NCLEX NURSING Study Guide Exam
2025–2026 Accurate Real Exam
Questions and Verified Correct
Answers JUST RELEASED
The nurse administers oral levothyroxine to a client
with hypothyroidism. Which of the following would be
the PRIORITY for the nurse to monitor for?
A. Diarrhea
B. Palpitations
C. Diaphoresis
D. Weight loss - answer>>>B. Palpitations
Explanation:
Thyroid replacement is used to treat hypothyroidism a
condition in which the thyroid gland produces insufficient
thyroid hormones to support the metabolic functions of the
n=body. Autoimmune disease (Hashimoto thyroiditis), surgical
removal, destruction, by irradiation, cancer, medications
(amiodarone), and a poorly functioning thyroid gland are all
causes of hypothyroidism
Levothyroxine is a synthetic thyroid hormone use to treat
hypothyroidism. It is an isomer of thyroxine (T4) that
stimulates T4 receptors in the body, effectively "replacing" the
client's thyroid hormone. Side effects of overdose can be
serious and resemble an extreme hyperthyroid state.
symptoms indicating possible cardiac toxicity (e.g., chest pain,
hypertension tachycardia), should be reported immediately to
the healthcare provider. Palpitations are a sign of toxicity that
can indicate arrhythmias, including atrial fibrillation.
1|Page
,Takeaway: Serious cardiovascular side effects of levothyroxine
monitored for and report include:
Palpitations
Chest pain
Hypertensio
n
Tachycardia
The nurse is caring for a 76-year old female client who was
recently prescribed hydrochlorothiazide.
Which client finding would be MOST concerning?
A. Increased triglyceride levels
B. Nausea, headache, and lethargy
C. Client has been urinating frequently at night
D. Rash on sun-exposed skin of the face and arms -
answer>>>B. Nausea, headache, and lethargy
Explanation:
Nausea, headache, and lethargy are symptoms of
hyponatremia hyponatremia is a side effect of thiazide diuretics
(e.g., hydrochlorothiazide) that occurs when too much sodium
is lost in the urine. Thiazide diuretics treat edema or
hypertension by blocking the reabsorption of sodium and
chloride in the distal convoluted tubules. These symptoms are
most concerning, as hyponatremia can progress to confusion
or seizures if the electrolyte disturbance is not corrected.
Takeaway:
2|Page
,Side effects of thiazide diuretics include hyponatremia,
increasedtriglyceride levels, and photosensitivity.
Nausea, headache, and lethargy are symptoms of hyponatremia
that require follow-up. The nurse has taught a client with
anemia who is receiving ferrous sulfate.
Which of the following statements by the client would
indicate a correct UNDERSTANDING of the teaching?
A. " I should take this medication in between mealtimes."
B. " If I have black stools, I will notify my health care provider."
C. " O can take an antacid with this medication if it gives me
heartburn."
D. " The liquid medication should be taken undiluted in a
medicine cup." - answer>>>A. " I should take this medication
in between mealtimes."
Explanation:
The common side effect of ferrous sulfate include nausea,
heartburn, bloating, constipation, and diarrhea. These effects
are typically dose-dependent and diminish over time. Antacids
should NOT be taken with ferrous sulfate to mitigate these
symptoms as co-administration with calcium decreases iron
adsorption.
Liquid ferrous sulfate preparations can cause permanent teeth
staining. To prevent this the dose should be diluted and taken
through a straw.
Additionally the client should be educated to rinse their mouth
after taking the dose. Takeaway Ferrous sulfate teaching includes:
3|Page
, Take on an empty stomach to maximize
absorption. Avoid taking with calcium.
Common side effects (e.g., gastrointestinal upset, black or
greenish-colored stools) Liquid iron preparations should be
diluted and taken through a straw.
The nurse is caring for a client with pneumonia who spikes
a fever and has a drop in blood pressure to 88/58.
Which order should the nurse implement FIRST?
A. Administer IV fluids bolus
B. Administer IV antibiotics
C. Draw 2 sets of blood cultures
D. Initiate IV norepinephrine infusion - answer>>>A. Administer IV
fluids bolus
Explanation:
Septic shock occurs when inflammatory mediators (e.g.,
cytokines) are released in response to infection, inducing
widespread vasodilation and increased capillary permeability.
Priority treatment includes aggressive fluid resuscitation to
improve intravascular fluid volume and tissue perfusion.
Recommendations include the rapid administration of a 30
mL/kg bolus of crystalloid IV fluids (e.g., 30 mL x 100 kg =
3000 mL)
Takeaway:
4|Page
2025–2026 Accurate Real Exam
Questions and Verified Correct
Answers JUST RELEASED
The nurse administers oral levothyroxine to a client
with hypothyroidism. Which of the following would be
the PRIORITY for the nurse to monitor for?
A. Diarrhea
B. Palpitations
C. Diaphoresis
D. Weight loss - answer>>>B. Palpitations
Explanation:
Thyroid replacement is used to treat hypothyroidism a
condition in which the thyroid gland produces insufficient
thyroid hormones to support the metabolic functions of the
n=body. Autoimmune disease (Hashimoto thyroiditis), surgical
removal, destruction, by irradiation, cancer, medications
(amiodarone), and a poorly functioning thyroid gland are all
causes of hypothyroidism
Levothyroxine is a synthetic thyroid hormone use to treat
hypothyroidism. It is an isomer of thyroxine (T4) that
stimulates T4 receptors in the body, effectively "replacing" the
client's thyroid hormone. Side effects of overdose can be
serious and resemble an extreme hyperthyroid state.
symptoms indicating possible cardiac toxicity (e.g., chest pain,
hypertension tachycardia), should be reported immediately to
the healthcare provider. Palpitations are a sign of toxicity that
can indicate arrhythmias, including atrial fibrillation.
1|Page
,Takeaway: Serious cardiovascular side effects of levothyroxine
monitored for and report include:
Palpitations
Chest pain
Hypertensio
n
Tachycardia
The nurse is caring for a 76-year old female client who was
recently prescribed hydrochlorothiazide.
Which client finding would be MOST concerning?
A. Increased triglyceride levels
B. Nausea, headache, and lethargy
C. Client has been urinating frequently at night
D. Rash on sun-exposed skin of the face and arms -
answer>>>B. Nausea, headache, and lethargy
Explanation:
Nausea, headache, and lethargy are symptoms of
hyponatremia hyponatremia is a side effect of thiazide diuretics
(e.g., hydrochlorothiazide) that occurs when too much sodium
is lost in the urine. Thiazide diuretics treat edema or
hypertension by blocking the reabsorption of sodium and
chloride in the distal convoluted tubules. These symptoms are
most concerning, as hyponatremia can progress to confusion
or seizures if the electrolyte disturbance is not corrected.
Takeaway:
2|Page
,Side effects of thiazide diuretics include hyponatremia,
increasedtriglyceride levels, and photosensitivity.
Nausea, headache, and lethargy are symptoms of hyponatremia
that require follow-up. The nurse has taught a client with
anemia who is receiving ferrous sulfate.
Which of the following statements by the client would
indicate a correct UNDERSTANDING of the teaching?
A. " I should take this medication in between mealtimes."
B. " If I have black stools, I will notify my health care provider."
C. " O can take an antacid with this medication if it gives me
heartburn."
D. " The liquid medication should be taken undiluted in a
medicine cup." - answer>>>A. " I should take this medication
in between mealtimes."
Explanation:
The common side effect of ferrous sulfate include nausea,
heartburn, bloating, constipation, and diarrhea. These effects
are typically dose-dependent and diminish over time. Antacids
should NOT be taken with ferrous sulfate to mitigate these
symptoms as co-administration with calcium decreases iron
adsorption.
Liquid ferrous sulfate preparations can cause permanent teeth
staining. To prevent this the dose should be diluted and taken
through a straw.
Additionally the client should be educated to rinse their mouth
after taking the dose. Takeaway Ferrous sulfate teaching includes:
3|Page
, Take on an empty stomach to maximize
absorption. Avoid taking with calcium.
Common side effects (e.g., gastrointestinal upset, black or
greenish-colored stools) Liquid iron preparations should be
diluted and taken through a straw.
The nurse is caring for a client with pneumonia who spikes
a fever and has a drop in blood pressure to 88/58.
Which order should the nurse implement FIRST?
A. Administer IV fluids bolus
B. Administer IV antibiotics
C. Draw 2 sets of blood cultures
D. Initiate IV norepinephrine infusion - answer>>>A. Administer IV
fluids bolus
Explanation:
Septic shock occurs when inflammatory mediators (e.g.,
cytokines) are released in response to infection, inducing
widespread vasodilation and increased capillary permeability.
Priority treatment includes aggressive fluid resuscitation to
improve intravascular fluid volume and tissue perfusion.
Recommendations include the rapid administration of a 30
mL/kg bolus of crystalloid IV fluids (e.g., 30 mL x 100 kg =
3000 mL)
Takeaway:
4|Page
