Comprehensive NCLEX-RN Nursing Practice Exam 1
With Complete Solutions Merged. Well elaborated,
updated, and Detailed Answers
1. Question
Category: Reduction of Risk Potential
During a community health assessment at a local school’s parent-teacher conference, the nurse
encounters several parents and caregivers. Based on their shared histories and lifestyles, the nurse
determines the risk factors for hypertension among them. Which of the following individuals is at
the HIGHEST risk for developing hypertension?
• A. A 45-year-old African-American attorney with a family history of hypertension, who has a
sedentary lifestyle, consumes a diet high in sodium, and recently had a significant weight gain.
• B. A 60-year-old Asian-American shop owner with a BMI of 28, who has well-managed type 2
diabetes, takes medications for high cholesterol, and engages in regular physical activity.
• C. A 40-year-old Caucasian nurse who is a vegetarian, has a healthy BMI, is a non-smoker but
reports high levels of work-related stress and consumes excessive amounts of caffeine.
• D. A 55-year-old Hispanic teacher who smokes occasionally, has a healthy BMI, participates in a
moderate-intensity exercise program, and recently started taking oral contraceptives.
• E. A 50-year-old Middle Eastern engineer with a BMI of 26, who has a family history of
cardiovascular diseases, does not engage in any form of exercise, and has recently been
diagnosed with obstructive sleep apnea.
• F. A 52-year-old Native American artist with a family history of kidney disease, who smokes a
pack of cigarettes daily, drinks alcohol excessively, and reports infrequent physical activity.
• G. A 43-year-old European baker who has a BMI of 30, often deals with job-related stress,
consumes a diet rich in pastries and sweets, and has a sedentary lifestyle due to long work
hours.
Correct Answer: A. A 45-year-old African-American attorney with a family history of hypertension,
who has a sedentary lifestyle and consumes a diet high in sodium.
African-American adults have a higher prevalence of hypertension compared to other racial and ethnic
groups in the United States. This individual also has a family history of hypertension, a sedentary
lifestyle, and a diet high in sodium, which are all risk factors for hypertension. Therefore, this individual is
at the greatest risk for developing hypertension among the given choices.
2. Question
,Category: Pharmacological and Parenteral Therapies
A 15-year-old female with a history of depression is brought to the emergency department.
Nurse’s Notes:
1115: A 15-year-old female with a history of depression and recent relationship troubles with her close
friends is brought to the emergency department by her concerned parents after they found an empty
bottle of maximum-strength acetaminophen in her room. Upon questioning, the patient tearfully admits
to ingesting 15 tablets of the medication 45 minutes ago. She is visibly anxious and frequently looks at
the marks on her wrists, which seem to be superficial scratches.
Vital signs as of 1115:
• Blood pressure: 120/70
• Heart rate: 88 bpm
• Respiratory rate: 18 bpm
• Oxygen saturation: 98% on room air
As the nurse prepares to address the situation, several orders from the primary care provider come in.
Which of the following orders should the nurse prioritize and carry out first?
• A. Perform gastric lavage
• B. Administer acetylcysteine (Mucomyst) orally
• C. Start an IV with Dextrose 5% and 0.33% normal saline
• D. Have the patient drink activated charcoal mixed with water
• E. Conduct a psychiatric evaluation.
• F. Apply wrist restraints to prevent further self-harm.
Correct Answer: B. Administer acetylcysteine (Mucomyst) orally
Although gastric lavage can help remove any remaining acetaminophen from the stomach, it is not the
priority intervention in this situation. Administering the antidote, acetylcysteine (Mucomyst), should be
the primary focus to counteract the toxic effects of acetaminophen on the liver. Acetylcysteine is the
antidote for acetaminophen toxicity and should be administered as soon as possible to maximize its
effectiveness in preventing liver damage.
3. Question
Category: Management of Care
A 68-year-old male with a history of hypertension and diabetes has undergone a cardiac catheterization
to evaluate potential coronary artery disease. He has a known allergy to iodine-based contrast agents,
which required premedication with corticosteroids and antihistamines. The procedure was successful,
but the patient experienced brief hypotension during the administration of the contrast material. The
patient has been transferred to the cardiac step-down unit for observation, and the nurse is aware of the
, potential complications that can arise in the initial 24 hours post-procedure. Which complication should
the nurse monitor closely during this period?
• A. Persistent angina despite being at rest and receiving nitroglycerin
• B. Thrombus formation leading to decreased peripheral pulses and cyanosis
• C. Dizziness accompanied by a sudden drop in blood pressure when standing
• D. Gradual decrease in blood pressure with no other symptoms
Correct Answer: B. Thrombus formation
In the initial 24 hours after a cardiac catheterization, the nurse should closely monitor for thrombus
formation. Thrombus formation at the catheterization site can lead to serious complications, such as
decreased blood flow to the extremities or embolization to other parts of the body. While the other
options (angina at rest, dizziness, and falling blood pressure) can be potential concerns, thrombus
formation is the most critical complication to monitor for during the immediate post-procedure period.
4. Question
Category: Basic Care and Comfort
A 43-year-old male with a history of recurrent renal calculi is admitted to the emergency department
presenting with severe left flank pain radiating to the groin, nausea, and an episode of vomiting. He also
reports burning and urgency during urination. His vital signs reveal a temperature of 100.8ºF (38.2ºC),
blood pressure of 145/90 mmHg, pulse of 100 beats/min, and respiratory rate of 20 breaths/min. The
client is visibly anxious and uncomfortable due to the severity of the pain. The nurse is assigned to care
for the patient and must prioritize the nursing goals to ensure optimal care. Which nursing goal should
be the top priority for this client?
• A. Maintain fluid and electrolyte balance
• B. Control nausea
• C. Manage pain
• D. Prevent urinary tract infection
Correct Answer: C. Manage pain
Managing pain is always a priority because it ultimately improves the quality of life. The cornerstone of
ureteral colic management is analgesia, which can be achieved most expediently with parenteral
narcotics or nonsteroidal anti-inflammatory drugs (NSAIDs).
5. Question
Category: Health Promotion and Maintenance
During a school screening program for children aged 6-12, a nurse is tasked with evaluating their growth
parameters. She encounters a 9-year-old girl who is shorter than her peers and seems to have less
With Complete Solutions Merged. Well elaborated,
updated, and Detailed Answers
1. Question
Category: Reduction of Risk Potential
During a community health assessment at a local school’s parent-teacher conference, the nurse
encounters several parents and caregivers. Based on their shared histories and lifestyles, the nurse
determines the risk factors for hypertension among them. Which of the following individuals is at
the HIGHEST risk for developing hypertension?
• A. A 45-year-old African-American attorney with a family history of hypertension, who has a
sedentary lifestyle, consumes a diet high in sodium, and recently had a significant weight gain.
• B. A 60-year-old Asian-American shop owner with a BMI of 28, who has well-managed type 2
diabetes, takes medications for high cholesterol, and engages in regular physical activity.
• C. A 40-year-old Caucasian nurse who is a vegetarian, has a healthy BMI, is a non-smoker but
reports high levels of work-related stress and consumes excessive amounts of caffeine.
• D. A 55-year-old Hispanic teacher who smokes occasionally, has a healthy BMI, participates in a
moderate-intensity exercise program, and recently started taking oral contraceptives.
• E. A 50-year-old Middle Eastern engineer with a BMI of 26, who has a family history of
cardiovascular diseases, does not engage in any form of exercise, and has recently been
diagnosed with obstructive sleep apnea.
• F. A 52-year-old Native American artist with a family history of kidney disease, who smokes a
pack of cigarettes daily, drinks alcohol excessively, and reports infrequent physical activity.
• G. A 43-year-old European baker who has a BMI of 30, often deals with job-related stress,
consumes a diet rich in pastries and sweets, and has a sedentary lifestyle due to long work
hours.
Correct Answer: A. A 45-year-old African-American attorney with a family history of hypertension,
who has a sedentary lifestyle and consumes a diet high in sodium.
African-American adults have a higher prevalence of hypertension compared to other racial and ethnic
groups in the United States. This individual also has a family history of hypertension, a sedentary
lifestyle, and a diet high in sodium, which are all risk factors for hypertension. Therefore, this individual is
at the greatest risk for developing hypertension among the given choices.
2. Question
,Category: Pharmacological and Parenteral Therapies
A 15-year-old female with a history of depression is brought to the emergency department.
Nurse’s Notes:
1115: A 15-year-old female with a history of depression and recent relationship troubles with her close
friends is brought to the emergency department by her concerned parents after they found an empty
bottle of maximum-strength acetaminophen in her room. Upon questioning, the patient tearfully admits
to ingesting 15 tablets of the medication 45 minutes ago. She is visibly anxious and frequently looks at
the marks on her wrists, which seem to be superficial scratches.
Vital signs as of 1115:
• Blood pressure: 120/70
• Heart rate: 88 bpm
• Respiratory rate: 18 bpm
• Oxygen saturation: 98% on room air
As the nurse prepares to address the situation, several orders from the primary care provider come in.
Which of the following orders should the nurse prioritize and carry out first?
• A. Perform gastric lavage
• B. Administer acetylcysteine (Mucomyst) orally
• C. Start an IV with Dextrose 5% and 0.33% normal saline
• D. Have the patient drink activated charcoal mixed with water
• E. Conduct a psychiatric evaluation.
• F. Apply wrist restraints to prevent further self-harm.
Correct Answer: B. Administer acetylcysteine (Mucomyst) orally
Although gastric lavage can help remove any remaining acetaminophen from the stomach, it is not the
priority intervention in this situation. Administering the antidote, acetylcysteine (Mucomyst), should be
the primary focus to counteract the toxic effects of acetaminophen on the liver. Acetylcysteine is the
antidote for acetaminophen toxicity and should be administered as soon as possible to maximize its
effectiveness in preventing liver damage.
3. Question
Category: Management of Care
A 68-year-old male with a history of hypertension and diabetes has undergone a cardiac catheterization
to evaluate potential coronary artery disease. He has a known allergy to iodine-based contrast agents,
which required premedication with corticosteroids and antihistamines. The procedure was successful,
but the patient experienced brief hypotension during the administration of the contrast material. The
patient has been transferred to the cardiac step-down unit for observation, and the nurse is aware of the
, potential complications that can arise in the initial 24 hours post-procedure. Which complication should
the nurse monitor closely during this period?
• A. Persistent angina despite being at rest and receiving nitroglycerin
• B. Thrombus formation leading to decreased peripheral pulses and cyanosis
• C. Dizziness accompanied by a sudden drop in blood pressure when standing
• D. Gradual decrease in blood pressure with no other symptoms
Correct Answer: B. Thrombus formation
In the initial 24 hours after a cardiac catheterization, the nurse should closely monitor for thrombus
formation. Thrombus formation at the catheterization site can lead to serious complications, such as
decreased blood flow to the extremities or embolization to other parts of the body. While the other
options (angina at rest, dizziness, and falling blood pressure) can be potential concerns, thrombus
formation is the most critical complication to monitor for during the immediate post-procedure period.
4. Question
Category: Basic Care and Comfort
A 43-year-old male with a history of recurrent renal calculi is admitted to the emergency department
presenting with severe left flank pain radiating to the groin, nausea, and an episode of vomiting. He also
reports burning and urgency during urination. His vital signs reveal a temperature of 100.8ºF (38.2ºC),
blood pressure of 145/90 mmHg, pulse of 100 beats/min, and respiratory rate of 20 breaths/min. The
client is visibly anxious and uncomfortable due to the severity of the pain. The nurse is assigned to care
for the patient and must prioritize the nursing goals to ensure optimal care. Which nursing goal should
be the top priority for this client?
• A. Maintain fluid and electrolyte balance
• B. Control nausea
• C. Manage pain
• D. Prevent urinary tract infection
Correct Answer: C. Manage pain
Managing pain is always a priority because it ultimately improves the quality of life. The cornerstone of
ureteral colic management is analgesia, which can be achieved most expediently with parenteral
narcotics or nonsteroidal anti-inflammatory drugs (NSAIDs).
5. Question
Category: Health Promotion and Maintenance
During a school screening program for children aged 6-12, a nurse is tasked with evaluating their growth
parameters. She encounters a 9-year-old girl who is shorter than her peers and seems to have less
