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NCLEX-RN Exam Questions And Correct Answers
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NCLEX RN ACTUAL EXAM QUESTIONS AND ANSWERS
,1. A patient with congestive heart failure (CHF) is admitted with worsening dyspnea and edema.Which
assessments should the nurse prioritize? (Select all that apply)
a) Lung auscultation
b) Blood pressure measurement
c) Peripheral pulses assessment
d) Jugular vein distention assessment
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e) Daily weight measurement
Answer: a, b, d, e
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Strategy: Focus on signs of fluid overload and cardiac function—lung sounds, blood pressure, JVD, and weight
changes are most relevant. Peripheral pulses are important but less urgent here.
apply)
a) Avoid foods high in vitamin K
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2. A nurse is teaching a patient about warfarin therapy. Which instructions should be included?(Select all that
b) Use a soft toothbrush to prevent bleeding
c) Report any unusual bleeding immediately
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d) Stop the medication if you feel better
e) Regularly monitor INR levels
Answer: a,b, c,e
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Strategy: Vitamin K intake affects warfarin efficacy; bleeding precautions and INR monitoring are essential.
Never stop warfarin without consulting a healthcare provider.
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3. ECG Image Question: The ECG shows a regular rhythm with sawtooth flutter waves and a ventricular rate
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of 150. What is the likely rhythm?
a) Atrial fibrillation
b) Atrial flutter
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c) Supraventricular tachycardia
d) Ventricular tachycardia
Answer: b
Strategy: The sawtooth pattern with a regular ventricular rate indicates atrial flutter.
,4. A client with diabetic ketoacidosis (DKA) is admitted. Which lab value requires the most urgent attention?
a) Serum potassium 2.8 mEq/L
b) Serum sodium 140 mEq/L
c) Serum calcium 9.5 mg/dL
d) Serum phosphate 3.0 mg/dL
Answer: a
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Strategy: Hypokalemia during DKA treatment can cause life-threatening arrhythmias; potassium must be closely
monitored and corrected.
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5. A patient taking digoxin complains of blurred vision and nausea. What is the nurse’s priority action?
a) Administer an antiemetic
b) Check digoxin blood level
c) Reassure the patient this is normal
d) Increase fluid intake
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Answer:b
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Strategy: These symptoms suggest digoxin toxicity; verifying blood levels is essential before further action.
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6. A patient is admitted with suspected stroke. Which assessment is the priority?
a) Blood glucose measurement
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b) Vital signs
c) Neurological exam using NIH Stroke Scale
d) Cardiac enzymes
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Answer: a
Strategy: Hypoglycemia can mimic stroke symptoms and must be ruled out immediately to avoid
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misdiagnosis.
7.Select all that apply: Which symptoms indicate early increased intracranial pressure (ICP)?
a) Decreased level of consciousness
b) Bradycardia
c) Pupillary changes
, d) Vomiting
e) Hypotension
Answer: a, c, d
Strategy: Early ICP signs include decreased consciousness, pupillary changes, and vomiting. Bradycardia
and hypotension are late signs.
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8. The nurse is caring for a patient with COPD who is experiencing respiratory distress. ABGs show
pH 7.29, PaCO2 60 mmHg, PaO2 55 mmHg, HCO3 26 mEq/L. What is the correct interpretation?
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a) Respiratory acidosis with hypoxemia
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Metabolic acidosis
Answer: a am
Strategy: Elevated PaCO2 with low pH and hypoxemia indicates respiratory acidosis, common in COPD
exacerbations.
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9. Image Question: The ECG strip shows irregularly irregular rhythm with no identifiable P waves and
narrow QRS complexes. What is the rhythm?
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a) Atrial fibrillation
b) Ventricular fibrillation
c) Sinus arrhythmia
d) Atrial flutter
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Answer: a
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Strategy: Irregularly irregular rhythm without P waves points to atrial fibrillation.
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10. A patient with chronic kidney disease has a potassium level of 6.5 mEq/L. Which medication
should the nurse expect to administer?
a) Sodium polystyrene sulfonate (Kayexalate)
b) Furosemide
c) Calcium gluconate
d) All of the above
Answer: d
NCLEX-RN Exam Questions And Correct Answers
26
20
am
Ex
ng
si
ur
N
NCLEX RN ACTUAL EXAM QUESTIONS AND ANSWERS
,1. A patient with congestive heart failure (CHF) is admitted with worsening dyspnea and edema.Which
assessments should the nurse prioritize? (Select all that apply)
a) Lung auscultation
b) Blood pressure measurement
c) Peripheral pulses assessment
d) Jugular vein distention assessment
26
e) Daily weight measurement
Answer: a, b, d, e
20
Strategy: Focus on signs of fluid overload and cardiac function—lung sounds, blood pressure, JVD, and weight
changes are most relevant. Peripheral pulses are important but less urgent here.
apply)
a) Avoid foods high in vitamin K
am
2. A nurse is teaching a patient about warfarin therapy. Which instructions should be included?(Select all that
b) Use a soft toothbrush to prevent bleeding
c) Report any unusual bleeding immediately
Ex
d) Stop the medication if you feel better
e) Regularly monitor INR levels
Answer: a,b, c,e
ng
Strategy: Vitamin K intake affects warfarin efficacy; bleeding precautions and INR monitoring are essential.
Never stop warfarin without consulting a healthcare provider.
si
3. ECG Image Question: The ECG shows a regular rhythm with sawtooth flutter waves and a ventricular rate
ur
of 150. What is the likely rhythm?
a) Atrial fibrillation
b) Atrial flutter
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c) Supraventricular tachycardia
d) Ventricular tachycardia
Answer: b
Strategy: The sawtooth pattern with a regular ventricular rate indicates atrial flutter.
,4. A client with diabetic ketoacidosis (DKA) is admitted. Which lab value requires the most urgent attention?
a) Serum potassium 2.8 mEq/L
b) Serum sodium 140 mEq/L
c) Serum calcium 9.5 mg/dL
d) Serum phosphate 3.0 mg/dL
Answer: a
26
Strategy: Hypokalemia during DKA treatment can cause life-threatening arrhythmias; potassium must be closely
monitored and corrected.
20
5. A patient taking digoxin complains of blurred vision and nausea. What is the nurse’s priority action?
a) Administer an antiemetic
b) Check digoxin blood level
c) Reassure the patient this is normal
d) Increase fluid intake
am
Answer:b
Ex
Strategy: These symptoms suggest digoxin toxicity; verifying blood levels is essential before further action.
ng
6. A patient is admitted with suspected stroke. Which assessment is the priority?
a) Blood glucose measurement
si
b) Vital signs
c) Neurological exam using NIH Stroke Scale
d) Cardiac enzymes
ur
Answer: a
Strategy: Hypoglycemia can mimic stroke symptoms and must be ruled out immediately to avoid
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misdiagnosis.
7.Select all that apply: Which symptoms indicate early increased intracranial pressure (ICP)?
a) Decreased level of consciousness
b) Bradycardia
c) Pupillary changes
, d) Vomiting
e) Hypotension
Answer: a, c, d
Strategy: Early ICP signs include decreased consciousness, pupillary changes, and vomiting. Bradycardia
and hypotension are late signs.
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8. The nurse is caring for a patient with COPD who is experiencing respiratory distress. ABGs show
pH 7.29, PaCO2 60 mmHg, PaO2 55 mmHg, HCO3 26 mEq/L. What is the correct interpretation?
20
a) Respiratory acidosis with hypoxemia
b) Metabolic alkalosis
c) Respiratory alkalosis
d) Metabolic acidosis
Answer: a am
Strategy: Elevated PaCO2 with low pH and hypoxemia indicates respiratory acidosis, common in COPD
exacerbations.
Ex
9. Image Question: The ECG strip shows irregularly irregular rhythm with no identifiable P waves and
narrow QRS complexes. What is the rhythm?
ng
a) Atrial fibrillation
b) Ventricular fibrillation
c) Sinus arrhythmia
d) Atrial flutter
si
Answer: a
ur
Strategy: Irregularly irregular rhythm without P waves points to atrial fibrillation.
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10. A patient with chronic kidney disease has a potassium level of 6.5 mEq/L. Which medication
should the nurse expect to administer?
a) Sodium polystyrene sulfonate (Kayexalate)
b) Furosemide
c) Calcium gluconate
d) All of the above
Answer: d
