NCLEX PN-1
1. A nurse is preparing to administer a medication to a patient. Which of the following actions should
be taken prior to administration? Select all that apply.
• Verify the patient's allergies.
• Check the expiration date of the medication.
• Confirm the patient’s identity with two identifiers.
• Review the patient's lab values.
• Assess for contraindications.
Rationale: Before administering medication, it’s essential to confirm patient identity, check expiration
dates, and assess for contraindications. Lab values are important for specific drugs but aren’t a standard
step for all medications.
2. A client with pneumonia is receiving antibiotics. Which assessment finding should prompt
immediate notification of the healthcare provider?
• Low-grade fever
• Cough producing green sputum
• Increased respiratory rate and difficulty breathing
• Mild fatigue
Rationale: Increased respiratory rate and difficulty breathing indicate worsening respiratory status,
which may signal complications or ineffective treatment.
3. A patient is scheduled to receive 0.4 mg of a medication but the vial contains 0.8 mg/mL. How many
mL should the nurse administer?
• 0.5 mL
• 0.5 mL
• 1 mL
• 0.25 mL
Rationale: Dose calculation formula: (Desired Dose/Stock Dose) x Stock Volume. (0.4 mg/0.8 mg) x 1 mL =
0.5 mL.
,4. A nurse is caring for a patient in labor. Which of the following findings is most concerning?
• Blood pressure of 110/70 mm Hg
• Uterine contractions every 2-3 minutes
• Fetal heart rate of 90 beats per minute
• Patient reports discomfort during contractions
Rationale: A fetal heart rate below 110 bpm is bradycardic and can indicate fetal distress.
5. Which of the following medications requires the nurse to monitor for signs of hypokalemia? Select
all that apply.
• Atenolol
• Furosemide
• Hydrochlorothiazide
• Losartan
• Prednisone
Rationale: Furosemide, hydrochlorothiazide, and prednisone can lead to hypokalemia due to increased
renal excretion or metabolic effects.
6. A patient is prescribed heparin for deep vein thrombosis (DVT). Which laboratory value should the
nurse review before administering the medication?
• aPTT
• INR
• Platelet count
• Hemoglobin level
Rationale: aPTT is used to monitor the therapeutic level of heparin therapy.
7. Calculate the IV flow rate for 1,000 mL of NS to be infused over 8 hours. The IV tubing has a drop
factor of 20 gtt/mL. How many drops per minute should the nurse set the IV to?
• 42 gtt/min
, • 50 gtt/min
• 25 gtt/min
• 60 gtt/min
Rationale: Flow rate = (Volume x Drop Factor) / Time (in minutes). (1000 mL x 20) / (8 x 60) = 42 gtt/min.
8. A patient with chronic kidney disease (CKD) is prescribed erythropoietin. The nurse understands this
medication is intended to:
• Reduce blood pressure
• Increase red blood cell production
• Improve kidney function
• Decrease serum creatinine
Rationale: Erythropoietin is used to stimulate RBC production in patients with anemia secondary to CKD.
9. Which of the following are appropriate interventions for a patient receiving IV potassium? Select all
that apply.
• Monitor for signs of hyperkalemia.
• Administer as a rapid IV push.
• Check the IV site for signs of phlebitis.
• Dilute in normal saline and administer undiluted.
• Monitor ECG changes.
Rationale: IV potassium requires slow infusion, monitoring for hyperkalemia, and ECG monitoring to
prevent complications.
10. A patient is receiving morphine for pain management. Which adverse effect should the nurse
monitor for?
• Diarrhea
• Respiratory depression
• Hypertension
• Increased urine output
, Rationale: Respiratory depression is a serious side effect of opioids like morphine.
11. A nurse is preparing to administer digoxin to a patient with heart failure. Which assessment finding
would prompt the nurse to hold the dose and notify the healthcare provider?
• Apical pulse of 54 beats per minute
• Blood pressure of 110/70 mm Hg
• Mild edema in lower extremities
• Respiratory rate of 18 breaths per minute
Rationale: Digoxin can cause bradycardia. An apical pulse below 60 bpm is a contraindication for
administering the dose.
12. A postpartum client who delivered vaginally is experiencing heavy bleeding. Which of the
following interventions should the nurse prioritize?
• Apply an ice pack to the perineal area.
• Massage the fundus until firm.
• Encourage the patient to empty her bladder.
• Apply warm compresses to the lower abdomen.
Rationale: Fundal massage helps stimulate uterine contractions, which is crucial in reducing postpartum
bleeding.
13. A nurse is calculating the pediatric dose for a medication ordered at 15 mg/kg. The child weighs 20
kg. What is the correct dose?
• 200 mg
• 250 mg
• 300 mg
• 350 mg
Rationale: 15 mg/kg x 20 kg = 300 mg.
14. Which adverse effect should the nurse monitor for in a patient receiving prednisone? Select all that
apply.
1. A nurse is preparing to administer a medication to a patient. Which of the following actions should
be taken prior to administration? Select all that apply.
• Verify the patient's allergies.
• Check the expiration date of the medication.
• Confirm the patient’s identity with two identifiers.
• Review the patient's lab values.
• Assess for contraindications.
Rationale: Before administering medication, it’s essential to confirm patient identity, check expiration
dates, and assess for contraindications. Lab values are important for specific drugs but aren’t a standard
step for all medications.
2. A client with pneumonia is receiving antibiotics. Which assessment finding should prompt
immediate notification of the healthcare provider?
• Low-grade fever
• Cough producing green sputum
• Increased respiratory rate and difficulty breathing
• Mild fatigue
Rationale: Increased respiratory rate and difficulty breathing indicate worsening respiratory status,
which may signal complications or ineffective treatment.
3. A patient is scheduled to receive 0.4 mg of a medication but the vial contains 0.8 mg/mL. How many
mL should the nurse administer?
• 0.5 mL
• 0.5 mL
• 1 mL
• 0.25 mL
Rationale: Dose calculation formula: (Desired Dose/Stock Dose) x Stock Volume. (0.4 mg/0.8 mg) x 1 mL =
0.5 mL.
,4. A nurse is caring for a patient in labor. Which of the following findings is most concerning?
• Blood pressure of 110/70 mm Hg
• Uterine contractions every 2-3 minutes
• Fetal heart rate of 90 beats per minute
• Patient reports discomfort during contractions
Rationale: A fetal heart rate below 110 bpm is bradycardic and can indicate fetal distress.
5. Which of the following medications requires the nurse to monitor for signs of hypokalemia? Select
all that apply.
• Atenolol
• Furosemide
• Hydrochlorothiazide
• Losartan
• Prednisone
Rationale: Furosemide, hydrochlorothiazide, and prednisone can lead to hypokalemia due to increased
renal excretion or metabolic effects.
6. A patient is prescribed heparin for deep vein thrombosis (DVT). Which laboratory value should the
nurse review before administering the medication?
• aPTT
• INR
• Platelet count
• Hemoglobin level
Rationale: aPTT is used to monitor the therapeutic level of heparin therapy.
7. Calculate the IV flow rate for 1,000 mL of NS to be infused over 8 hours. The IV tubing has a drop
factor of 20 gtt/mL. How many drops per minute should the nurse set the IV to?
• 42 gtt/min
, • 50 gtt/min
• 25 gtt/min
• 60 gtt/min
Rationale: Flow rate = (Volume x Drop Factor) / Time (in minutes). (1000 mL x 20) / (8 x 60) = 42 gtt/min.
8. A patient with chronic kidney disease (CKD) is prescribed erythropoietin. The nurse understands this
medication is intended to:
• Reduce blood pressure
• Increase red blood cell production
• Improve kidney function
• Decrease serum creatinine
Rationale: Erythropoietin is used to stimulate RBC production in patients with anemia secondary to CKD.
9. Which of the following are appropriate interventions for a patient receiving IV potassium? Select all
that apply.
• Monitor for signs of hyperkalemia.
• Administer as a rapid IV push.
• Check the IV site for signs of phlebitis.
• Dilute in normal saline and administer undiluted.
• Monitor ECG changes.
Rationale: IV potassium requires slow infusion, monitoring for hyperkalemia, and ECG monitoring to
prevent complications.
10. A patient is receiving morphine for pain management. Which adverse effect should the nurse
monitor for?
• Diarrhea
• Respiratory depression
• Hypertension
• Increased urine output
, Rationale: Respiratory depression is a serious side effect of opioids like morphine.
11. A nurse is preparing to administer digoxin to a patient with heart failure. Which assessment finding
would prompt the nurse to hold the dose and notify the healthcare provider?
• Apical pulse of 54 beats per minute
• Blood pressure of 110/70 mm Hg
• Mild edema in lower extremities
• Respiratory rate of 18 breaths per minute
Rationale: Digoxin can cause bradycardia. An apical pulse below 60 bpm is a contraindication for
administering the dose.
12. A postpartum client who delivered vaginally is experiencing heavy bleeding. Which of the
following interventions should the nurse prioritize?
• Apply an ice pack to the perineal area.
• Massage the fundus until firm.
• Encourage the patient to empty her bladder.
• Apply warm compresses to the lower abdomen.
Rationale: Fundal massage helps stimulate uterine contractions, which is crucial in reducing postpartum
bleeding.
13. A nurse is calculating the pediatric dose for a medication ordered at 15 mg/kg. The child weighs 20
kg. What is the correct dose?
• 200 mg
• 250 mg
• 300 mg
• 350 mg
Rationale: 15 mg/kg x 20 kg = 300 mg.
14. Which adverse effect should the nurse monitor for in a patient receiving prednisone? Select all that
apply.
