NCLEX PN Practice Exam
1. The nurse is caring for a client following an appendectomy. The
client reports nausea and complains of surgical site pain at a 6 on a
0 to 10 scale. The client's employer is present in the room and
states he is paying for the insurance and wants to know what pain
medication has been prescribed by the physician. Which of the
following is the appropriate nurse response?
A. Answer any questions the employer may have as he pays for the
insurance.
B. Tell the employer his question is inappropriate and that the information is
none of his business.
C. Explain to the employer that you cannot release private information and
ask the employer to step out while you conduct your assessment of the
client.
D. Ask the employer to leave and wait until the client returns home to visit.
2. The nurse is caring for a client with a history of advanced chronic
obstructive pulmonary disease (COPD). The client had conventional
gallbladder surgery 2 days previously. Which intervention has
priority for preventing respiratory complications?
A. Incentive spirometry every 4 hours.
B. Coughing and deep breathing four times daily.
C. Getting the client out of bed 4 times daily as ordered by the physician.
D. Giving oxygen at 4 L/minute according to the physician's order.
3. A nurse is developing a care plan for a client with acute mania.
Place the following behaviors in the order in which they occur as the
client develops acute mania. Use all of the options.
A. Delusions of grandeur.
B. Relevant, calm speech patterns.
C. Highly productive and competitive in work and leisure activities.
D. Easily irritated.
E. Poor judgment and impulse control.
4. When educating a pregnant client about home safety, which of
the following information is appropriate for the nurse to include in
the teaching plan? Select all that apply.
1
,A. When taking a shower, place a non-skid mat on the floor of the tub or
shower.
B. Avoid climbing stairs.
C. Avoid wearing high heels.
D. Use non-slip rugs on the floors.
5. A client had a C5 spinal cord contusion that resulted in
quadriplegia. Two days after the injury occurred, the nurse sees his
mother crying in the waiting room. The mother asks the nurse
whether her son will ever play football again. Which of the following
is the best initial response?
A. "Given time and motivation, your son can return to normal function."
B. "I'm not sure, but I'll call the physician to talk to you right away."
C. "What do you know about your son's injury?"
D. "Getting upset isn't in you son's best interest."
6. The nurse is caring for a client who will undergo surgical repair of
a detached retina. Which of the following is the most likely
preoperative nursing diagnosis for this client?
A. Anxiety related to loss of vision and potential failure to regain vision.
B. Deficient knowledge (preoperative and postoperative activities) related to
lack of information.
C. Acute pain related to tissue injury and decreased circulation to the eye.
D. Risk for infection related to the eye injury.
7. When assessing a client with glaucoma, a nurse expects which of
the following findings?
A. Complaints of double vision.
B. Complaints of halos around lights.
C. Intraocular pressure of 15 mm Hg.
D. Soft globe on palpation.
8. A client had a Caesarean delivery and is postpartum day 1. She
asks for pain medication when the nurse enters the room to do her
shift assessment. The client states that her pain level is an 8 on a
scale of 1 to 10. What should be the nurse's priority of care?
A. Give the pain medication and return in an hour for further assessment to
allow time for the medication to work.
B. Complete the postpartum assessment and then give the client pain
2
,medication.
C. Give the pain medication first, do a quick assessment while administering
the medication to ensure the pain is not caused by a complication, and
return for the full assessment after the client's pain has subsided.
D. Instruct the patient to do relaxation exercises to relieve her discomfort.
9. The nurse is preparing to teach a client about the effects of
isoniazid (INH). Which information is important for the client to
understand?
A. Isoniazid should be taken on an empty stomach.
B. Prolonged use of isoniazid produces poorly concentrated urine.
C. Taking aluminum hydroxide (Maalox)® with isoniazid minimizes
gastrointestinal upset.
D. Drinking alcohol daily can increase the incidence of drug-induced
hepatitis.
10. A one-month old infant in the neonatal intensive care unit is
dying. The parents request that the nurse administer an opioid
analgesic to their infant, who is crying weakly. The infant's heart
rate is 68 beats per minute and the respiratory rate is 18 breaths
per minute. The infant is on room air and the oxygen saturation is
92%. The nurse's response is based on which of the following
principles?
A. Providing analgesia during the last days and hours is an ethically-
appropriate nursing action.
B. Withholding the opioid analgesia during the last days and hours is an
ethical duty because administering it would represent assisted suicide.
C. Administering analgesia during the last days and hours is the parent's
ethical decision.
D. Withholding the opioid analgesia is clinically appropriate because it will
hasten the infant's death.
11. While undergoing hemodialysis, the client becomes restless and
tells the nurse he has a headache and feels nauseous. Which of the
following complications does the nurse suspect?
A. Infection.
B. Disequilibrium syndrome.
C. Air embolus.
D. Acute hemolysis.
3
, 12. An elderly couple is speaking to the nurse about their
ambivalence related to sending the client, their adult, dual-
diagnosed (bipolar and drug addict) son, into residential placement.
They tell the nurse that neither keeping their son at home nor
sending him to a facility is a satisfactory solution for them. What
information should the nurse keep in mind when discussing this
dilemma with the family? Select all that apply.
A. Implement what is best for the couple.
B. Suggest another psychiatric evaluation for the son.
C. Look for all potential options for care.
D. Review the client's treatment history.
E. Consult legal authorities for information.
13. The nurse is caring for a 44-year-old client diagnosed with
hypoparathyroidism. Which electrolyte imbalance is closely
associated with hypoparathyroidism?
A. Hypocalcemia.
B. Hyponatremia.
C. Hyperkalemia.
D. Hypophosphatemia.
14. The nurse is caring for a client diagnosed with end-stage liver
disease. The client has completed an advance directive and a do-
not-resuscitate (DNR) document and wishes to receive palliative
care. Which of the following would correspond to the client's wish
for comfort care?
A. Positioning frequently to prevent skin breakdown and providing pain
management and other comfort measures.
B. Carrying out vigorous resuscitation efforts if the client were to stop
breathing, but no resuscitation if the heart stops beating.
C. Providing intravenous fluids when the client becomes dehydrated.
D. Providing total parenteral nutrition (TPN) if the client is not able to eat.
15. The nurse is caring for a client receiving warfarin therapy
(Coumadin®) following a stroke. The client's PT/INR was completed
at 7:00 A.M. prior to the morning meal with an INR reading of 4.0.
Which of the following is the nurse's first priority?
A. Call the physician to request an increase in the Coumadin® dose.
B. Administer a vitamin K injection IM and notify the physician of the results.
4
1. The nurse is caring for a client following an appendectomy. The
client reports nausea and complains of surgical site pain at a 6 on a
0 to 10 scale. The client's employer is present in the room and
states he is paying for the insurance and wants to know what pain
medication has been prescribed by the physician. Which of the
following is the appropriate nurse response?
A. Answer any questions the employer may have as he pays for the
insurance.
B. Tell the employer his question is inappropriate and that the information is
none of his business.
C. Explain to the employer that you cannot release private information and
ask the employer to step out while you conduct your assessment of the
client.
D. Ask the employer to leave and wait until the client returns home to visit.
2. The nurse is caring for a client with a history of advanced chronic
obstructive pulmonary disease (COPD). The client had conventional
gallbladder surgery 2 days previously. Which intervention has
priority for preventing respiratory complications?
A. Incentive spirometry every 4 hours.
B. Coughing and deep breathing four times daily.
C. Getting the client out of bed 4 times daily as ordered by the physician.
D. Giving oxygen at 4 L/minute according to the physician's order.
3. A nurse is developing a care plan for a client with acute mania.
Place the following behaviors in the order in which they occur as the
client develops acute mania. Use all of the options.
A. Delusions of grandeur.
B. Relevant, calm speech patterns.
C. Highly productive and competitive in work and leisure activities.
D. Easily irritated.
E. Poor judgment and impulse control.
4. When educating a pregnant client about home safety, which of
the following information is appropriate for the nurse to include in
the teaching plan? Select all that apply.
1
,A. When taking a shower, place a non-skid mat on the floor of the tub or
shower.
B. Avoid climbing stairs.
C. Avoid wearing high heels.
D. Use non-slip rugs on the floors.
5. A client had a C5 spinal cord contusion that resulted in
quadriplegia. Two days after the injury occurred, the nurse sees his
mother crying in the waiting room. The mother asks the nurse
whether her son will ever play football again. Which of the following
is the best initial response?
A. "Given time and motivation, your son can return to normal function."
B. "I'm not sure, but I'll call the physician to talk to you right away."
C. "What do you know about your son's injury?"
D. "Getting upset isn't in you son's best interest."
6. The nurse is caring for a client who will undergo surgical repair of
a detached retina. Which of the following is the most likely
preoperative nursing diagnosis for this client?
A. Anxiety related to loss of vision and potential failure to regain vision.
B. Deficient knowledge (preoperative and postoperative activities) related to
lack of information.
C. Acute pain related to tissue injury and decreased circulation to the eye.
D. Risk for infection related to the eye injury.
7. When assessing a client with glaucoma, a nurse expects which of
the following findings?
A. Complaints of double vision.
B. Complaints of halos around lights.
C. Intraocular pressure of 15 mm Hg.
D. Soft globe on palpation.
8. A client had a Caesarean delivery and is postpartum day 1. She
asks for pain medication when the nurse enters the room to do her
shift assessment. The client states that her pain level is an 8 on a
scale of 1 to 10. What should be the nurse's priority of care?
A. Give the pain medication and return in an hour for further assessment to
allow time for the medication to work.
B. Complete the postpartum assessment and then give the client pain
2
,medication.
C. Give the pain medication first, do a quick assessment while administering
the medication to ensure the pain is not caused by a complication, and
return for the full assessment after the client's pain has subsided.
D. Instruct the patient to do relaxation exercises to relieve her discomfort.
9. The nurse is preparing to teach a client about the effects of
isoniazid (INH). Which information is important for the client to
understand?
A. Isoniazid should be taken on an empty stomach.
B. Prolonged use of isoniazid produces poorly concentrated urine.
C. Taking aluminum hydroxide (Maalox)® with isoniazid minimizes
gastrointestinal upset.
D. Drinking alcohol daily can increase the incidence of drug-induced
hepatitis.
10. A one-month old infant in the neonatal intensive care unit is
dying. The parents request that the nurse administer an opioid
analgesic to their infant, who is crying weakly. The infant's heart
rate is 68 beats per minute and the respiratory rate is 18 breaths
per minute. The infant is on room air and the oxygen saturation is
92%. The nurse's response is based on which of the following
principles?
A. Providing analgesia during the last days and hours is an ethically-
appropriate nursing action.
B. Withholding the opioid analgesia during the last days and hours is an
ethical duty because administering it would represent assisted suicide.
C. Administering analgesia during the last days and hours is the parent's
ethical decision.
D. Withholding the opioid analgesia is clinically appropriate because it will
hasten the infant's death.
11. While undergoing hemodialysis, the client becomes restless and
tells the nurse he has a headache and feels nauseous. Which of the
following complications does the nurse suspect?
A. Infection.
B. Disequilibrium syndrome.
C. Air embolus.
D. Acute hemolysis.
3
, 12. An elderly couple is speaking to the nurse about their
ambivalence related to sending the client, their adult, dual-
diagnosed (bipolar and drug addict) son, into residential placement.
They tell the nurse that neither keeping their son at home nor
sending him to a facility is a satisfactory solution for them. What
information should the nurse keep in mind when discussing this
dilemma with the family? Select all that apply.
A. Implement what is best for the couple.
B. Suggest another psychiatric evaluation for the son.
C. Look for all potential options for care.
D. Review the client's treatment history.
E. Consult legal authorities for information.
13. The nurse is caring for a 44-year-old client diagnosed with
hypoparathyroidism. Which electrolyte imbalance is closely
associated with hypoparathyroidism?
A. Hypocalcemia.
B. Hyponatremia.
C. Hyperkalemia.
D. Hypophosphatemia.
14. The nurse is caring for a client diagnosed with end-stage liver
disease. The client has completed an advance directive and a do-
not-resuscitate (DNR) document and wishes to receive palliative
care. Which of the following would correspond to the client's wish
for comfort care?
A. Positioning frequently to prevent skin breakdown and providing pain
management and other comfort measures.
B. Carrying out vigorous resuscitation efforts if the client were to stop
breathing, but no resuscitation if the heart stops beating.
C. Providing intravenous fluids when the client becomes dehydrated.
D. Providing total parenteral nutrition (TPN) if the client is not able to eat.
15. The nurse is caring for a client receiving warfarin therapy
(Coumadin®) following a stroke. The client's PT/INR was completed
at 7:00 A.M. prior to the morning meal with an INR reading of 4.0.
Which of the following is the nurse's first priority?
A. Call the physician to request an increase in the Coumadin® dose.
B. Administer a vitamin K injection IM and notify the physician of the results.
4
