NCLEX PN ACTUAL EXAM 2024 QUESTIONS AND
ANSWERS WITH EXPLANATION . A GRADED
Question 1:
A client with diabetes is admitted with a blood glucose level of 450 mg/dL. The nurse plans care
understanding that which of the following is the most likely cause of this client's elevated glucose
level?
A) Increased intake of carbohydrates
B) Excessive insulin administration
C) Stress response to illness
D) Lack of physical activity
Answer: C) Stress response to illness
Explanation: When a client with diabetes is ill or stressed, the body releases stress hormones, such as
cortisol and epinephrine. These hormones raise blood glucose levels by stimulating the liver to
release stored glucose into the bloodstream. This is known as the "stress response." Options A, B,
and D are less likely causes of the sudden elevation in blood glucose levels in this scenario.
Question 2:
A client with chronic renal failure is prescribed a low-protein diet. The nurse teaches the client that
this diet is necessary because:
A) Protein intake can worsen kidney function
B) Low protein helps prevent anemia
C) It reduces the risk of cardiovascular disease
D) Protein can cause electrolyte imbalances
Answer: A) Protein intake can worsen kidney function
,Explanation: In clients with chronic renal failure, a low-protein diet is often prescribed to reduce the
workload on the kidneys. Excessive protein intake can lead to increased levels of waste products in
the blood, which the kidneys must filter. This can worsen kidney function over time. Options B, C, and
D are not the primary reasons for a low-protein diet in chronic renal failure.
Question 3:
The nurse is caring for a client with heart failure who is prescribed furosemide (Lasix), a loop diuretic.
The nurse understands that the primary action of this medication is to:
A) Increase sodium reabsorption in the kidneys
B) Decrease potassium excretion in the urine
C) Increase urine output by blocking reabsorption of water
D) Promote vasodilation to reduce blood pressure
Answer: C) Increase urine output by blocking reabsorption of water
Explanation: Furosemide (Lasix) is a loop diuretic that works by blocking the reabsorption of sodium
and water in the loop of Henle in the kidneys. This leads to increased urine output and helps reduce
fluid volume in clients with heart failure. Options A, B, and D are not correct actions of furosemide.
Question 4:
A client is receiving heparin therapy for deep vein thrombosis (DVT). The nurse is aware that the
effectiveness of heparin therapy is monitored by which laboratory test?
A) Platelet count
B) Prothrombin time (PT)
C) Activated partial thromboplastin time (aPTT)
D) International normalized ratio (INR)
Answer: C) Activated partial thromboplastin time (aPTT)
Explanation: Heparin's effectiveness is monitored using the activated partial thromboplastin time
(aPTT) because it measures the time it takes for blood to clot in the presence of heparin. The aPTT is
used to adjust the heparin dosage to maintain therapeutic levels. Options A, B, and D are not specific
tests used to monitor heparin therapy.
, Question 5:
The nurse is caring for a client with pancreatitis. The client reports severe abdominal pain that
worsens after eating. The nurse understands that this pain is due to:
A) Increased gastric acid secretion
B) Enzymatic autodigestion of pancreatic tissue
C) Obstruction of the bile duct
D) Inflammation of the gastric mucosa
Answer: B) Enzymatic autodigestion of pancreatic tissue
Explanation: In pancreatitis, the enzymes normally released by the pancreas for digestion become
activated within the pancreas itself, leading to autodigestion of pancreatic tissue. This process causes
severe abdominal pain that worsens after eating. Options A, C, and D are not the primary
mechanisms of pain in pancreatitis.
Question 6:
A client with hypertension is prescribed hydrochlorothiazide (HCTZ). The nurse teaches the client to
take the medication in the morning to prevent:
A) Hyperkalemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypomagnesemia
Answer: B) Hypokalemia
Explanation: Hydrochlorothiazide (HCTZ) is a thiazide diuretic that can cause potassium loss through
increased urine output. Taking the medication in the morning helps prevent potassium loss during
the day. Hypokalemia (low potassium levels) is a potential side effect of thiazide diuretics. Options A,
C, and D are not typically associated with HCTZ use.
Question 7:
A client with chronic obstructive pulmonary disease (COPD) is prescribed oxygen therapy. The nurse
understands that oxygen therapy is administered cautiously because it can:
A) Increase carbon dioxide retention
ANSWERS WITH EXPLANATION . A GRADED
Question 1:
A client with diabetes is admitted with a blood glucose level of 450 mg/dL. The nurse plans care
understanding that which of the following is the most likely cause of this client's elevated glucose
level?
A) Increased intake of carbohydrates
B) Excessive insulin administration
C) Stress response to illness
D) Lack of physical activity
Answer: C) Stress response to illness
Explanation: When a client with diabetes is ill or stressed, the body releases stress hormones, such as
cortisol and epinephrine. These hormones raise blood glucose levels by stimulating the liver to
release stored glucose into the bloodstream. This is known as the "stress response." Options A, B,
and D are less likely causes of the sudden elevation in blood glucose levels in this scenario.
Question 2:
A client with chronic renal failure is prescribed a low-protein diet. The nurse teaches the client that
this diet is necessary because:
A) Protein intake can worsen kidney function
B) Low protein helps prevent anemia
C) It reduces the risk of cardiovascular disease
D) Protein can cause electrolyte imbalances
Answer: A) Protein intake can worsen kidney function
,Explanation: In clients with chronic renal failure, a low-protein diet is often prescribed to reduce the
workload on the kidneys. Excessive protein intake can lead to increased levels of waste products in
the blood, which the kidneys must filter. This can worsen kidney function over time. Options B, C, and
D are not the primary reasons for a low-protein diet in chronic renal failure.
Question 3:
The nurse is caring for a client with heart failure who is prescribed furosemide (Lasix), a loop diuretic.
The nurse understands that the primary action of this medication is to:
A) Increase sodium reabsorption in the kidneys
B) Decrease potassium excretion in the urine
C) Increase urine output by blocking reabsorption of water
D) Promote vasodilation to reduce blood pressure
Answer: C) Increase urine output by blocking reabsorption of water
Explanation: Furosemide (Lasix) is a loop diuretic that works by blocking the reabsorption of sodium
and water in the loop of Henle in the kidneys. This leads to increased urine output and helps reduce
fluid volume in clients with heart failure. Options A, B, and D are not correct actions of furosemide.
Question 4:
A client is receiving heparin therapy for deep vein thrombosis (DVT). The nurse is aware that the
effectiveness of heparin therapy is monitored by which laboratory test?
A) Platelet count
B) Prothrombin time (PT)
C) Activated partial thromboplastin time (aPTT)
D) International normalized ratio (INR)
Answer: C) Activated partial thromboplastin time (aPTT)
Explanation: Heparin's effectiveness is monitored using the activated partial thromboplastin time
(aPTT) because it measures the time it takes for blood to clot in the presence of heparin. The aPTT is
used to adjust the heparin dosage to maintain therapeutic levels. Options A, B, and D are not specific
tests used to monitor heparin therapy.
, Question 5:
The nurse is caring for a client with pancreatitis. The client reports severe abdominal pain that
worsens after eating. The nurse understands that this pain is due to:
A) Increased gastric acid secretion
B) Enzymatic autodigestion of pancreatic tissue
C) Obstruction of the bile duct
D) Inflammation of the gastric mucosa
Answer: B) Enzymatic autodigestion of pancreatic tissue
Explanation: In pancreatitis, the enzymes normally released by the pancreas for digestion become
activated within the pancreas itself, leading to autodigestion of pancreatic tissue. This process causes
severe abdominal pain that worsens after eating. Options A, C, and D are not the primary
mechanisms of pain in pancreatitis.
Question 6:
A client with hypertension is prescribed hydrochlorothiazide (HCTZ). The nurse teaches the client to
take the medication in the morning to prevent:
A) Hyperkalemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypomagnesemia
Answer: B) Hypokalemia
Explanation: Hydrochlorothiazide (HCTZ) is a thiazide diuretic that can cause potassium loss through
increased urine output. Taking the medication in the morning helps prevent potassium loss during
the day. Hypokalemia (low potassium levels) is a potential side effect of thiazide diuretics. Options A,
C, and D are not typically associated with HCTZ use.
Question 7:
A client with chronic obstructive pulmonary disease (COPD) is prescribed oxygen therapy. The nurse
understands that oxygen therapy is administered cautiously because it can:
A) Increase carbon dioxide retention
