 200 mL/ hour.
4. Give 20 mEq KCl IV over 10 minutes.
Answer 4
Why the Correct Option Is Right
• 4. Give 20 mEq KCl IV over 10 minutes.
o Critical Safety Warning: Intravenous potassium chloride (KCl) is a
high-alert medication and must never be administered via rapid
intravenous infusion or IV push.
o The Danger: Injecting 20 mEq of concentrated potassium over 10
minutes causes a sudden, localized spike in serum potassium that can
instantly induce lethal cardiac arrhythmias, such as ventricular
fibrillation or asystole (cardiac arrest).
o Standard Practice: In a standard peripheral or central line, the
maximum safe rate for infusing IV potassium replacement is typically
10 to 20 mEq per hour.
Why the Other Options Are Safe (Do Not Need to be
Questioned)
NCLEX-PN TYPE QUESTIONS FOR EXAM WITH CORRECT
ANSWERS,RATIONALES AND WHY THE OTHERS ARE NOT
CORRECT NEWEST 2026 QUESTIONS WITH ANSWERS
EXAM 2026 LATEST EDITION SOLVED QUESTIONS &
ANSWERS VERIFIED
NCLEX Practice Test questions for exam 3
The community health nurse is assigned to a client who recently was
discharged from the hospital with resolving hypernatremia. During the initial
assessment interview, what information would be of critical importance in
determining a plan of care for this client?
1. The client lives on the second floor of an apartment building that has an
elevator.
2. The client needs to walk 100 feet each day to reach the mailbox for the
apartment building.
3. The client performs self- monitoring of blood glucose once a day.
4. The client uses Alka- Seltzer on a frequent basis for gastrointestinal
complaints.
Answer 4
Why the Correct Option Is Right
• 4. The client uses Alka-Seltzer on a frequent basis for gastrointestinal
complaints.
o Pathophysiology: Hypernatremia indicates an excess concentration of
sodium in the blood.
o The Hidden Danger: Effervescent antacids like Alka-Seltzer contain an
extremely high amount of sodium bicarbonate (often exceeding 500
mg of sodium per tablet).
o Clinical Impact: Frequent use of this over-the-counter medication
introduces massive, hidden amounts of dietary sodium into the body.
This can completely undo the hospital's treatment and trigger a severe,
dangerous recurrence of hypernatremia. Identifying and stopping this
habit is critical to creating a safe plan of care.
, Page 2 of 209
Why the Other Options Are Wrong
• ❌ 1. The client lives on the second floor of an apartment building that
has an elevator.
o Knowing the client's home layout and mobility access is a standard part
of a home health environmental assessment, but it does not present an
immediate, physiological threat to their fluid and electrolyte balance.
• ❌ 2. The client needs to walk 100 feet each day to reach the mailbox for
the apartment building.
o While physical activity can increase fluid loss through sweat, walking a
short distance of 100 feet inside or near an apartment building is light
exertion and unlikely to cause severe dehydration or alter sodium
levels.
• ❌ 3. The client performs self-monitoring of blood glucose once a day.
o Tracking blood sugar is essential for managing diabetes. While severe
hyperglycemia can cause osmotic diuresis and secondary dehydration,
a client who is already stable and actively tracking their blood glucose
once a day does not pose the immediate, hidden electrolyte risk that
frequent Alka-Seltzer use does.
The nurse is caring for a client who has sustained partial and full thickness
burns over 30% of his body 18 hours ago. The nurse assesses for which fluid
and electrolyte imbalances at this time? Select all that apply.
1. Hyperkalemia
2. Hypokalemia
3. Hypervolemia
4. Hypercalcemia
5. Hypovolemia
Answer 1, 5
Why the Correct Options Are Right
• 1. Hyperkalemia
o Pathophysiology: The patient is in the emergent/resuscitation phase
of a burn injury (the first 24 to 48 hours post-burn).
o The Mechanism: Massive thermal trauma causes extensive cellular
destruction. Because potassium (\(K^{+}\)) is the primary intracellular
cation, the ruptured and damaged cells instantly spill their potassium
stores into the extracellular fluid and bloodstream. This causes serum
potassium levels to spike dramatically. [1, 2, 3, 4]
• 5. Hypovolemia
o Pathophysiology: Severe burns cause a massive inflammatory
response that damages capillary integrity.
o The Mechanism: Capillaries become highly permeable, causing a
dramatic "capillary leak." Intravascular plasma, fluids, and proteins
rapidly escape from the bloodstream and shift into the surrounding
interstitial tissues (causing extensive third-spacing and edema).
, Page 3 of 209
Without aggressive fluid resuscitation, this profound fluid volume deficit
rapidly progresses to life-threatening hypovolemic shock. [1, 2, 3, 4]
Why the Other Options Are Wrong
• ❌ 2. Hypokalemia
o Hypokalemia (low potassium) is not an expected finding during the first
24 hours of a burn injury. Low potassium typically occurs later during
the acute/diuretic phase (after 48 to 72 hours), as fluid shifts back into
the intravascular space and the kidneys begin excreting large amounts
of water and potassium. [1]
• ❌ 3. Hypervolemia
o Hypervolemia (fluid volume excess) does not occur spontaneously in
the early emergent phase of a burn. The patient is losing fluids from
their blood vessels at an alarming rate. Hypervolemia is only a risk later
if fluid resuscitation volume is miscalculated or over-administered. [1, 2,
3, 4]
• ❌ 4. Hypercalcemia
o Hypercalcemia (high calcium) is not associated with early burn trauma.
Instead, clients are much more vulnerable to hypocalcemia (low
calcium) because calcium binds to the albumin that is leaking out of the
damaged capillaries into the tissues
The nurse concludes that a history of which condition places a client at risk
for possible hypokalemia?
1. Chronic obstructive pulmonary disease (COPD)
2. Cirrhosis
3. Addison's disease
4. Chronic renal failure (CRF)
Answer 2
Why the Correct Option Is Right
• 2. Cirrhosis
o Pathophysiology: Clients with cirrhosis of the liver commonly develop
severe fluid retention, resulting in ascites (fluid accumulation in the
abdomen) and peripheral edema.
o The Mechanism: To manage this fluid overload, these clients are
routinely prescribed potassium-wasting loop or thiazide diuretics
(such as furosemide). Furthermore, cirrhosis often triggers a secondary
state of hyperaldosteronism (where the body produces too much
aldosterone), which causes the kidneys to retain sodium and excrete
massive amounts of potassium into the urine. This combination puts
the client at high risk for developing hypokalemia (low serum
potassium).
, Page 4 of 209
Why the Other Options Are Wrong
• ❌ 1. Chronic obstructive pulmonary disease (COPD)
o Clients with COPD frequently suffer from respiratory acidosis due to
chronic carbon dioxide (\(CO_{2}\)) retention. When the blood is acidic,
the body tries to compensate by shifting excess hydrogen ions
(\(H^{+}\)) into the cells. To maintain electrical balance, potassium
shifts out of the cells and into the bloodstream, which typically
causes hyperkalemia (high potassium), not hypokalemia.
• ❌ 3. Addison's disease
o Addison's disease features an absolute deficiency in adrenal
hormones, specifically aldosterone. Because aldosterone normally
excretes potassium, a lack of it means the kidneys cannot dump
potassium. This results in potassium retention and hyperkalemia.
• ❌ 4. Chronic renal failure (CRF)
o The kidneys are the primary organ responsible for excreting potassium
from the body. In chronic renal failure, the damaged kidneys lose their
ability to filter and excrete waste, leading to a dangerous accumulation
of potassium in the blood (hyperkalemia)
Which health care provider order for potassium chloride ( KCl) should the
nurse question regarding a client with severe hypokalemia?
1. Infuse 1000 mL normal saline with 20 mEq KCl IV over 8 hours.
2. Give KCl 20 mEq PO daily after meals.
3. Infuse 1000 mL normal saline with 40 mEq KCl IV at 200 mL/ hour.
4. Give 20 mEq KCl IV over 10 minutes.
Answer 4
Why the Correct Option Is Right
• 4. Give 20 mEq KCl IV over 10 minutes.
o Critical Safety Warning: Intravenous potassium chloride (KCl) is a
high-alert medication and must never be administered via rapid
intravenous infusion or IV push.
o The Danger: Injecting 20 mEq of concentrated potassium over 10
minutes causes a sudden, localized spike in serum potassium that can
instantly induce lethal cardiac arrhythmias, such as ventricular
fibrillation or asystole (cardiac arrest).
o Standard Practice: In a standard peripheral or central line, the
maximum safe rate for infusing IV potassium replacement is typically
10 to 20 mEq per hour.
Why the Other Options Are Safe (Do Not Need to be
Questioned)
