350 NCLEX-STYLE NURSING EXAM
QUESTIONS |COMPREHENSIVE NURSING
PRACTICE QUESTIONS WITH
RATIONALES
PART 1: FUNDAMENTALS OF NURSING (Questions 1-70)
Question 1
A nurse is caring for a client who is postoperative day 1 following abdominal
surgery. Which finding requires immediate intervention?
A) Heart rate 88 bpm
B) Temperature 99.2°F (37.3°C)
C) Wound dressing with scant serosanguineous drainage
D) Respiratory rate of 28 breaths/min with shallow breathing
Correct Answer: D
Rationale: A respiratory rate of 28 with shallow breathing indicates potential
respiratory compromise, possibly from pain, splinting, or atelectasis. This
requires immediate intervention to prevent complications such as pneumonia.
The other options are within normal limits or expected findings
postoperatively.
,---
Question 2
A client with hypertension is prescribed lisinopril. Which adverse effect
should the nurse monitor for?
A) Dry cough
B) Peripheral edema
C) Tachycardia
D) Hyperkalemia
Correct Answer: A
Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry
cough due to bradykinin accumulation. Peripheral edema is more common
with calcium channel blockers. Tachycardia is not a typical adverse effect.
Hyperkalemia is possible but less common than the cough.
---
Question 3
The nurse is preparing to administer digoxin to a client with heart failure.
Which finding indicates the medication should be withheld?
A) Heart rate 54 bpm
B) Blood pressure 130/80 mmHg
C) Serum potassium 4.0 mEq/L
D) Respiratory rate 18 breaths/min
,Correct Answer: A
Rationale: Digoxin should be withheld if the apical pulse is less than 60 bpm
(or as prescribed). A heart rate of 54 bpm is bradycardic and indicates
potential digoxin toxicity. The other values are within normal limits.
---
Question 4
A client is receiving a blood transfusion. Which sign indicates a hemolytic
transfusion reaction?
A) Fever and chills
B) Low back pain
C) Hypotension
D) All of the above
Correct Answer: D
Rationale: Hemolytic transfusion reactions present with fever, chills, low back
pain, hypotension, tachycardia, and hemoglobinuria. All options listed are
signs of this potentially fatal reaction requiring immediate intervention.
---
Question 5
The nurse is assessing a client with pneumonia. Which finding is most
concerning?
, A) Crackles in bilateral lung bases
B) Productive cough with green sputum
C) Oxygen saturation 88% on room air
D) Temperature 101.2°F (38.4°C)
Correct Answer: C
Rationale: An oxygen saturation of 88% indicates severe hypoxemia requiring
immediate intervention such as supplemental oxygen. While crackles,
productive cough, and fever are concerning findings in pneumonia, they do
not indicate immediate life-threatening compromise like significant
hypoxemia does.
---
Question 6
A client with diabetes mellitus type 2 is prescribed metformin. Which serious
adverse effect should the nurse educate the client about?
A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Hepatotoxicity
Correct Answer: B
Rationale: Metformin can cause lactic acidosis, a rare but serious adverse
effect. Risk factors include renal impairment, hepatic disease, and conditions
QUESTIONS |COMPREHENSIVE NURSING
PRACTICE QUESTIONS WITH
RATIONALES
PART 1: FUNDAMENTALS OF NURSING (Questions 1-70)
Question 1
A nurse is caring for a client who is postoperative day 1 following abdominal
surgery. Which finding requires immediate intervention?
A) Heart rate 88 bpm
B) Temperature 99.2°F (37.3°C)
C) Wound dressing with scant serosanguineous drainage
D) Respiratory rate of 28 breaths/min with shallow breathing
Correct Answer: D
Rationale: A respiratory rate of 28 with shallow breathing indicates potential
respiratory compromise, possibly from pain, splinting, or atelectasis. This
requires immediate intervention to prevent complications such as pneumonia.
The other options are within normal limits or expected findings
postoperatively.
,---
Question 2
A client with hypertension is prescribed lisinopril. Which adverse effect
should the nurse monitor for?
A) Dry cough
B) Peripheral edema
C) Tachycardia
D) Hyperkalemia
Correct Answer: A
Rationale: Lisinopril, an ACE inhibitor, commonly causes a persistent dry
cough due to bradykinin accumulation. Peripheral edema is more common
with calcium channel blockers. Tachycardia is not a typical adverse effect.
Hyperkalemia is possible but less common than the cough.
---
Question 3
The nurse is preparing to administer digoxin to a client with heart failure.
Which finding indicates the medication should be withheld?
A) Heart rate 54 bpm
B) Blood pressure 130/80 mmHg
C) Serum potassium 4.0 mEq/L
D) Respiratory rate 18 breaths/min
,Correct Answer: A
Rationale: Digoxin should be withheld if the apical pulse is less than 60 bpm
(or as prescribed). A heart rate of 54 bpm is bradycardic and indicates
potential digoxin toxicity. The other values are within normal limits.
---
Question 4
A client is receiving a blood transfusion. Which sign indicates a hemolytic
transfusion reaction?
A) Fever and chills
B) Low back pain
C) Hypotension
D) All of the above
Correct Answer: D
Rationale: Hemolytic transfusion reactions present with fever, chills, low back
pain, hypotension, tachycardia, and hemoglobinuria. All options listed are
signs of this potentially fatal reaction requiring immediate intervention.
---
Question 5
The nurse is assessing a client with pneumonia. Which finding is most
concerning?
, A) Crackles in bilateral lung bases
B) Productive cough with green sputum
C) Oxygen saturation 88% on room air
D) Temperature 101.2°F (38.4°C)
Correct Answer: C
Rationale: An oxygen saturation of 88% indicates severe hypoxemia requiring
immediate intervention such as supplemental oxygen. While crackles,
productive cough, and fever are concerning findings in pneumonia, they do
not indicate immediate life-threatening compromise like significant
hypoxemia does.
---
Question 6
A client with diabetes mellitus type 2 is prescribed metformin. Which serious
adverse effect should the nurse educate the client about?
A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Hepatotoxicity
Correct Answer: B
Rationale: Metformin can cause lactic acidosis, a rare but serious adverse
effect. Risk factors include renal impairment, hepatic disease, and conditions
