NEW ZEALAND NCLEX-RN FOR NZ REGISTRATION PREP
EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE
| PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A registered nurse working in a busy emergency department in Auckland is triaging a
client who presents with acute central chest pressure radiating to the left arm. Which of the
following actions should the nurse take first?
A. Obtain a detailed family cardiac history
B. Administer sublingual nitroglycerin as prescribed
C. Apply supplemental oxygen and obtain a 12-lead ECG
D. Draw blood samples for cardiac biomarker analysis
The immediate priority for a client presenting with signs of acute coronary syndrome is to
assess cardiac electrical activity and ensure adequate tissue oxygenation before administering
pharmacological agents or gathering non-urgent history.
2. A nurse is caring for an older adult client on a medical ward who is receiving
intravenous gentamicin therapy. Which of the following findings should the nurse report to
the medical officer immediately?
A. Serum creatinine level increasing from 70 to 140 micromoles per liter
B. Mild peripheral edema in the lower extremities
C. A slight decrease in appetite over the past twenty-four hours
D. Blood pressure reading of 128 over 82 millimeters of mercury
Aminoglycosides like gentamicin are highly nephrotoxic and ototoxic. A doubling of serum
creatinine indicates acute kidney injury, requiring immediate cessation or adjustment of the
medication.
3. An enrolled nurse asks the registered nurse about the scope of practice regarding
administering blood products independently in a New Zealand healthcare facility. What is
the correct response by the registered nurse?
A. Enrolled nurses may administer blood products if they have completed an approved institutional
competency framework
, B. Registered nurses bear ultimate accountability, but enrolled nurses can independently verify and hang
blood units
C. Enrolled nurses work under the direction and supervision of a registered nurse and generally cannot
independently administer blood products without specific endorsement and oversight
D. Administration of blood products is restricted exclusively to medical practitioners in all clinical
settings
Under Nursing Council of New Zealand guidelines, enrolled nurses practice under the
direction and supervision of a registered nurse. Specific high-risk competencies such as blood
administration require adherence to strict institutional policy and direct registered nurse
supervision.
4. A nurse is planning care for a client newly diagnosed with type 1 diabetes mellitus.
Which manifestation should the nurse identify as a primary indicator of hyperglycemia?
A. Diaphoresis and tremors
B. Polyuria and polydipsia
C. Bradycardia and bradypnea
D. Weight gain and peripheral edema
High blood glucose levels cause osmotic diuresis leading to excessive urination (polyuria),
which subsequently triggers severe thirst (polydipsia) as the body attempts to compensate for
fluid loss.
5. A community health nurse is visiting a family in a rural region of New Zealand who live
in a damp, poorly insulated home. The young child has frequent exacerbations of asthma.
Which nursing intervention addresses the root environmental risk factor?
A. Advising the family to relocate immediately to a different city
B. Providing education on identifying mold growth and facilitating access to housing insulation
support programs
C. Recommending the immediate cessation of all indoor cooking activities
D. Increasing the dose of the child's short-acting beta-agonist inhaler
Damp housing is a major determinant of respiratory illness in New Zealand. Practical
interventions include addressing environmental triggers like mold and connecting families
with healthy home initiatives.
, 6. A nurse is preparing to administer digoxin to a client with heart failure. Prior to
administration, the nurse checks the apical pulse rate and finds it to be 52 beats per
minute. What is the most appropriate action for the nurse to take?
A. Administer the dose and document the pulse rate
B. Withhold the dose and notify the prescribing physician
C. Administer half the prescribed dose and recheck the pulse in one hour
D. Give the medication with a glass of orange juice to increase absorption
Digoxin has a negative chronotropic effect. An apical pulse below 60 beats per minute in an
adult indicates potential toxicity, requiring the nurse to withhold the medication and inform
the medical team.
7. A nurse is assessing a client who has returned from the post-anaesthetic care unit
following a thyroidectomy. The client exhibits stridor and frequent harsh coughing. Which
complication should the nurse suspect?
A. Hypocalcemia secondary to parathyroid injury
B. Thyroid storm triggered by surgical manipulation
C. Laryngeal edema and airway obstruction
D. Acute hemorrhage within the surgical drain
Stridor following thyroid surgery is a medical emergency indicating acute airway compromise
caused by laryngeal edema, hematoma formation, or recurrent laryngeal nerve damage.
8. A nurse is conducting a medication reconciliation for an older adult client admitted from
home. The client takes multiple medications prescribed by different specialists. Which
concept best describes the primary risk facing this client?
A. Pharmacokinetics saturation
B. Polypharmacy and potential drug-drug interactions
C. Therapeutic drug monitoring failure
D. Drug tolerance development
Polypharmacy, the concurrent use of multiple medications, significantly increases the risk of
adverse drug reactions, compliance issues, and harmful drug interactions, particularly in
older adults.
EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS PLUS RATIONALES | GUARANTEED
PASS | LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE
| PRACTICE TEST| DOWNLOAD INSTANT PDF
1. A registered nurse working in a busy emergency department in Auckland is triaging a
client who presents with acute central chest pressure radiating to the left arm. Which of the
following actions should the nurse take first?
A. Obtain a detailed family cardiac history
B. Administer sublingual nitroglycerin as prescribed
C. Apply supplemental oxygen and obtain a 12-lead ECG
D. Draw blood samples for cardiac biomarker analysis
The immediate priority for a client presenting with signs of acute coronary syndrome is to
assess cardiac electrical activity and ensure adequate tissue oxygenation before administering
pharmacological agents or gathering non-urgent history.
2. A nurse is caring for an older adult client on a medical ward who is receiving
intravenous gentamicin therapy. Which of the following findings should the nurse report to
the medical officer immediately?
A. Serum creatinine level increasing from 70 to 140 micromoles per liter
B. Mild peripheral edema in the lower extremities
C. A slight decrease in appetite over the past twenty-four hours
D. Blood pressure reading of 128 over 82 millimeters of mercury
Aminoglycosides like gentamicin are highly nephrotoxic and ototoxic. A doubling of serum
creatinine indicates acute kidney injury, requiring immediate cessation or adjustment of the
medication.
3. An enrolled nurse asks the registered nurse about the scope of practice regarding
administering blood products independently in a New Zealand healthcare facility. What is
the correct response by the registered nurse?
A. Enrolled nurses may administer blood products if they have completed an approved institutional
competency framework
, B. Registered nurses bear ultimate accountability, but enrolled nurses can independently verify and hang
blood units
C. Enrolled nurses work under the direction and supervision of a registered nurse and generally cannot
independently administer blood products without specific endorsement and oversight
D. Administration of blood products is restricted exclusively to medical practitioners in all clinical
settings
Under Nursing Council of New Zealand guidelines, enrolled nurses practice under the
direction and supervision of a registered nurse. Specific high-risk competencies such as blood
administration require adherence to strict institutional policy and direct registered nurse
supervision.
4. A nurse is planning care for a client newly diagnosed with type 1 diabetes mellitus.
Which manifestation should the nurse identify as a primary indicator of hyperglycemia?
A. Diaphoresis and tremors
B. Polyuria and polydipsia
C. Bradycardia and bradypnea
D. Weight gain and peripheral edema
High blood glucose levels cause osmotic diuresis leading to excessive urination (polyuria),
which subsequently triggers severe thirst (polydipsia) as the body attempts to compensate for
fluid loss.
5. A community health nurse is visiting a family in a rural region of New Zealand who live
in a damp, poorly insulated home. The young child has frequent exacerbations of asthma.
Which nursing intervention addresses the root environmental risk factor?
A. Advising the family to relocate immediately to a different city
B. Providing education on identifying mold growth and facilitating access to housing insulation
support programs
C. Recommending the immediate cessation of all indoor cooking activities
D. Increasing the dose of the child's short-acting beta-agonist inhaler
Damp housing is a major determinant of respiratory illness in New Zealand. Practical
interventions include addressing environmental triggers like mold and connecting families
with healthy home initiatives.
, 6. A nurse is preparing to administer digoxin to a client with heart failure. Prior to
administration, the nurse checks the apical pulse rate and finds it to be 52 beats per
minute. What is the most appropriate action for the nurse to take?
A. Administer the dose and document the pulse rate
B. Withhold the dose and notify the prescribing physician
C. Administer half the prescribed dose and recheck the pulse in one hour
D. Give the medication with a glass of orange juice to increase absorption
Digoxin has a negative chronotropic effect. An apical pulse below 60 beats per minute in an
adult indicates potential toxicity, requiring the nurse to withhold the medication and inform
the medical team.
7. A nurse is assessing a client who has returned from the post-anaesthetic care unit
following a thyroidectomy. The client exhibits stridor and frequent harsh coughing. Which
complication should the nurse suspect?
A. Hypocalcemia secondary to parathyroid injury
B. Thyroid storm triggered by surgical manipulation
C. Laryngeal edema and airway obstruction
D. Acute hemorrhage within the surgical drain
Stridor following thyroid surgery is a medical emergency indicating acute airway compromise
caused by laryngeal edema, hematoma formation, or recurrent laryngeal nerve damage.
8. A nurse is conducting a medication reconciliation for an older adult client admitted from
home. The client takes multiple medications prescribed by different specialists. Which
concept best describes the primary risk facing this client?
A. Pharmacokinetics saturation
B. Polypharmacy and potential drug-drug interactions
C. Therapeutic drug monitoring failure
D. Drug tolerance development
Polypharmacy, the concurrent use of multiple medications, significantly increases the risk of
adverse drug reactions, compliance issues, and harmful drug interactions, particularly in
older adults.
