Illinois NCLEX RN Nursing Licensure
Exam Practice Questions And Correct
Answers (Verified
1. A patient with advanced heart failure is prescribed sacubitril/valsartan. Which
concurrent medication requires immediate clarification because of a potentially fatal
interaction?
A. Spironolactone
B. Lisinopril
C. Metoprolol succinate
D. Furosemide
Answer: B. Lisinopril
Rationale: Sacubitril/valsartan and ACE inhibitors (e.g., lisinopril) both increase
bradykinin, causing additive angioedema risk; a 36-hour washout is required.
Spironolactone, metoprolol, and furosemide are commonly used concurrently without this
specific contraindication.
2. Which assessment finding best differentiates autonomic dysreflexia from a panic
attack in a patient with a T6 spinal cord injury?
A. Sudden onset of severe anxiety
B. Hypertension with bradycardia
C. Tachycardia with hypotension
D. Diaphoresis above the level of injury
Answer: B. Hypertension with bradycardia
Rationale: Autonomic dysreflexia classically presents with hypertension and reflex
bradycardia, unlike panic attack which typically causes tachycardia. Diaphoresis above the
injury is also seen in dysreflexia but is not as specific as the hemodynamic pattern.
Page 1 of 72
,3. A patient on mechanical ventilation has an arterial blood gas: pH 7.28, PaCO2 58
mm Hg, HCO3- 26 mEq/L. Which action should the nurse anticipate?
A. Increase the respiratory rate
B. Administer sodium bicarbonate
C. Decrease the tidal volume
D. Increase the inspiratory time
Answer: A. Increase the respiratory rate
Rationale: This ABG indicates acute respiratory acidosis (elevated PaCO2, low pH, normal
HCO3-). Increasing the respiratory rate enhances CO2 elimination. Sodium bicarbonate is
not indicated for respiratory acidosis unless severe, and decreasing tidal volume or
increasing inspiratory time would worsen CO2 retention.
4. A patient with a new ileostomy has a serum potassium of 3.1 mEq/L. Which
assessment finding is most consistent with this value?
A. Muscle weakness and U waves on ECG
B. Peaked T waves and hypertension
C. Hyperreflexia and tetany
D. Bradycardia and constipation
Answer: A. Muscle weakness and U waves on ECG
Rationale: Hypokalemia (K+ <3.5) causes muscle weakness, fatigue, and ECG changes
including U waves and flattened T waves. Peaked T waves and hypertension suggest
hyperkalemia; hyperreflexia and tetany are associated with hypocalcemia; bradycardia
and constipation are not typical of hypokalemia.
Page 2 of 72
,5. A patient with major depressive disorder is started on phenelzine. Which dietary
choice indicates a need for further teaching?
A. Grilled salmon with steamed broccoli
B. Aged cheddar cheese and red wine
C. Fresh fruit salad with yogurt
D. Whole grain toast with peanut butter
Answer: B. Aged cheddar cheese and red wine
Rationale: Phenelzine is an MAOI; tyramine-rich foods like aged cheese and red wine can
precipitate a hypertensive crisis. The other options are low in tyramine and safe.
6. Which nursing action best demonstrates the ethical principle of veracity when a
patient asks about a terminal diagnosis?
A. Withholding the diagnosis to prevent emotional harm
B. Telling the patient the diagnosis is uncertain
C. Providing truthful information in a compassionate manner
D. Deferring all questions to the family
Answer: C. Providing truthful information in a compassionate manner
Rationale: Veracity is the duty to tell the truth. Providing truthful information
compassionately respects patient autonomy. Withholding, misleading, or deferring to
family violates this principle.
Page 3 of 72
, 7. A patient in the emergency department has a core temperature of 41.2°C (106.2°F)
after exertional heat stroke. Which intervention is the priority?
A. Administer acetaminophen
B. Apply ice packs to the groin and axillae
C. Initiate rapid evaporative cooling
D. Start a cool IV fluid bolus
Answer: C. Initiate rapid evaporative cooling
Rationale: Rapid evaporative cooling (e.g., misting and fans) is the most effective method
for heat stroke. Antipyretics are ineffective for non-pyrogenic hyperthermia. Ice packs and
cool IV fluids are adjuncts but not the priority.
8. A patient with preeclampsia is receiving magnesium sulfate. Which finding
indicates magnesium toxicity and requires immediate intervention?
A. Respiratory rate of 10 breaths/min
B. Blood pressure 140/90 mm Hg
C. Deep tendon reflexes 2+
D. Urine output 40 mL/hr
Answer: A. Respiratory rate of 10 breaths/min
Rationale: Magnesium toxicity manifests as respiratory depression (RR <12), loss of deep
tendon reflexes, and oliguria. A respiratory rate of 10 is a critical sign. The other findings
are not indicative of toxicity.
Page 4 of 72
Exam Practice Questions And Correct
Answers (Verified
1. A patient with advanced heart failure is prescribed sacubitril/valsartan. Which
concurrent medication requires immediate clarification because of a potentially fatal
interaction?
A. Spironolactone
B. Lisinopril
C. Metoprolol succinate
D. Furosemide
Answer: B. Lisinopril
Rationale: Sacubitril/valsartan and ACE inhibitors (e.g., lisinopril) both increase
bradykinin, causing additive angioedema risk; a 36-hour washout is required.
Spironolactone, metoprolol, and furosemide are commonly used concurrently without this
specific contraindication.
2. Which assessment finding best differentiates autonomic dysreflexia from a panic
attack in a patient with a T6 spinal cord injury?
A. Sudden onset of severe anxiety
B. Hypertension with bradycardia
C. Tachycardia with hypotension
D. Diaphoresis above the level of injury
Answer: B. Hypertension with bradycardia
Rationale: Autonomic dysreflexia classically presents with hypertension and reflex
bradycardia, unlike panic attack which typically causes tachycardia. Diaphoresis above the
injury is also seen in dysreflexia but is not as specific as the hemodynamic pattern.
Page 1 of 72
,3. A patient on mechanical ventilation has an arterial blood gas: pH 7.28, PaCO2 58
mm Hg, HCO3- 26 mEq/L. Which action should the nurse anticipate?
A. Increase the respiratory rate
B. Administer sodium bicarbonate
C. Decrease the tidal volume
D. Increase the inspiratory time
Answer: A. Increase the respiratory rate
Rationale: This ABG indicates acute respiratory acidosis (elevated PaCO2, low pH, normal
HCO3-). Increasing the respiratory rate enhances CO2 elimination. Sodium bicarbonate is
not indicated for respiratory acidosis unless severe, and decreasing tidal volume or
increasing inspiratory time would worsen CO2 retention.
4. A patient with a new ileostomy has a serum potassium of 3.1 mEq/L. Which
assessment finding is most consistent with this value?
A. Muscle weakness and U waves on ECG
B. Peaked T waves and hypertension
C. Hyperreflexia and tetany
D. Bradycardia and constipation
Answer: A. Muscle weakness and U waves on ECG
Rationale: Hypokalemia (K+ <3.5) causes muscle weakness, fatigue, and ECG changes
including U waves and flattened T waves. Peaked T waves and hypertension suggest
hyperkalemia; hyperreflexia and tetany are associated with hypocalcemia; bradycardia
and constipation are not typical of hypokalemia.
Page 2 of 72
,5. A patient with major depressive disorder is started on phenelzine. Which dietary
choice indicates a need for further teaching?
A. Grilled salmon with steamed broccoli
B. Aged cheddar cheese and red wine
C. Fresh fruit salad with yogurt
D. Whole grain toast with peanut butter
Answer: B. Aged cheddar cheese and red wine
Rationale: Phenelzine is an MAOI; tyramine-rich foods like aged cheese and red wine can
precipitate a hypertensive crisis. The other options are low in tyramine and safe.
6. Which nursing action best demonstrates the ethical principle of veracity when a
patient asks about a terminal diagnosis?
A. Withholding the diagnosis to prevent emotional harm
B. Telling the patient the diagnosis is uncertain
C. Providing truthful information in a compassionate manner
D. Deferring all questions to the family
Answer: C. Providing truthful information in a compassionate manner
Rationale: Veracity is the duty to tell the truth. Providing truthful information
compassionately respects patient autonomy. Withholding, misleading, or deferring to
family violates this principle.
Page 3 of 72
, 7. A patient in the emergency department has a core temperature of 41.2°C (106.2°F)
after exertional heat stroke. Which intervention is the priority?
A. Administer acetaminophen
B. Apply ice packs to the groin and axillae
C. Initiate rapid evaporative cooling
D. Start a cool IV fluid bolus
Answer: C. Initiate rapid evaporative cooling
Rationale: Rapid evaporative cooling (e.g., misting and fans) is the most effective method
for heat stroke. Antipyretics are ineffective for non-pyrogenic hyperthermia. Ice packs and
cool IV fluids are adjuncts but not the priority.
8. A patient with preeclampsia is receiving magnesium sulfate. Which finding
indicates magnesium toxicity and requires immediate intervention?
A. Respiratory rate of 10 breaths/min
B. Blood pressure 140/90 mm Hg
C. Deep tendon reflexes 2+
D. Urine output 40 mL/hr
Answer: A. Respiratory rate of 10 breaths/min
Rationale: Magnesium toxicity manifests as respiratory depression (RR <12), loss of deep
tendon reflexes, and oliguria. A respiratory rate of 10 is a critical sign. The other findings
are not indicative of toxicity.
Page 4 of 72
