NCLEX-RN and NCLEX-PN Examination 2020
Question Bank NCLEX-RN
1. A nurse is caring for a client with heart failure who is receiving furosemide (Lasix). Which
laboratory value requires immediate intervention?
A. Serum potassium 3.0 mEq/L
B. Serum sodium 138 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum magnesium 2.0 mEq/L
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Furosemide is a loop diuretic that causes potassium wasting. A potassium of 3.0 mEq/L is
critically low (normal 3.5–5.0) and increases the risk of cardiac arrhythmias. The other values
are within normal limits. </details>
2. A postoperative client reports sudden chest pain and dyspnea. The nurse notes tachycardia
and hypotension. Which action should the nurse take first?
A. Administer oxygen via nasal cannula
B. Notify the healthcare provider
C. Prepare for IV heparin infusion
D. Elevate the head of the bed
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
These symptoms suggest a pulmonary embolism. The priority is to administer oxygen to correct
hypoxemia. Airway and breathing always come first. After that, notify the provider and prepare
for interventions. </details>
3. A client with diabetes mellitus type 1 is exhibiting confusion, diaphoresis, and tachycardia.
What is the nurse's priority action?
A. Administer 15 g of fast-acting carbohydrate
B. Check blood glucose level
C. Administer insulin per sliding scale
D. Call the provider for orders
,<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
The client shows signs of hypoglycemia. The priority is to check the blood glucose to confirm the
diagnosis before treatment. If glucose is low, then administer 15 g of carbohydrate. </details>
4. A nurse is preparing to insert a nasogastric tube. In which position should the client be
placed?
A. Supine with head hyperextended
B. High Fowler's position
C. Left lateral recumbent
D. Trendelenburg position
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
High Fowler's position facilitates swallowing and reduces the risk of aspiration during NG tube
insertion. It also helps the tube pass more easily down the esophagus. </details>
5. Which finding in a client with a tracheostomy requires immediate intervention?
A. Copious thick secretions
B. Heart rate 88 bpm
C. Respiratory rate 18/min
D. SpO2 89%
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: D**
An SpO2 of 89% indicates hypoxia and requires immediate intervention. Normal SpO2 is 95–
100%. The nurse should assess the airway, suction if needed, and provide oxygen. </details>
6. A nurse is assessing a client with appendicitis. Which finding is most concerning?
A. Nausea and vomiting
B. Rebound tenderness at McBurney's point
C. Sudden relief of pain followed by fever
D. Anorexia
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: C**
Sudden relief of pain followed by fever may indicate perforation of the appendix, leading to
peritonitis. This is a surgical emergency. The other findings are typical of appendicitis but not as
critical. </details>
,7. A client with hypertension is prescribed lisinopril. Which side effect should the nurse teach
the client to report?
A. Dry cough
B. Peripheral edema
C. Dizziness
D. Constipation
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Lisinopril is an ACE inhibitor. A persistent dry cough is a common side effect that may require
discontinuation. Dizziness can also occur but is usually transient. Edema and constipation are
not typical. </details>
8. A postpartum client reports heavy bleeding with large clots. The nurse assesses a boggy
uterus. Which medication should the nurse anticipate administering?
A. Magnesium sulfate
B. Oxytocin (Pitocin)
C. Naloxone (Narcan)
D. Terbutaline
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
A boggy uterus with heavy bleeding indicates uterine atony. Oxytocin is the first-line medication
to promote uterine contraction and control postpartum hemorrhage. </details>
9. A client on warfarin (Coumadin) has an INR of 5.0. Which action should the nurse take?
A. Administer vitamin K
B. Increase the warfarin dose
C. Continue current dose
D. Administer protamine sulfate
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Therapeutic INR for warfarin is 2.0–3.0 (or up to 3.5 for some conditions). An INR of 5.0 is
dangerously high and increases bleeding risk. Vitamin K is the antidote. Protamine sulfate is for
heparin. </details>
10. A nurse is teaching a client with asthma about using a peak flow meter. Which instruction
is correct?
A. Use the meter only during an attack
, B. Take a deep breath and exhale forcefully into the meter
C. Record the average of three readings
D. Use the meter immediately after taking a bronchodilator
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
The client should take a deep breath and exhale as forcefully and quickly as possible into the
meter. The highest of three readings is recorded, not the average. It is used daily to monitor
status. </details>
11. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
intervention is most appropriate?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Encourage high-potassium foods
C. Administer IV potassium chloride
D. Restrict oral fluids
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Hyperkalemia (K > 5.0) is life-threatening. Kayexalate binds potassium in the GI tract and
promotes excretion. The client should avoid high-potassium foods and potassium-containing IV
solutions. </details>
12. A nurse is caring for a client with active tuberculosis. Which personal protective
equipment is required?
A. Surgical mask
B. N95 respirator
C. Gown and gloves
D. Eye goggles
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
TB is transmitted via airborne droplets. An N95 respirator (or higher) is required. A surgical mask
is insufficient. Gown and gloves are not needed unless contact precautions are also indicated.
</details>
13. A client is receiving IV dopamine for shock. Which finding indicates a positive response?
A. Urine output 25 mL/hour
B. Blood pressure 90/60 mmHg
Question Bank NCLEX-RN
1. A nurse is caring for a client with heart failure who is receiving furosemide (Lasix). Which
laboratory value requires immediate intervention?
A. Serum potassium 3.0 mEq/L
B. Serum sodium 138 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum magnesium 2.0 mEq/L
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Furosemide is a loop diuretic that causes potassium wasting. A potassium of 3.0 mEq/L is
critically low (normal 3.5–5.0) and increases the risk of cardiac arrhythmias. The other values
are within normal limits. </details>
2. A postoperative client reports sudden chest pain and dyspnea. The nurse notes tachycardia
and hypotension. Which action should the nurse take first?
A. Administer oxygen via nasal cannula
B. Notify the healthcare provider
C. Prepare for IV heparin infusion
D. Elevate the head of the bed
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
These symptoms suggest a pulmonary embolism. The priority is to administer oxygen to correct
hypoxemia. Airway and breathing always come first. After that, notify the provider and prepare
for interventions. </details>
3. A client with diabetes mellitus type 1 is exhibiting confusion, diaphoresis, and tachycardia.
What is the nurse's priority action?
A. Administer 15 g of fast-acting carbohydrate
B. Check blood glucose level
C. Administer insulin per sliding scale
D. Call the provider for orders
,<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
The client shows signs of hypoglycemia. The priority is to check the blood glucose to confirm the
diagnosis before treatment. If glucose is low, then administer 15 g of carbohydrate. </details>
4. A nurse is preparing to insert a nasogastric tube. In which position should the client be
placed?
A. Supine with head hyperextended
B. High Fowler's position
C. Left lateral recumbent
D. Trendelenburg position
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
High Fowler's position facilitates swallowing and reduces the risk of aspiration during NG tube
insertion. It also helps the tube pass more easily down the esophagus. </details>
5. Which finding in a client with a tracheostomy requires immediate intervention?
A. Copious thick secretions
B. Heart rate 88 bpm
C. Respiratory rate 18/min
D. SpO2 89%
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: D**
An SpO2 of 89% indicates hypoxia and requires immediate intervention. Normal SpO2 is 95–
100%. The nurse should assess the airway, suction if needed, and provide oxygen. </details>
6. A nurse is assessing a client with appendicitis. Which finding is most concerning?
A. Nausea and vomiting
B. Rebound tenderness at McBurney's point
C. Sudden relief of pain followed by fever
D. Anorexia
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: C**
Sudden relief of pain followed by fever may indicate perforation of the appendix, leading to
peritonitis. This is a surgical emergency. The other findings are typical of appendicitis but not as
critical. </details>
,7. A client with hypertension is prescribed lisinopril. Which side effect should the nurse teach
the client to report?
A. Dry cough
B. Peripheral edema
C. Dizziness
D. Constipation
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Lisinopril is an ACE inhibitor. A persistent dry cough is a common side effect that may require
discontinuation. Dizziness can also occur but is usually transient. Edema and constipation are
not typical. </details>
8. A postpartum client reports heavy bleeding with large clots. The nurse assesses a boggy
uterus. Which medication should the nurse anticipate administering?
A. Magnesium sulfate
B. Oxytocin (Pitocin)
C. Naloxone (Narcan)
D. Terbutaline
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
A boggy uterus with heavy bleeding indicates uterine atony. Oxytocin is the first-line medication
to promote uterine contraction and control postpartum hemorrhage. </details>
9. A client on warfarin (Coumadin) has an INR of 5.0. Which action should the nurse take?
A. Administer vitamin K
B. Increase the warfarin dose
C. Continue current dose
D. Administer protamine sulfate
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Therapeutic INR for warfarin is 2.0–3.0 (or up to 3.5 for some conditions). An INR of 5.0 is
dangerously high and increases bleeding risk. Vitamin K is the antidote. Protamine sulfate is for
heparin. </details>
10. A nurse is teaching a client with asthma about using a peak flow meter. Which instruction
is correct?
A. Use the meter only during an attack
, B. Take a deep breath and exhale forcefully into the meter
C. Record the average of three readings
D. Use the meter immediately after taking a bronchodilator
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
The client should take a deep breath and exhale as forcefully and quickly as possible into the
meter. The highest of three readings is recorded, not the average. It is used daily to monitor
status. </details>
11. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
intervention is most appropriate?
A. Administer sodium polystyrene sulfonate (Kayexalate)
B. Encourage high-potassium foods
C. Administer IV potassium chloride
D. Restrict oral fluids
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: A**
Hyperkalemia (K > 5.0) is life-threatening. Kayexalate binds potassium in the GI tract and
promotes excretion. The client should avoid high-potassium foods and potassium-containing IV
solutions. </details>
12. A nurse is caring for a client with active tuberculosis. Which personal protective
equipment is required?
A. Surgical mask
B. N95 respirator
C. Gown and gloves
D. Eye goggles
<details> <summary><strong>Answer & Rationale</strong></summary> **Correct Answer: B**
TB is transmitted via airborne droplets. An N95 respirator (or higher) is required. A surgical mask
is insufficient. Gown and gloves are not needed unless contact precautions are also indicated.
</details>
13. A client is receiving IV dopamine for shock. Which finding indicates a positive response?
A. Urine output 25 mL/hour
B. Blood pressure 90/60 mmHg
