NCLEX Exam Questions And Answers
NCLEX
Single Best Answer 45
Select All That Apply (SATA) 15
Priority/ FIRST / BEST / NEXT 15
Delegation & Assignment 10
NGN Case Studies 10
Bow-Tie/ Matrix / Trend / Cloze 30
TOTAL 125
PARTI-SINGLE BEST ANSWER
1.A nurse is caring for a client with heart failure. Which finding is most consistent with left-sided heart
failure?
A. Jugular venous distention
B. Crackles in both lung bases
C.Hepatomegaly
D.Dependent edema
Answer: B. Crackles in both lung bases
Rationale: Left-sided heart failure causes pulmonary congestion,resulting in crackles,
dyspnea,orthopnea,and decreased oxygenation. Peripheral edema and jugular venous distention are
more associated with right-sided heart failure.
2.A client taking furosemide is at greatest risk for which electrolyte imbalance?
A.Hyperkalemia
B.Hypokalemia
C.Hypercalcemia
D.Hypermagnesemia
Answer:B.Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary potassium loss.Hypokalemia can cause
muscle weakness and cardiac dysrhythmias.
3.Which laboratory value should the nurse monitor for a client receiving warfarin?
A.aPTT
B.INR
C.Troponin
D.Platelet aggregation time
Answer:B.INR
Rationale:Warfarin therapy is monitored using PT/INR.Heparin therapy is commonly monitored using
aPTT or anti-Xa levels.
4.A client receiving digoxin reports nausea and seeing yellow halos around lights. What should the nurse
suspect?
A.Hypoglycemia
B. Digoxin toxicity
C.Hyperthyroidism
D.Expected medication effect
Answer: B. Digoxin toxicity
11Page
,Rationale: Nausea, vomiting, anorexia, visual disturbances, bradycardia, and dysrhythmias are classic
manifestations of digoxin toxicity.
5.Which medication reverses opioid-induced respiratory depression?
A.Flumazenil
B. Naloxone
C.Protamine sulfate
D.Vitamin K
Answer:B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory and CNS
depression.
6.Which medication is commonly used to reverse heparin?
A.Vitamin K
B. Protamine sulfate
C.Naloxone
D.Calcium gluconate
Answer: B. Protamine sulfate
Rationale: Protamine sulfate neutralizes heparin. Vitamin K is associated with reversal of warfarin.
7.A client with diabetes has a blood glucose of 52 mg/dL and is awake and able to swallow. What should
the nurse do?
A.Administer glucagon IM
B. Give 15 g of rapid-acting carbohydrate
C. Start IV insulin
D.Restrict oral intake
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive approximately 15 g of fast-acting
carbohydrate followed by rechecking the glucose level after about 15 minutes.
8.Which finding is most consistent with diabetic ketoacidosis?
A.Shallow respirations
B.Kussmaul respirations
C.Bradycardia
D.Severe hypoglycemia
Answer: B. Kussmaul respirations
Rationale: DKA causes metabolic acidosis. Deep, rapid Kussmaul respirations help compensate by
eliminating carbon dioxide.
9.Which ECG change is commonly associated with hyperkalemia?
A.U waves
B.Peaked T waves
C.Prolonged PR intervaIonly
D.ST depression as the classic finding
Answer:B. Peaked T waves
Rationale: Hyperkalemia can cause tall peaked T waves and may progress to widened QRS
complexes and life-threatening dysrhythmias.
10.Which finding is associated with hypocalcemia?
A.Positive Trousseau sign
B. Decreased neuromuscular activity
C.Constipation only
D.Bradyreflexia
Answer:A. Positive Trousseau sign
2|Page
,Rationale:Hypocalcemia increases neuromuscular excitability and can cause tetany, paresthesias,and
positive Chvostek and Trousseau signs.
11.Which finding is expected in syndrome of inappropriate antidiuretic hormone secretion?
A.Hypernatremia
B.Dilutional hyponatremia
C. Large amounts of dilute urine
D.Severe dehydration
Answer:B. Dilutional hyponatremia
Rationale: Excess ADH causes water retention, which dilutes serum sodium and results in
concentrated urine.
12.A client with diabetes insipidus would most likely exhibit:
A.Low urine output
B.Concentrated urine
C.Large amounts of dilute urine
D.Water retention
Answer:C. Large amounts of dilute urine
Rationale: Diabetes insipidus involves inadequate ADH activity, causing polyuria, dilute urine, thirst,and risk
for dehydration.
13.Which manifestation is characteristic of Addison disease?
A.Moon face
B.Hyperpigmentation
C.Buffalo hump
D.Hypernatremia
Answer: B.Hyperpigmentation
Rationale: Primary adrenal insufficiency can cause hyperpigmentation, hypotension,
hyponatremia,hyperkalemia,and weakness.
14.Which manifestation is expected with Cushing syndrome?
A.Weight loss
B.Hyperpigmentation only
C.Moon face and truncal obesity
D.Hypoglycemia
Answer: C.Moon face and truncal obesity
Rationale: Excess cortisol causes central obesity, moon face, buffalo hump,hyperglycemia, thin skin,and
increased infection risk.
15.A client with COPD is prescribed oxygen.Which nursing action is appropriate?
A. Withhold oxygen because it suppresses respiratory drive
B.Titrate oxygen to the prescribed target and monitor response
C.Administer maximum oxygen without reassessment
D.Discontinue pulse oximetry
Answer: B. Titrate oxygen to the prescribed target and monitor response
Rationale: Hypoxemia should be treated. Oxygen is titrated to the prescribed goal while the nurse
monitors respiratory status and response.
16.Which medication is commonly used for rapid relief of acute bronchospasm?
A.Albuterol
B.Montelukast
C.Fluticasone
D.Prednisone
Answer:A.Albuterol
, 3|Page
NCLEX
Single Best Answer 45
Select All That Apply (SATA) 15
Priority/ FIRST / BEST / NEXT 15
Delegation & Assignment 10
NGN Case Studies 10
Bow-Tie/ Matrix / Trend / Cloze 30
TOTAL 125
PARTI-SINGLE BEST ANSWER
1.A nurse is caring for a client with heart failure. Which finding is most consistent with left-sided heart
failure?
A. Jugular venous distention
B. Crackles in both lung bases
C.Hepatomegaly
D.Dependent edema
Answer: B. Crackles in both lung bases
Rationale: Left-sided heart failure causes pulmonary congestion,resulting in crackles,
dyspnea,orthopnea,and decreased oxygenation. Peripheral edema and jugular venous distention are
more associated with right-sided heart failure.
2.A client taking furosemide is at greatest risk for which electrolyte imbalance?
A.Hyperkalemia
B.Hypokalemia
C.Hypercalcemia
D.Hypermagnesemia
Answer:B.Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary potassium loss.Hypokalemia can cause
muscle weakness and cardiac dysrhythmias.
3.Which laboratory value should the nurse monitor for a client receiving warfarin?
A.aPTT
B.INR
C.Troponin
D.Platelet aggregation time
Answer:B.INR
Rationale:Warfarin therapy is monitored using PT/INR.Heparin therapy is commonly monitored using
aPTT or anti-Xa levels.
4.A client receiving digoxin reports nausea and seeing yellow halos around lights. What should the nurse
suspect?
A.Hypoglycemia
B. Digoxin toxicity
C.Hyperthyroidism
D.Expected medication effect
Answer: B. Digoxin toxicity
11Page
,Rationale: Nausea, vomiting, anorexia, visual disturbances, bradycardia, and dysrhythmias are classic
manifestations of digoxin toxicity.
5.Which medication reverses opioid-induced respiratory depression?
A.Flumazenil
B. Naloxone
C.Protamine sulfate
D.Vitamin K
Answer:B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory and CNS
depression.
6.Which medication is commonly used to reverse heparin?
A.Vitamin K
B. Protamine sulfate
C.Naloxone
D.Calcium gluconate
Answer: B. Protamine sulfate
Rationale: Protamine sulfate neutralizes heparin. Vitamin K is associated with reversal of warfarin.
7.A client with diabetes has a blood glucose of 52 mg/dL and is awake and able to swallow. What should
the nurse do?
A.Administer glucagon IM
B. Give 15 g of rapid-acting carbohydrate
C. Start IV insulin
D.Restrict oral intake
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive approximately 15 g of fast-acting
carbohydrate followed by rechecking the glucose level after about 15 minutes.
8.Which finding is most consistent with diabetic ketoacidosis?
A.Shallow respirations
B.Kussmaul respirations
C.Bradycardia
D.Severe hypoglycemia
Answer: B. Kussmaul respirations
Rationale: DKA causes metabolic acidosis. Deep, rapid Kussmaul respirations help compensate by
eliminating carbon dioxide.
9.Which ECG change is commonly associated with hyperkalemia?
A.U waves
B.Peaked T waves
C.Prolonged PR intervaIonly
D.ST depression as the classic finding
Answer:B. Peaked T waves
Rationale: Hyperkalemia can cause tall peaked T waves and may progress to widened QRS
complexes and life-threatening dysrhythmias.
10.Which finding is associated with hypocalcemia?
A.Positive Trousseau sign
B. Decreased neuromuscular activity
C.Constipation only
D.Bradyreflexia
Answer:A. Positive Trousseau sign
2|Page
,Rationale:Hypocalcemia increases neuromuscular excitability and can cause tetany, paresthesias,and
positive Chvostek and Trousseau signs.
11.Which finding is expected in syndrome of inappropriate antidiuretic hormone secretion?
A.Hypernatremia
B.Dilutional hyponatremia
C. Large amounts of dilute urine
D.Severe dehydration
Answer:B. Dilutional hyponatremia
Rationale: Excess ADH causes water retention, which dilutes serum sodium and results in
concentrated urine.
12.A client with diabetes insipidus would most likely exhibit:
A.Low urine output
B.Concentrated urine
C.Large amounts of dilute urine
D.Water retention
Answer:C. Large amounts of dilute urine
Rationale: Diabetes insipidus involves inadequate ADH activity, causing polyuria, dilute urine, thirst,and risk
for dehydration.
13.Which manifestation is characteristic of Addison disease?
A.Moon face
B.Hyperpigmentation
C.Buffalo hump
D.Hypernatremia
Answer: B.Hyperpigmentation
Rationale: Primary adrenal insufficiency can cause hyperpigmentation, hypotension,
hyponatremia,hyperkalemia,and weakness.
14.Which manifestation is expected with Cushing syndrome?
A.Weight loss
B.Hyperpigmentation only
C.Moon face and truncal obesity
D.Hypoglycemia
Answer: C.Moon face and truncal obesity
Rationale: Excess cortisol causes central obesity, moon face, buffalo hump,hyperglycemia, thin skin,and
increased infection risk.
15.A client with COPD is prescribed oxygen.Which nursing action is appropriate?
A. Withhold oxygen because it suppresses respiratory drive
B.Titrate oxygen to the prescribed target and monitor response
C.Administer maximum oxygen without reassessment
D.Discontinue pulse oximetry
Answer: B. Titrate oxygen to the prescribed target and monitor response
Rationale: Hypoxemia should be treated. Oxygen is titrated to the prescribed goal while the nurse
monitors respiratory status and response.
16.Which medication is commonly used for rapid relief of acute bronchospasm?
A.Albuterol
B.Montelukast
C.Fluticasone
D.Prednisone
Answer:A.Albuterol
, 3|Page
