NCLEX PN EXAM HESI QUESTIONS WITH
ANSWERS 2023 UPDATED/ GRADED A+/PN
FINAL EXAM TEST BANK
EXAM COVERAGE
1. Fundamentals of Nursing Practice and Safety
2. Pharmacology and Parenteral Therapies
3. Medical-Surgical Nursing: Cardiovascular and Respiratory
4. Medical-Surgical Nursing: Endocrine and Gastrointestinal
5. Maternal-Newborn Nursing
6. Pediatric Nursing Care
7. Mental Health Nursing and Therapeutic Communication
8. Gerontological Nursing
9. Legal and Ethical Responsibilities
10. Nutrition and Fluid/Electrolyte Balance
1. A nurse is caring for a client who is 2 days postoperative following a total hip arthroplasty. The
client reports sudden sharp chest pain and shortness of breath. Which action should the nurse
take first?
A. Administer a PRN analgesic.
B. Elevate the head of the bed and apply oxygen.
, C. Check the surgical incision for signs of infection.
D. Document the client's vital signs and report to the surgeon.
Answer: B
Rationale: The client is exhibiting symptoms of a pulmonary embolism, a life-threatening
complication. The nurse must prioritize airway, breathing, and circulation by elevating the head
of the bed to facilitate breathing and applying oxygen immediately before further assessment or
notification.
2. A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse
is 58/min. Which action should the nurse take?
A. Administer the medication as ordered.
B. Administer half of the prescribed dose.
C. Withhold the medication and notify the healthcare provider.
D. Administer the medication and monitor the client for 1 hour.
Answer: C
Rationale: Digoxin slows the heart rate; holding the medication is required if the apical pulse is
less than 60/min in an adult to prevent symptomatic bradycardia. Administering it would
exacerbate the low heart rate, and partial dosing is not a standard nursing intervention for
digoxin.
3. A client with type 1 diabetes mellitus is found unconscious, diaphoretic, and tachycardic. Which
action is the priority?
A. Administer subcutaneous regular insulin.
B. Administer 50% dextrose solution via IV bolus.
C. Check the client's urine for ketones.
D. Offer the client a glass of orange juice.
Answer: B
Rationale: The client is exhibiting signs of severe hypoglycemia. For an unconscious client who
cannot safely swallow, intravenous dextrose is the immediate life-saving intervention.
Subcutaneous insulin would worsen the hypoglycemia, and oral fluids are contraindicated due to
the risk of aspiration.
, 4. A nurse is caring for a client who is receiving a blood transfusion. The client develops chills,
fever, and flank pain. Which action should the nurse take first?
A. Notify the blood bank.
B. Stop the transfusion immediately.
C. Obtain a urine specimen.
D. Administer an antihistamine.
Answer: B
Rationale: The client's symptoms indicate a hemolytic transfusion reaction, which is an
emergency. The nurse must stop the infusion immediately to prevent further infusion of
incompatible blood. The other actions follow only after the infusion has been terminated.
5. A nurse is providing care for a toddler who has ingested an unknown quantity of household
cleaning solution. Which action is contraindicated?
A. Monitoring the client's level of consciousness.
B. Inducing emesis.
C. Contacting the poison control center.
D. Administering intravenous fluids.
Answer: B
Rationale: Inducing emesis is contraindicated for caustic substances because re-exposing the
esophagus and oropharynx to the chemical can cause further tissue damage or lead to aspiration
pneumonia. Management should focus on airway protection and poison control guidance.
6. A nurse is planning care for a client who has dementia and frequently wanders. Which
intervention is the most appropriate?
A. Apply physical restraints during the night.
B. Assign the client to a room near the nurses' station.
C. Provide a sedative medication at scheduled intervals.
D. Keep the client’s room door locked at all times.
Answer: B
ANSWERS 2023 UPDATED/ GRADED A+/PN
FINAL EXAM TEST BANK
EXAM COVERAGE
1. Fundamentals of Nursing Practice and Safety
2. Pharmacology and Parenteral Therapies
3. Medical-Surgical Nursing: Cardiovascular and Respiratory
4. Medical-Surgical Nursing: Endocrine and Gastrointestinal
5. Maternal-Newborn Nursing
6. Pediatric Nursing Care
7. Mental Health Nursing and Therapeutic Communication
8. Gerontological Nursing
9. Legal and Ethical Responsibilities
10. Nutrition and Fluid/Electrolyte Balance
1. A nurse is caring for a client who is 2 days postoperative following a total hip arthroplasty. The
client reports sudden sharp chest pain and shortness of breath. Which action should the nurse
take first?
A. Administer a PRN analgesic.
B. Elevate the head of the bed and apply oxygen.
, C. Check the surgical incision for signs of infection.
D. Document the client's vital signs and report to the surgeon.
Answer: B
Rationale: The client is exhibiting symptoms of a pulmonary embolism, a life-threatening
complication. The nurse must prioritize airway, breathing, and circulation by elevating the head
of the bed to facilitate breathing and applying oxygen immediately before further assessment or
notification.
2. A nurse is preparing to administer digoxin to a client with heart failure. The client’s apical pulse
is 58/min. Which action should the nurse take?
A. Administer the medication as ordered.
B. Administer half of the prescribed dose.
C. Withhold the medication and notify the healthcare provider.
D. Administer the medication and monitor the client for 1 hour.
Answer: C
Rationale: Digoxin slows the heart rate; holding the medication is required if the apical pulse is
less than 60/min in an adult to prevent symptomatic bradycardia. Administering it would
exacerbate the low heart rate, and partial dosing is not a standard nursing intervention for
digoxin.
3. A client with type 1 diabetes mellitus is found unconscious, diaphoretic, and tachycardic. Which
action is the priority?
A. Administer subcutaneous regular insulin.
B. Administer 50% dextrose solution via IV bolus.
C. Check the client's urine for ketones.
D. Offer the client a glass of orange juice.
Answer: B
Rationale: The client is exhibiting signs of severe hypoglycemia. For an unconscious client who
cannot safely swallow, intravenous dextrose is the immediate life-saving intervention.
Subcutaneous insulin would worsen the hypoglycemia, and oral fluids are contraindicated due to
the risk of aspiration.
, 4. A nurse is caring for a client who is receiving a blood transfusion. The client develops chills,
fever, and flank pain. Which action should the nurse take first?
A. Notify the blood bank.
B. Stop the transfusion immediately.
C. Obtain a urine specimen.
D. Administer an antihistamine.
Answer: B
Rationale: The client's symptoms indicate a hemolytic transfusion reaction, which is an
emergency. The nurse must stop the infusion immediately to prevent further infusion of
incompatible blood. The other actions follow only after the infusion has been terminated.
5. A nurse is providing care for a toddler who has ingested an unknown quantity of household
cleaning solution. Which action is contraindicated?
A. Monitoring the client's level of consciousness.
B. Inducing emesis.
C. Contacting the poison control center.
D. Administering intravenous fluids.
Answer: B
Rationale: Inducing emesis is contraindicated for caustic substances because re-exposing the
esophagus and oropharynx to the chemical can cause further tissue damage or lead to aspiration
pneumonia. Management should focus on airway protection and poison control guidance.
6. A nurse is planning care for a client who has dementia and frequently wanders. Which
intervention is the most appropriate?
A. Apply physical restraints during the night.
B. Assign the client to a room near the nurses' station.
C. Provide a sedative medication at scheduled intervals.
D. Keep the client’s room door locked at all times.
Answer: B
