NCLEX-PN NEWEST EXAM 2024 -2025 TEST BANK/
COMPLETE 400 ACTUAL EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
A client in the cardiac step-down unit requires suctioning for excess mucous
secretions. The nurse should be most careful to monitor the client for which
dysrhythmia during this procedure?
A. Bradycardia
B. Tachycardia
C. Premature ventricular beats
D. Heart block - Correct Answer - A. Bradycardia
Suctioning can cause a vagal response and bradycardia.
The nurse is caring for a client scheduled for a surgical repair of a secular
abdominal aortic aneurysm. Which assessment is most crucial during the
preoperative period?
A. Assessment of the client's level of anxiety.
B. Evaluation of the client's exercise tolerance
C. Identification of peripheral pulses.
D. Assessment of bowel sounds and activity. - Correct Answer - C. Identification of
peripheral pulses
The assessment that is most crucial to the client is identification of peripheral pulses
because aorta is clammed during surgery. This decreases blood circulation to the
kidneys and lower extremities. The nurse must also assess for the return of circulation
to the lower extremities.
pg. 1
,The nurse is performing an assessment on a client with possible pernicious
anemia. Which data would support this diagnosis?
A. A weight loss of 10 pounds in 2 weeks.
B. Complaints of numbness and tingling in the extremities.
C. A red, beefy tongue.
D. A hemoglobin level of 12.0 gm/dL - Correct Answer - C. A red, beefy tongue
A red, beefy tongue is characteristic of a client with pernicious anemia.
A client arrives in the emergency room with a possible fractured femur. The nurse
should anticipate an order for:
A. Trendelenburg position
B. Ice to the entire extremity
C. Bucks traction
D. An abduction pillow - Correct Answer - C. Bucks traction
The client with a fractured femur will be placed in Bucks traction to realign the leg and
decrease spasms and pain.
A client with caner is to undergo an intravenous pyelogram. The nurse should:
A. Force fluids 24 hours before the procedure.
B. Ask the client to void immediately before the study.
C. Hold medication that affects the central nervous system for 12 hours pre- and post-
test.
D. Cover the client's reproductive organs with an x-ray shield. - Correct Answer - B. Ask
the client to void immediately before the study.
The client having an intravenous pyelogram will have orders for laxatives of enemas so
asking the client to void before the test is in order. A full bladder or bowel can obscure
the visualization of the kidney, ureters, and urethra.
pg. 2
,The nurse is caring for a client with a malignancy. The classification of the
primary tumor is Tis. The nurse should plan care for a tumor:
A. That cannot be assessed
B. That is in situ
C. With increasing lymph node involvement
D. With distant metastasis - Correct Answer - B. That is in situ.
Cancer in situ means that the cancer is still localized in the primary site. Cancer is
graded in terms of tumor, grade, node, involvement, and metastasis.
A client is 2 days post-operative colon resection. After a coughing episode, the
client's wound eviscerates. Which nursing action is most appropriate?
A. Reinsert the protruding organ and cover with 4x4s
B. Cover the wound with a sterile 4x4 and ABD dressing
C. Cover the wound with a sterile saline-soaked dressing
D. Apply an abdominal binder and manual pressure to the wound - Correct Answer - C.
Cover the wound with a sterile saline-soaked dressing.
If the client eviscerates, the abdominal content should be covered with a sterile saline-
soaked dressing.
The nurse is preparing a client for surgery. Which item is most important to
remove before sending the client to surgery?
A. Hearing aid
B. Contact lenses
C. Wedding ring
D. Artificial eye - Correct Answer - B. Contact lenses
It is most important to remove the contact lenses because leaving them in can lead to
corneal drying, particularly with contact lenses that are not extended wear lenses.
The nurse on the 3-11 shift is assessing the chart of a client with an abdominal
aneurysm scheduled for surgery in the morning and finds that the consent form
pg. 3
, has been signed, but the client is unclear about the surgery and possible
complications. Which is the most appropriate action?
A. Call the surgeon and ask him or her to see the client to clarify the information
B. Explain the procedure and complications to the client
C. Check in the physician's progress notes to see if understanding has been
documented.
D. Check with the client's family to see if they understand the procedure fully - Correct
Answer - A. Call the surgeon and ask him or her to see the client to clarify the
information
It is the responsibility of the physician to explain and clarify the procedure to the client.
When assessing a client for risk of hyperphosphatemia, which piece of
information is most important for the nurse to obtain?
A. A history of radiation treatment in the neck region
B. A history of recent orthopedic surgery
C. A history of minimal physical activity
D. A history of the client's food intake - Correct Answer - A. A history of radiation
treatment in the neck region
Previous radiation to the neck might have damaged parathyroid glands, which are
located on the thyroid gland and interfered with calcium and phosphorus regulation.
A client is admitted to the acute care unit. Initial laboratory values reveal serum
sodium of 170 meq/L. What behavioral changes would be common for this client?
A. Anger
B. Mania
C. Depression
D. Psychosis - Correct Answer - B. Mania
The client with serum sodium of 170 me/L has hypernatremia and might exhibit manic
behavior.
pg. 4
COMPLETE 400 ACTUAL EXAM QUESTIONS WITH
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
GRADED A+
A client in the cardiac step-down unit requires suctioning for excess mucous
secretions. The nurse should be most careful to monitor the client for which
dysrhythmia during this procedure?
A. Bradycardia
B. Tachycardia
C. Premature ventricular beats
D. Heart block - Correct Answer - A. Bradycardia
Suctioning can cause a vagal response and bradycardia.
The nurse is caring for a client scheduled for a surgical repair of a secular
abdominal aortic aneurysm. Which assessment is most crucial during the
preoperative period?
A. Assessment of the client's level of anxiety.
B. Evaluation of the client's exercise tolerance
C. Identification of peripheral pulses.
D. Assessment of bowel sounds and activity. - Correct Answer - C. Identification of
peripheral pulses
The assessment that is most crucial to the client is identification of peripheral pulses
because aorta is clammed during surgery. This decreases blood circulation to the
kidneys and lower extremities. The nurse must also assess for the return of circulation
to the lower extremities.
pg. 1
,The nurse is performing an assessment on a client with possible pernicious
anemia. Which data would support this diagnosis?
A. A weight loss of 10 pounds in 2 weeks.
B. Complaints of numbness and tingling in the extremities.
C. A red, beefy tongue.
D. A hemoglobin level of 12.0 gm/dL - Correct Answer - C. A red, beefy tongue
A red, beefy tongue is characteristic of a client with pernicious anemia.
A client arrives in the emergency room with a possible fractured femur. The nurse
should anticipate an order for:
A. Trendelenburg position
B. Ice to the entire extremity
C. Bucks traction
D. An abduction pillow - Correct Answer - C. Bucks traction
The client with a fractured femur will be placed in Bucks traction to realign the leg and
decrease spasms and pain.
A client with caner is to undergo an intravenous pyelogram. The nurse should:
A. Force fluids 24 hours before the procedure.
B. Ask the client to void immediately before the study.
C. Hold medication that affects the central nervous system for 12 hours pre- and post-
test.
D. Cover the client's reproductive organs with an x-ray shield. - Correct Answer - B. Ask
the client to void immediately before the study.
The client having an intravenous pyelogram will have orders for laxatives of enemas so
asking the client to void before the test is in order. A full bladder or bowel can obscure
the visualization of the kidney, ureters, and urethra.
pg. 2
,The nurse is caring for a client with a malignancy. The classification of the
primary tumor is Tis. The nurse should plan care for a tumor:
A. That cannot be assessed
B. That is in situ
C. With increasing lymph node involvement
D. With distant metastasis - Correct Answer - B. That is in situ.
Cancer in situ means that the cancer is still localized in the primary site. Cancer is
graded in terms of tumor, grade, node, involvement, and metastasis.
A client is 2 days post-operative colon resection. After a coughing episode, the
client's wound eviscerates. Which nursing action is most appropriate?
A. Reinsert the protruding organ and cover with 4x4s
B. Cover the wound with a sterile 4x4 and ABD dressing
C. Cover the wound with a sterile saline-soaked dressing
D. Apply an abdominal binder and manual pressure to the wound - Correct Answer - C.
Cover the wound with a sterile saline-soaked dressing.
If the client eviscerates, the abdominal content should be covered with a sterile saline-
soaked dressing.
The nurse is preparing a client for surgery. Which item is most important to
remove before sending the client to surgery?
A. Hearing aid
B. Contact lenses
C. Wedding ring
D. Artificial eye - Correct Answer - B. Contact lenses
It is most important to remove the contact lenses because leaving them in can lead to
corneal drying, particularly with contact lenses that are not extended wear lenses.
The nurse on the 3-11 shift is assessing the chart of a client with an abdominal
aneurysm scheduled for surgery in the morning and finds that the consent form
pg. 3
, has been signed, but the client is unclear about the surgery and possible
complications. Which is the most appropriate action?
A. Call the surgeon and ask him or her to see the client to clarify the information
B. Explain the procedure and complications to the client
C. Check in the physician's progress notes to see if understanding has been
documented.
D. Check with the client's family to see if they understand the procedure fully - Correct
Answer - A. Call the surgeon and ask him or her to see the client to clarify the
information
It is the responsibility of the physician to explain and clarify the procedure to the client.
When assessing a client for risk of hyperphosphatemia, which piece of
information is most important for the nurse to obtain?
A. A history of radiation treatment in the neck region
B. A history of recent orthopedic surgery
C. A history of minimal physical activity
D. A history of the client's food intake - Correct Answer - A. A history of radiation
treatment in the neck region
Previous radiation to the neck might have damaged parathyroid glands, which are
located on the thyroid gland and interfered with calcium and phosphorus regulation.
A client is admitted to the acute care unit. Initial laboratory values reveal serum
sodium of 170 meq/L. What behavioral changes would be common for this client?
A. Anger
B. Mania
C. Depression
D. Psychosis - Correct Answer - B. Mania
The client with serum sodium of 170 me/L has hypernatremia and might exhibit manic
behavior.
pg. 4
