# NCLEX-RN Exam Pack Set 8 (75 Questions & ANSWERs
Updated 2022) – Latest Edition for Success in 2024/2025
---
**01.** A nurse is caring for a client who has just been diagnosed with terminal cancer. The client
states, “I’ve always been healthy. This can’t be happening to me.” Which stage of grief is the client
exhibiting?
A) Denial
B) Anger
C) Bargaining
D) Depression
🔍 RATIONALE💡-- Denial is the initial stage of Kübler‑Ross’s grief model, characterized by refusal to
accept the reality of the diagnosis. It serves as a temporary defense mechanism.
ANSWER💫✔️-- A) Denial
---
**02.** A nurse is assessing a client who is receiving a blood transfusion. The client reports low back
pain and chills. What is the priority action?
A) Slow the infusion rate
B) Stop the transfusion and infuse normal saline
C) Administer acetaminophen as prescribed
D) Notify the blood bank
🔍 RATIONALE💡-- Low back pain and chills suggest an acute hemolytic reaction. The transfusion must
be stopped immediately, and the IV line kept open with normal saline while notifying the provider.
,ANSWER💫✔️-- B) Stop the transfusion and infuse normal saline
---
**03.** A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse
is 52 bpm, and they report nausea. What should the nurse do first?
A) Administer the digoxin as prescribed
B) Check the digoxin level
C) Hold the dose and assess further
D) Administer atropine to increase heart rate
🔍 RATIONALE💡-- Bradycardia (<60 bpm) and nausea are signs of digoxin toxicity. The nurse should hold
the dose and perform further assessment (e.g., digoxin level, electrolytes, ECG) before notifying the
provider.
ANSWER💫✔️-- C) Hold the dose and assess further
---
**04.** A nurse is teaching a client with a new prescription for warfarin. Which over‑the‑counter
medication should the client avoid?
A) Acetaminophen
B) Ibuprofen
C) Diphenhydramine
D) Loratadine
🔍 RATIONALE💡-- Ibuprofen (an NSAID) increases bleeding risk when taken with warfarin due to
platelet inhibition and GI mucosal irritation. Acetaminophen is safer for pain/fever.
,ANSWER💫✔️-- B) Ibuprofen
---
**05.** A nurse is caring for a client with a chest tube after a thoracotomy. The nurse notes continuous
bubbling in the water seal chamber. Which action is most appropriate?
A) Clamp the chest tube near the insertion site
B) Increase the suction pressure
C) Check the system for an air leak
D) Document the finding as normal
🔍 RATIONALE💡-- Continuous bubbling in the water seal chamber indicates an air leak, which can lead
to pneumothorax. The nurse should check all connections for tightness.
ANSWER💫✔️-- C) Check the system for an air leak
---
**06.** A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates understanding of stoma care?
A) “I will change the pouch every day to prevent infection.”
B) “My stoma should look dark purple and dry.”
C) “I will cut the skin barrier opening about 2 mm larger than my stoma.”
D) “I can use hydrogen peroxide to clean the stoma.”
🔍 RATIONALE💡-- The skin barrier opening should be cut 1‑2 mm larger than the stoma to prevent skin
irritation. A healthy stoma is pink/red and moist; hydrogen peroxide is too harsh.
ANSWER💫✔️-- C) “I will cut the skin barrier opening about 2 mm larger than my stoma.”
, ---
**07.** A nurse is assessing a client with a traumatic brain injury. Which finding suggests increased
intracranial pressure (ICP)?
A) Glasgow Coma Scale score of 15
B) Pupils that are equal and reactive to light
C) Widening pulse pressure with bradycardia
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Widening pulse pressure (increasing systolic with stable diastolic) and bradycardia
are components of Cushing’s triad, a late sign of increased ICP.
ANSWER💫✔️-- C) Widening pulse pressure with bradycardia
---
**08.** A nurse is caring for a client with a central venous catheter (CVC) who develops sudden
dyspnea, chest pain, and hypotension. What is the priority action?
A) Clamp the central line
B) Place the client in Trendelenburg position on the left side
C) Administer oxygen at 10 L/min
D) Notify the provider
🔍 RATIONALE💡-- Suspected air embolism. The priority is to clamp the CVC immediately to prevent
more air from entering, then position the client in left lateral Trendelenburg.
ANSWER💫✔️-- A) Clamp the central line
---
Updated 2022) – Latest Edition for Success in 2024/2025
---
**01.** A nurse is caring for a client who has just been diagnosed with terminal cancer. The client
states, “I’ve always been healthy. This can’t be happening to me.” Which stage of grief is the client
exhibiting?
A) Denial
B) Anger
C) Bargaining
D) Depression
🔍 RATIONALE💡-- Denial is the initial stage of Kübler‑Ross’s grief model, characterized by refusal to
accept the reality of the diagnosis. It serves as a temporary defense mechanism.
ANSWER💫✔️-- A) Denial
---
**02.** A nurse is assessing a client who is receiving a blood transfusion. The client reports low back
pain and chills. What is the priority action?
A) Slow the infusion rate
B) Stop the transfusion and infuse normal saline
C) Administer acetaminophen as prescribed
D) Notify the blood bank
🔍 RATIONALE💡-- Low back pain and chills suggest an acute hemolytic reaction. The transfusion must
be stopped immediately, and the IV line kept open with normal saline while notifying the provider.
,ANSWER💫✔️-- B) Stop the transfusion and infuse normal saline
---
**03.** A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse
is 52 bpm, and they report nausea. What should the nurse do first?
A) Administer the digoxin as prescribed
B) Check the digoxin level
C) Hold the dose and assess further
D) Administer atropine to increase heart rate
🔍 RATIONALE💡-- Bradycardia (<60 bpm) and nausea are signs of digoxin toxicity. The nurse should hold
the dose and perform further assessment (e.g., digoxin level, electrolytes, ECG) before notifying the
provider.
ANSWER💫✔️-- C) Hold the dose and assess further
---
**04.** A nurse is teaching a client with a new prescription for warfarin. Which over‑the‑counter
medication should the client avoid?
A) Acetaminophen
B) Ibuprofen
C) Diphenhydramine
D) Loratadine
🔍 RATIONALE💡-- Ibuprofen (an NSAID) increases bleeding risk when taken with warfarin due to
platelet inhibition and GI mucosal irritation. Acetaminophen is safer for pain/fever.
,ANSWER💫✔️-- B) Ibuprofen
---
**05.** A nurse is caring for a client with a chest tube after a thoracotomy. The nurse notes continuous
bubbling in the water seal chamber. Which action is most appropriate?
A) Clamp the chest tube near the insertion site
B) Increase the suction pressure
C) Check the system for an air leak
D) Document the finding as normal
🔍 RATIONALE💡-- Continuous bubbling in the water seal chamber indicates an air leak, which can lead
to pneumothorax. The nurse should check all connections for tightness.
ANSWER💫✔️-- C) Check the system for an air leak
---
**06.** A nurse is providing discharge teaching to a client with a new colostomy. Which statement by
the client indicates understanding of stoma care?
A) “I will change the pouch every day to prevent infection.”
B) “My stoma should look dark purple and dry.”
C) “I will cut the skin barrier opening about 2 mm larger than my stoma.”
D) “I can use hydrogen peroxide to clean the stoma.”
🔍 RATIONALE💡-- The skin barrier opening should be cut 1‑2 mm larger than the stoma to prevent skin
irritation. A healthy stoma is pink/red and moist; hydrogen peroxide is too harsh.
ANSWER💫✔️-- C) “I will cut the skin barrier opening about 2 mm larger than my stoma.”
, ---
**07.** A nurse is assessing a client with a traumatic brain injury. Which finding suggests increased
intracranial pressure (ICP)?
A) Glasgow Coma Scale score of 15
B) Pupils that are equal and reactive to light
C) Widening pulse pressure with bradycardia
D) Tachycardia and hypotension
🔍 RATIONALE💡-- Widening pulse pressure (increasing systolic with stable diastolic) and bradycardia
are components of Cushing’s triad, a late sign of increased ICP.
ANSWER💫✔️-- C) Widening pulse pressure with bradycardia
---
**08.** A nurse is caring for a client with a central venous catheter (CVC) who develops sudden
dyspnea, chest pain, and hypotension. What is the priority action?
A) Clamp the central line
B) Place the client in Trendelenburg position on the left side
C) Administer oxygen at 10 L/min
D) Notify the provider
🔍 RATIONALE💡-- Suspected air embolism. The priority is to clamp the CVC immediately to prevent
more air from entering, then position the client in left lateral Trendelenburg.
ANSWER💫✔️-- A) Clamp the central line
---
