NCLEX-PN NGN EXAM PREP: 200 MUST-KNOW QUESTIONS COMPLETE
WITH VERIFIED ANSWERS AND DETAILED RATIONALES
1. A nurse is caring for a client with cardiac arrest and assisting the
registered nurse (RN) in identifying priorities and delegation. As
the LPN/VN assists with assigning roles to other staff, this is
demonstrating which leadership style?
A. Authoritative
B. Situational
C. Democratic
D. Laissez-faire
Answer: A. Authoritative
Rationale: Authoritative leadership is demonstrated in this
situation as the nurse assists with delegation and provides
directives to accomplish tasks. This is an appropriate leadership
style in an emergency where one individual assigns tasks/roles to
decrease confusion and chaos in an emergent situation.
2. What is the normal level of creatinine in a healthy adult male?
A. 0.4 to 0.8 mg/dL
B. 0.1 to 0.4 mg/dL
C. 0.6 to 1.2 mg/dL
D. 1.5 to 2.0 mg/dL
Answer: C. 0.6 to 1.2 mg/dL
Rationale: Creatinine values reflect both the amount of muscle a
person has and their amount of kidney function. Most men with
, normal kidney function have 0.6 to 1.2 mg/dL of creatinine. Most
women have between 0.5 to 1.1 mg/dL due to lesser muscle mass.
3. The nurse is caring for a client who has a serum calcium level of
13.2 mg/dL (normal 9-10.5 mg/dL). Which of the following
medications would be expected orders for this condition? Select
all that apply.
A. Phosphorus
B. Calcitonin
C. Vitamin D
D. IV calcium gluconate
E. Glucocorticoids
Answer: A, B, E (Phosphorus, Calcitonin, Glucocorticoids)
Rationale: This client has hypercalcemia. Phosphorus and calcium
have an inverse relationship, so phosphorus decreases calcium.
Calcitonin inhibits bone resorption and lowers serum calcium.
Glucocorticoids treat hypercalcemia associated with cancers by
inhibiting bone breakdown. Vitamin D and IV calcium gluconate
would increase calcium and are contraindicated.
4. The nurse is reviewing labs for a patient with a serum potassium
level of 3.3 mEq/L (normal 3.5-5.0 mEq/L). Which action would
the nurse recognize as the highest priority?
A. Educate the patient on potassium-rich foods
B. Implement telemetry monitoring
C. Obtain an order for STAT IM KCl
D. Assess the patient’s neurological status
Answer: B. Implement telemetry monitoring
Rationale: Hypokalemia can lead to life-threatening cardiac
arrhythmias. Initiating telemetry monitoring is the highest priority
, to assess heart function and monitor for changes. IM KCl is never
given; it is irritant and causes tissue necrosis. Education and neuro
checks are important but not the priority.
5. The nurse is caring for a client with acute renal failure. Which
laboratory result should be reported to the primary healthcare
provider immediately?
A. Blood urea nitrogen 20 mg/dL
B. Serum potassium 6 mEq/L
C. Venous blood pH 7.30
D. Hemoglobin of 10.3 g/dL
Answer: B. Serum potassium 6 mEq/L
Rationale: Acute renal failure causes imbalances. Although all are
abnormal, elevated potassium (6 mEq/L) is life-threatening and can
cause cardiac arrest. Normal potassium is 3.5-5.0 mEq/L. BUN 20 is
slightly elevated, pH 7.30 is mild acidosis, and hemoglobin 10.3 is
low but not immediately life-threatening.
6. The nurse cares for a client with a sodium of 130 mEq/L (normal
135-145 mEq/L). Which medications may cause this abnormality?
Select all that apply.
A. Spironolactone
B. Hydrochlorothiazide
C. Prednisone
D. Sodium polystyrene
E. Tolvaptan
Answer: B, C, E (Hydrochlorothiazide, Prednisone, Tolvaptan)
Rationale: Hyponatremia (sodium 130) can be caused by thiazide
diuretics (hydrochlorothiazide), corticosteroids (prednisone) which
cause fluid retention diluting sodium, and tolvaptan which
, promotes water excretion but can lead to electrolyte shifts.
Spironolactone is potassium-sparing and sodium polystyrene treats
hyperkalemia.
7. A client is receiving a blood transfusion and reports chills, low
back pain, and difficulty breathing. What is the nurse’s priority
action?
A. Slow the infusion rate
B. Administer diphenhydramine
C. Stop the transfusion immediately
D. Notify the blood bank
Answer: C. Stop the transfusion immediately
Rationale: These symptoms indicate a possible acute hemolytic
transfusion reaction. The priority is to stop the transfusion
immediately to prevent further harm, then maintain IV access with
normal saline, notify the provider, and send the blood bag and
tubing to the blood bank.
8. Which client should the LPN/VN assign to the nursing assistant
(UAP) for morning care?
A. Client with newly placed chest tube
B. Client with continuous bladder irrigation
C. Client who is ambulatory and stable
D. Client receiving IV heparin infusion
Answer: C. Client who is ambulatory and stable
Rationale: The UAP can provide morning care and assist with
activities of daily living for stable, ambulatory clients. Clients with
chest tubes, continuous bladder irrigation, or IV heparin require
skilled nursing assessment and interventions and should not be
delegated to UAP.
WITH VERIFIED ANSWERS AND DETAILED RATIONALES
1. A nurse is caring for a client with cardiac arrest and assisting the
registered nurse (RN) in identifying priorities and delegation. As
the LPN/VN assists with assigning roles to other staff, this is
demonstrating which leadership style?
A. Authoritative
B. Situational
C. Democratic
D. Laissez-faire
Answer: A. Authoritative
Rationale: Authoritative leadership is demonstrated in this
situation as the nurse assists with delegation and provides
directives to accomplish tasks. This is an appropriate leadership
style in an emergency where one individual assigns tasks/roles to
decrease confusion and chaos in an emergent situation.
2. What is the normal level of creatinine in a healthy adult male?
A. 0.4 to 0.8 mg/dL
B. 0.1 to 0.4 mg/dL
C. 0.6 to 1.2 mg/dL
D. 1.5 to 2.0 mg/dL
Answer: C. 0.6 to 1.2 mg/dL
Rationale: Creatinine values reflect both the amount of muscle a
person has and their amount of kidney function. Most men with
, normal kidney function have 0.6 to 1.2 mg/dL of creatinine. Most
women have between 0.5 to 1.1 mg/dL due to lesser muscle mass.
3. The nurse is caring for a client who has a serum calcium level of
13.2 mg/dL (normal 9-10.5 mg/dL). Which of the following
medications would be expected orders for this condition? Select
all that apply.
A. Phosphorus
B. Calcitonin
C. Vitamin D
D. IV calcium gluconate
E. Glucocorticoids
Answer: A, B, E (Phosphorus, Calcitonin, Glucocorticoids)
Rationale: This client has hypercalcemia. Phosphorus and calcium
have an inverse relationship, so phosphorus decreases calcium.
Calcitonin inhibits bone resorption and lowers serum calcium.
Glucocorticoids treat hypercalcemia associated with cancers by
inhibiting bone breakdown. Vitamin D and IV calcium gluconate
would increase calcium and are contraindicated.
4. The nurse is reviewing labs for a patient with a serum potassium
level of 3.3 mEq/L (normal 3.5-5.0 mEq/L). Which action would
the nurse recognize as the highest priority?
A. Educate the patient on potassium-rich foods
B. Implement telemetry monitoring
C. Obtain an order for STAT IM KCl
D. Assess the patient’s neurological status
Answer: B. Implement telemetry monitoring
Rationale: Hypokalemia can lead to life-threatening cardiac
arrhythmias. Initiating telemetry monitoring is the highest priority
, to assess heart function and monitor for changes. IM KCl is never
given; it is irritant and causes tissue necrosis. Education and neuro
checks are important but not the priority.
5. The nurse is caring for a client with acute renal failure. Which
laboratory result should be reported to the primary healthcare
provider immediately?
A. Blood urea nitrogen 20 mg/dL
B. Serum potassium 6 mEq/L
C. Venous blood pH 7.30
D. Hemoglobin of 10.3 g/dL
Answer: B. Serum potassium 6 mEq/L
Rationale: Acute renal failure causes imbalances. Although all are
abnormal, elevated potassium (6 mEq/L) is life-threatening and can
cause cardiac arrest. Normal potassium is 3.5-5.0 mEq/L. BUN 20 is
slightly elevated, pH 7.30 is mild acidosis, and hemoglobin 10.3 is
low but not immediately life-threatening.
6. The nurse cares for a client with a sodium of 130 mEq/L (normal
135-145 mEq/L). Which medications may cause this abnormality?
Select all that apply.
A. Spironolactone
B. Hydrochlorothiazide
C. Prednisone
D. Sodium polystyrene
E. Tolvaptan
Answer: B, C, E (Hydrochlorothiazide, Prednisone, Tolvaptan)
Rationale: Hyponatremia (sodium 130) can be caused by thiazide
diuretics (hydrochlorothiazide), corticosteroids (prednisone) which
cause fluid retention diluting sodium, and tolvaptan which
, promotes water excretion but can lead to electrolyte shifts.
Spironolactone is potassium-sparing and sodium polystyrene treats
hyperkalemia.
7. A client is receiving a blood transfusion and reports chills, low
back pain, and difficulty breathing. What is the nurse’s priority
action?
A. Slow the infusion rate
B. Administer diphenhydramine
C. Stop the transfusion immediately
D. Notify the blood bank
Answer: C. Stop the transfusion immediately
Rationale: These symptoms indicate a possible acute hemolytic
transfusion reaction. The priority is to stop the transfusion
immediately to prevent further harm, then maintain IV access with
normal saline, notify the provider, and send the blood bag and
tubing to the blood bank.
8. Which client should the LPN/VN assign to the nursing assistant
(UAP) for morning care?
A. Client with newly placed chest tube
B. Client with continuous bladder irrigation
C. Client who is ambulatory and stable
D. Client receiving IV heparin infusion
Answer: C. Client who is ambulatory and stable
Rationale: The UAP can provide morning care and assist with
activities of daily living for stable, ambulatory clients. Clients with
chest tubes, continuous bladder irrigation, or IV heparin require
skilled nursing assessment and interventions and should not be
delegated to UAP.
