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
Test (100 items)
Fundamentals (15 items)
1. (SBA) A postoperative client who had an abdominal
hysterectomy 6 hours ago reports sudden shortness of
breath and pleuritic chest pain. Which action should the
nurse take first?
A. Apply oxygen by nasal cannula.
B. Call the surgeon.
C. Obtain a STAT chest x-ray.
D. Assess breath sounds and pulse oximetry.
, Answer: D
Domain: PI-RR (Reduction of Risk Potential). Cognitive:
Application.
Rationale:
• D (Correct) — rapid focused assessment (breath sounds,
SpO₂) clarifies severity and guides immediate
interventions.
• A — oxygen may be needed but assessment informs
whether high-flow or other measures are required.
• B — surgeon notification is appropriate after
assessment/initial stabilization.
• C — imaging may be indicated but is not the immediate
first step before assessment.
2. (SATA) Which of the following are appropriate measures to
prevent postoperative deep-vein thrombosis (select all
that apply)?
A. Encourage early ambulation.
B. Apply intermittent pneumatic compression devices.
C. Instruct client to perform Valsalva maneuver frequently.
D. Give low-molecular-weight heparin as ordered.
E. Use sequential compression devices under the client’s
knees only.
Answer: A, B, D
Domain: SECE / PI-RR. Cognitive: Application.
Rationale:
,• A (Correct) — early ambulation reduces venous stasis.
• B (Correct) — pneumatic devices promote venous return.
• C — Valsalva increases venous pressure and is not
preventive.
• D (Correct) — LMWH prophylaxis reduces DVT risk when
indicated.
• E — incorrect placement under knees can compress
popliteal vessels; wrap should be applied per manufacturer
instructions (thigh or calf as indicated).
3. (SBA) The nurse is teaching a new graduate about sterile
technique when opening a sterile field. Which statement
by the graduate indicates correct understanding?
A. “I can reach over the sterile field to place instruments.”
B. “I will open the package with the top flap away from me
first.”
C. “I should hold sterile forceps below waist level to be
safe.”
D. “A wet area on the sterile drape is still sterile.”
Answer: B
Domain: SECE. Cognitive: Application.
Rationale:
• B (Correct) — opening away prevents reaching across and
contamination.
• A — reaching over a sterile field contaminates it.
, • C — sterile items held below waist are considered
contaminated.
• D — moisture can wick contaminants; wet areas are not
sterile.
4. (SBA) A client asks why the nurse takes a full medication
reconciliation on admission. The best nursing response is:
A. “Because the hospital is required to do it.”
B. “To identify and prevent potential medication errors.”
C. “So we can stop all nonessential medicines.”
D. “To find out what your insurance covers.”
Answer: B
Domain: SECE / PI-RR. Cognitive: Evaluation.
Rationale:
• B (Correct) — reconciliation identifies discrepancies and
prevents errors.
• A — technically true but not the best patient-centered
explanation.
• C — deprescribing decisions require provider
collaboration; not the sole purpose.
• D — not relevant to clinical safety.
5. (SATA) For a client with a nasogastric tube receiving
continuous enteral nutrition, which actions are
appropriate? (Select all that apply.)
A. Verify tube placement before first feed by x-ray, then pH
checks per policy.
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
Test (100 items)
Fundamentals (15 items)
1. (SBA) A postoperative client who had an abdominal
hysterectomy 6 hours ago reports sudden shortness of
breath and pleuritic chest pain. Which action should the
nurse take first?
A. Apply oxygen by nasal cannula.
B. Call the surgeon.
C. Obtain a STAT chest x-ray.
D. Assess breath sounds and pulse oximetry.
, Answer: D
Domain: PI-RR (Reduction of Risk Potential). Cognitive:
Application.
Rationale:
• D (Correct) — rapid focused assessment (breath sounds,
SpO₂) clarifies severity and guides immediate
interventions.
• A — oxygen may be needed but assessment informs
whether high-flow or other measures are required.
• B — surgeon notification is appropriate after
assessment/initial stabilization.
• C — imaging may be indicated but is not the immediate
first step before assessment.
2. (SATA) Which of the following are appropriate measures to
prevent postoperative deep-vein thrombosis (select all
that apply)?
A. Encourage early ambulation.
B. Apply intermittent pneumatic compression devices.
C. Instruct client to perform Valsalva maneuver frequently.
D. Give low-molecular-weight heparin as ordered.
E. Use sequential compression devices under the client’s
knees only.
Answer: A, B, D
Domain: SECE / PI-RR. Cognitive: Application.
Rationale:
,• A (Correct) — early ambulation reduces venous stasis.
• B (Correct) — pneumatic devices promote venous return.
• C — Valsalva increases venous pressure and is not
preventive.
• D (Correct) — LMWH prophylaxis reduces DVT risk when
indicated.
• E — incorrect placement under knees can compress
popliteal vessels; wrap should be applied per manufacturer
instructions (thigh or calf as indicated).
3. (SBA) The nurse is teaching a new graduate about sterile
technique when opening a sterile field. Which statement
by the graduate indicates correct understanding?
A. “I can reach over the sterile field to place instruments.”
B. “I will open the package with the top flap away from me
first.”
C. “I should hold sterile forceps below waist level to be
safe.”
D. “A wet area on the sterile drape is still sterile.”
Answer: B
Domain: SECE. Cognitive: Application.
Rationale:
• B (Correct) — opening away prevents reaching across and
contamination.
• A — reaching over a sterile field contaminates it.
, • C — sterile items held below waist are considered
contaminated.
• D — moisture can wick contaminants; wet areas are not
sterile.
4. (SBA) A client asks why the nurse takes a full medication
reconciliation on admission. The best nursing response is:
A. “Because the hospital is required to do it.”
B. “To identify and prevent potential medication errors.”
C. “So we can stop all nonessential medicines.”
D. “To find out what your insurance covers.”
Answer: B
Domain: SECE / PI-RR. Cognitive: Evaluation.
Rationale:
• B (Correct) — reconciliation identifies discrepancies and
prevents errors.
• A — technically true but not the best patient-centered
explanation.
• C — deprescribing decisions require provider
collaboration; not the sole purpose.
• D — not relevant to clinical safety.
5. (SATA) For a client with a nasogastric tube receiving
continuous enteral nutrition, which actions are
appropriate? (Select all that apply.)
A. Verify tube placement before first feed by x-ray, then pH
checks per policy.
