NCLEX NURSING SCHOOL SURVIVAL
KIT – COMPLETE THRIVE & SURVIVE
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via a
nasal cannula at 2 L/min. The nurse notes the patient’s arterial blood gas (ABG) results: pH
7.33, PaCO2 58 mmHg, PaO2 62 mmHg, and HCO3 30 mEq/L. Which action should the nurse
take first?
A. Continue to monitor the respiratory status
B. Initiate bag-valve-mask ventilations
C. Increase the oxygen flow rate to 4 L/min
D. Prepare for immediate endotracheal intubation
Answer: A
Conceptual Explanation: These ABG results reflect compensated respiratory acidosis,
which is common in chronic COPD patients. Increasing oxygen could suppress the hypoxic
drive, and intubation is not indicated as the patient is compensated.
2. A client is admitted with a diagnosis of Addisonian Crisis. Which of the following provider
orders should the nurse perform first?
A. Administer intravenous hydrocortisone
,B. Obtain a 12-lead electrocardiogram
C. Infuse 1,000 mL of 0.9% Normal Saline
D. Draw blood for serum potassium levels
Answer: C
Conceptual Explanation: In Addisonian Crisis, the immediate life-threatening issues are
hypotension and hypovolemia. Fluid resuscitation with normal saline is the highest
priority, followed by steroid replacement.
3. The nurse is caring for a client with a history of cirrhosis who begins to exhibit altered
mental status and asterixis. Which medication should the nurse anticipate administering?
A. Spironolactone
B. Lactulose
C. Propranolol
D. Vitamin K
Answer: B
Conceptual Explanation: Altered mental status and asterixis (flapping tremors) are signs
of hepatic encephalopathy caused by high ammonia levels. Lactulose promotes ammonia
excretion through the stool.
, 4. A child is admitted with suspected epiglottitis. Which of the following nursing interventions
is contraindicated?
A. Placing the child in a tripod position
B. Visualizing the throat with a tongue blade
C. Administering humidified oxygen
D. Preparing for emergency airway management
Answer: B
Conceptual Explanation: Attempting to visualize the throat with a tongue blade or swab
can trigger a complete airway obstruction in a child with epiglottitis.
5. The nurse is evaluating a 12-lead EKG of a patient who reports palpitations. The EKG shows
a regular rhythm, a rate of 160 bpm, and a lack of visible P waves. Which is the initial nursing
action?
A. Instruct the patient to perform a Valsalva maneuver
B. Perform immediate synchronized cardioversion
C. Administer a 6 mg rapid IV bolus of Adenosine
D. Prepare for temporary transcutaneous pacing
Answer: A
KIT – COMPLETE THRIVE & SURVIVE
STUDY GUIDE QUESTIONS AND
ANSWERS
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen via a
nasal cannula at 2 L/min. The nurse notes the patient’s arterial blood gas (ABG) results: pH
7.33, PaCO2 58 mmHg, PaO2 62 mmHg, and HCO3 30 mEq/L. Which action should the nurse
take first?
A. Continue to monitor the respiratory status
B. Initiate bag-valve-mask ventilations
C. Increase the oxygen flow rate to 4 L/min
D. Prepare for immediate endotracheal intubation
Answer: A
Conceptual Explanation: These ABG results reflect compensated respiratory acidosis,
which is common in chronic COPD patients. Increasing oxygen could suppress the hypoxic
drive, and intubation is not indicated as the patient is compensated.
2. A client is admitted with a diagnosis of Addisonian Crisis. Which of the following provider
orders should the nurse perform first?
A. Administer intravenous hydrocortisone
,B. Obtain a 12-lead electrocardiogram
C. Infuse 1,000 mL of 0.9% Normal Saline
D. Draw blood for serum potassium levels
Answer: C
Conceptual Explanation: In Addisonian Crisis, the immediate life-threatening issues are
hypotension and hypovolemia. Fluid resuscitation with normal saline is the highest
priority, followed by steroid replacement.
3. The nurse is caring for a client with a history of cirrhosis who begins to exhibit altered
mental status and asterixis. Which medication should the nurse anticipate administering?
A. Spironolactone
B. Lactulose
C. Propranolol
D. Vitamin K
Answer: B
Conceptual Explanation: Altered mental status and asterixis (flapping tremors) are signs
of hepatic encephalopathy caused by high ammonia levels. Lactulose promotes ammonia
excretion through the stool.
, 4. A child is admitted with suspected epiglottitis. Which of the following nursing interventions
is contraindicated?
A. Placing the child in a tripod position
B. Visualizing the throat with a tongue blade
C. Administering humidified oxygen
D. Preparing for emergency airway management
Answer: B
Conceptual Explanation: Attempting to visualize the throat with a tongue blade or swab
can trigger a complete airway obstruction in a child with epiglottitis.
5. The nurse is evaluating a 12-lead EKG of a patient who reports palpitations. The EKG shows
a regular rhythm, a rate of 160 bpm, and a lack of visible P waves. Which is the initial nursing
action?
A. Instruct the patient to perform a Valsalva maneuver
B. Perform immediate synchronized cardioversion
C. Administer a 6 mg rapid IV bolus of Adenosine
D. Prepare for temporary transcutaneous pacing
Answer: A
