___________________________________________________________________
Nursing 354 NCLEX-RN Practice Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
___________________________________________________________________
Question 1
A nurse is assessing a client who has pneumonia. Which finding requires the
nurse's immediate attention?
A. Temperature of 38.1°C (100.6°F)
B. Productive cough with yellow sputum
C. Respiratory rate of 32/min with oxygen saturation of 86%
D. Fatigue when ambulating
Answer: C. Respiratory rate of 32/min with oxygen saturation of 86%
Rationale: Severe tachypnea and hypoxemia indicate impaired oxygenation and
require immediate intervention. Airway and breathing take priority according to
the ABC framework.
Question 2
A client taking furosemide reports muscle weakness and irregular heartbeats.
Which laboratory value should the nurse assess first?
A. Sodium
B. Potassium
,C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Furosemide can cause potassium loss. Hypokalemia can produce
muscle weakness and potentially dangerous cardiac dysrhythmias.
Question 3
Which intervention is most appropriate when administering insulin lispro?
A. Administer it 30 minutes before meals
B. Give it at bedtime only
C. Administer it shortly before meals
D. Hold it whenever the client is hungry
Answer: C. Administer it shortly before meals
Rationale: Insulin lispro is rapid-acting insulin and is generally administered
immediately before meals so its action corresponds with food intake.
Question 4
A nurse is caring for a client who has heart failure. Which assessment finding
indicates worsening fluid overload?
A. Weight loss of 1 kg
B. Clear lung sounds
C. Dependent edema and increasing weight
D. Increased urine output
Answer: C. Dependent edema and increasing weight
Rationale: Rapid weight gain and peripheral edema are common manifestations
of fluid retention associated with worsening heart failure.
Question 5
A client with diabetes is confused, diaphoretic, and shaky. What should the nurse
do first if the client is awake and able to swallow?
,A. Administer regular insulin
B. Give a rapid source of glucose
C. Encourage exercise
D. Restrict oral fluids
Answer: B. Give a rapid source of glucose
Rationale: The manifestations are consistent with hypoglycemia. An alert client
who can swallow should receive a rapid source of glucose immediately.
Question 6
Which statement by a client taking warfarin indicates a need for further teaching?
A. "I will report unusual bleeding."
B. "I will have my blood tests monitored."
C. "I can take aspirin whenever I have a headache."
D. "I should tell healthcare providers that I take warfarin."
Answer: C. "I can take aspirin whenever I have a headache."
Rationale: Aspirin can increase bleeding risk when combined with warfarin.
Clients should consult their healthcare provider before taking medications that
affect coagulation.
Question 7
A client is experiencing an acute asthma exacerbation. Which medication should
the nurse expect to administer for rapid bronchodilation?
A. Albuterol
B. Montelukast
C. Fluticasone
D. Salmeterol
Answer: A. Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid
relief of acute bronchospasm.
, Question 8
A nurse is caring for a client after a thyroidectomy. Which finding requires
immediate intervention?
A. Mild sore throat
B. Hoarse voice
C. Stridor
D. Incisional discomfort
Answer: C. Stridor
Rationale: Stridor may indicate airway obstruction from swelling or bleeding
and requires immediate assessment and intervention.
Question 9
Which finding is most consistent with increased intracranial pressure?
A. Bradycardia with increasing blood pressure
B. Hypotension with tachycardia
C. Increased appetite
D. Warm, flushed skin
Answer: A. Bradycardia with increasing blood pressure
Rationale: Hypertension with bradycardia can occur as part of Cushing's
response, a late sign of increased intracranial pressure.
Question 10
A client has a suspected stroke. Which assessment finding is most important for
determining eligibility for time-sensitive treatment?
A. Last known well time
B. Favorite food
C. Previous vaccination history
D. Usual bedtime
Answer: A. Last known well time
Nursing 354 NCLEX-RN Practice Exam
Questions And Correct Answers (Verified
Answers) Plus Rationales 2026 Q&A
Instant Download Pdf
___________________________________________________________________
Question 1
A nurse is assessing a client who has pneumonia. Which finding requires the
nurse's immediate attention?
A. Temperature of 38.1°C (100.6°F)
B. Productive cough with yellow sputum
C. Respiratory rate of 32/min with oxygen saturation of 86%
D. Fatigue when ambulating
Answer: C. Respiratory rate of 32/min with oxygen saturation of 86%
Rationale: Severe tachypnea and hypoxemia indicate impaired oxygenation and
require immediate intervention. Airway and breathing take priority according to
the ABC framework.
Question 2
A client taking furosemide reports muscle weakness and irregular heartbeats.
Which laboratory value should the nurse assess first?
A. Sodium
B. Potassium
,C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Furosemide can cause potassium loss. Hypokalemia can produce
muscle weakness and potentially dangerous cardiac dysrhythmias.
Question 3
Which intervention is most appropriate when administering insulin lispro?
A. Administer it 30 minutes before meals
B. Give it at bedtime only
C. Administer it shortly before meals
D. Hold it whenever the client is hungry
Answer: C. Administer it shortly before meals
Rationale: Insulin lispro is rapid-acting insulin and is generally administered
immediately before meals so its action corresponds with food intake.
Question 4
A nurse is caring for a client who has heart failure. Which assessment finding
indicates worsening fluid overload?
A. Weight loss of 1 kg
B. Clear lung sounds
C. Dependent edema and increasing weight
D. Increased urine output
Answer: C. Dependent edema and increasing weight
Rationale: Rapid weight gain and peripheral edema are common manifestations
of fluid retention associated with worsening heart failure.
Question 5
A client with diabetes is confused, diaphoretic, and shaky. What should the nurse
do first if the client is awake and able to swallow?
,A. Administer regular insulin
B. Give a rapid source of glucose
C. Encourage exercise
D. Restrict oral fluids
Answer: B. Give a rapid source of glucose
Rationale: The manifestations are consistent with hypoglycemia. An alert client
who can swallow should receive a rapid source of glucose immediately.
Question 6
Which statement by a client taking warfarin indicates a need for further teaching?
A. "I will report unusual bleeding."
B. "I will have my blood tests monitored."
C. "I can take aspirin whenever I have a headache."
D. "I should tell healthcare providers that I take warfarin."
Answer: C. "I can take aspirin whenever I have a headache."
Rationale: Aspirin can increase bleeding risk when combined with warfarin.
Clients should consult their healthcare provider before taking medications that
affect coagulation.
Question 7
A client is experiencing an acute asthma exacerbation. Which medication should
the nurse expect to administer for rapid bronchodilation?
A. Albuterol
B. Montelukast
C. Fluticasone
D. Salmeterol
Answer: A. Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid
relief of acute bronchospasm.
, Question 8
A nurse is caring for a client after a thyroidectomy. Which finding requires
immediate intervention?
A. Mild sore throat
B. Hoarse voice
C. Stridor
D. Incisional discomfort
Answer: C. Stridor
Rationale: Stridor may indicate airway obstruction from swelling or bleeding
and requires immediate assessment and intervention.
Question 9
Which finding is most consistent with increased intracranial pressure?
A. Bradycardia with increasing blood pressure
B. Hypotension with tachycardia
C. Increased appetite
D. Warm, flushed skin
Answer: A. Bradycardia with increasing blood pressure
Rationale: Hypertension with bradycardia can occur as part of Cushing's
response, a late sign of increased intracranial pressure.
Question 10
A client has a suspected stroke. Which assessment finding is most important for
determining eligibility for time-sensitive treatment?
A. Last known well time
B. Favorite food
C. Previous vaccination history
D. Usual bedtime
Answer: A. Last known well time
