NCLEX NGN RN ACTUAL EXAM 300 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH
RATIONALES LATEST UPDATE 2024-2025 AGRADE
When selecting an NCLEX answer or determining the order of priority what should you
remember or use and what is the exception? - CORRECT- Use the ABC rule: Airway
breathing, and circulation. The exception to the rule is with actual CPR, use C-A-B for
CPR. Also remember safety first and acute before chronic. If the pt. is not in distress
then you assess. If the pt is in distress then you should do something. If the pt has
diaphorisis you should always do something.
How should you address questions related to Maslow's Hierarchy of Needs -
CORRECT- Address physiological needs first, followed by safety and security needs,
love and belonging needs, self esteem needs and finally self actualization needs.
*When a physiological need is not addressed in the question, look for the option that
addresses safety.
If a question is related to the nursing process, read the question to determine the step of
the nursing process. What are the steps in the nursing process and what kind of
question might be related to that step. - CORRECT- Assessment question address the
gathering and verification of data.
Analysis questions require the nurse to: interpret data, collect additional information,
identify and communicate nursing diagnoses and determine the health team's ability to
meet the pts needs.
Planning questions ask about determining, prioritizing, and modifying outcomes of care.
Implementation questions reflect the management and organization of care and the
assignment and delegation of tasks. Be prepared for questions on client teaching.
Evaluation questions focus on comparing the actual outcomes of care with the expected
outcomes and on communicating and documenting findings.
What are the normal ranges for H&H? What are the nursing implications -
CORRECT- Hemoglobin - Male 14-18 Female 12-16 Newborn 14-24
High altitude living increases value, slight decrease during pregnancy. Drug therapy can
alter values.
Hematocrit - Male 42-52 Female 37-47 Newborn 44-64
Prolonged stasis from vasoconstriction secondary to the tourniquet can alter values.
Abnormalities in RBC size may alter Hct values
,What are the normal ranges for WBC?
What can increase values?
What can decrease values?
How long does the postpartum period of pregnancy affect normal ranges? What range
is normal during the postpartum period? - CORRECT- Both genders 5000-10000
Newborn 9000-30000
Anesthetics, stress, exercise, and convulsions can increased values.
Drug therapy can decrease values.
24-28 hr postpartum: a count as high as 25000 is normal
What are the normal ranges for RBC?
What can increase levels
What happens to levels during pregnancy? - CORRECT- Males: 4.7-6.1 million
Female: 4.2-5.4 million
Exercise and high altitudes can cause an increase levels
pregnancy usually lower values
drug therapy can alter values
Never draw a specimen from an arm with an infusing IV.
What are the normal ranges for PLATELETS?
What may increase values?
What may decrease values?
What drugs decrease values? - CORRECT- Both Genders: 150000-400000
Living at high altitudes, exercising strenuously or taking oral contraceptives may
increase values
decreased values may be caused by hemorrhage, DIC, reduced production of platelets,
infections, use of prosthetic heart valves, and drugs.
Drugs that decrease platelets: acetaminophen, aspirin, chemotherapy, H2 blockers,
INH, Levaquin, streptomycin, sulfonamides, thiazide diuretics.
What are the normal ranges for K+? What should you keep in mind when getting a
specimen? - CORRECT- 3.5-5 is normal range for potassium
Exercise of the forearm with tourniquet in place may cause an increased level.
Hemolysis of specimen can result in a falsely elevated value
What are the normal ranges for Na+? What should you consider when collecting a
specimen? - CORRECT- 136-145 is a normal sodium range
Do Not collect from an arm with an infusing IV solution
What are the normal ranges for Ca+?
, What type of drug can increase calcium levels?
What are two tests with positive results that are associated with hypocalcemia?
How do you preform the two tests? - CORRECT- 9-10.5 for adults. slightly lower in the
elder
Use of thiazide diuretics can cause increased levels of calcium
Positive Chvostek and Trousseau tests are associated with hypocalcemia.
• Chvostek sign: contraction of ipsilateral facial muscles when the facial nerve is
tapped just in front of the ear.
• Trousseau sign: carpopedal spasm elicited by inflating a sphygmomanometer
above systolic BP for 3 minutes.
What are the normal ranges for Mg+?
What may high magnesium levels indicate?
What may low magnesium levels indicate? - CORRECT- 1.7-2.2
A high magnesium level may indicate: Addison disease
Chronic renal failure, Dehydration, Diabetic acidosis
Oliguria
A low magnesium level may indicate: Alcoholism
Chronic diarrhea, Delirium tremens, Hemodialysis
Hepatic (liver) cirrhosis, Hyperaldosteronism
Hypoparathyroidism, Pancreatitis, Too much insulin
Toxemia of pregnancy, Ulcerative colitis
What are the normal ranges for Cl- - CORRECT- 98-106 is the normal range for
chloride
What are the normal ranges for ALP (alkaline phosphatase)? - CORRECT- 30-120
slightly increased in the elderly
What are the normal ranges for BUN?
What does BUN stand for?
What is the ratio of BUN-creatinine?
What does it indicate? - CORRECT- 10-20
blood urea nitrogen
BUN-creatinine ratio of 20:1 indicates adequate kidney functioning
What are the normal ranges for Creatinine?
What is the ratio of BUN-creatinine?
What does it indicate? - CORRECT- Male 0.6-1.2
Female 0.5-1.1
BUN-creatinine ratio of 20:1 indicates adequate kidney functioning
AND CORRECT DETAILED ANSWERS WITH
RATIONALES LATEST UPDATE 2024-2025 AGRADE
When selecting an NCLEX answer or determining the order of priority what should you
remember or use and what is the exception? - CORRECT- Use the ABC rule: Airway
breathing, and circulation. The exception to the rule is with actual CPR, use C-A-B for
CPR. Also remember safety first and acute before chronic. If the pt. is not in distress
then you assess. If the pt is in distress then you should do something. If the pt has
diaphorisis you should always do something.
How should you address questions related to Maslow's Hierarchy of Needs -
CORRECT- Address physiological needs first, followed by safety and security needs,
love and belonging needs, self esteem needs and finally self actualization needs.
*When a physiological need is not addressed in the question, look for the option that
addresses safety.
If a question is related to the nursing process, read the question to determine the step of
the nursing process. What are the steps in the nursing process and what kind of
question might be related to that step. - CORRECT- Assessment question address the
gathering and verification of data.
Analysis questions require the nurse to: interpret data, collect additional information,
identify and communicate nursing diagnoses and determine the health team's ability to
meet the pts needs.
Planning questions ask about determining, prioritizing, and modifying outcomes of care.
Implementation questions reflect the management and organization of care and the
assignment and delegation of tasks. Be prepared for questions on client teaching.
Evaluation questions focus on comparing the actual outcomes of care with the expected
outcomes and on communicating and documenting findings.
What are the normal ranges for H&H? What are the nursing implications -
CORRECT- Hemoglobin - Male 14-18 Female 12-16 Newborn 14-24
High altitude living increases value, slight decrease during pregnancy. Drug therapy can
alter values.
Hematocrit - Male 42-52 Female 37-47 Newborn 44-64
Prolonged stasis from vasoconstriction secondary to the tourniquet can alter values.
Abnormalities in RBC size may alter Hct values
,What are the normal ranges for WBC?
What can increase values?
What can decrease values?
How long does the postpartum period of pregnancy affect normal ranges? What range
is normal during the postpartum period? - CORRECT- Both genders 5000-10000
Newborn 9000-30000
Anesthetics, stress, exercise, and convulsions can increased values.
Drug therapy can decrease values.
24-28 hr postpartum: a count as high as 25000 is normal
What are the normal ranges for RBC?
What can increase levels
What happens to levels during pregnancy? - CORRECT- Males: 4.7-6.1 million
Female: 4.2-5.4 million
Exercise and high altitudes can cause an increase levels
pregnancy usually lower values
drug therapy can alter values
Never draw a specimen from an arm with an infusing IV.
What are the normal ranges for PLATELETS?
What may increase values?
What may decrease values?
What drugs decrease values? - CORRECT- Both Genders: 150000-400000
Living at high altitudes, exercising strenuously or taking oral contraceptives may
increase values
decreased values may be caused by hemorrhage, DIC, reduced production of platelets,
infections, use of prosthetic heart valves, and drugs.
Drugs that decrease platelets: acetaminophen, aspirin, chemotherapy, H2 blockers,
INH, Levaquin, streptomycin, sulfonamides, thiazide diuretics.
What are the normal ranges for K+? What should you keep in mind when getting a
specimen? - CORRECT- 3.5-5 is normal range for potassium
Exercise of the forearm with tourniquet in place may cause an increased level.
Hemolysis of specimen can result in a falsely elevated value
What are the normal ranges for Na+? What should you consider when collecting a
specimen? - CORRECT- 136-145 is a normal sodium range
Do Not collect from an arm with an infusing IV solution
What are the normal ranges for Ca+?
, What type of drug can increase calcium levels?
What are two tests with positive results that are associated with hypocalcemia?
How do you preform the two tests? - CORRECT- 9-10.5 for adults. slightly lower in the
elder
Use of thiazide diuretics can cause increased levels of calcium
Positive Chvostek and Trousseau tests are associated with hypocalcemia.
• Chvostek sign: contraction of ipsilateral facial muscles when the facial nerve is
tapped just in front of the ear.
• Trousseau sign: carpopedal spasm elicited by inflating a sphygmomanometer
above systolic BP for 3 minutes.
What are the normal ranges for Mg+?
What may high magnesium levels indicate?
What may low magnesium levels indicate? - CORRECT- 1.7-2.2
A high magnesium level may indicate: Addison disease
Chronic renal failure, Dehydration, Diabetic acidosis
Oliguria
A low magnesium level may indicate: Alcoholism
Chronic diarrhea, Delirium tremens, Hemodialysis
Hepatic (liver) cirrhosis, Hyperaldosteronism
Hypoparathyroidism, Pancreatitis, Too much insulin
Toxemia of pregnancy, Ulcerative colitis
What are the normal ranges for Cl- - CORRECT- 98-106 is the normal range for
chloride
What are the normal ranges for ALP (alkaline phosphatase)? - CORRECT- 30-120
slightly increased in the elderly
What are the normal ranges for BUN?
What does BUN stand for?
What is the ratio of BUN-creatinine?
What does it indicate? - CORRECT- 10-20
blood urea nitrogen
BUN-creatinine ratio of 20:1 indicates adequate kidney functioning
What are the normal ranges for Creatinine?
What is the ratio of BUN-creatinine?
What does it indicate? - CORRECT- Male 0.6-1.2
Female 0.5-1.1
BUN-creatinine ratio of 20:1 indicates adequate kidney functioning
