NCLEX Mastery Volume 7 – 100 Practice
Questions with Rationales.
Q1. A patient with type 1 diabetes reports excessive thirst, frequent urination, and fruity breath
odor. Which action should the nurse take first?
A) Administer IV insulin
B) Obtain a fingerstick glucose
C) Provide oral fluids
D) Restrict activity
Answer: B) Obtain a fingerstick glucose
Rationale: Assessment comes before intervention; confirm hyperglycemia before treatment.
Q2. A patient is prescribed lisinopril. Which adverse effect should be reported immediately?
A) Dry cough
B) Dizziness
C) Angioedema
D) Headache
Answer: C) Angioedema
Rationale: Swelling of the lips/tongue can obstruct the airway and is life-threatening.
Q3. Which diet choice is most appropriate for a patient with chronic kidney disease?
A) Baked chicken and rice
B) Ham sandwich with cheese
C) Beef stew with potatoes
D) Peanut butter with crackers
Answer: A) Baked chicken and rice
Rationale: Low-sodium, moderate protein meals are preferred in kidney disease.
Q4. A nurse prepares to insert a Foley catheter in a female patient. Which step is correct?
A) Clean from back to front
B) Inflate the balloon before insertion
C) Insert into urethra until urine appears
D) Use sterile gloves after insertion
Answer: C) Insert into urethra until urine appears
Rationale: Urine flow confirms correct placement before balloon inflation.
Q5. Which finding requires immediate action in a patient with a chest tube?
A) Intermittent bubbling in water seal
B) Continuous bubbling in suction chamber
C) No tidaling in water seal
D) Drainage of 60 mL in 2 hours
For expert assistance contact us on WhatsApp: +254700486651
,Answer: C) No tidaling in water seal
Rationale: This may indicate tube obstruction or lung re-expansion; assess immediately.
Q6. A patient with ulcerative colitis is prescribed corticosteroids. Which teaching is most
important?
A) Report weight gain and swelling
B) Avoid dairy products
C) Limit fluid intake
D) Increase potassium foods
Answer: A) Report weight gain and swelling
Rationale: Corticosteroids can cause fluid retention and hypertension.
Q7. Which patient is at greatest risk for developing hypoglycemia?
A) Type 1 diabetic on sliding scale insulin
B) Type 2 diabetic on metformin
C) Patient with fasting blood sugar 110 mg/dL
D) Obese patient on diet control only
Answer: A) Type 1 diabetic on sliding scale insulin
Rationale: Insulin therapy poses the highest risk for hypoglycemia.
Q8. A patient on long-term prednisone therapy is at risk for which complication?
A) Hypoglycemia
B) Osteoporosis
C) Weight loss
D) Hypotension
Answer: B) Osteoporosis
Rationale: Corticosteroids cause bone demineralization over time.
Q9. Which assessment finding indicates possible appendicitis?
A) Left lower quadrant pain
B) Pain relieved by eating
C) Right lower quadrant pain
D) Hematemesis
Answer: C) Right lower quadrant pain
Rationale: RLQ pain at McBurney’s point is classic for appendicitis.
Q10. Which action is priority when administering IV vancomycin?
A) Infuse rapidly over 15 minutes
B) Monitor for ototoxicity
C) Administer IM if IV not available
D) Give with fruit juice
Answer: B) Monitor for ototoxicity
Rationale: Vancomycin can cause hearing loss; assess auditory function regularly.
For expert assistance contact us on WhatsApp: +254700486651
, Q11. A patient with pneumonia has fever and thick sputum. Which intervention is most
important?
A) Encourage deep breathing and coughing
B) Restrict fluids to prevent overload
C) Limit ambulation
D) Give antidiarrheal medication
Answer: A) Encourage deep breathing and coughing
Rationale: Promotes airway clearance and improves oxygenation.
Q12. Which finding suggests digoxin toxicity?
A) Bradycardia
B) Tachycardia
C) Hypertension
D) Dry cough
Answer: A) Bradycardia
Rationale: Digoxin toxicity often causes bradycardia and visual disturbances.
Q13. A patient with hyperthyroidism is prescribed propranolol. Why is this drug used?
A) Reduce thyroid hormone production
B) Prevent weight loss
C) Control tachycardia and tremors
D) Cure the disease
Answer: C) Control tachycardia and tremors
Rationale: Beta-blockers help manage symptoms of hyperthyroidism.
Q14. Which is the best snack for a patient with anemia?
A) Apple slices
B) Spinach salad
C) Yogurt
D) Rice cake
Answer: B) Spinach salad
Rationale: Spinach provides iron, essential for red blood cell production.
Q15. Which is the most important action after giving subcutaneous heparin?
A) Aspirate before injection
B) Massage the site
C) Avoid rubbing the site
D) Inject into the arm
Answer: C) Avoid rubbing the site
Rationale: Rubbing increases risk of hematoma and bruising.
For expert assistance contact us on WhatsApp: +254700486651
Questions with Rationales.
Q1. A patient with type 1 diabetes reports excessive thirst, frequent urination, and fruity breath
odor. Which action should the nurse take first?
A) Administer IV insulin
B) Obtain a fingerstick glucose
C) Provide oral fluids
D) Restrict activity
Answer: B) Obtain a fingerstick glucose
Rationale: Assessment comes before intervention; confirm hyperglycemia before treatment.
Q2. A patient is prescribed lisinopril. Which adverse effect should be reported immediately?
A) Dry cough
B) Dizziness
C) Angioedema
D) Headache
Answer: C) Angioedema
Rationale: Swelling of the lips/tongue can obstruct the airway and is life-threatening.
Q3. Which diet choice is most appropriate for a patient with chronic kidney disease?
A) Baked chicken and rice
B) Ham sandwich with cheese
C) Beef stew with potatoes
D) Peanut butter with crackers
Answer: A) Baked chicken and rice
Rationale: Low-sodium, moderate protein meals are preferred in kidney disease.
Q4. A nurse prepares to insert a Foley catheter in a female patient. Which step is correct?
A) Clean from back to front
B) Inflate the balloon before insertion
C) Insert into urethra until urine appears
D) Use sterile gloves after insertion
Answer: C) Insert into urethra until urine appears
Rationale: Urine flow confirms correct placement before balloon inflation.
Q5. Which finding requires immediate action in a patient with a chest tube?
A) Intermittent bubbling in water seal
B) Continuous bubbling in suction chamber
C) No tidaling in water seal
D) Drainage of 60 mL in 2 hours
For expert assistance contact us on WhatsApp: +254700486651
,Answer: C) No tidaling in water seal
Rationale: This may indicate tube obstruction or lung re-expansion; assess immediately.
Q6. A patient with ulcerative colitis is prescribed corticosteroids. Which teaching is most
important?
A) Report weight gain and swelling
B) Avoid dairy products
C) Limit fluid intake
D) Increase potassium foods
Answer: A) Report weight gain and swelling
Rationale: Corticosteroids can cause fluid retention and hypertension.
Q7. Which patient is at greatest risk for developing hypoglycemia?
A) Type 1 diabetic on sliding scale insulin
B) Type 2 diabetic on metformin
C) Patient with fasting blood sugar 110 mg/dL
D) Obese patient on diet control only
Answer: A) Type 1 diabetic on sliding scale insulin
Rationale: Insulin therapy poses the highest risk for hypoglycemia.
Q8. A patient on long-term prednisone therapy is at risk for which complication?
A) Hypoglycemia
B) Osteoporosis
C) Weight loss
D) Hypotension
Answer: B) Osteoporosis
Rationale: Corticosteroids cause bone demineralization over time.
Q9. Which assessment finding indicates possible appendicitis?
A) Left lower quadrant pain
B) Pain relieved by eating
C) Right lower quadrant pain
D) Hematemesis
Answer: C) Right lower quadrant pain
Rationale: RLQ pain at McBurney’s point is classic for appendicitis.
Q10. Which action is priority when administering IV vancomycin?
A) Infuse rapidly over 15 minutes
B) Monitor for ototoxicity
C) Administer IM if IV not available
D) Give with fruit juice
Answer: B) Monitor for ototoxicity
Rationale: Vancomycin can cause hearing loss; assess auditory function regularly.
For expert assistance contact us on WhatsApp: +254700486651
, Q11. A patient with pneumonia has fever and thick sputum. Which intervention is most
important?
A) Encourage deep breathing and coughing
B) Restrict fluids to prevent overload
C) Limit ambulation
D) Give antidiarrheal medication
Answer: A) Encourage deep breathing and coughing
Rationale: Promotes airway clearance and improves oxygenation.
Q12. Which finding suggests digoxin toxicity?
A) Bradycardia
B) Tachycardia
C) Hypertension
D) Dry cough
Answer: A) Bradycardia
Rationale: Digoxin toxicity often causes bradycardia and visual disturbances.
Q13. A patient with hyperthyroidism is prescribed propranolol. Why is this drug used?
A) Reduce thyroid hormone production
B) Prevent weight loss
C) Control tachycardia and tremors
D) Cure the disease
Answer: C) Control tachycardia and tremors
Rationale: Beta-blockers help manage symptoms of hyperthyroidism.
Q14. Which is the best snack for a patient with anemia?
A) Apple slices
B) Spinach salad
C) Yogurt
D) Rice cake
Answer: B) Spinach salad
Rationale: Spinach provides iron, essential for red blood cell production.
Q15. Which is the most important action after giving subcutaneous heparin?
A) Aspirate before injection
B) Massage the site
C) Avoid rubbing the site
D) Inject into the arm
Answer: C) Avoid rubbing the site
Rationale: Rubbing increases risk of hematoma and bruising.
For expert assistance contact us on WhatsApp: +254700486651
