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
Fundamentals (20 questions)
1 (Fundamentals) — Single-Best-Answer (Application) — Safe
& Effective Care Environment
A postoperative client with an epidural infusion reports
decreased pain relief and numbness in both legs. The nurse’s
first action is to:
A. Assess the epidural insertion site for signs of infection.
B. Check the infusion pump settings and tubing for occlusion.
C. Notify the anesthesiologist immediately.
D. Remove the epidural catheter.
,Answer: B.
Rationale:
A: Infection assessment is important but not the immediate
cause of acute decreased analgesia.
B: Correct — assess pump/tubing first (common reversible
cause: occlusion or infusion stoppage).
C: Not first—notify after assessing and attempting corrective
basic checks.
D: Removing catheter is invasive and premature without
assessment.
2 (Fundamentals) — Single-Best-Answer (Analysis) — Safe &
Effective Care Environment
Which nursing action best reduces risk of medication errors
during handoff at shift change?
A. Read back critical medication orders aloud during handoff.
B. Use a paper list of current medications.
C. Rely on computerized provider order entry (CPOE) alone.
D. Delay handoff until charting is complete.
Answer: A.
Rationale:
A: Correct — read-back is a proven safety strategy (closed-loop
communication).
B: Paper lists are error-prone and can be outdated.
C: CPOE reduces but does not eliminate human error—should
,be combined with verbal checks.
D: Delaying handoff can increase risk and is not practical.
3 (Fundamentals) — SATA (Application) — Physiological
Integrity; Safe & Effective Care
Select all appropriate steps when caring for a client with a new
peripheral IV that is not flushing:
A. Reposition the arm and try to flush again.
B. Aspirate for blood return before flushing.
C. Apply warm compress over the insertion site.
D. Remove the IV if resistance persists and start a new site.
E. Increase flushing pressure forcefully to clear occlusion.
Answers: A, B, C, D.
Rationale:
A: Correct — repositioning may correct mechanical occlusion.
B: Correct — checking blood return assesses patency.
C: Correct — heat may help relieve vasospasm.
D: Correct — if occlusion persists, remove and restart to
prevent infiltration/complications.
E: Incorrect — forceful flushing risks catheter rupture or
embolism.
4 (Fundamentals) — Single-Best-Answer (Application) —
Health Promotion & Maintenance
, A nurse teaches a client with rheumatoid arthritis about energy
conservation. The best example of energy conservation is:
A. Completing all household tasks in one long session.
B. Alternating rest and activity periods throughout the day.
C. Avoiding all exercise to prevent joint pain.
D. Using hot packs for 30 consecutive minutes three times daily.
Answer: B.
Rationale:
A: Incorrect—fatigue risk.
B: Correct — balanced rest/activity conserves energy.
C: Incorrect—appropriate exercise maintains function.
D: Heat may help but not an energy conservation strategy.
5 (Fundamentals) — Matrix (Analysis) — Psychosocial
Integrity; Health Promotion
Match the nursing intervention (Column A) to the appropriate
therapeutic communication example (Column B). (Provide pairs
as A1→B#, etc.)
Column A:
A1. Encourage expression of feelings
A2. Reflect client statement
A3. Offer self (presence)
A4. Provide information
Column B:
B1. “It sounds like you’re feeling overwhelmed.”
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
Fundamentals (20 questions)
1 (Fundamentals) — Single-Best-Answer (Application) — Safe
& Effective Care Environment
A postoperative client with an epidural infusion reports
decreased pain relief and numbness in both legs. The nurse’s
first action is to:
A. Assess the epidural insertion site for signs of infection.
B. Check the infusion pump settings and tubing for occlusion.
C. Notify the anesthesiologist immediately.
D. Remove the epidural catheter.
,Answer: B.
Rationale:
A: Infection assessment is important but not the immediate
cause of acute decreased analgesia.
B: Correct — assess pump/tubing first (common reversible
cause: occlusion or infusion stoppage).
C: Not first—notify after assessing and attempting corrective
basic checks.
D: Removing catheter is invasive and premature without
assessment.
2 (Fundamentals) — Single-Best-Answer (Analysis) — Safe &
Effective Care Environment
Which nursing action best reduces risk of medication errors
during handoff at shift change?
A. Read back critical medication orders aloud during handoff.
B. Use a paper list of current medications.
C. Rely on computerized provider order entry (CPOE) alone.
D. Delay handoff until charting is complete.
Answer: A.
Rationale:
A: Correct — read-back is a proven safety strategy (closed-loop
communication).
B: Paper lists are error-prone and can be outdated.
C: CPOE reduces but does not eliminate human error—should
,be combined with verbal checks.
D: Delaying handoff can increase risk and is not practical.
3 (Fundamentals) — SATA (Application) — Physiological
Integrity; Safe & Effective Care
Select all appropriate steps when caring for a client with a new
peripheral IV that is not flushing:
A. Reposition the arm and try to flush again.
B. Aspirate for blood return before flushing.
C. Apply warm compress over the insertion site.
D. Remove the IV if resistance persists and start a new site.
E. Increase flushing pressure forcefully to clear occlusion.
Answers: A, B, C, D.
Rationale:
A: Correct — repositioning may correct mechanical occlusion.
B: Correct — checking blood return assesses patency.
C: Correct — heat may help relieve vasospasm.
D: Correct — if occlusion persists, remove and restart to
prevent infiltration/complications.
E: Incorrect — forceful flushing risks catheter rupture or
embolism.
4 (Fundamentals) — Single-Best-Answer (Application) —
Health Promotion & Maintenance
, A nurse teaches a client with rheumatoid arthritis about energy
conservation. The best example of energy conservation is:
A. Completing all household tasks in one long session.
B. Alternating rest and activity periods throughout the day.
C. Avoiding all exercise to prevent joint pain.
D. Using hot packs for 30 consecutive minutes three times daily.
Answer: B.
Rationale:
A: Incorrect—fatigue risk.
B: Correct — balanced rest/activity conserves energy.
C: Incorrect—appropriate exercise maintains function.
D: Heat may help but not an energy conservation strategy.
5 (Fundamentals) — Matrix (Analysis) — Psychosocial
Integrity; Health Promotion
Match the nursing intervention (Column A) to the appropriate
therapeutic communication example (Column B). (Provide pairs
as A1→B#, etc.)
Column A:
A1. Encourage expression of feelings
A2. Reflect client statement
A3. Offer self (presence)
A4. Provide information
Column B:
B1. “It sounds like you’re feeling overwhelmed.”
