KAPLAN DIAGNOSTIC NCLEX-RN
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A nurse is caring for a client who is 24 hours post-thyroidectomy. The client reports tingling
in the fingers and around the mouth. Which action should the nurse take first?
A. Administer a prescribed analgesic.
B. Check the client’s potassium level.
C. Assess for Chvostek’s sign.
D. Encourage the client to use an incentive spirometer.
Answer: C
Conceptual Explanation: Tingling around the mouth and in the fingers is a sign of
hypocalcemia, a potential complication of thyroidectomy due to accidental parathyroid
gland removal. Assessing for Chvostek’s sign helps confirm neuromuscular irritability
associated with low calcium.
,2. A client with a history of heart failure is prescribed digoxin. Which of the following
laboratory results should the nurse report to the healthcare provider immediately?
A. Sodium level of 138 mEq/L
B. Potassium level of 3.2 mEq/L
C. Digoxin level of 1.2 ng/mL
D. Calcium level of 9.5 mg/dL
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity, even if the digoxin level is within the therapeutic range (0.5-2.0
ng/mL).
3. The nurse is assessing a client with Cushing’s syndrome. Which clinical manifestation
should the nurse expect to find?
A. Trunkal obesity and a ‘buffalo hump’
B. Hyperkalemia and hyponatremia
C. Weight loss and hypotension
D. Increased skin pigmentation and hypoglycemia
Answer: A
Conceptual Explanation: Cushing’s syndrome is caused by excess cortisol, leading to
characteristic fat redistribution such as trunkal obesity, buffalo hump, and moon face.
, 4. A nurse is preparing to administer a blood transfusion. Which IV fluid is the only one
compatible for administration with blood products?
A. Lactated Ringer’s
B. 0.9% Sodium Chloride
C. Dextrose 5% in Water
D. 0.45% Sodium Chloride
Answer: B
Conceptual Explanation: 0.9% Sodium Chloride (Normal Saline) is the only fluid
compatible with blood. Other solutions can cause hemolysis or clotting of the blood
product.
5. A client is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which nursing intervention is most appropriate?
A. Encourage increased fluid intake.
B. Administer intravenous 0.45% sodium chloride.
C. Restrict oral fluid intake to 800-1000 mL per day.
D. Monitor for signs of hypernatremia.
Answer: C
COMPREHENSIVE PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A nurse is caring for a client who is 24 hours post-thyroidectomy. The client reports tingling
in the fingers and around the mouth. Which action should the nurse take first?
A. Administer a prescribed analgesic.
B. Check the client’s potassium level.
C. Assess for Chvostek’s sign.
D. Encourage the client to use an incentive spirometer.
Answer: C
Conceptual Explanation: Tingling around the mouth and in the fingers is a sign of
hypocalcemia, a potential complication of thyroidectomy due to accidental parathyroid
gland removal. Assessing for Chvostek’s sign helps confirm neuromuscular irritability
associated with low calcium.
,2. A client with a history of heart failure is prescribed digoxin. Which of the following
laboratory results should the nurse report to the healthcare provider immediately?
A. Sodium level of 138 mEq/L
B. Potassium level of 3.2 mEq/L
C. Digoxin level of 1.2 ng/mL
D. Calcium level of 9.5 mg/dL
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity, even if the digoxin level is within the therapeutic range (0.5-2.0
ng/mL).
3. The nurse is assessing a client with Cushing’s syndrome. Which clinical manifestation
should the nurse expect to find?
A. Trunkal obesity and a ‘buffalo hump’
B. Hyperkalemia and hyponatremia
C. Weight loss and hypotension
D. Increased skin pigmentation and hypoglycemia
Answer: A
Conceptual Explanation: Cushing’s syndrome is caused by excess cortisol, leading to
characteristic fat redistribution such as trunkal obesity, buffalo hump, and moon face.
, 4. A nurse is preparing to administer a blood transfusion. Which IV fluid is the only one
compatible for administration with blood products?
A. Lactated Ringer’s
B. 0.9% Sodium Chloride
C. Dextrose 5% in Water
D. 0.45% Sodium Chloride
Answer: B
Conceptual Explanation: 0.9% Sodium Chloride (Normal Saline) is the only fluid
compatible with blood. Other solutions can cause hemolysis or clotting of the blood
product.
5. A client is admitted with a diagnosis of Syndrome of Inappropriate Antidiuretic Hormone
(SIADH). Which nursing intervention is most appropriate?
A. Encourage increased fluid intake.
B. Administer intravenous 0.45% sodium chloride.
C. Restrict oral fluid intake to 800-1000 mL per day.
D. Monitor for signs of hypernatremia.
Answer: C
