NCLEX NGN PRE-TEST QUESTIONS AND
ANSWERS 100% CORRECT!!!!
,A nurse is assigned to care for a client with chronic renal failure who is undergoing
hemodialysis through an internal AV fistula in the RA. Which intervention should the
nurse implement in caring for the client? SATA
a. Assessing the radial pulse in the right extremity
b. Using the LA ti take BP readings
c. Drawing pre-dialysis blood specimens from the LA
d. Assessing the area over the AV fistula for a bruit and three each shift
e. Placing a pressure dressing over the site after each dialysis treatment
f. Administering IV fluids through the venous site of the AV fistula as needed - ANSWER
A, B, C, D
A nurse is evaluating outcomes for a client with Guillain-Barre syndrome. Which
outcome does the nurse recognize as optimal respiratory outcomes for the client?
a. Normal deep tendon reflexes
b. Improved skeletal muscle tone
c. Absences of paresthesias in the lower extremities
d. Clear sound in the lower lung fields bilaterally
e. pO2 of 85 mmHg and pCO2 of 40 mmHg - ANSWER D, E
A nurse of the telemetry unit is caring for a client who has had a MI and is now attached
to a cardiac monitor. The nurse is monitoring the client's cardiac rhythm and nots
ventricular fibrillation. Which nursing intervention should the nurse take first?
a. Calling the rapid response team
b. Preparing the client for cardioversion
c. Asking the client to bear down and cough
d. Preparing to administer diltiazem - ANSWER A
The pattern of ventricular fibrillation is identified and can be a result after a patient with
an MI. VF makes the patient feel faint, then loses consciousness and becomes
pulseless and apneic (BP and heart sounds absent). Treatment is to terminate VF and
covert it into a rhythm via defibrillation-> call a rapid and initiate CPR. Cardioversion is
used for ventricular or supraventricular tachydysrhythmias.
A nurse developing a plan of care for a client with a spinal cord injury includes
measures to prevent autonomic dysreflexia (hyperreflexia). Which intervention does the
nurse incorporate into the plan to prevent this complication?
a. Keeping the fan running in the client's room
b. Keeping the linens wrinkle free under the client
c. Limiting bladder catheterization to once every 12 hours
d. Avoiding the administration of enemas and rectal suppositories - ANSWER B
, The most frequent cause of autonomic dysreflexias are a distended bladder and
impacted feces. Other causes include stimulation of the skin by tactile, thermal, or
painful stimuli. The nurse renders care in such a way as to minimize these risks.
A nurse is caring for a client who has just undergone cardioversion. Which intervention
is the nurse's priority after this procedure.
a. Administer oxygen
b. Monitoring the BP
c. Administering antidysrhythmic medications
d. Monitoring the client's LOC - ANSWER A
ABC's of nursing. All other choices are correct, but not priority.
A client with diabetes mellitus who is scheduled to have blood drawn for determination
of the glycosylated hemoglobin (HbA1c) level asks the nurse why the test is necessary
if he is performing blood glucose monitoring at home. Which is the best response for the
nurse to provide?
a. Detect diabetic complications
b. Assess long-term glycemic control
c. Determine whether the client is at risk for hypoglycemia
d Determine whether the prescribed insulin dosage is correct - ANSWER B
A nurse caring for a client with acquired immunodeficiency syndrome is monitoring the
client for signs of complications. Which of the following would cause the nurse to
suspect infection with Pneumocystis jirovec? SATA
a. Diarrhea
b. Tachypnea
c. Pedal edema
d. Intermittent fever
e. Dyspnea with ambulating
f. Expectoration of frothy mucus - ANSWER B, D, E
A opportunistic respiratory infection associated with AIDs that causes dyspnea,
nonproductive cough, intermittent fever, fatigue, anorexia, tachypnea, wt. loss.
Zidovudine is prescribed for a client with AIDS. The nurse tells the client that it is
important to report back to the clinic as scheduled for which follow-up diagnostic?
a. Blood glucose checks
b. Blood pressure checks
c. Complete blood counts (CBC)
d. Electrocradiographic studies - ANSWER C
Zidovudine is an antiviral medication that cause cause agranulocytosis and anemia.
ANSWERS 100% CORRECT!!!!
,A nurse is assigned to care for a client with chronic renal failure who is undergoing
hemodialysis through an internal AV fistula in the RA. Which intervention should the
nurse implement in caring for the client? SATA
a. Assessing the radial pulse in the right extremity
b. Using the LA ti take BP readings
c. Drawing pre-dialysis blood specimens from the LA
d. Assessing the area over the AV fistula for a bruit and three each shift
e. Placing a pressure dressing over the site after each dialysis treatment
f. Administering IV fluids through the venous site of the AV fistula as needed - ANSWER
A, B, C, D
A nurse is evaluating outcomes for a client with Guillain-Barre syndrome. Which
outcome does the nurse recognize as optimal respiratory outcomes for the client?
a. Normal deep tendon reflexes
b. Improved skeletal muscle tone
c. Absences of paresthesias in the lower extremities
d. Clear sound in the lower lung fields bilaterally
e. pO2 of 85 mmHg and pCO2 of 40 mmHg - ANSWER D, E
A nurse of the telemetry unit is caring for a client who has had a MI and is now attached
to a cardiac monitor. The nurse is monitoring the client's cardiac rhythm and nots
ventricular fibrillation. Which nursing intervention should the nurse take first?
a. Calling the rapid response team
b. Preparing the client for cardioversion
c. Asking the client to bear down and cough
d. Preparing to administer diltiazem - ANSWER A
The pattern of ventricular fibrillation is identified and can be a result after a patient with
an MI. VF makes the patient feel faint, then loses consciousness and becomes
pulseless and apneic (BP and heart sounds absent). Treatment is to terminate VF and
covert it into a rhythm via defibrillation-> call a rapid and initiate CPR. Cardioversion is
used for ventricular or supraventricular tachydysrhythmias.
A nurse developing a plan of care for a client with a spinal cord injury includes
measures to prevent autonomic dysreflexia (hyperreflexia). Which intervention does the
nurse incorporate into the plan to prevent this complication?
a. Keeping the fan running in the client's room
b. Keeping the linens wrinkle free under the client
c. Limiting bladder catheterization to once every 12 hours
d. Avoiding the administration of enemas and rectal suppositories - ANSWER B
, The most frequent cause of autonomic dysreflexias are a distended bladder and
impacted feces. Other causes include stimulation of the skin by tactile, thermal, or
painful stimuli. The nurse renders care in such a way as to minimize these risks.
A nurse is caring for a client who has just undergone cardioversion. Which intervention
is the nurse's priority after this procedure.
a. Administer oxygen
b. Monitoring the BP
c. Administering antidysrhythmic medications
d. Monitoring the client's LOC - ANSWER A
ABC's of nursing. All other choices are correct, but not priority.
A client with diabetes mellitus who is scheduled to have blood drawn for determination
of the glycosylated hemoglobin (HbA1c) level asks the nurse why the test is necessary
if he is performing blood glucose monitoring at home. Which is the best response for the
nurse to provide?
a. Detect diabetic complications
b. Assess long-term glycemic control
c. Determine whether the client is at risk for hypoglycemia
d Determine whether the prescribed insulin dosage is correct - ANSWER B
A nurse caring for a client with acquired immunodeficiency syndrome is monitoring the
client for signs of complications. Which of the following would cause the nurse to
suspect infection with Pneumocystis jirovec? SATA
a. Diarrhea
b. Tachypnea
c. Pedal edema
d. Intermittent fever
e. Dyspnea with ambulating
f. Expectoration of frothy mucus - ANSWER B, D, E
A opportunistic respiratory infection associated with AIDs that causes dyspnea,
nonproductive cough, intermittent fever, fatigue, anorexia, tachypnea, wt. loss.
Zidovudine is prescribed for a client with AIDS. The nurse tells the client that it is
important to report back to the clinic as scheduled for which follow-up diagnostic?
a. Blood glucose checks
b. Blood pressure checks
c. Complete blood counts (CBC)
d. Electrocradiographic studies - ANSWER C
Zidovudine is an antiviral medication that cause cause agranulocytosis and anemia.
