75 Free NCLEX Questions – c/o BrilliantNurse.com
Complete Practice Questions With Detailed
Rationales
A 23-year-old woman is admitted to the infusion clinic after a Multiple Sclerosis Exacerbation.
The physician orders methylprednisolone infusions (Solu-Medrol). The nurse would expect
which of the following outcomes after administration of this medication?
1. A decrease in muscle spasticity and involuntary movements
2. A slowed progression of Multiple Sclerosis related plaques
3. A decrease in the length of the exacerbation
4. A stabilization of mood and sleep -Answer:1. A decrease in muscle spasticity and involuntary
movements
Incorrect - While muscle spasticity and involuntary movements can be symptoms of MS, a
corticosteroid infusion is not meant to directly treat these symptoms.
2. A slowed progression of Multiple Sclerosis related plaques
Incorrect - Special drugs like Interferon Beta, Natalizumab, or Glatiramir acetate are used as
first-line treatments to slow the progression of MS. While corticosteroids can be used in
conjunction with these drugs on a long-term basis, they would not be infused. They would be
taken orally.
3. A decrease in the length of the exacerbation
Correct - A methylprednisolone infusion is the first line of treatment during an acute
exacerbation and is used to decrease the length and severity of a relapse.
4. A stabilization of mood and sleep
Incorrect - Some of the frequent side effects of a Methylprednisolone infusion are anxiety,
insomnia, and mood swings.
A 30-year old Caucasian woman who works the night shift has been found to have early bone
loss and has a high risk for osteomalacia and bone degradation. She asks the nurse exactly why
she should take Vitamin D supplements. What is the nurse's best response?
1. "It's a standard part of the overall nutritional treatment for the prevention of osteomalacia"
2. "It helps your intestines absorb calcium, which is important for bone formation."
,3. "It stimulates skin cells to produce calcium, which is then released into the bloodstream to be
used for bone formation."
4. "Vitamin D supplements should not be taken by someone of your age." -Answer:1. "It's a
standard part of the overall nutritional treatment for the prevention of osteomalacia"
Incorrect - While this is true, it doesn't answer the woman's question.
2. "It helps your intestines absorb calcium, which is important for bone formation."
Correct - This is the correct mechanism of action for Vitamin D
3. "It stimulates skin cells to produce calcium, which is then released into the bloodstream to be
used for bone formation."
Incorrect- This is not the correct mechanism of action for Vitamin D
4. "Vitamin D supplements should not be taken by someone of your age."
Incorrect - Vitamin D supplements should be taken for patients who are homebound,
institutionalized, or by some other limitations, unable to meet daily requirements. This woman
works the night shift, which may limit her ability to absorb Vitamin D naturally.
A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The patient is
living at home with her daughter. The nurse is most concerned about which side effect of
ropinirole?
1. Slurred speech
2. Sudden dizziness
3. Masklike facial expression
4. Stooped Posture -Answer:1. Slurred speech
Incorrect - Slurred speech is a common symptom of PD, not a side effect of this drug.
2. Sudden dizziness
Correct - Dizziness and orthostatic hypotension are serious adverse effects of this drug that can
lead to an increased risk of falls. Ropinirole's drug class is a dopamine agonist, which mimic
dopamine in the brain (PD is characterized by a lack of dopamine).
3. Masklike facial expression
Incorrect - Masklike facial expression is a common symptom of PD, not a side effect of this
drug.
4. Stooped Posture
Incorrect - Stooped Posture is a common symptom of PD, not a side effect of this drug.
A 65 year old man is prescribed Flomax (Tamsulosin) for Benign Prostatic Hyperplasia. The
patient lives in an upstairs apartment. The nurse is most concerned about which side effect of
Flomax?
1. Hypotension
,2. Tachycardia
3. Back Pain
4. Difficulty Urinating -Answer:1. Hypotension
Correct - Hypotension can lead to dizziness and a risk for injury to the patient.
2. Tachycardia
Tachycardia can be a side effect of Flomax, but is not an immediate safety risk, nor is it a
common side effect.
3. Back Pain
Back Pain can be a side effect of Floma, but is not a safety risk
4. Difficulty Urinating
Dysuria is a symptom of Benign Prostatic Hyperplasia, not a side effect of Flomax
A client with Multiple Sclerosis reports a constant, burning, tingling pain in the shoulders. The
nurse anticipates that the physician will order which medication for this type of pain?
1. alprazolam (Xanax)
2. Corticosteroid injection
3. gabapentin (Neurontin)
4. hydrocodone/acetaminophen (Norco) -Answer:1. alprazolam (Xanax)
Incorrect - alprazolam is used to reduce anxiety
2. Corticosteroid injection
Incorrect - Corticosteroid injections are used to reduce inflammation in a localized area, often
due to joint breakdown. In MS patients it is used to treat acute exacerbations ("flare-ups"), but
the symptoms described do not constitute an acute exacerbation.
3. gabapentin (Neurontin)
Correct - Anticonvulsants like gabapentin are often the first line of treatment for nerve pain
4. hydrocodone/acetaminophen (Norco)
Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
A female patient is prescribed metformin for glucose control. The patient is on NPO status
pending a diagnostic test. The nurse is most concerned about which side effect of metformin?
1. Diarrhea and Vomiting
2. Dizziness and Drowsiness
3. Metallic taste
4. Hypoglycemia -Answer:1. Diarrhea and Vomiting
Incorrect - While these may occur, the patient is at higher risk for another adverse effect.
2. Dizziness and Drowsiness
Incorrect - While these may occur, the patient is at higher risk for another adverse effect.
, 3. Metallic taste
Incorrect - While this may occur, the patient is at higher risk for another adverse effect.
4. Hypoglycemia
Correct - The patient is at risk because she is on NPO status and continuing to take an anti-
glycemic drug.
A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl, a
platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is critical
and should be reported to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L -Answer:1. Hemoglobin 11 g/dl
This is below normal, but a normal female hemoglobin is 12-14. There is a more critical lab
result.
2. Platelet of 150,000
This is also below the normal values, but is not the most critical lab result.
3. INR of 2.5
This is a therapeutic range for a patient who is taking an anticoagulant for atrial fibrillation
4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a patient with a history of dysrhythmia can be life-
threatening and can lead to cardiac distress.
A man is has been taking lisinopril for CHF. The patient is seen in the emergency room for
persistent diarrhea. The nurse is concerned about which side effect of lisinopril?
1. Vertigo
2. Hypotension
3. Palpitations
4. Nagging, dry cough -Answer:1. Vertigo
Incorrect - While this may occur, the patient is at higher risk due to another adverse effect.
2. Hypotension
Correct - The patient is particularly at risk for hypotension due to possible dehydration from
fluid loss.
3. Palpitations
Incorrect - While this may occur, the patient is at higher risk for another adverse effect.
4. Nagging, dry cough
Complete Practice Questions With Detailed
Rationales
A 23-year-old woman is admitted to the infusion clinic after a Multiple Sclerosis Exacerbation.
The physician orders methylprednisolone infusions (Solu-Medrol). The nurse would expect
which of the following outcomes after administration of this medication?
1. A decrease in muscle spasticity and involuntary movements
2. A slowed progression of Multiple Sclerosis related plaques
3. A decrease in the length of the exacerbation
4. A stabilization of mood and sleep -Answer:1. A decrease in muscle spasticity and involuntary
movements
Incorrect - While muscle spasticity and involuntary movements can be symptoms of MS, a
corticosteroid infusion is not meant to directly treat these symptoms.
2. A slowed progression of Multiple Sclerosis related plaques
Incorrect - Special drugs like Interferon Beta, Natalizumab, or Glatiramir acetate are used as
first-line treatments to slow the progression of MS. While corticosteroids can be used in
conjunction with these drugs on a long-term basis, they would not be infused. They would be
taken orally.
3. A decrease in the length of the exacerbation
Correct - A methylprednisolone infusion is the first line of treatment during an acute
exacerbation and is used to decrease the length and severity of a relapse.
4. A stabilization of mood and sleep
Incorrect - Some of the frequent side effects of a Methylprednisolone infusion are anxiety,
insomnia, and mood swings.
A 30-year old Caucasian woman who works the night shift has been found to have early bone
loss and has a high risk for osteomalacia and bone degradation. She asks the nurse exactly why
she should take Vitamin D supplements. What is the nurse's best response?
1. "It's a standard part of the overall nutritional treatment for the prevention of osteomalacia"
2. "It helps your intestines absorb calcium, which is important for bone formation."
,3. "It stimulates skin cells to produce calcium, which is then released into the bloodstream to be
used for bone formation."
4. "Vitamin D supplements should not be taken by someone of your age." -Answer:1. "It's a
standard part of the overall nutritional treatment for the prevention of osteomalacia"
Incorrect - While this is true, it doesn't answer the woman's question.
2. "It helps your intestines absorb calcium, which is important for bone formation."
Correct - This is the correct mechanism of action for Vitamin D
3. "It stimulates skin cells to produce calcium, which is then released into the bloodstream to be
used for bone formation."
Incorrect- This is not the correct mechanism of action for Vitamin D
4. "Vitamin D supplements should not be taken by someone of your age."
Incorrect - Vitamin D supplements should be taken for patients who are homebound,
institutionalized, or by some other limitations, unable to meet daily requirements. This woman
works the night shift, which may limit her ability to absorb Vitamin D naturally.
A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The patient is
living at home with her daughter. The nurse is most concerned about which side effect of
ropinirole?
1. Slurred speech
2. Sudden dizziness
3. Masklike facial expression
4. Stooped Posture -Answer:1. Slurred speech
Incorrect - Slurred speech is a common symptom of PD, not a side effect of this drug.
2. Sudden dizziness
Correct - Dizziness and orthostatic hypotension are serious adverse effects of this drug that can
lead to an increased risk of falls. Ropinirole's drug class is a dopamine agonist, which mimic
dopamine in the brain (PD is characterized by a lack of dopamine).
3. Masklike facial expression
Incorrect - Masklike facial expression is a common symptom of PD, not a side effect of this
drug.
4. Stooped Posture
Incorrect - Stooped Posture is a common symptom of PD, not a side effect of this drug.
A 65 year old man is prescribed Flomax (Tamsulosin) for Benign Prostatic Hyperplasia. The
patient lives in an upstairs apartment. The nurse is most concerned about which side effect of
Flomax?
1. Hypotension
,2. Tachycardia
3. Back Pain
4. Difficulty Urinating -Answer:1. Hypotension
Correct - Hypotension can lead to dizziness and a risk for injury to the patient.
2. Tachycardia
Tachycardia can be a side effect of Flomax, but is not an immediate safety risk, nor is it a
common side effect.
3. Back Pain
Back Pain can be a side effect of Floma, but is not a safety risk
4. Difficulty Urinating
Dysuria is a symptom of Benign Prostatic Hyperplasia, not a side effect of Flomax
A client with Multiple Sclerosis reports a constant, burning, tingling pain in the shoulders. The
nurse anticipates that the physician will order which medication for this type of pain?
1. alprazolam (Xanax)
2. Corticosteroid injection
3. gabapentin (Neurontin)
4. hydrocodone/acetaminophen (Norco) -Answer:1. alprazolam (Xanax)
Incorrect - alprazolam is used to reduce anxiety
2. Corticosteroid injection
Incorrect - Corticosteroid injections are used to reduce inflammation in a localized area, often
due to joint breakdown. In MS patients it is used to treat acute exacerbations ("flare-ups"), but
the symptoms described do not constitute an acute exacerbation.
3. gabapentin (Neurontin)
Correct - Anticonvulsants like gabapentin are often the first line of treatment for nerve pain
4. hydrocodone/acetaminophen (Norco)
Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
A female patient is prescribed metformin for glucose control. The patient is on NPO status
pending a diagnostic test. The nurse is most concerned about which side effect of metformin?
1. Diarrhea and Vomiting
2. Dizziness and Drowsiness
3. Metallic taste
4. Hypoglycemia -Answer:1. Diarrhea and Vomiting
Incorrect - While these may occur, the patient is at higher risk for another adverse effect.
2. Dizziness and Drowsiness
Incorrect - While these may occur, the patient is at higher risk for another adverse effect.
, 3. Metallic taste
Incorrect - While this may occur, the patient is at higher risk for another adverse effect.
4. Hypoglycemia
Correct - The patient is at risk because she is on NPO status and continuing to take an anti-
glycemic drug.
A female patient with atrial fibrillation has the following lab results: Hemoglobin of 11 g/dl, a
platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which result is critical
and should be reported to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L -Answer:1. Hemoglobin 11 g/dl
This is below normal, but a normal female hemoglobin is 12-14. There is a more critical lab
result.
2. Platelet of 150,000
This is also below the normal values, but is not the most critical lab result.
3. INR of 2.5
This is a therapeutic range for a patient who is taking an anticoagulant for atrial fibrillation
4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a patient with a history of dysrhythmia can be life-
threatening and can lead to cardiac distress.
A man is has been taking lisinopril for CHF. The patient is seen in the emergency room for
persistent diarrhea. The nurse is concerned about which side effect of lisinopril?
1. Vertigo
2. Hypotension
3. Palpitations
4. Nagging, dry cough -Answer:1. Vertigo
Incorrect - While this may occur, the patient is at higher risk due to another adverse effect.
2. Hypotension
Correct - The patient is particularly at risk for hypotension due to possible dehydration from
fluid loss.
3. Palpitations
Incorrect - While this may occur, the patient is at higher risk for another adverse effect.
4. Nagging, dry cough
