NCLEX-RN Next-Generation Ultimate Exam Questions And Correct Verified Answers
Question 1
The nurse prepares to administer a continuous intravenous infusion of regular insulin to a client
with diabetic ketoacidosis (DKA). Which action should the nurse take first?
A.Flush the entire intravenous tubing with 20 to 50 mL of the insulin solution before connecting to
26
the client.
B. Ensure the client's potassium level is greater than 3.3 mEq/L (3.3 mmol/L).
C. Program the infusion pump to deliver the solution at a rate of 0.5 units/kg/hour.
20
D. Check the blood glucose level using a bedside point-of-care glucometer.
Question 2
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with acute
respiratory failure. The client is receiving oxygen at 2 L/min via nasal cannula. The arterial blood
action should the nurse take first? am
gas (ABG) results reveal: pH 7.28, PaC02 58 mmHg, HC03 30 mEq/L, and Pa02 55 mmHg. Which
A. Increase the nasal cannula oxygen flow rate to 6 L/min.
B. Administer an immediate dose of an intravenous corticosteroid.
C. Prepare the client for noninvasive positive pressure ventilation (BiPAP).
Ex
D. Position the client in a high-Fowler's position and encourage pursed-lip breathing.
Question 3
The nurse in the emergency department cares for a client presenting with a rigid, board-like
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abdomen,severe epigastric pain radiating to the shoulder, and a temperature of 101.2°F (38.4°C).
The client reports a history of peptic ulcer disease. Which healthcare provider prescription should
the nurse implement first?
si
A. Insert a nasogastric tube and connect it to low intermittent suction.
B. Draw blood for a complete blood count and metabolic panel.
C. Administer morphine sulfate 4 mg intravenous push.
ur
D. Initiate an intravenous infusion of 0.9% normal saline at 150 mL/hour.
Question 4
N
A client with deep vein thrombosis (DVT) is receiving a continuous heparin infusion at 1,200
units/hour.The most recent activated partial thromboplastin time (aPTT) is115 seconds. The client's
baseline aPTT was 30seconds. Which action should the nurse take immediately?
A. Stop the heparin infusion and prepare to administer protamine sulfate.
B. Stop the heparin infusion for 1 hour and decrease the rate by 100 units/hour per protocol.
C. Hold the infusion, notify the provider, and assess the client for signs of bleeding.
D. Continue the infusion and repeat the drawing of the aPTT lab sample from the opposite arm.
,Question 5
The nurse reviews the chart of a client scheduled for aan elective cardiac catheterization in 2 hours.
Which finding requires immediate notification to the healthcare provider?
A. Serum creatinine level of 2.1 mg/dL (185.6 μmol/L).
B. International Normalized Ratio (INR) of 1.2.
C. Blood pressure reading of 142/88 mmHg.
D. Client reports feeling highly anxious about the procedure.
26
Question 6
A client with type 1 diabetes mellitus is found unresponsive in bed. The nurse performs a
20
fingerstick blood glucose test and the meter reads "Low." The client has no intravenous access.
Which action should the nurse take immediately?
A. Insert a peripheral intravenous line and administer 50 mL of 50% dextrose (D50).
B. Administer 1 mg of glucagon intramuscularly or subcutaneously.
C. Place a small amount of oral glucose gel between the client’s cheek and gums.
am
D. Attempt to force the client to drink 4 ounces of orange juice.
Question 7
The nurse provides care for an infant diagnosed with Tetralogy of Fallot. During a blood draw, the
Ex
infant becomes severely cyanotic, tachypneic, and begins to cry uncontrollably. Which action should
the nurse perform first?
A. Administer supplemental oxygen via a blowv-by face mask.
B. Place the infant in a knee-chest position.
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C.Administer an ordered dose of intravenous morphine sulfate.
D. Notify the pediatric healthcare provider immediately.
Question 8
si
The nurse reviews laboratory results for a client receiving digoxin 0.25 mg orally daily for heart
failure.Which laboratory value puts this client at the highest risk for developing digoxin toxicity?
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A. Serum potassium level of 3.2 mEq/L (3.2 mmol/L).
B. Serum calcium level of 9.2 mg/dL (2.3 mmol/L).
C. Serum magnesium level of 1.9 mg/dL (0.78 mmol/L).
N
D. Serum digoxin level of 1.1 ng/mL (1.4 nmol/L).
Question 9
A client is admitted to the psychiatric unit with a diagnosis of severe obsessive-compulsive disorder
(OCD). The client spends 2 hours every morning washing their hands, causing severe skin breakdown.
Which nursing intervention is most appropriate during the first few days of admission?
A. Lock the bathroom door to prevent the client from washing their hands continuously.
B. Allow theclient sufficient time to perform the ritualistic handwashing behavior.
,C. Contract with the client to limit handwashing to 10 minutes per hour.
D. Interrupt the ritual and redirect the client to a group therapy session.
Question 10
The nurse receives a shift report on four clients. Which client should the nurse assess first?
A. A client with acute pancreatitis who reports severe, radiating epigastric pain.
B. A client with a femur fracture who is newly confused, restless, and has petechiae on the chest.
C.A client with chronic kidney disease whose serum potassium level is 5.4 mEq/L
26
D. A client 1 day postoperative total hip arthroplasty who reports pain of 7 on a 1-10 scale.
Question 11
The nurse cares for a client in the oliguric phase of acute kidney injury (AKI). Which electrocardiogram
20
(ECG) changes should the nurse anticipate if the client develops severe hyperkalemia? Select all that
apply.
A. Tall, peaked T waves
B. Flattened or absent P waves
C. Prolonged PR interval
D. Widened QRS complex
am
E. Prominent U waves
F. Shortened QT interval
Ex
Question 12
A client at 38 weeks gestation is admitted to the labor and delivery unit in active labor. The nurse
notes a pattern of late decelerations on the electronic fetal monitor. Which action should the nurse
take first?
g
A. Perform a sterile vaginal examination to assess for umbilical cord prolapse.
B.Increase the rate of the continuous intravenous oxytocin infusion.
n
C. Turn the client onto their left side.
si
D. Administer oxygen at 2 L/min via nasal cannula.
Question 13
ur
The nurse evaluates a client who just returned to the unit following a thyroidectomy. The client
reports a tinglingsensation around the mouth and fingers. Which action is the priority for the nurse
to perform?
A. Assess the client's surgical dressing for signs of hemorrhage or bleeding.
N
B. Check the client for Chvostek’s sign and Trousseau’s sign.
C. Support the client's head and neck with pillows to prevent hyperextension.
D. Administer the prescribed oral analgesic for surgical incisional pain.
Question 14
A client with a closed head injury is monitored in the intensive care unit. The nurse notes that the
client's intracranial pressure (ICP) has risen from 12 mmHg to 24 mmHg. Which nursing intervention
is appropriate to help decrease the ICP?
, A. Hyperventilate the client using a manual resuscitation bag to maintain PaCO2 between 30-
35mmHg.
B. Group nursing care activities together to maximize the client’s rest periods.
C. Elevate the head of the bed to 30 to 45 degrees and maintain neutral head alignment.
D.Position the client in a prone position to optimize luing expansion.
Question 15
26
The nurse performs discharge teaching for a client prescribed warfarin therapy for atrial
fibrillation.Which statement by the client indicates a need for further instruction?
A. "I will use a soft-bristled toothbrush to clean my teeth every day."
B. "I need to avoid eating green leafy vegetables entirely while taking this medicine."
20
C. "I will report any dark, tarry stools or unexpected bruising to my provider."
D. "I will use an electric razor instead of a straight razor when shaving."
Question 16
am
A client with an acute myocardial infarction is prescribed an intravenous infusion of alteplase
(tPA).Which assessment finding would cause the nurse to immediately stop the infusion?
A. Frequent premature ventricular contractions(PVCs) on the monitor.
B. Mild oozing of blood from the peripheral intravenous insertion site.
C. Sudden change in neurological status and severe headache.
Ex
D. A reduction in chest pain severity from 8 to 2 on a 0-10 scale.
Question 17
The nurse prepares to administer a dose of mannitol 20% intravenous solution to a client with
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increased intracranial pressure. Upon inspecting the glass vial, the nurse notes the presence of fine
crystals throughout the solution. Which action should the nurse take?
A. Discard the vial and obtain a new one from the pharmacy.
si
B. Warm the vial in a warm water bath until the crystals completely dissolve.
C. Shake the vial vigorously for 1 minute before infusing.
D. Administer the medication through an in-line filter without warming.
ur
Question 18
A child is admitted with a diagnosis of acute glomerulonephritis. Which clinical manifestation
N
should the nurse expect to find during the physical assessment?
A. Massive generalized edema and severe hypotension.
B. Periorbital edema, tea-colored urine, and elevated blood pressure.
C. Profuse watery diarrhea, abdominal crammping, and weight loss.
D. High fever, productive cough, and bilateral wheezing.
Question 1
The nurse prepares to administer a continuous intravenous infusion of regular insulin to a client
with diabetic ketoacidosis (DKA). Which action should the nurse take first?
A.Flush the entire intravenous tubing with 20 to 50 mL of the insulin solution before connecting to
26
the client.
B. Ensure the client's potassium level is greater than 3.3 mEq/L (3.3 mmol/L).
C. Program the infusion pump to deliver the solution at a rate of 0.5 units/kg/hour.
20
D. Check the blood glucose level using a bedside point-of-care glucometer.
Question 2
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted with acute
respiratory failure. The client is receiving oxygen at 2 L/min via nasal cannula. The arterial blood
action should the nurse take first? am
gas (ABG) results reveal: pH 7.28, PaC02 58 mmHg, HC03 30 mEq/L, and Pa02 55 mmHg. Which
A. Increase the nasal cannula oxygen flow rate to 6 L/min.
B. Administer an immediate dose of an intravenous corticosteroid.
C. Prepare the client for noninvasive positive pressure ventilation (BiPAP).
Ex
D. Position the client in a high-Fowler's position and encourage pursed-lip breathing.
Question 3
The nurse in the emergency department cares for a client presenting with a rigid, board-like
ng
abdomen,severe epigastric pain radiating to the shoulder, and a temperature of 101.2°F (38.4°C).
The client reports a history of peptic ulcer disease. Which healthcare provider prescription should
the nurse implement first?
si
A. Insert a nasogastric tube and connect it to low intermittent suction.
B. Draw blood for a complete blood count and metabolic panel.
C. Administer morphine sulfate 4 mg intravenous push.
ur
D. Initiate an intravenous infusion of 0.9% normal saline at 150 mL/hour.
Question 4
N
A client with deep vein thrombosis (DVT) is receiving a continuous heparin infusion at 1,200
units/hour.The most recent activated partial thromboplastin time (aPTT) is115 seconds. The client's
baseline aPTT was 30seconds. Which action should the nurse take immediately?
A. Stop the heparin infusion and prepare to administer protamine sulfate.
B. Stop the heparin infusion for 1 hour and decrease the rate by 100 units/hour per protocol.
C. Hold the infusion, notify the provider, and assess the client for signs of bleeding.
D. Continue the infusion and repeat the drawing of the aPTT lab sample from the opposite arm.
,Question 5
The nurse reviews the chart of a client scheduled for aan elective cardiac catheterization in 2 hours.
Which finding requires immediate notification to the healthcare provider?
A. Serum creatinine level of 2.1 mg/dL (185.6 μmol/L).
B. International Normalized Ratio (INR) of 1.2.
C. Blood pressure reading of 142/88 mmHg.
D. Client reports feeling highly anxious about the procedure.
26
Question 6
A client with type 1 diabetes mellitus is found unresponsive in bed. The nurse performs a
20
fingerstick blood glucose test and the meter reads "Low." The client has no intravenous access.
Which action should the nurse take immediately?
A. Insert a peripheral intravenous line and administer 50 mL of 50% dextrose (D50).
B. Administer 1 mg of glucagon intramuscularly or subcutaneously.
C. Place a small amount of oral glucose gel between the client’s cheek and gums.
am
D. Attempt to force the client to drink 4 ounces of orange juice.
Question 7
The nurse provides care for an infant diagnosed with Tetralogy of Fallot. During a blood draw, the
Ex
infant becomes severely cyanotic, tachypneic, and begins to cry uncontrollably. Which action should
the nurse perform first?
A. Administer supplemental oxygen via a blowv-by face mask.
B. Place the infant in a knee-chest position.
ng
C.Administer an ordered dose of intravenous morphine sulfate.
D. Notify the pediatric healthcare provider immediately.
Question 8
si
The nurse reviews laboratory results for a client receiving digoxin 0.25 mg orally daily for heart
failure.Which laboratory value puts this client at the highest risk for developing digoxin toxicity?
ur
A. Serum potassium level of 3.2 mEq/L (3.2 mmol/L).
B. Serum calcium level of 9.2 mg/dL (2.3 mmol/L).
C. Serum magnesium level of 1.9 mg/dL (0.78 mmol/L).
N
D. Serum digoxin level of 1.1 ng/mL (1.4 nmol/L).
Question 9
A client is admitted to the psychiatric unit with a diagnosis of severe obsessive-compulsive disorder
(OCD). The client spends 2 hours every morning washing their hands, causing severe skin breakdown.
Which nursing intervention is most appropriate during the first few days of admission?
A. Lock the bathroom door to prevent the client from washing their hands continuously.
B. Allow theclient sufficient time to perform the ritualistic handwashing behavior.
,C. Contract with the client to limit handwashing to 10 minutes per hour.
D. Interrupt the ritual and redirect the client to a group therapy session.
Question 10
The nurse receives a shift report on four clients. Which client should the nurse assess first?
A. A client with acute pancreatitis who reports severe, radiating epigastric pain.
B. A client with a femur fracture who is newly confused, restless, and has petechiae on the chest.
C.A client with chronic kidney disease whose serum potassium level is 5.4 mEq/L
26
D. A client 1 day postoperative total hip arthroplasty who reports pain of 7 on a 1-10 scale.
Question 11
The nurse cares for a client in the oliguric phase of acute kidney injury (AKI). Which electrocardiogram
20
(ECG) changes should the nurse anticipate if the client develops severe hyperkalemia? Select all that
apply.
A. Tall, peaked T waves
B. Flattened or absent P waves
C. Prolonged PR interval
D. Widened QRS complex
am
E. Prominent U waves
F. Shortened QT interval
Ex
Question 12
A client at 38 weeks gestation is admitted to the labor and delivery unit in active labor. The nurse
notes a pattern of late decelerations on the electronic fetal monitor. Which action should the nurse
take first?
g
A. Perform a sterile vaginal examination to assess for umbilical cord prolapse.
B.Increase the rate of the continuous intravenous oxytocin infusion.
n
C. Turn the client onto their left side.
si
D. Administer oxygen at 2 L/min via nasal cannula.
Question 13
ur
The nurse evaluates a client who just returned to the unit following a thyroidectomy. The client
reports a tinglingsensation around the mouth and fingers. Which action is the priority for the nurse
to perform?
A. Assess the client's surgical dressing for signs of hemorrhage or bleeding.
N
B. Check the client for Chvostek’s sign and Trousseau’s sign.
C. Support the client's head and neck with pillows to prevent hyperextension.
D. Administer the prescribed oral analgesic for surgical incisional pain.
Question 14
A client with a closed head injury is monitored in the intensive care unit. The nurse notes that the
client's intracranial pressure (ICP) has risen from 12 mmHg to 24 mmHg. Which nursing intervention
is appropriate to help decrease the ICP?
, A. Hyperventilate the client using a manual resuscitation bag to maintain PaCO2 between 30-
35mmHg.
B. Group nursing care activities together to maximize the client’s rest periods.
C. Elevate the head of the bed to 30 to 45 degrees and maintain neutral head alignment.
D.Position the client in a prone position to optimize luing expansion.
Question 15
26
The nurse performs discharge teaching for a client prescribed warfarin therapy for atrial
fibrillation.Which statement by the client indicates a need for further instruction?
A. "I will use a soft-bristled toothbrush to clean my teeth every day."
B. "I need to avoid eating green leafy vegetables entirely while taking this medicine."
20
C. "I will report any dark, tarry stools or unexpected bruising to my provider."
D. "I will use an electric razor instead of a straight razor when shaving."
Question 16
am
A client with an acute myocardial infarction is prescribed an intravenous infusion of alteplase
(tPA).Which assessment finding would cause the nurse to immediately stop the infusion?
A. Frequent premature ventricular contractions(PVCs) on the monitor.
B. Mild oozing of blood from the peripheral intravenous insertion site.
C. Sudden change in neurological status and severe headache.
Ex
D. A reduction in chest pain severity from 8 to 2 on a 0-10 scale.
Question 17
The nurse prepares to administer a dose of mannitol 20% intravenous solution to a client with
ng
increased intracranial pressure. Upon inspecting the glass vial, the nurse notes the presence of fine
crystals throughout the solution. Which action should the nurse take?
A. Discard the vial and obtain a new one from the pharmacy.
si
B. Warm the vial in a warm water bath until the crystals completely dissolve.
C. Shake the vial vigorously for 1 minute before infusing.
D. Administer the medication through an in-line filter without warming.
ur
Question 18
A child is admitted with a diagnosis of acute glomerulonephritis. Which clinical manifestation
N
should the nurse expect to find during the physical assessment?
A. Massive generalized edema and severe hypotension.
B. Periorbital edema, tea-colored urine, and elevated blood pressure.
C. Profuse watery diarrhea, abdominal crammping, and weight loss.
D. High fever, productive cough, and bilateral wheezing.
