NCLEX NGN Pre-Test Questions and answers
2024
A nurse is monitoring the neurological status of a client who underwent craniotomy 3 days ago. Which
signs or symptoms would prompt the nurse to notify the primary health care provider immediately?
a. Disorientation to date
b. Pupils equal and reactive at 4 mm
c. Mild headache relieved by acetaminophen with codeine
d. Pain with forward flexion of the neck onto the chest - Correct Answer-D
A complication of cranial surgery is meningitis.
A man calls the clinic and tells the nurse that he sustained a bee sting on his leg while working in his yard.
The client states that he is not allergic to bees and wants to know how to treat the sting. The nurse tells
the client to first take which action?
a. Place a cool compress on the sting site
b. Apply an antipruritic lotion to the sting site
c. Apply a topical corticosteroid to the sting site
d. Take an oral antihistamine such as diphenhydramine (Benadryl) - Correct Answer-A
A nurse is assigned to conduct an admission assessment of a client who was treated in the emergency
department after attempting suicide by cutting her wrists with a razor blade. When the client arrives at
the nursing unit, the nurse should take which action first?
a. Ask the client to sign a no-harm contract
b. Ask the client to report any suicidal thoughts immediately
c. Place the client under suicide precautions with 15-minute checks
,d. Check the dressings that were placed over the client's wrists in the emergency department - Correct
Answer-D
First assess the physical state of the patient for safety then implement precautions.
A nurse is preparing to administer digoxin to a client with heart failure. When assessing the client, the
nurse notes an apical pulse rate of 58 beats/min. Also, the client complains of anorexia and nausea.
Which action should the nurse take first on the basis of these assessment findings?
a. Contact the primary health care provider
b. Administer an as-needed antiemetic
c. Check the most recent digoxin level
d. Administer the digoxin with an antacid - Correct Answer-C
The pattern of ventricular fibrillation is identified and can be a result after a patient with an MI. VF makes
the patient feel faint, then loses consciousness and becomes pulseless and apneic (BP and heart sounds
absent). Treatment is to terminate VF and covert it into a rhythm via defibrillation-> call a rapid and
initiate CPR. Cardioversion is used for ventricular or supraventricular tachydysrhythmias.
A nurse developing a plan of care for a client with a spinal cord injury includes measures to prevent
autonomic dysreflexia (hyperreflexia). Which intervention does the nurse incorporate into the plan to
prevent this complication?
a. Keeping the fan running in the client's room
b. Keeping the linens wrinkle free under the client
c. Limiting bladder catheterization to once every 12 hours
d. Avoiding the administration of enemas and rectal suppositories - Correct Answer-B
The most frequent cause of autonomic dysreflexias are a distended bladder and impacted feces. Other
causes include stimulation of the skin by tactile, thermal, or painful stimuli. The nurse renders care in
such a way as to minimize these risks.
, A nurse provides home care instructions to a client who has been fitted with a halo device to treat a
cervical fracture. Which statement by the client indicates the need for further teaching?
a. I need to get more fluids and fiber into my diet
b. I should cut my food into small pieces before I eat
c. I need to put powder under the vest twice a day to prevent sweating
d. I have to check the pin sites everyday and watch for signs of infection - Correct Answer-C
Cleanse the skin under the wool liner each day to prevent rashes and soars.
A nurse is caring for a client with increased intracranial pressure. In which position should the nurse
maintain the client?
a. Supine with the head extended
b. Side lying with the neck flexed
c. Supine with the head turned to the side
d. Head midline and elevated 30-45 degrees - Correct Answer-D
Proper positioning promotes venous drainage from the cranium to minimize ICP.
A client with a basilar skull fracture has clear fluid leaking from the ears. The nurse should take which
action first?
a. Asses the clear fluid for protein
b. Check the clear fluid for glucose
c. Place cotton calls or dry gauze loosely in the ears
d. Use an otoscope to assess the tympanic membrane for rupture - Correct Answer-B
CSF contains glucose not protein.
A nurse is caring for a client who has just undergone cardioversion. Which intervention is the nurse's
priority after this procedure.
2024
A nurse is monitoring the neurological status of a client who underwent craniotomy 3 days ago. Which
signs or symptoms would prompt the nurse to notify the primary health care provider immediately?
a. Disorientation to date
b. Pupils equal and reactive at 4 mm
c. Mild headache relieved by acetaminophen with codeine
d. Pain with forward flexion of the neck onto the chest - Correct Answer-D
A complication of cranial surgery is meningitis.
A man calls the clinic and tells the nurse that he sustained a bee sting on his leg while working in his yard.
The client states that he is not allergic to bees and wants to know how to treat the sting. The nurse tells
the client to first take which action?
a. Place a cool compress on the sting site
b. Apply an antipruritic lotion to the sting site
c. Apply a topical corticosteroid to the sting site
d. Take an oral antihistamine such as diphenhydramine (Benadryl) - Correct Answer-A
A nurse is assigned to conduct an admission assessment of a client who was treated in the emergency
department after attempting suicide by cutting her wrists with a razor blade. When the client arrives at
the nursing unit, the nurse should take which action first?
a. Ask the client to sign a no-harm contract
b. Ask the client to report any suicidal thoughts immediately
c. Place the client under suicide precautions with 15-minute checks
,d. Check the dressings that were placed over the client's wrists in the emergency department - Correct
Answer-D
First assess the physical state of the patient for safety then implement precautions.
A nurse is preparing to administer digoxin to a client with heart failure. When assessing the client, the
nurse notes an apical pulse rate of 58 beats/min. Also, the client complains of anorexia and nausea.
Which action should the nurse take first on the basis of these assessment findings?
a. Contact the primary health care provider
b. Administer an as-needed antiemetic
c. Check the most recent digoxin level
d. Administer the digoxin with an antacid - Correct Answer-C
The pattern of ventricular fibrillation is identified and can be a result after a patient with an MI. VF makes
the patient feel faint, then loses consciousness and becomes pulseless and apneic (BP and heart sounds
absent). Treatment is to terminate VF and covert it into a rhythm via defibrillation-> call a rapid and
initiate CPR. Cardioversion is used for ventricular or supraventricular tachydysrhythmias.
A nurse developing a plan of care for a client with a spinal cord injury includes measures to prevent
autonomic dysreflexia (hyperreflexia). Which intervention does the nurse incorporate into the plan to
prevent this complication?
a. Keeping the fan running in the client's room
b. Keeping the linens wrinkle free under the client
c. Limiting bladder catheterization to once every 12 hours
d. Avoiding the administration of enemas and rectal suppositories - Correct Answer-B
The most frequent cause of autonomic dysreflexias are a distended bladder and impacted feces. Other
causes include stimulation of the skin by tactile, thermal, or painful stimuli. The nurse renders care in
such a way as to minimize these risks.
, A nurse provides home care instructions to a client who has been fitted with a halo device to treat a
cervical fracture. Which statement by the client indicates the need for further teaching?
a. I need to get more fluids and fiber into my diet
b. I should cut my food into small pieces before I eat
c. I need to put powder under the vest twice a day to prevent sweating
d. I have to check the pin sites everyday and watch for signs of infection - Correct Answer-C
Cleanse the skin under the wool liner each day to prevent rashes and soars.
A nurse is caring for a client with increased intracranial pressure. In which position should the nurse
maintain the client?
a. Supine with the head extended
b. Side lying with the neck flexed
c. Supine with the head turned to the side
d. Head midline and elevated 30-45 degrees - Correct Answer-D
Proper positioning promotes venous drainage from the cranium to minimize ICP.
A client with a basilar skull fracture has clear fluid leaking from the ears. The nurse should take which
action first?
a. Asses the clear fluid for protein
b. Check the clear fluid for glucose
c. Place cotton calls or dry gauze loosely in the ears
d. Use an otoscope to assess the tympanic membrane for rupture - Correct Answer-B
CSF contains glucose not protein.
A nurse is caring for a client who has just undergone cardioversion. Which intervention is the nurse's
priority after this procedure.
