NCLEX NURSING SCHOOL SURVIVAL
KIT – COMPLETE THRIVE & SURVIVE
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which of the following
ECG changes is the most critical to monitor for?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Inverted T waves
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) is associated with tall,
peaked T waves, widened QRS complexes, and potentially cardiac arrest. U waves are seen
in hypokalemia.
,2. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following arterial blood
gas results would the nurse expect?
A. pH 7.30, PaCO2 40, HCO3 18
B. pH 7.50, PaCO2 30, HCO3 24
C. pH 7.48, PaCO2 48, HCO3 30
D. pH 7.32, PaCO2 35, HCO3 16
Answer: D
Conceptual Explanation: DKA causes metabolic acidosis. pH below 7.35 and HCO3 below
22 mEq/L are indicative. Partial compensation may occur via the lungs (lowering PaCO2).
3. The nurse is preparing to administer Digoxin to a client with heart failure. Which
assessment finding should lead the nurse to withhold the medication?
A. Heart rate of 54 beats per minute
B. Blood pressure of 140/90 mmHg
C. Respiratory rate of 22 breaths per minute
D. Potassium level of 4.5 mEq/L
Answer: A
Conceptual Explanation: Digoxin should be held if the apical pulse is less than 60 bpm in
adults because it is a negative chronotrope that slows the heart rate.
, 4. A client is receiving Magnesium Sulfate for preeclampsia. Which finding is the first sign of
Magnesium toxicity?
A. Increased urinary output
B. Loss of deep tendon reflexes
C. Respiratory rate of 16 breaths per minute
D. Tachycardia
Answer: B
Conceptual Explanation: The loss of deep tendon reflexes (DTRs) is often the earliest sign
of Magnesium Sulfate toxicity. Respiratory depression and cardiac arrest follow.
5. The nurse is caring for a client with a Chest Tube. The nurse notes continuous bubbling in
the water seal chamber. What is the most likely cause?
A. The system is working normally
B. There is an air leak in the system
C. The client has a pneumothorax
D. The suction pressure is too high
Answer: B
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak. Intermittent bubbling during expiration or coughing is normal in a patient with a
pneumothorax.
KIT – COMPLETE THRIVE & SURVIVE
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A nurse is caring for a patient with a potassium level of 6.2 mEq/L. Which of the following
ECG changes is the most critical to monitor for?
A. Prominent U waves
B. ST-segment depression
C. Tall, peaked T waves
D. Inverted T waves
Answer: C
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) is associated with tall,
peaked T waves, widened QRS complexes, and potentially cardiac arrest. U waves are seen
in hypokalemia.
,2. A client is admitted with Diabetic Ketoacidosis (DKA). Which of the following arterial blood
gas results would the nurse expect?
A. pH 7.30, PaCO2 40, HCO3 18
B. pH 7.50, PaCO2 30, HCO3 24
C. pH 7.48, PaCO2 48, HCO3 30
D. pH 7.32, PaCO2 35, HCO3 16
Answer: D
Conceptual Explanation: DKA causes metabolic acidosis. pH below 7.35 and HCO3 below
22 mEq/L are indicative. Partial compensation may occur via the lungs (lowering PaCO2).
3. The nurse is preparing to administer Digoxin to a client with heart failure. Which
assessment finding should lead the nurse to withhold the medication?
A. Heart rate of 54 beats per minute
B. Blood pressure of 140/90 mmHg
C. Respiratory rate of 22 breaths per minute
D. Potassium level of 4.5 mEq/L
Answer: A
Conceptual Explanation: Digoxin should be held if the apical pulse is less than 60 bpm in
adults because it is a negative chronotrope that slows the heart rate.
, 4. A client is receiving Magnesium Sulfate for preeclampsia. Which finding is the first sign of
Magnesium toxicity?
A. Increased urinary output
B. Loss of deep tendon reflexes
C. Respiratory rate of 16 breaths per minute
D. Tachycardia
Answer: B
Conceptual Explanation: The loss of deep tendon reflexes (DTRs) is often the earliest sign
of Magnesium Sulfate toxicity. Respiratory depression and cardiac arrest follow.
5. The nurse is caring for a client with a Chest Tube. The nurse notes continuous bubbling in
the water seal chamber. What is the most likely cause?
A. The system is working normally
B. There is an air leak in the system
C. The client has a pneumothorax
D. The suction pressure is too high
Answer: B
Conceptual Explanation: Continuous bubbling in the water seal chamber indicates an air
leak. Intermittent bubbling during expiration or coughing is normal in a patient with a
pneumothorax.
