NCLEX Questions and Rationales
NCLEX Question: 11-2-13 Question: A client diagnosed with panic disorder begins to exhibit
signs of a panic attack in a busy day room of a psychiatric unit, including anxiety,
hyperventilation, trembling, and sweating. What should the nurse do first?
• a. Administer alprazolam (Xanax), a benzodiazepine
• b. Explore the cause of the panic attack with the client
• c. Move the client to a quieter, calmer environment
• d. Request the unlicensed assistive personnel to check the client's vital signs
Correct Answer: c. Move the client to a quieter, calmer environment. Rationale: The
immediate priority is to reduce environmental stimuli to help calm the client. While medication
may be necessary, it takes 15–30 minutes to take effect. Discussing the cause or checking vital
signs can follow after the initial calming intervention.
NCLEX Question: 11-16-13 & 11-25-13 Question: What should be included in the care plan
for a client admitted with acute renal colic?
• A. Insert a urinary catheter
• B. Strain all urine
• C. Ensure T-tube patency
• D. Restrict fluid intake to 1–2 liters/day
Correct Answer: B. Strain all urine Rationale: Urine should be filtered to check for kidney
stones. Inserting a catheter unnecessarily increases infection risk. T-tubes are for biliary
drainage, not renal care. Fluids should be increased (3–4 liters/day) to help eliminate stones.
NCLEX Question: 12-3-14 & 1-13-14 Question: A client with a brain tumor has been
prescribed intravenous mannitol (Osmitrol), an osmotic diuretic. What nursing interventions are
appropriate? (Select all that apply)
• a. Check for crystals in the solution bottle
• b. Monitor intake and output every 8 hours
• c. Listen to lung sounds
• d. Perform a neurological assessment
• e. Keep calcium gluconate at the bedside
Correct Answers: a, b, c Rationale: Mannitol may crystallize in solution; it should be inspected
before administration. Monitoring intake and output helps ensure fluid balance. Lung sounds
should be assessed as fluid overload may occur. Neurological exams relate to the condition, not
the medication. Calcium gluconate is not related to mannitol use.
NCLEX Question: 11-2-13 Question: A client diagnosed with panic disorder begins to exhibit
signs of a panic attack in a busy day room of a psychiatric unit, including anxiety,
hyperventilation, trembling, and sweating. What should the nurse do first?
• a. Administer alprazolam (Xanax), a benzodiazepine
• b. Explore the cause of the panic attack with the client
• c. Move the client to a quieter, calmer environment
• d. Request the unlicensed assistive personnel to check the client's vital signs
Correct Answer: c. Move the client to a quieter, calmer environment. Rationale: The
immediate priority is to reduce environmental stimuli to help calm the client. While medication
may be necessary, it takes 15–30 minutes to take effect. Discussing the cause or checking vital
signs can follow after the initial calming intervention.
NCLEX Question: 11-16-13 & 11-25-13 Question: What should be included in the care plan
for a client admitted with acute renal colic?
• A. Insert a urinary catheter
• B. Strain all urine
• C. Ensure T-tube patency
• D. Restrict fluid intake to 1–2 liters/day
Correct Answer: B. Strain all urine Rationale: Urine should be filtered to check for kidney
stones. Inserting a catheter unnecessarily increases infection risk. T-tubes are for biliary
drainage, not renal care. Fluids should be increased (3–4 liters/day) to help eliminate stones.
NCLEX Question: 12-3-14 & 1-13-14 Question: A client with a brain tumor has been
prescribed intravenous mannitol (Osmitrol), an osmotic diuretic. What nursing interventions are
appropriate? (Select all that apply)
• a. Check for crystals in the solution bottle
• b. Monitor intake and output every 8 hours
• c. Listen to lung sounds
• d. Perform a neurological assessment
• e. Keep calcium gluconate at the bedside
Correct Answers: a, b, c Rationale: Mannitol may crystallize in solution; it should be inspected
before administration. Monitoring intake and output helps ensure fluid balance. Lung sounds
should be assessed as fluid overload may occur. Neurological exams relate to the condition, not
the medication. Calcium gluconate is not related to mannitol use.
