NCLEX-RN PRACTICE QUESTIONS
Comprehensive High-Yield Question Bank & In-Depth Clinical Rationales
Source: Archer Next Gen Review Target: Next-Generation NCLEX (NGN) Preparation
QUESTION CARDIOVASCULAR
1
The nurse is reviewing laboratory data for a client suspected of having a myocardial infarction. The nurse
anticipates that the CK-MB isoenzyme will peak within how many hours?
a. 3-6 hours (Elevates 3-6 hrs, Peaks ~18 hrs)
b. 1-2 hours
c. 48-72 hours
d. 18 hours
CORRECT ANSWER: A
Rationale: CK-MB (creatine kinase myocardial muscle) levels measure muscle cell necrosis. Levels begin elevating
approximately 3 to 6 hours following cellular injury or MI and reach their peak elevation at around 18 hours. Between 48 and 72
hours, CK-MB levels return to baseline.
QUESTION PEDIATRICS / INFECTION CONTROL
2
The nurse is triaging a child with suspected impetigo. Which actions should the nurse take? (Select All That
Apply - SATA)
a. Initiate droplet precautions
b. Set up a decontamination room
c. Use a disposable blood pressure cuff
d. Initiate contact precautions
e. Apply sterile gloves while examining the client
CORRECT ANSWERS: C, D
Rationale: Impetigo is a highly contagious superficial bacterial skin infection commonly seen in children. Contact precautions
(gown and clean gloves) are required. Disposable single-use medical equipment (such as a dedicated BP cuff) should be
utilized to prevent cross-contamination.
NCLEX-RN Exam Preparation • Comprehensive Question Bank Page 1 of 28
, QUESTION PHARMACOLOGY / FALL PREVENTION
3
The nurse is reviewing the medical records of clients who have sustained several falls. While reviewing a
client's medical record who has fallen twice in the past month, which medications should the nurse
recommend be discontinued to lower the client's risk for future falls? (SATA)
a. Fluoxetine
b. Temazepam
c. Bupropion
d. Ferrous sulfate
e. Hydrocodone-acetaminophen
f. Hydroxyzine
g. Docusate
CORRECT ANSWERS: B, E, F
Rationale: High-risk fall medications in older adults directly involve CNS depressants and anticholinergics. Temazepam (a
benzodiazepine causing sedation), Hydrocodone-acetaminophen (an opioid causing sedation and ataxia), and Hydroxyzine (an
anticholinergic antihistamine causing altered sensorium) significantly elevate fall risk and should be deprescribed or substituted
(e.g., melatonin for insomnia).
QUESTION IMMUNIZATION / PUBLIC HEALTH
4
The nurse is educating a group of students on the measles, mumps, and rubella (MMR) vaccine. Which
statement, if made by the student, would indicate effective teaching?
a. "Egg allergy is a contraindication to giving this vaccine"
b. "This is a 3-series vaccine that should be started at birth"
c. "It is safe for breastfeeding women to receive the MMR vaccine"
d. "This vaccine is safe if the client is pregnant"
CORRECT ANSWER: C
Rationale: The MMR vaccine is a live attenuated virus vaccine. It is completely safe for postpartum/breastfeeding mothers.
However, live vaccines are strictly contraindicated during pregnancy due to teratogenic risks. An egg allergy is no longer
considered a contraindication for MMR administration.
NCLEX-RN Exam Preparation • Comprehensive Question Bank Page 2 of 28
, QUESTION MATERNAL-NEWBORN / PHARMACOLOGY
5
The nurse is caring for a client receiving a terbutaline infusion to prevent preterm labor. Which clinical
finding indicates that the nurse should continue the infusion?
a. Blood pressure 91/58 mmHg
b. Heart rate 132 BPM
c. Serum potassium 3.3 mEq/L
d. Blood glucose 104 mg/dL
CORRECT ANSWER: D
Rationale: Terbutaline is a beta-2 adrenergic agonist used as a tocolytic. Adverse effects include maternal tachycardia (>120
BPM), hypotension, hypokalemia, and hyperglycemia. A blood glucose of 104 mg/dL is within normal limits (70-110 mg/dL),
confirming safety to maintain the infusion.
QUESTION RENAL / DIAGNOSTICS
6
The nurse is assessing a client with suspected acute glomerulonephritis (AGN). Which of the following
findings would support a diagnosis of acute glomerulonephritis? (SATA)
a. Metabolic acidosis
b. Increased serum creatinine
c. Hematuria
d. Costovertebral tenderness
e. Increased serum ammonia level
f. Hypovolemia
CORRECT ANSWERS: B, C
Rationale: Acute Glomerulonephritis is characterized by glomerular inflammation resulting in impaired renal filtration. Hallmark
manifestations include hematuria (tea/cola-colored urine due to RBC leakage) and elevated BUN/creatinine due to decreased
GFR. Hypervolemia/edema (not hypovolemia) typically occurs.
NCLEX-RN Exam Preparation • Comprehensive Question Bank Page 3 of 28
Comprehensive High-Yield Question Bank & In-Depth Clinical Rationales
Source: Archer Next Gen Review Target: Next-Generation NCLEX (NGN) Preparation
QUESTION CARDIOVASCULAR
1
The nurse is reviewing laboratory data for a client suspected of having a myocardial infarction. The nurse
anticipates that the CK-MB isoenzyme will peak within how many hours?
a. 3-6 hours (Elevates 3-6 hrs, Peaks ~18 hrs)
b. 1-2 hours
c. 48-72 hours
d. 18 hours
CORRECT ANSWER: A
Rationale: CK-MB (creatine kinase myocardial muscle) levels measure muscle cell necrosis. Levels begin elevating
approximately 3 to 6 hours following cellular injury or MI and reach their peak elevation at around 18 hours. Between 48 and 72
hours, CK-MB levels return to baseline.
QUESTION PEDIATRICS / INFECTION CONTROL
2
The nurse is triaging a child with suspected impetigo. Which actions should the nurse take? (Select All That
Apply - SATA)
a. Initiate droplet precautions
b. Set up a decontamination room
c. Use a disposable blood pressure cuff
d. Initiate contact precautions
e. Apply sterile gloves while examining the client
CORRECT ANSWERS: C, D
Rationale: Impetigo is a highly contagious superficial bacterial skin infection commonly seen in children. Contact precautions
(gown and clean gloves) are required. Disposable single-use medical equipment (such as a dedicated BP cuff) should be
utilized to prevent cross-contamination.
NCLEX-RN Exam Preparation • Comprehensive Question Bank Page 1 of 28
, QUESTION PHARMACOLOGY / FALL PREVENTION
3
The nurse is reviewing the medical records of clients who have sustained several falls. While reviewing a
client's medical record who has fallen twice in the past month, which medications should the nurse
recommend be discontinued to lower the client's risk for future falls? (SATA)
a. Fluoxetine
b. Temazepam
c. Bupropion
d. Ferrous sulfate
e. Hydrocodone-acetaminophen
f. Hydroxyzine
g. Docusate
CORRECT ANSWERS: B, E, F
Rationale: High-risk fall medications in older adults directly involve CNS depressants and anticholinergics. Temazepam (a
benzodiazepine causing sedation), Hydrocodone-acetaminophen (an opioid causing sedation and ataxia), and Hydroxyzine (an
anticholinergic antihistamine causing altered sensorium) significantly elevate fall risk and should be deprescribed or substituted
(e.g., melatonin for insomnia).
QUESTION IMMUNIZATION / PUBLIC HEALTH
4
The nurse is educating a group of students on the measles, mumps, and rubella (MMR) vaccine. Which
statement, if made by the student, would indicate effective teaching?
a. "Egg allergy is a contraindication to giving this vaccine"
b. "This is a 3-series vaccine that should be started at birth"
c. "It is safe for breastfeeding women to receive the MMR vaccine"
d. "This vaccine is safe if the client is pregnant"
CORRECT ANSWER: C
Rationale: The MMR vaccine is a live attenuated virus vaccine. It is completely safe for postpartum/breastfeeding mothers.
However, live vaccines are strictly contraindicated during pregnancy due to teratogenic risks. An egg allergy is no longer
considered a contraindication for MMR administration.
NCLEX-RN Exam Preparation • Comprehensive Question Bank Page 2 of 28
, QUESTION MATERNAL-NEWBORN / PHARMACOLOGY
5
The nurse is caring for a client receiving a terbutaline infusion to prevent preterm labor. Which clinical
finding indicates that the nurse should continue the infusion?
a. Blood pressure 91/58 mmHg
b. Heart rate 132 BPM
c. Serum potassium 3.3 mEq/L
d. Blood glucose 104 mg/dL
CORRECT ANSWER: D
Rationale: Terbutaline is a beta-2 adrenergic agonist used as a tocolytic. Adverse effects include maternal tachycardia (>120
BPM), hypotension, hypokalemia, and hyperglycemia. A blood glucose of 104 mg/dL is within normal limits (70-110 mg/dL),
confirming safety to maintain the infusion.
QUESTION RENAL / DIAGNOSTICS
6
The nurse is assessing a client with suspected acute glomerulonephritis (AGN). Which of the following
findings would support a diagnosis of acute glomerulonephritis? (SATA)
a. Metabolic acidosis
b. Increased serum creatinine
c. Hematuria
d. Costovertebral tenderness
e. Increased serum ammonia level
f. Hypovolemia
CORRECT ANSWERS: B, C
Rationale: Acute Glomerulonephritis is characterized by glomerular inflammation resulting in impaired renal filtration. Hallmark
manifestations include hematuria (tea/cola-colored urine due to RBC leakage) and elevated BUN/creatinine due to decreased
GFR. Hypervolemia/edema (not hypovolemia) typically occurs.
NCLEX-RN Exam Preparation • Comprehensive Question Bank Page 3 of 28
