NCLEX-RN Comprehensive Exam – Final
Test 2024/2025 (Questions and correct
Answers)
1. A nurse is caring for a client with heart failure who is receiving furosemide.
Which of the following findings should the nurse report to the provider?
A. Increased urine output
B. Blood pressure of 110/70 mmHg
C. Potassium level of 3.0 mEq/L
D. Weight loss of 2 lb in 24 hours
Rationale: C – Furosemide is a loop diuretic that can cause significant potassium
loss. A potassium level of 3.0 mEq/L indicates hypokalemia, which is dangerous
and should be reported.
2. Which of the following clients should the nurse see first after receiving
morning report?
A. A client with COPD requesting PRN albuterol
B. A client who had a thyroidectomy yesterday and is hoarse
C. A client with a blood glucose level of 210 mg/dL
D. A client with rheumatoid arthritis requesting pain medication
,Rationale: B – Hoarseness after thyroidectomy may indicate laryngeal nerve
damage or airway edema, which could compromise the airway.
3. A client receiving chemotherapy develops a low white blood cell count.
Which is the priority nursing action?
A. Encourage oral fluids
B. Promote a low-fat diet
C. Institute neutropenic precautions
D. Provide mouth care every 8 hours
Rationale: C – Neutropenic precautions help protect the immunocompromised
patient from infections due to their low white blood cell count.
4. A nurse is teaching a client how to use a metered-dose inhaler (MDI). Which
statement by the client indicates an understanding of the teaching?
A. “I will exhale quickly after inhaling the medication.”
B. “I should shake the inhaler only the first time I use it.”
C. “I will hold my breath for 10 seconds after inhaling the medication.”
D. “I will take two puffs without waiting in between.”
Rationale: C – Holding the breath after inhalation helps increase the medication's
effectiveness in the lungs.
5. A nurse is reviewing a client’s lab results. Which finding indicates a
therapeutic effect of warfarin therapy?
, A. PT of 9 seconds
B. INR of 2.5
C. Platelet count of 100,000/mm³
D. aPTT of 30 seconds
Rationale: B – An INR of 2.0 to 3.0 is the therapeutic range for most conditions
requiring anticoagulation with warfarin.
6. A nurse is caring for a client who is newly prescribed lithium carbonate.
Which finding should the nurse report to the provider?
A. Sodium level of 128 mEq/L
B. Weight gain of 2 lb in one week
C. Mild hand tremor
D. Serum lithium level of 0.8 mEq/L
Rationale: A – Hyponatremia increases the risk of lithium toxicity. The sodium
level is dangerously low and should be reported.
7. A client with cirrhosis is at risk for hepatic encephalopathy. Which assessment
finding should the nurse report immediately?
A. Anorexia
B. Jaundice
C. Asterixis
D. Peripheral edema
Test 2024/2025 (Questions and correct
Answers)
1. A nurse is caring for a client with heart failure who is receiving furosemide.
Which of the following findings should the nurse report to the provider?
A. Increased urine output
B. Blood pressure of 110/70 mmHg
C. Potassium level of 3.0 mEq/L
D. Weight loss of 2 lb in 24 hours
Rationale: C – Furosemide is a loop diuretic that can cause significant potassium
loss. A potassium level of 3.0 mEq/L indicates hypokalemia, which is dangerous
and should be reported.
2. Which of the following clients should the nurse see first after receiving
morning report?
A. A client with COPD requesting PRN albuterol
B. A client who had a thyroidectomy yesterday and is hoarse
C. A client with a blood glucose level of 210 mg/dL
D. A client with rheumatoid arthritis requesting pain medication
,Rationale: B – Hoarseness after thyroidectomy may indicate laryngeal nerve
damage or airway edema, which could compromise the airway.
3. A client receiving chemotherapy develops a low white blood cell count.
Which is the priority nursing action?
A. Encourage oral fluids
B. Promote a low-fat diet
C. Institute neutropenic precautions
D. Provide mouth care every 8 hours
Rationale: C – Neutropenic precautions help protect the immunocompromised
patient from infections due to their low white blood cell count.
4. A nurse is teaching a client how to use a metered-dose inhaler (MDI). Which
statement by the client indicates an understanding of the teaching?
A. “I will exhale quickly after inhaling the medication.”
B. “I should shake the inhaler only the first time I use it.”
C. “I will hold my breath for 10 seconds after inhaling the medication.”
D. “I will take two puffs without waiting in between.”
Rationale: C – Holding the breath after inhalation helps increase the medication's
effectiveness in the lungs.
5. A nurse is reviewing a client’s lab results. Which finding indicates a
therapeutic effect of warfarin therapy?
, A. PT of 9 seconds
B. INR of 2.5
C. Platelet count of 100,000/mm³
D. aPTT of 30 seconds
Rationale: B – An INR of 2.0 to 3.0 is the therapeutic range for most conditions
requiring anticoagulation with warfarin.
6. A nurse is caring for a client who is newly prescribed lithium carbonate.
Which finding should the nurse report to the provider?
A. Sodium level of 128 mEq/L
B. Weight gain of 2 lb in one week
C. Mild hand tremor
D. Serum lithium level of 0.8 mEq/L
Rationale: A – Hyponatremia increases the risk of lithium toxicity. The sodium
level is dangerously low and should be reported.
7. A client with cirrhosis is at risk for hepatic encephalopathy. Which assessment
finding should the nurse report immediately?
A. Anorexia
B. Jaundice
C. Asterixis
D. Peripheral edema
