1|Page
NCLEX-PN 2024 REAL EXAM PRACTICE QUESTIONS SET I
TO V EACH HAVING 20 QUESTIONS AND CORRECT
DETAILED ANSWERS KEYS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
1. The nurse is caring for a client following an appendectomy. The client reports
f f f f f f f f f f f f f
nausea and complains of surgical site pain at a 6 on a 0 to 10 scale. The client's
f f f f f f f f f f f f f f f f f f
employer is present in the room and states he is paying for the insurance and
f f f f f f f f f f f f f f f
wants to know what pain medication has been prescribed by the physician. Which
f f f f f f f f f f f f f
of the following is the appropriate nurse response?
f f f f f f f f
A. Answer any questions the employer may have as he pays for the insurance.
f f f f f f f f f f f f f f
B. Tell the employer his question is inappropriate and that the information is none of
f f f f f f f f f f f f f f
his business.
f f f
C. Explain to the employer that you cannot release private information and ask the
f f f f f f f f f f f f f
employer to step out while you conduct your assessment of the client.
f f f f f f f f f f f f f
D. Ask the employer to leave and wait until the client returns home to visit.
f f f f f f f f f f f f f f
2. The nurse is caring for a client with a history of advanced chronic obstructive
f f f f f f f f f f f f f f
pulmonary disease (COPD). The client had conventional gallbladder surgery 2 days
f f f f f f f f f f f
previously. Which intervention has priority for preventing respiratory
f f f f f f f f
complications?
f
A. Incentive spirometry every 4 hours.
f f f f f f
B. Coughing and deep breathing four times daily.
f f f f f f f f
C. Getting the client out of bed 4 times daily as ordered by the physician.
f f f f f f f f f f f f f f f
D. Giving oxygen at 4 L/minute according to the physician's order.
f f f f f f f f f f
3. A nurse is developing a care plan for a client with acute mania. Place the
f f f f f f f f f f f f f f f
following behaviors in the order in which they occur as the client develops acute
f f f f f f f f f f f f f f
mania. Use all of the options.
f f f f f f
A. Delusions of grandeur.
f f f f
B. Relevant, calm speech patterns.
f f f f f
C. Highly productive and competitive in work and leisure activities.
f f f f f f f f f f
D. Easily irritated.
f f f
E. Poor judgment and impulse control.
f f f f f
1
,2|Page
4. When educating a pregnant client about home safety, which of the following
f f f f f f f f f f f f
information is appropriate for the nurse to include in the teaching plan? Select all
f f f f f f f f f f f f f f
that apply.
f f
A. When taking a shower, place a non-skid mat on the floor of the tub or shower.
f f f f f f f f f f f f f f f f f
B. Avoid climbing stairs.
f f f f
C. Avoid wearing high heels.
f f f f f
D. Use non-slip rugs on the floors.
f f f f f f
5. A client had a C5 spinal cord contusion that resulted in quadriplegia. Two days
f f f f f f f f f f f f f f
after the injury occurred, the nurse sees his mother crying in the waiting room.
f f f f f f f f f f f f f f
The mother asks the nurse whether her son will ever play football again. Which of
f f f f f f f f f f f f f f f
the following is the best initial response?
f f f f f f f
A. "Given time and motivation, your son can return to normal function."
f f f f f f f f f f f f
B. "I'm not sure, but I'll call the physician to talk to you right away."
f f f f f f f f f f f f f f f
C. "What do you know about your son's injury?"
f f f f f f f f f
D. "Getting upset isn't in you son's best interest."
f f f f f f f f
6. The nurse is caring for a client who will undergo surgical repair of a detached
f f f f f f f f f f f f f f f
retina. Which of the following is the most likely preoperative nursing diagnosis
f f f f f f f f f f f f
for this client?
f f f
A. Anxiety related to loss of vision and potential failure to regain vision.
f f f f f f f f f f f f f
B. Deficient knowledge (preoperative and postoperative activities) related to lack of
f f f f f f f f f f
information.
f f
C. Acute pain related to tissue injury and decreased circulation to the eye.
f f f f f f f f f f f f f
D. Risk for infection related to the eye injury.
f f f f f f f f
7. When assessing a client with glaucoma, a nurse expects which of the following
f f f f f f f f f f f f f
findings?
f
A. Complaints of double vision.
f f f f f
B. Complaints of halos around lights.
f f f f f f
C. Intraocular pressure of 15 mm Hg.
f f f f f f f
D. Soft globe on palpation.
f f f f
8. A client had a Caesarean delivery and is postpartum day 1. She asks for pain
f f f f f f f f f f f f f f f
medication when the nurse enters the room to do her shift assessment. The client
f f f f f f f f f f f f f f
states that her pain level is an 8 on a scale of 1 to 10. What should be the nurse's
f f f f f f f f f f f f f f f f f f f f
priority of care?
f f f
2
,3|Page
A. Give the pain medication and return in an hour for further assessment to allow
f f f f f f f f f f f f f f
time for the medication to work.
f f f f f f f
B. Complete the postpartum assessment and then give the client pain medication.
f f f f f f f f f f f f
C. Give the pain medication first, do a quick assessment while administering the
f f f f f f f f f f f f
medication to ensure the pain is not caused by a complication, and return for the full
f f f f f f f f f f f f f f f f
assessment after the client's pain has subsided.
f f f f f f f f
D. Instruct the patient to do relaxation exercises to relieve her discomfort.
f f f f f f f f f f f
9. The nurse is preparing to teach a client about the effects of isoniazid (INH).
f f f f f f f f f f f f f f
Which information is important for the client to understand?
f f f f f f f f f
A. Isoniazid should be taken on an empty stomach.
f f f f f f f f f
B. Prolonged use of isoniazid produces poorly concentrated urine.
f f f f f f f f f
C. Taking aluminum hydroxide (Maalox)® with isoniazid minimizes gastrointestinal
f f f f f f f f
upset.
f f
D. Drinking alcohol daily can increase the incidence of drug-induced hepatitis.
f f f f f f f f f f
10. A one-month old infant in the neonatal intensive care unit is dying. The
f f f f f f f f f f f f f
parents request that the nurse administer an opioid analgesic to their infant, who
f f f f f f f f f f f f f
is crying weakly. The infant's heart rate is 68 beats per minute and the respiratory
f f f f f f f f f f f f f f f
rate is 18 breaths per minute. The infant is on room air and the oxygen saturation
f f f f f f f f f f f f f f f f
is 92%. The nurse's response is based on which of the following principles?
f f f f f f f f f f f f f
A. Providing analgesia during the last days and hours is an ethically-appropriate
f f f f f f f f f f f
nursing action.
f f f
B. Withholding the opioid analgesia during the last days and hours is an ethical duty
f f f f f f f f f f f f f f
because administering it would represent assisted suicide.
f f f f f f f f
C. Administering analgesia during the last days and hours is the parent's ethical
f f f f f f f f f f f f
decision.
f f
D. Withholding the opioid analgesia is clinically appropriate because it will hasten the
f f f f f f f f f f f f
infant's death.
f f
11. While undergoing hemodialysis, the client becomes restless and tells the nurse
f f f f f f f f f f f
he has a headache and feels nauseous. Which of the following complications does
f f f f f f f f f f f f f
the nurse suspect?
f f f
A. Infection.
f f
B. Disequilibrium syndrome.
f f f
C. Air embolus.
f f f
D. Acute hemolysis.
f f
3
, 4|Page
12. An elderly couple is speaking to the nurse about their ambivalence related to
f f f f f f f f f f f f f
sending the client, their adult, dual-diagnosed (bipolar and drug addict) son, into
f f f f f f f f f f f f
residential placement. They tell the nurse that neither keeping their son at home
f f f f f f f f f f f f f
nor sending him to a facility is a satisfactory solution for them. What information
f f f f f f f f f f f f f f
should the nurse keep in mind when discussing this dilemma with the family?
f f f f f f f f f f f f f
Select all that apply.
f f f f
A. Implement what is best for the couple.
f f f f f f f f
B. Suggest another psychiatric evaluation for the son.
f f f f f f f f
C. Look for all potential options for care.
f f f f f f f f
D. Review the client's treatment history.
f f f f f f
E. Consult legal authorities for information.
f f f f f
13. The nurse is caring for a 44-year-old client diagnosed with
f f f f f f f f f f
hypoparathyroidism. Which electrolyte imbalance is closely associated with
f f f f f f f f
hypoparathyroidism?
f
A. Hypocalcemia.
f f
B. Hyponatremia.
f f
C. Hyperkalemia.
f f
D. Hypophosphatemia.
f
14. The nurse is caring for a client diagnosed with end-stage liver disease. The
f f f f f f f f f f f f f
client has completed an advance directive and a do-not-resuscitate (DNR)
f f f f f f f f f f
document and wishes to receive palliative care. Which of the following would
f f f f f f f f f f f f
correspond to the client's wish for comfort care?
f f f f f f f f
A. Positioning frequently to prevent skin breakdown and providing pain management
f f f f f f f f f f
and other comfort measures.
f f f f f
B. Carrying out vigorous resuscitation efforts if the client were to stop breathing, but
f f f f f f f f f f f f f
no resuscitation if the heart stops beating.
f f f f f f f f
C. Providing intravenous fluids when the client becomes dehydrated.
f f f f f f f f f
D. Providing total parenteral nutrition (TPN) if the client is not able to eat.
f f f f f f f f f f f f f
15. The nurse is caring for a client receiving warfarin therapy (Coumadin®)
f f f f f f f f f f f
following a stroke. The client's PT/INR was completed at 7:00 A.M. prior to the
f f f f f f f f f f f f f f
morning meal with an INR reading of 4.0. Which of the following is the nurse's
f f f f f f f f f f f f f f f
first priority?
f f
A. Call the physician to request an increase in the Coumadin® dose.
f f f f f f f f f f f f
B. Administer a vitamin K injection IM and notify the physician of the results.
f f f f f f f f f f f f f f
C. Assess the client for bleeding around the gums or in the stool and notify the
f f f f f f f f f f f f f f f
4
NCLEX-PN 2024 REAL EXAM PRACTICE QUESTIONS SET I
TO V EACH HAVING 20 QUESTIONS AND CORRECT
DETAILED ANSWERS KEYS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
1. The nurse is caring for a client following an appendectomy. The client reports
f f f f f f f f f f f f f
nausea and complains of surgical site pain at a 6 on a 0 to 10 scale. The client's
f f f f f f f f f f f f f f f f f f
employer is present in the room and states he is paying for the insurance and
f f f f f f f f f f f f f f f
wants to know what pain medication has been prescribed by the physician. Which
f f f f f f f f f f f f f
of the following is the appropriate nurse response?
f f f f f f f f
A. Answer any questions the employer may have as he pays for the insurance.
f f f f f f f f f f f f f f
B. Tell the employer his question is inappropriate and that the information is none of
f f f f f f f f f f f f f f
his business.
f f f
C. Explain to the employer that you cannot release private information and ask the
f f f f f f f f f f f f f
employer to step out while you conduct your assessment of the client.
f f f f f f f f f f f f f
D. Ask the employer to leave and wait until the client returns home to visit.
f f f f f f f f f f f f f f
2. The nurse is caring for a client with a history of advanced chronic obstructive
f f f f f f f f f f f f f f
pulmonary disease (COPD). The client had conventional gallbladder surgery 2 days
f f f f f f f f f f f
previously. Which intervention has priority for preventing respiratory
f f f f f f f f
complications?
f
A. Incentive spirometry every 4 hours.
f f f f f f
B. Coughing and deep breathing four times daily.
f f f f f f f f
C. Getting the client out of bed 4 times daily as ordered by the physician.
f f f f f f f f f f f f f f f
D. Giving oxygen at 4 L/minute according to the physician's order.
f f f f f f f f f f
3. A nurse is developing a care plan for a client with acute mania. Place the
f f f f f f f f f f f f f f f
following behaviors in the order in which they occur as the client develops acute
f f f f f f f f f f f f f f
mania. Use all of the options.
f f f f f f
A. Delusions of grandeur.
f f f f
B. Relevant, calm speech patterns.
f f f f f
C. Highly productive and competitive in work and leisure activities.
f f f f f f f f f f
D. Easily irritated.
f f f
E. Poor judgment and impulse control.
f f f f f
1
,2|Page
4. When educating a pregnant client about home safety, which of the following
f f f f f f f f f f f f
information is appropriate for the nurse to include in the teaching plan? Select all
f f f f f f f f f f f f f f
that apply.
f f
A. When taking a shower, place a non-skid mat on the floor of the tub or shower.
f f f f f f f f f f f f f f f f f
B. Avoid climbing stairs.
f f f f
C. Avoid wearing high heels.
f f f f f
D. Use non-slip rugs on the floors.
f f f f f f
5. A client had a C5 spinal cord contusion that resulted in quadriplegia. Two days
f f f f f f f f f f f f f f
after the injury occurred, the nurse sees his mother crying in the waiting room.
f f f f f f f f f f f f f f
The mother asks the nurse whether her son will ever play football again. Which of
f f f f f f f f f f f f f f f
the following is the best initial response?
f f f f f f f
A. "Given time and motivation, your son can return to normal function."
f f f f f f f f f f f f
B. "I'm not sure, but I'll call the physician to talk to you right away."
f f f f f f f f f f f f f f f
C. "What do you know about your son's injury?"
f f f f f f f f f
D. "Getting upset isn't in you son's best interest."
f f f f f f f f
6. The nurse is caring for a client who will undergo surgical repair of a detached
f f f f f f f f f f f f f f f
retina. Which of the following is the most likely preoperative nursing diagnosis
f f f f f f f f f f f f
for this client?
f f f
A. Anxiety related to loss of vision and potential failure to regain vision.
f f f f f f f f f f f f f
B. Deficient knowledge (preoperative and postoperative activities) related to lack of
f f f f f f f f f f
information.
f f
C. Acute pain related to tissue injury and decreased circulation to the eye.
f f f f f f f f f f f f f
D. Risk for infection related to the eye injury.
f f f f f f f f
7. When assessing a client with glaucoma, a nurse expects which of the following
f f f f f f f f f f f f f
findings?
f
A. Complaints of double vision.
f f f f f
B. Complaints of halos around lights.
f f f f f f
C. Intraocular pressure of 15 mm Hg.
f f f f f f f
D. Soft globe on palpation.
f f f f
8. A client had a Caesarean delivery and is postpartum day 1. She asks for pain
f f f f f f f f f f f f f f f
medication when the nurse enters the room to do her shift assessment. The client
f f f f f f f f f f f f f f
states that her pain level is an 8 on a scale of 1 to 10. What should be the nurse's
f f f f f f f f f f f f f f f f f f f f
priority of care?
f f f
2
,3|Page
A. Give the pain medication and return in an hour for further assessment to allow
f f f f f f f f f f f f f f
time for the medication to work.
f f f f f f f
B. Complete the postpartum assessment and then give the client pain medication.
f f f f f f f f f f f f
C. Give the pain medication first, do a quick assessment while administering the
f f f f f f f f f f f f
medication to ensure the pain is not caused by a complication, and return for the full
f f f f f f f f f f f f f f f f
assessment after the client's pain has subsided.
f f f f f f f f
D. Instruct the patient to do relaxation exercises to relieve her discomfort.
f f f f f f f f f f f
9. The nurse is preparing to teach a client about the effects of isoniazid (INH).
f f f f f f f f f f f f f f
Which information is important for the client to understand?
f f f f f f f f f
A. Isoniazid should be taken on an empty stomach.
f f f f f f f f f
B. Prolonged use of isoniazid produces poorly concentrated urine.
f f f f f f f f f
C. Taking aluminum hydroxide (Maalox)® with isoniazid minimizes gastrointestinal
f f f f f f f f
upset.
f f
D. Drinking alcohol daily can increase the incidence of drug-induced hepatitis.
f f f f f f f f f f
10. A one-month old infant in the neonatal intensive care unit is dying. The
f f f f f f f f f f f f f
parents request that the nurse administer an opioid analgesic to their infant, who
f f f f f f f f f f f f f
is crying weakly. The infant's heart rate is 68 beats per minute and the respiratory
f f f f f f f f f f f f f f f
rate is 18 breaths per minute. The infant is on room air and the oxygen saturation
f f f f f f f f f f f f f f f f
is 92%. The nurse's response is based on which of the following principles?
f f f f f f f f f f f f f
A. Providing analgesia during the last days and hours is an ethically-appropriate
f f f f f f f f f f f
nursing action.
f f f
B. Withholding the opioid analgesia during the last days and hours is an ethical duty
f f f f f f f f f f f f f f
because administering it would represent assisted suicide.
f f f f f f f f
C. Administering analgesia during the last days and hours is the parent's ethical
f f f f f f f f f f f f
decision.
f f
D. Withholding the opioid analgesia is clinically appropriate because it will hasten the
f f f f f f f f f f f f
infant's death.
f f
11. While undergoing hemodialysis, the client becomes restless and tells the nurse
f f f f f f f f f f f
he has a headache and feels nauseous. Which of the following complications does
f f f f f f f f f f f f f
the nurse suspect?
f f f
A. Infection.
f f
B. Disequilibrium syndrome.
f f f
C. Air embolus.
f f f
D. Acute hemolysis.
f f
3
, 4|Page
12. An elderly couple is speaking to the nurse about their ambivalence related to
f f f f f f f f f f f f f
sending the client, their adult, dual-diagnosed (bipolar and drug addict) son, into
f f f f f f f f f f f f
residential placement. They tell the nurse that neither keeping their son at home
f f f f f f f f f f f f f
nor sending him to a facility is a satisfactory solution for them. What information
f f f f f f f f f f f f f f
should the nurse keep in mind when discussing this dilemma with the family?
f f f f f f f f f f f f f
Select all that apply.
f f f f
A. Implement what is best for the couple.
f f f f f f f f
B. Suggest another psychiatric evaluation for the son.
f f f f f f f f
C. Look for all potential options for care.
f f f f f f f f
D. Review the client's treatment history.
f f f f f f
E. Consult legal authorities for information.
f f f f f
13. The nurse is caring for a 44-year-old client diagnosed with
f f f f f f f f f f
hypoparathyroidism. Which electrolyte imbalance is closely associated with
f f f f f f f f
hypoparathyroidism?
f
A. Hypocalcemia.
f f
B. Hyponatremia.
f f
C. Hyperkalemia.
f f
D. Hypophosphatemia.
f
14. The nurse is caring for a client diagnosed with end-stage liver disease. The
f f f f f f f f f f f f f
client has completed an advance directive and a do-not-resuscitate (DNR)
f f f f f f f f f f
document and wishes to receive palliative care. Which of the following would
f f f f f f f f f f f f
correspond to the client's wish for comfort care?
f f f f f f f f
A. Positioning frequently to prevent skin breakdown and providing pain management
f f f f f f f f f f
and other comfort measures.
f f f f f
B. Carrying out vigorous resuscitation efforts if the client were to stop breathing, but
f f f f f f f f f f f f f
no resuscitation if the heart stops beating.
f f f f f f f f
C. Providing intravenous fluids when the client becomes dehydrated.
f f f f f f f f f
D. Providing total parenteral nutrition (TPN) if the client is not able to eat.
f f f f f f f f f f f f f
15. The nurse is caring for a client receiving warfarin therapy (Coumadin®)
f f f f f f f f f f f
following a stroke. The client's PT/INR was completed at 7:00 A.M. prior to the
f f f f f f f f f f f f f f
morning meal with an INR reading of 4.0. Which of the following is the nurse's
f f f f f f f f f f f f f f f
first priority?
f f
A. Call the physician to request an increase in the Coumadin® dose.
f f f f f f f f f f f f
B. Administer a vitamin K injection IM and notify the physician of the results.
f f f f f f f f f f f f f f
C. Assess the client for bleeding around the gums or in the stool and notify the
f f f f f f f f f f f f f f f
4
