NCLEX-RN COMPREHENSIVE CHALLENGE EXAM 3 QUESTIONS AND
ANSWERS WITH RATIONALE – TOP PRACTICE NCLEX Q&As WITH
GUARANTEED SUCCESS LATEST UPDATE 2025-2026
Your path to NCLEX success starts here!
NCLEX-RN BEST ChALLENGE EXAM 3
1. CATEGORY: Physiological Adaptation
Question 1
The nurse is aware that the following terms used to describe reduced cardiac output and
perfusion impairment due to ineffective pumping of the heart is:
• A. Anaphylactic shock
• B. Cardiogenic shock
• C. Distributive shock
• D. Myocardial infarction (MI)
Correct Answer: B. Cardiogenic shock
Rationale:
Cardiogenic shock is a condition where the heart fails to pump blood effectively, resulting in
poor perfusion of organs. This is directly caused by heart failure, which leads to inadequate
cardiac output.
Quick Tip:
Cardiogenic shock is related to ineffective heart pumping. Watch for hypotension, tachycardia,
and reduced urine output.
2. CATEGORY: Physiological Adaptation
Question 2
A client with hypertension asks the nurse which factors can cause blood pressure to drop to
normal levels?
• A. Kidneys’ excretion to sodium only
, • B. Kidneys’ retention of sodium and water
• C. Kidneys’ excretion of sodium and water
• D. Kidneys’ retention of sodium and excretion of water
Correct Answer: C. Kidneys’ excretion of sodium and water
Rationale:
The kidneys regulate blood pressure by excreting sodium and excess water. This process lowers
blood volume, which in turn helps reduce blood pressure.
Quick Tip:
The kidneys regulate blood pressure by excreting both sodium and water. This helps lower blood
volume, which reduces pressure.
3. CATEGORY: Pharmacological and Parenteral Therapies
Question 3
Nurse Rose is aware that the statement that best explains why furosemide (Lasix) is administered
to treat hypertension is:
• A. It dilates peripheral blood vessels
• B. It decreases sympathetic cardio acceleration
• C. It inhibits the angiotensin-converting enzymes
• D. It inhibits the reabsorption of sodium and water in the loop of Henle
Correct Answer: D. It inhibits the reabsorption of sodium and water in the loop of
Henle
Rationale:
Furosemide is a loop diuretic that works by inhibiting sodium and water reabsorption in the loop
of Henle, which leads to reduced blood volume and lower blood pressure.
Quick Tip:
Furosemide is a diuretic that works by blocking sodium and water reabsorption in the kidneys,
helping to lower blood pressure by reducing blood volume.
4. CATEGORY: Reduction of Risk Potential
, Question 4
Nurse Nikki knows that laboratory results support the diagnosis of systemic lupus erythematosus
(SLE). Which result is most indicative?
• A. Elevated serum complement level
• B. Thrombocytosis, elevated sedimentation rate
• C. Pancytopenia, elevated antinuclear antibody (ANA) titer
• D. Leukocytosis, elevated blood urea nitrogen (BUN) and creatinine levels
Correct Answer: C. Pancytopenia, elevated antinuclear antibody (ANA) titer
Rationale:
Laboratory findings for SLE typically show pancytopenia and an elevated ANA titer, which are
key indicators of the autoimmune response seen in this condition.
Quick Tip:
SLE can cause pancytopenia and an elevated ANA titer. These lab results are critical in
confirming the diagnosis.
5. CATEGORY: Health Promotion and Maintenance
Question 5
Arnold, a 19-year-old client with a mild concussion, is discharged from the emergency
department. Before discharge, he complains of a headache. When offered acetaminophen, his
mother tells the nurse the headache is severe and she would like her son to have something
stronger. Which of the following responses by the nurse is appropriate?
• A. “Your son had a mild concussion, acetaminophen is strong enough.”
• B. “Aspirin is avoided because of the danger of Reye’s syndrome in children or young
adults.”
• C. “Narcotics are avoided after a head injury because they may hide a worsening
condition.”
• D. “Stronger medications may lead to vomiting, which increases the intracranial
pressure (ICP).”
Correct Answer: C. Narcotics are avoided after a head injury because they may hide a
worsening condition
ANSWERS WITH RATIONALE – TOP PRACTICE NCLEX Q&As WITH
GUARANTEED SUCCESS LATEST UPDATE 2025-2026
Your path to NCLEX success starts here!
NCLEX-RN BEST ChALLENGE EXAM 3
1. CATEGORY: Physiological Adaptation
Question 1
The nurse is aware that the following terms used to describe reduced cardiac output and
perfusion impairment due to ineffective pumping of the heart is:
• A. Anaphylactic shock
• B. Cardiogenic shock
• C. Distributive shock
• D. Myocardial infarction (MI)
Correct Answer: B. Cardiogenic shock
Rationale:
Cardiogenic shock is a condition where the heart fails to pump blood effectively, resulting in
poor perfusion of organs. This is directly caused by heart failure, which leads to inadequate
cardiac output.
Quick Tip:
Cardiogenic shock is related to ineffective heart pumping. Watch for hypotension, tachycardia,
and reduced urine output.
2. CATEGORY: Physiological Adaptation
Question 2
A client with hypertension asks the nurse which factors can cause blood pressure to drop to
normal levels?
• A. Kidneys’ excretion to sodium only
, • B. Kidneys’ retention of sodium and water
• C. Kidneys’ excretion of sodium and water
• D. Kidneys’ retention of sodium and excretion of water
Correct Answer: C. Kidneys’ excretion of sodium and water
Rationale:
The kidneys regulate blood pressure by excreting sodium and excess water. This process lowers
blood volume, which in turn helps reduce blood pressure.
Quick Tip:
The kidneys regulate blood pressure by excreting both sodium and water. This helps lower blood
volume, which reduces pressure.
3. CATEGORY: Pharmacological and Parenteral Therapies
Question 3
Nurse Rose is aware that the statement that best explains why furosemide (Lasix) is administered
to treat hypertension is:
• A. It dilates peripheral blood vessels
• B. It decreases sympathetic cardio acceleration
• C. It inhibits the angiotensin-converting enzymes
• D. It inhibits the reabsorption of sodium and water in the loop of Henle
Correct Answer: D. It inhibits the reabsorption of sodium and water in the loop of
Henle
Rationale:
Furosemide is a loop diuretic that works by inhibiting sodium and water reabsorption in the loop
of Henle, which leads to reduced blood volume and lower blood pressure.
Quick Tip:
Furosemide is a diuretic that works by blocking sodium and water reabsorption in the kidneys,
helping to lower blood pressure by reducing blood volume.
4. CATEGORY: Reduction of Risk Potential
, Question 4
Nurse Nikki knows that laboratory results support the diagnosis of systemic lupus erythematosus
(SLE). Which result is most indicative?
• A. Elevated serum complement level
• B. Thrombocytosis, elevated sedimentation rate
• C. Pancytopenia, elevated antinuclear antibody (ANA) titer
• D. Leukocytosis, elevated blood urea nitrogen (BUN) and creatinine levels
Correct Answer: C. Pancytopenia, elevated antinuclear antibody (ANA) titer
Rationale:
Laboratory findings for SLE typically show pancytopenia and an elevated ANA titer, which are
key indicators of the autoimmune response seen in this condition.
Quick Tip:
SLE can cause pancytopenia and an elevated ANA titer. These lab results are critical in
confirming the diagnosis.
5. CATEGORY: Health Promotion and Maintenance
Question 5
Arnold, a 19-year-old client with a mild concussion, is discharged from the emergency
department. Before discharge, he complains of a headache. When offered acetaminophen, his
mother tells the nurse the headache is severe and she would like her son to have something
stronger. Which of the following responses by the nurse is appropriate?
• A. “Your son had a mild concussion, acetaminophen is strong enough.”
• B. “Aspirin is avoided because of the danger of Reye’s syndrome in children or young
adults.”
• C. “Narcotics are avoided after a head injury because they may hide a worsening
condition.”
• D. “Stronger medications may lead to vomiting, which increases the intracranial
pressure (ICP).”
Correct Answer: C. Narcotics are avoided after a head injury because they may hide a
worsening condition
