NCLEX NURSING SCHOOL SURVIVAL
KIT - COMPREHENSIVE MASTERY
TEST QUESTIONS AND ANSWERS
1. A patient with a history of heart failure is prescribed Furosemide. Which laboratory value
should the nurse monitor most closely to prevent life-threatening arrhythmias?
A. Serum potassium 3.2 mEq/L
B. Serum sodium 135 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum magnesium 2.0 mg/dL
Answer: A
Conceptual Explanation: Furosemide is a loop diuretic that causes significant potassium
loss. Hypokalemia (K+ < 3.5) can lead to dangerous cardiac arrhythmias and increases the
risk of digoxin toxicity.
2. The nurse is caring for a client with a chest tube. While repositioning the client, the chest
tube becomes accidentally dislodged. What is the immediate priority action?
A. Notify the healthcare provider immediately
B. Perform an immediate tracheal suctioning
,C. Apply an occlusive dressing taped on three sides
D. Instruct the client to take deep breaths
Answer: C
Conceptual Explanation: Applying an occlusive dressing (like petroleum gauze) taped on
three sides creates a one-way valve that prevents air from entering the pleural space
during inspiration while allowing air to escape during expiration, preventing a tension
pneumothorax.
3. Which assessment finding in a client with Chronic Obstructive Pulmonary Disease (COPD)
requires immediate intervention?
A. Oxygen saturation of 89% on room air
B. Presence of a barrel chest
C. Productive cough with clear sputum
D. Increased use of accessory muscles and lethargy
Answer: D
Conceptual Explanation: While low SpO2 and barrel chest are expected in COPD, the use
of accessory muscles combined with lethargy indicates respiratory muscle fatigue and
impending respiratory failure (CO2 narcosis).
, 4. A nurse is reviewing arterial blood gas (ABG) results: pH 7.25, PaCO2 50 mmHg, HCO3 24
mEq/L. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory
acidosis.
5. Which medication is the priority for a client experiencing an acute anaphylactic reaction?
A. Diphenhydramine IV
B. Epinephrine IM
C. Methylprednisolone IV
D. Albuterol nebulizer
Answer: B
Conceptual Explanation: Epinephrine is the first-line treatment for anaphylaxis as it
causes bronchodilation and vasoconstriction, rapidly reversing airway obstruction and
hypotension.
KIT - COMPREHENSIVE MASTERY
TEST QUESTIONS AND ANSWERS
1. A patient with a history of heart failure is prescribed Furosemide. Which laboratory value
should the nurse monitor most closely to prevent life-threatening arrhythmias?
A. Serum potassium 3.2 mEq/L
B. Serum sodium 135 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum magnesium 2.0 mg/dL
Answer: A
Conceptual Explanation: Furosemide is a loop diuretic that causes significant potassium
loss. Hypokalemia (K+ < 3.5) can lead to dangerous cardiac arrhythmias and increases the
risk of digoxin toxicity.
2. The nurse is caring for a client with a chest tube. While repositioning the client, the chest
tube becomes accidentally dislodged. What is the immediate priority action?
A. Notify the healthcare provider immediately
B. Perform an immediate tracheal suctioning
,C. Apply an occlusive dressing taped on three sides
D. Instruct the client to take deep breaths
Answer: C
Conceptual Explanation: Applying an occlusive dressing (like petroleum gauze) taped on
three sides creates a one-way valve that prevents air from entering the pleural space
during inspiration while allowing air to escape during expiration, preventing a tension
pneumothorax.
3. Which assessment finding in a client with Chronic Obstructive Pulmonary Disease (COPD)
requires immediate intervention?
A. Oxygen saturation of 89% on room air
B. Presence of a barrel chest
C. Productive cough with clear sputum
D. Increased use of accessory muscles and lethargy
Answer: D
Conceptual Explanation: While low SpO2 and barrel chest are expected in COPD, the use
of accessory muscles combined with lethargy indicates respiratory muscle fatigue and
impending respiratory failure (CO2 narcosis).
, 4. A nurse is reviewing arterial blood gas (ABG) results: pH 7.25, PaCO2 50 mmHg, HCO3 24
mEq/L. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory
acidosis.
5. Which medication is the priority for a client experiencing an acute anaphylactic reaction?
A. Diphenhydramine IV
B. Epinephrine IM
C. Methylprednisolone IV
D. Albuterol nebulizer
Answer: B
Conceptual Explanation: Epinephrine is the first-line treatment for anaphylaxis as it
causes bronchodilation and vasoconstriction, rapidly reversing airway obstruction and
hypotension.
