NCLEX-PN 2023/2024 EXAM EXPERT
QUESTIONS AND ANSWERS WITH GUIDED
RATIONALES INCLUDED ALREADY GRADED A
The nurse is visiting a home health client with osteoporosis. The client has a new prescription for
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alendronate (Fosamax). Which instructions should be given to the client h h h h h h h h h
A. Rest in bed after taking the medication for at least 30 mins
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B. Avoid rapid movements after taking the medication
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C. Take medication with water only
h h h h h
D. Allow at least 1 hour between taking the medicine and taking other medications
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C. Take medication with water only why?
h h h h h h
Fosmax should be taken with water only. The client should also remain upright for at least 30 mins
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after taking the medication.
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The nurse is making initial rounds on a client with a C5 fracture and crutchfield thongs. Which
h h h h h h h h h h h h h h h h h
equipment should be kept at the bedside? h h h h h h
A. A pair of forceps
h h h h
B. A torque wrench
h h h
C. A pair or wire cutters
h h h h h
D. A screwdriver
h h
B.Atorque wrench why?
h h h h
A tourque wrench is kept at the bedside to tighten and loosen the screws of crutchfield tongs. This
h h h h h h h h h h h h h h h h h h
wrench controls the amount of pressure that is placed on the screws.
h h h h h h h h h h h
An infant weighs 7 pounds at birth. The excpectd weight by 1 year should be:
h h h h h h h h h h h h h h
A. 10 pounds
h h
B.12 pounds h
,C. 18 pounds
h h
D. 21 pounds
h h
D.21pounds
h h h
why?
A birth weight of 7 pounds would indicate 21 pounds in 1 year or triple the his birth weight.
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A client is admitted with a Ewing's sacroma. Which symptoms would be expected due to this tumor's
h h h h h h h h h h h h h h h h h
location?
A. Hemiplegia
h
B. Aphasia
h
C. Nausea
h
D. Bone Pain
h h
D.BonePain
h h h
why?
Sacroma is a type of bone cancer, therefor, bone pain would be expected
h h h h h h h h h h h h
The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol).
h h h h h h h h h h h h h h h h
Which labatory value might be a indicate a serious side effect of this drug?
h h h h h h h h h h h h h
A. Uric acid of 5mg/dl
h h h h
B. Hematoccrit of 33%
h h h
C. WBC 2,000 per cubic millimeter
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D. Platelets 150,000 per cubic millimeter
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C. WBC 2,000 per cubic millimeter why?
h h h h h h
Tegratol can suppress the bone marrow and decrease the white blood cells count; thus, a lab value of
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WBC 2,000 per cubic millimeter indicates side effects of the drug.
h h h h h h h h h h
The nurse is caring for a client scheduled for removal of a pituitary tumor using the transsphenoidal
h h h h h h h h h h h h h h h h h
approach. The nurse should be particularly alert to: h h h h h h h
A. Nasal congestion
h h
B. Abdominal Tenderness
h h
C. Muscle Tetany
h h
D. Oliguria
h
,A. Nasal congestion
h h
why?
Removal of the pituitary gland is usually done by transsphernoidal approach through the nose. Nasal
h h h h h h h h h h h h h h h
congestion further interferes with the airway. h h h h h
A client with cancer is a, admitted to the oncology unit. Stat lab values revel Hgb 12.6, WBC 6500,
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K+1.9, uric acid 7.0, Na+136, and platelets 178,000. The nurse evaluates that the client is
h h h h h h h h h h h h h h h
experiencing which of the following? h h h h
A. Hypernatremia
h
B. Hypokalemia
h
C. Myelosuppression
h
D. Leukocytosis
h
B. Hypokalemia
h
why?
Hypokalemia is evident from the lab values listed. The other laboratory findings are within normal
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limits. Making answers A,C and D incorrect
h h h h h h
A 24 year-old female client is scheduled for surgery in the morning. Which of the following is the
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primary responsibility of the nurse?
h h h h
A. Taking the vital signs
h h h h
B. Obtaining the permit
h h h
C. Explaining the procedure
h h h
D. Checking the lab work
h h h h
A. Taking the vital signs
h h h h
why?
The primary responisblity of the nurse is to take the vital signs before any surgery.
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Answers B,C and D are the responsibility of the doctor.
h h h h h h h h h
The nurse is working in the emergency room when a client arrives with severe burns of the left arm,
h h h h h h h h h h h h h h h h h h h
hands, face, and neck. Which action should receive priority?
h h h h h h h h
A. Starting an IV?
h h h
B. Applying oxygen
h h h
C.Obtainingblood gas h h
D. Medicating the client foe pain
h h h h h
B. Applying oxygen
h h
, why?
The client with burns to the neck needs airway assessments and supplemental oxygen, so applying
h h h h h h h h h h h h h h h
oxygen is priority. The next action should be to start an IV and medicate for pain.
h h h h h h h h h h h h h h h
A 6-month-old client is admitted with possible intussuception. Which question during the nursing
h h h h h h h h h h h h h
history is least helpful in obtaining information regarding this diagnosis?
h h h h h h h h h
A. "tell me about the pain"
h h h h h
B."what does his vomit look like?" h h h h h
C." Describe his usual diet."
h h h h
D. " have you noticed changes in his adominal size?" C."
h h h h h h h h h h h
Describe his usual diet." h h h
why?
The least-helpful questions are those describing his usual diet. A, B, and D are useful in determining
h h h h h h h h h h h h h h h h h
the extent of disease process and thus, are incorrect
h h h h h h h h
The nurse is assisting a client with diverticulosis to select appropiate foods. Which food should be
h h h h h h h h h h h h h h h h
avoided?
A. Bran h
B. Fresh Peaches
h h
C. Cucumber salad
h h
D. Yeast Rolls
h h
C.Cucumbersalad why?
h h h
The client with diverticulitis should avoid foods with seeds.
h h h h h h h h
A client has rectal cancer and is scheduled for an abdominal perineal resection. What should be the
h h h h h h h h h h h h h h h h h
priority nursing care during the post-op period?
h h h h h h
A. Teaching how to irrigate the illeostomy
h h h h h h
B. Stopping electrolytes loss in the incisional area
h h h h h h h
C. Encouraging a high fiber diet
h h h h h
D. Facilitating perineal wound drainage
h h h h
D. Facilitatingperineal wound drainage
h h h h h
why?
QUESTIONS AND ANSWERS WITH GUIDED
RATIONALES INCLUDED ALREADY GRADED A
The nurse is visiting a home health client with osteoporosis. The client has a new prescription for
h h h h h h h h h h h h h h h h h
alendronate (Fosamax). Which instructions should be given to the client h h h h h h h h h
A. Rest in bed after taking the medication for at least 30 mins
h h h h h h h h h h h h
B. Avoid rapid movements after taking the medication
h h h h h h h
C. Take medication with water only
h h h h h
D. Allow at least 1 hour between taking the medicine and taking other medications
h h h h h h h h h h h h h
C. Take medication with water only why?
h h h h h h
Fosmax should be taken with water only. The client should also remain upright for at least 30 mins
h h h h h h h h h h h h h h h h h h
after taking the medication.
h h h
The nurse is making initial rounds on a client with a C5 fracture and crutchfield thongs. Which
h h h h h h h h h h h h h h h h h
equipment should be kept at the bedside? h h h h h h
A. A pair of forceps
h h h h
B. A torque wrench
h h h
C. A pair or wire cutters
h h h h h
D. A screwdriver
h h
B.Atorque wrench why?
h h h h
A tourque wrench is kept at the bedside to tighten and loosen the screws of crutchfield tongs. This
h h h h h h h h h h h h h h h h h h
wrench controls the amount of pressure that is placed on the screws.
h h h h h h h h h h h
An infant weighs 7 pounds at birth. The excpectd weight by 1 year should be:
h h h h h h h h h h h h h h
A. 10 pounds
h h
B.12 pounds h
,C. 18 pounds
h h
D. 21 pounds
h h
D.21pounds
h h h
why?
A birth weight of 7 pounds would indicate 21 pounds in 1 year or triple the his birth weight.
h h h h h h h h h h h h h h h h h h
A client is admitted with a Ewing's sacroma. Which symptoms would be expected due to this tumor's
h h h h h h h h h h h h h h h h h
location?
A. Hemiplegia
h
B. Aphasia
h
C. Nausea
h
D. Bone Pain
h h
D.BonePain
h h h
why?
Sacroma is a type of bone cancer, therefor, bone pain would be expected
h h h h h h h h h h h h
The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol).
h h h h h h h h h h h h h h h h
Which labatory value might be a indicate a serious side effect of this drug?
h h h h h h h h h h h h h
A. Uric acid of 5mg/dl
h h h h
B. Hematoccrit of 33%
h h h
C. WBC 2,000 per cubic millimeter
h h h h h
D. Platelets 150,000 per cubic millimeter
h h h h h
C. WBC 2,000 per cubic millimeter why?
h h h h h h
Tegratol can suppress the bone marrow and decrease the white blood cells count; thus, a lab value of
h h h h h h h h h h h h h h h h h h
WBC 2,000 per cubic millimeter indicates side effects of the drug.
h h h h h h h h h h
The nurse is caring for a client scheduled for removal of a pituitary tumor using the transsphenoidal
h h h h h h h h h h h h h h h h h
approach. The nurse should be particularly alert to: h h h h h h h
A. Nasal congestion
h h
B. Abdominal Tenderness
h h
C. Muscle Tetany
h h
D. Oliguria
h
,A. Nasal congestion
h h
why?
Removal of the pituitary gland is usually done by transsphernoidal approach through the nose. Nasal
h h h h h h h h h h h h h h h
congestion further interferes with the airway. h h h h h
A client with cancer is a, admitted to the oncology unit. Stat lab values revel Hgb 12.6, WBC 6500,
h h h h h h h h h h h h h h h h h h h
K+1.9, uric acid 7.0, Na+136, and platelets 178,000. The nurse evaluates that the client is
h h h h h h h h h h h h h h h
experiencing which of the following? h h h h
A. Hypernatremia
h
B. Hypokalemia
h
C. Myelosuppression
h
D. Leukocytosis
h
B. Hypokalemia
h
why?
Hypokalemia is evident from the lab values listed. The other laboratory findings are within normal
h h h h h h h h h h h h h h h
limits. Making answers A,C and D incorrect
h h h h h h
A 24 year-old female client is scheduled for surgery in the morning. Which of the following is the
h h h h h h h h h h h h h h h h h h
primary responsibility of the nurse?
h h h h
A. Taking the vital signs
h h h h
B. Obtaining the permit
h h h
C. Explaining the procedure
h h h
D. Checking the lab work
h h h h
A. Taking the vital signs
h h h h
why?
The primary responisblity of the nurse is to take the vital signs before any surgery.
h h h h h h h h h h h h h h
Answers B,C and D are the responsibility of the doctor.
h h h h h h h h h
The nurse is working in the emergency room when a client arrives with severe burns of the left arm,
h h h h h h h h h h h h h h h h h h h
hands, face, and neck. Which action should receive priority?
h h h h h h h h
A. Starting an IV?
h h h
B. Applying oxygen
h h h
C.Obtainingblood gas h h
D. Medicating the client foe pain
h h h h h
B. Applying oxygen
h h
, why?
The client with burns to the neck needs airway assessments and supplemental oxygen, so applying
h h h h h h h h h h h h h h h
oxygen is priority. The next action should be to start an IV and medicate for pain.
h h h h h h h h h h h h h h h
A 6-month-old client is admitted with possible intussuception. Which question during the nursing
h h h h h h h h h h h h h
history is least helpful in obtaining information regarding this diagnosis?
h h h h h h h h h
A. "tell me about the pain"
h h h h h
B."what does his vomit look like?" h h h h h
C." Describe his usual diet."
h h h h
D. " have you noticed changes in his adominal size?" C."
h h h h h h h h h h h
Describe his usual diet." h h h
why?
The least-helpful questions are those describing his usual diet. A, B, and D are useful in determining
h h h h h h h h h h h h h h h h h
the extent of disease process and thus, are incorrect
h h h h h h h h
The nurse is assisting a client with diverticulosis to select appropiate foods. Which food should be
h h h h h h h h h h h h h h h h
avoided?
A. Bran h
B. Fresh Peaches
h h
C. Cucumber salad
h h
D. Yeast Rolls
h h
C.Cucumbersalad why?
h h h
The client with diverticulitis should avoid foods with seeds.
h h h h h h h h
A client has rectal cancer and is scheduled for an abdominal perineal resection. What should be the
h h h h h h h h h h h h h h h h h
priority nursing care during the post-op period?
h h h h h h
A. Teaching how to irrigate the illeostomy
h h h h h h
B. Stopping electrolytes loss in the incisional area
h h h h h h h
C. Encouraging a high fiber diet
h h h h h
D. Facilitating perineal wound drainage
h h h h
D. Facilitatingperineal wound drainage
h h h h h
why?
