Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
INTEGRATED REVIEW — COMPREHENSIVE NCLEX
PRACTICE PACK [FUNDAMENTALS,
PHARMACOLOGY, MEDICAL-SURGICAL,
MATERNITY, PEDIATRIC, EMERGENCY, AND
SPECIALTY SYSTEMS] TEST BANK
1 (SBA) — Fundamentals — Domain: Safe & Effective Care
Environment (Management of Care) — Application
A newly licensed RN is assigned 4 patients. Which assignment
should the RN accept?
A. Post-op day 1 open cholecystectomy patient who is
ambulatory and reports pain 3/10.
B. New admission with continuous chest pain and ST elevations
on ECG.
C. Stable 78-year-old post-op hip replacement, ambulatory with
,walker, requires PT later.
D. Patient with newly documented suicidal ideation and a plan.
Answer: C.
Rationales:
A. Incorrect — Post-op day 1 open abdominal surgery with
controllable pain is appropriate for an RN, but the ambulatory
patient may require frequent assessments and pain
management; still not the best single choice compared to stable
routine post-op with PT planned.
B. Incorrect — Chest pain with ST elevations is unstable and
requires immediate critical/telemetry care or RN with advanced
cardiac capability; not an ideal assignment for a new RN.
C. Correct — This patient is stable, predictable, and appropriate
for a newly licensed RN; meets assignment principles (stable,
expected needs, routine care).
D. Incorrect — New suicidal ideation with plan requires mental
health/close monitoring and experienced staff; not optimal
assignment for a new RN.
2 (SATA) — Pharmacology — Domain: Physiological Integrity
(Pharmacological Therapies) — Analysis
A client is started on amiodarone for atrial fibrillation. Which of
the following are important patient teaching points? (Select all
that apply.)
A. Report blue-gray skin discoloration.
,B. Expect immediate improvement in heart rate within minutes.
C. Avoid exposure to ultraviolet (sun) light.
D. Monitor for shortness of breath or cough.
E. Stop all other medications while taking amiodarone.
Answers: A, C, D.
Rationales:
A. Correct — Amiodarone can cause blue-gray skin discoloration
(photosensitivity) with prolonged use; patients should report.
B. Incorrect — Amiodarone has a delayed onset and variable
kinetics; immediate improvement within minutes is not
expected.
C. Correct — Photosensitivity and skin changes are possible;
avoid excessive UV exposure.
D. Correct — Pulmonary toxicity (fibrosis) is a serious adverse
effect; report new dyspnea/cough.
E. Incorrect — Do not stop all other medications suddenly;
interactions exist but stopping other meds without direction is
unsafe.
3 (SBA) — Medical-Surgical — Domain: Physiological Integrity
(Reduction of Risk Potential) — Application
A 62-year-old with history of COPD is admitted with
community-acquired pneumonia. Which nursing action most
directly reduces the risk of respiratory failure?
A. Encourage and assist with incentive spirometry hourly while
, awake.
B. Start broad-spectrum IV antibiotics immediately.
C. Provide high-flow oxygen via non-rebreather continuously.
D. Place the client in Trendelenburg position.
Answer: A.
Rationales:
A. Correct — Incentive spirometry improves lung expansion,
prevents atelectasis, and reduces risk of respiratory
compromise; an immediate nursing action.
B. Incorrect — Antibiotics are important but the nurse’s
immediate action to reduce respiratory failure risk includes
breathing exercises and secretion clearance.
C. Incorrect — High-flow O2 without titration may depress
respiratory drive in COPD; not first-line without assessment.
D. Incorrect — Trendelenburg does not improve oxygenation for
pneumonia and may worsen respiratory status.
4 (Matrix) — Pharmacology — Domain: Physiological Integrity
(Pharmacological Therapies) — Analysis
Match each opioid side effect (left column) with the correct
intervention (right column). (Use each intervention once.)
Left:
1. Respiratory depression
2. Constipation
PN® Examination
9th Edition
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
INTEGRATED REVIEW — COMPREHENSIVE NCLEX
PRACTICE PACK [FUNDAMENTALS,
PHARMACOLOGY, MEDICAL-SURGICAL,
MATERNITY, PEDIATRIC, EMERGENCY, AND
SPECIALTY SYSTEMS] TEST BANK
1 (SBA) — Fundamentals — Domain: Safe & Effective Care
Environment (Management of Care) — Application
A newly licensed RN is assigned 4 patients. Which assignment
should the RN accept?
A. Post-op day 1 open cholecystectomy patient who is
ambulatory and reports pain 3/10.
B. New admission with continuous chest pain and ST elevations
on ECG.
C. Stable 78-year-old post-op hip replacement, ambulatory with
,walker, requires PT later.
D. Patient with newly documented suicidal ideation and a plan.
Answer: C.
Rationales:
A. Incorrect — Post-op day 1 open abdominal surgery with
controllable pain is appropriate for an RN, but the ambulatory
patient may require frequent assessments and pain
management; still not the best single choice compared to stable
routine post-op with PT planned.
B. Incorrect — Chest pain with ST elevations is unstable and
requires immediate critical/telemetry care or RN with advanced
cardiac capability; not an ideal assignment for a new RN.
C. Correct — This patient is stable, predictable, and appropriate
for a newly licensed RN; meets assignment principles (stable,
expected needs, routine care).
D. Incorrect — New suicidal ideation with plan requires mental
health/close monitoring and experienced staff; not optimal
assignment for a new RN.
2 (SATA) — Pharmacology — Domain: Physiological Integrity
(Pharmacological Therapies) — Analysis
A client is started on amiodarone for atrial fibrillation. Which of
the following are important patient teaching points? (Select all
that apply.)
A. Report blue-gray skin discoloration.
,B. Expect immediate improvement in heart rate within minutes.
C. Avoid exposure to ultraviolet (sun) light.
D. Monitor for shortness of breath or cough.
E. Stop all other medications while taking amiodarone.
Answers: A, C, D.
Rationales:
A. Correct — Amiodarone can cause blue-gray skin discoloration
(photosensitivity) with prolonged use; patients should report.
B. Incorrect — Amiodarone has a delayed onset and variable
kinetics; immediate improvement within minutes is not
expected.
C. Correct — Photosensitivity and skin changes are possible;
avoid excessive UV exposure.
D. Correct — Pulmonary toxicity (fibrosis) is a serious adverse
effect; report new dyspnea/cough.
E. Incorrect — Do not stop all other medications suddenly;
interactions exist but stopping other meds without direction is
unsafe.
3 (SBA) — Medical-Surgical — Domain: Physiological Integrity
(Reduction of Risk Potential) — Application
A 62-year-old with history of COPD is admitted with
community-acquired pneumonia. Which nursing action most
directly reduces the risk of respiratory failure?
A. Encourage and assist with incentive spirometry hourly while
, awake.
B. Start broad-spectrum IV antibiotics immediately.
C. Provide high-flow oxygen via non-rebreather continuously.
D. Place the client in Trendelenburg position.
Answer: A.
Rationales:
A. Correct — Incentive spirometry improves lung expansion,
prevents atelectasis, and reduces risk of respiratory
compromise; an immediate nursing action.
B. Incorrect — Antibiotics are important but the nurse’s
immediate action to reduce respiratory failure risk includes
breathing exercises and secretion clearance.
C. Incorrect — High-flow O2 without titration may depress
respiratory drive in COPD; not first-line without assessment.
D. Incorrect — Trendelenburg does not improve oxygenation for
pneumonia and may worsen respiratory status.
4 (Matrix) — Pharmacology — Domain: Physiological Integrity
(Pharmacological Therapies) — Analysis
Match each opioid side effect (left column) with the correct
intervention (right column). (Use each intervention once.)
Left:
1. Respiratory depression
2. Constipation
