NCLEX-RN Test 1 for 2024-2025 Proctored
Exam 2023-2025 WITH NGN 100 Questions
The nurse is teaching the client's spouse about managing worsening symptoms during the
evening and night. Which of the following statements by the spouse indicate a correct
understanding of the teaching?
1. "I can verbally redirect my spouse when my spouse refuses care."
2."I should avoid offering my spouse caffeine in the afternoon."
4. "I will keep the lights on and the blinds open during the day."
Clients with Alzheimer disease may experience neuropsychiatric symptoms (eg, agitation,
aggression, delusions, hallucinations) as the disease progresses. Many clients experience
worsening of these symptoms during the late afternoon and evening (eg, sundowning). The
nurse should teach the caregiver about techniques to reduce distress and manage symptoms of
sundowning, including:
Verbally redirecting the client when the client refuses care. Redirection shifts the client's
attention from a distressing situation and eases their anxiety and frustration (Option 1).
Promoting a normal daytime/nighttime cycle by restricting caffeine later in the day, and
increasing daytime exposure to light (eg, keeping lights on/blinds open) encourages a normal
circadian rhythm (Options 2 and 4).
The nurse conducts a developmental assessment of a 4-year-old child. Which of the following
tasks does the nurse anticipate that the child will perform successfully?
1. Draw a circle
4. Use a spoon and fork
5. Walk up and down the stairs
Preschool-age children begin to master more gross motor activities while rapidly increasing
their fine motor abilities. The preschooler age 4 should have the fine motor skills to manipulate
small tools (eg, scissors, pencil) and therefore be able to draw simple shapes (eg, circle, square)
and perform more self-care activities (eg, eating with a spoon and fork) (Options 1 and 4).
,The gross motor skills and balance of a child age 4 improve, allowing for more independent,
complex movements (eg, walking up and down stairs) (Option 5).
It is normal for preschool-age children to be unable to sit quietly for longer than 15 minutes at a
time. Jump rope: age 5
The nurse in the public health clinic is caring for a client with pubic lice. Which of the
following statements should the nurse include in the education? Select all that apply.
2. Remove nits from pubic hair with a fine-toothed nit comb."
3."Sexual partners should also receive treatment."
4."Wash clothes and linens with hot water."
5."Wash pubic hair with lice treatment shampoo."
Pediculosis pubis (ie, "crabs") is an infestation of pubic lice. Clients with pubic lice should be
given the following instructions:
Use lice treatment shampoo (1% permethrin) or rinse on pubic and body hair to kill lice (Option
5)
After treatment, remove nits with a fine-toothed nit comb, fingernails, or tweezers (Option 2)
Wash and dry clothes, towels, and bedding with hot water and highest-heat dryer
setting (Option 4)
Sexual partners should also receive pubic lice treatment (Option 3)
A client with a history of a seizure disorder has a seizure while sitting in a chair. Which
nursing interventions are appropriate for a client experiencing a seizure?
1. Administer oxygen as needed if client becomes cyanotic
- Administer oxygen as needed in response to signs of hypoxia (eg, cyanosis, pallor) (Option 1).
3.Move the client from the chair to the floor to prevent a fall
- Assist seated or standing clients to lie down (left lateral) while protecting the head, and
position the client on the side to maintain a patent airway and prevent aspiration
4.Record the duration of seizure activity for documentation
- Record and document the time and duration of the seizure
Loosen restrictive clothing and clear the area near the client (eg, furniture corners, sharp or
hard objects) to prevent injury.
,The nurse auscultates the lung sounds of a client with shortness of breath. Then, the nurse
notifies the health care provider about the adventitious sounds heard. Which medication
prescription should the nurse anticipate? Listen to the audio clip. (Headphones are required
for best audio quality.)
2. Bumetanide
Coarse crackles = presence of fluid or mucus in lower respiratory tract -< pulmonary
edema/fibrosis --> loop diuretic
Coarse crackles (loud, low-pitched bubbling) are heard primarily during inspiration and are not
cleared by coughing. The sound is similar to that of Velcro being pulled apart. Coarse crackles
may be confused with fine crackles (eg, atelectasis), which have a high-pitched, popping sound.
Coarse crackles are present when fluid or mucus collects in the lower respiratory tract (eg,
pulmonary edema, pulmonary fibrosis). During heart failure, the left ventricle fails to eject
enough blood, causing increased pressure in the pulmonary vasculature. As a result, fluid leaks
into the alveoli (pulmonary edema). Loop diuretics (eg, bumetanide, furosemide) treat
pulmonary edema by reducing intravascular fluid volume through significant increase of fluid
excretion by the kidneys
Clients with asthma or chronic obstructive pulmonary disease (eg, emphysema) develop
wheezing due to bronchospasm. Bronchodilators (eg, albuterol, ipratropium) and systemic
corticosteroids (eg, methylprednisolone) may be prescribed to these clients
upper respiratory infections or chronic bronchitis ==> guaifensin to loosen and improve the
expectoration of mucus
Math: The nurse is preparing to administer a continuous dopamine infusion at 5 mcg/kg/min.
The client weighs 187 lb and the available medication contains 400 mg of dopamine in 250 mL
of D5W. At what rate in milliliters per hour (mL/hr) should the nurse program the infusion
pump?
Answer: 16
Dopamine is an inotrope and vasopressor used to treat distributive shock and maintain cardiac
output. To calculate the dopamine infusion rate in milliliters per hour, the nurse should first
identify the prescribed dose (eg, 5 mcg/kg/min) and available medication (eg, 400 mg/250 mL)
and then convert to milliliters per hour (eg, 16 mL/hr).
The nurse is caring for an African American client with disseminated intravascular
coagulation. Which locations are best to assess for the presence of petechiae?
1. Buccal mucosae and conjunctivae of the eyes
, Petechiae are reddish or purple pinpoints on the skin that occur due to bleeding from
capillaries. Petechiae usually occur due to blood vessel injury or bleeding disorders (eg,
thrombocytopenia, disseminated intravascular coagulation). Petechiae and similar skin
conditions are often challenging to detect in dark-skinned clients as dark pigmentation makes it
difficult to assess skin color changes. In dark-skinned clients, petechiae can best be assessed in
the conjunctivae of the eyes and the buccal mucosae.
The palms of the hands and soles of the feet are ideal locations for assessing other skin color
changes that may occur in dark-skinned clients, such as jaundice (ie, yellowing of the skin due
to increased bilirubin in the blood). However, these are not ideal locations to assess for
petechiae in a dark-skinned client.
The pediatric nurse plans a home visit for a 2-year-old who will soon be discharged with
home health care. Which condition presents the most concern as a safety hazard in the child's
home environment?
2. House is heated by a wood-burning stove
An open wood-burning stove is a fire hazard that may cause physiologic damage from smoke
inhalation or burns (Option 2). The nurse should investigate the family's access to other
utilities and determine whether the stove is the home's only source of heat.
Houses built before 1978 have a high probability of containing lead-based paint.
The nurse on the antepartum unit is performing shift assessments of several clients that are
pregnant. Which client assessment is the priority to report to the health care provider?
4. Client with preeclampsia with 3+ reflexes and 2 beats of clonus
Clients with preeclampsia are at risk for developing preeclampsia-associated seizure activity
(eg, eclampsia) due to increased central nervous system irritability. The presence of neurologic
manifestations (eg, hyperreflexia, clonus) may indicate worsening preeclampsia and
can precede seizure activity (Option 4). This client is at the most immediate risk of harm and is
the priority to report to the health care provider.
Clients with gestational diabetes mellitus are more susceptible to infection (eg, urinary tract
infection, vaginal yeast infection). Although the client's report of dysuria may indicate a urinary
tract infection, the assessment findings do not indicate immediate risk
After addressing a group of female high school students about sexual health and hygiene, the
nurse recognizes that teaching about human papillomavirus (HPV) and genital warts has been
effective when hearing which of the following client statements? Select all that apply.
1. "A person's genital warts may come back again, even after receiving treatment."
3."Infection with HPV increases my risk of cervical cancer."
Exam 2023-2025 WITH NGN 100 Questions
The nurse is teaching the client's spouse about managing worsening symptoms during the
evening and night. Which of the following statements by the spouse indicate a correct
understanding of the teaching?
1. "I can verbally redirect my spouse when my spouse refuses care."
2."I should avoid offering my spouse caffeine in the afternoon."
4. "I will keep the lights on and the blinds open during the day."
Clients with Alzheimer disease may experience neuropsychiatric symptoms (eg, agitation,
aggression, delusions, hallucinations) as the disease progresses. Many clients experience
worsening of these symptoms during the late afternoon and evening (eg, sundowning). The
nurse should teach the caregiver about techniques to reduce distress and manage symptoms of
sundowning, including:
Verbally redirecting the client when the client refuses care. Redirection shifts the client's
attention from a distressing situation and eases their anxiety and frustration (Option 1).
Promoting a normal daytime/nighttime cycle by restricting caffeine later in the day, and
increasing daytime exposure to light (eg, keeping lights on/blinds open) encourages a normal
circadian rhythm (Options 2 and 4).
The nurse conducts a developmental assessment of a 4-year-old child. Which of the following
tasks does the nurse anticipate that the child will perform successfully?
1. Draw a circle
4. Use a spoon and fork
5. Walk up and down the stairs
Preschool-age children begin to master more gross motor activities while rapidly increasing
their fine motor abilities. The preschooler age 4 should have the fine motor skills to manipulate
small tools (eg, scissors, pencil) and therefore be able to draw simple shapes (eg, circle, square)
and perform more self-care activities (eg, eating with a spoon and fork) (Options 1 and 4).
,The gross motor skills and balance of a child age 4 improve, allowing for more independent,
complex movements (eg, walking up and down stairs) (Option 5).
It is normal for preschool-age children to be unable to sit quietly for longer than 15 minutes at a
time. Jump rope: age 5
The nurse in the public health clinic is caring for a client with pubic lice. Which of the
following statements should the nurse include in the education? Select all that apply.
2. Remove nits from pubic hair with a fine-toothed nit comb."
3."Sexual partners should also receive treatment."
4."Wash clothes and linens with hot water."
5."Wash pubic hair with lice treatment shampoo."
Pediculosis pubis (ie, "crabs") is an infestation of pubic lice. Clients with pubic lice should be
given the following instructions:
Use lice treatment shampoo (1% permethrin) or rinse on pubic and body hair to kill lice (Option
5)
After treatment, remove nits with a fine-toothed nit comb, fingernails, or tweezers (Option 2)
Wash and dry clothes, towels, and bedding with hot water and highest-heat dryer
setting (Option 4)
Sexual partners should also receive pubic lice treatment (Option 3)
A client with a history of a seizure disorder has a seizure while sitting in a chair. Which
nursing interventions are appropriate for a client experiencing a seizure?
1. Administer oxygen as needed if client becomes cyanotic
- Administer oxygen as needed in response to signs of hypoxia (eg, cyanosis, pallor) (Option 1).
3.Move the client from the chair to the floor to prevent a fall
- Assist seated or standing clients to lie down (left lateral) while protecting the head, and
position the client on the side to maintain a patent airway and prevent aspiration
4.Record the duration of seizure activity for documentation
- Record and document the time and duration of the seizure
Loosen restrictive clothing and clear the area near the client (eg, furniture corners, sharp or
hard objects) to prevent injury.
,The nurse auscultates the lung sounds of a client with shortness of breath. Then, the nurse
notifies the health care provider about the adventitious sounds heard. Which medication
prescription should the nurse anticipate? Listen to the audio clip. (Headphones are required
for best audio quality.)
2. Bumetanide
Coarse crackles = presence of fluid or mucus in lower respiratory tract -< pulmonary
edema/fibrosis --> loop diuretic
Coarse crackles (loud, low-pitched bubbling) are heard primarily during inspiration and are not
cleared by coughing. The sound is similar to that of Velcro being pulled apart. Coarse crackles
may be confused with fine crackles (eg, atelectasis), which have a high-pitched, popping sound.
Coarse crackles are present when fluid or mucus collects in the lower respiratory tract (eg,
pulmonary edema, pulmonary fibrosis). During heart failure, the left ventricle fails to eject
enough blood, causing increased pressure in the pulmonary vasculature. As a result, fluid leaks
into the alveoli (pulmonary edema). Loop diuretics (eg, bumetanide, furosemide) treat
pulmonary edema by reducing intravascular fluid volume through significant increase of fluid
excretion by the kidneys
Clients with asthma or chronic obstructive pulmonary disease (eg, emphysema) develop
wheezing due to bronchospasm. Bronchodilators (eg, albuterol, ipratropium) and systemic
corticosteroids (eg, methylprednisolone) may be prescribed to these clients
upper respiratory infections or chronic bronchitis ==> guaifensin to loosen and improve the
expectoration of mucus
Math: The nurse is preparing to administer a continuous dopamine infusion at 5 mcg/kg/min.
The client weighs 187 lb and the available medication contains 400 mg of dopamine in 250 mL
of D5W. At what rate in milliliters per hour (mL/hr) should the nurse program the infusion
pump?
Answer: 16
Dopamine is an inotrope and vasopressor used to treat distributive shock and maintain cardiac
output. To calculate the dopamine infusion rate in milliliters per hour, the nurse should first
identify the prescribed dose (eg, 5 mcg/kg/min) and available medication (eg, 400 mg/250 mL)
and then convert to milliliters per hour (eg, 16 mL/hr).
The nurse is caring for an African American client with disseminated intravascular
coagulation. Which locations are best to assess for the presence of petechiae?
1. Buccal mucosae and conjunctivae of the eyes
, Petechiae are reddish or purple pinpoints on the skin that occur due to bleeding from
capillaries. Petechiae usually occur due to blood vessel injury or bleeding disorders (eg,
thrombocytopenia, disseminated intravascular coagulation). Petechiae and similar skin
conditions are often challenging to detect in dark-skinned clients as dark pigmentation makes it
difficult to assess skin color changes. In dark-skinned clients, petechiae can best be assessed in
the conjunctivae of the eyes and the buccal mucosae.
The palms of the hands and soles of the feet are ideal locations for assessing other skin color
changes that may occur in dark-skinned clients, such as jaundice (ie, yellowing of the skin due
to increased bilirubin in the blood). However, these are not ideal locations to assess for
petechiae in a dark-skinned client.
The pediatric nurse plans a home visit for a 2-year-old who will soon be discharged with
home health care. Which condition presents the most concern as a safety hazard in the child's
home environment?
2. House is heated by a wood-burning stove
An open wood-burning stove is a fire hazard that may cause physiologic damage from smoke
inhalation or burns (Option 2). The nurse should investigate the family's access to other
utilities and determine whether the stove is the home's only source of heat.
Houses built before 1978 have a high probability of containing lead-based paint.
The nurse on the antepartum unit is performing shift assessments of several clients that are
pregnant. Which client assessment is the priority to report to the health care provider?
4. Client with preeclampsia with 3+ reflexes and 2 beats of clonus
Clients with preeclampsia are at risk for developing preeclampsia-associated seizure activity
(eg, eclampsia) due to increased central nervous system irritability. The presence of neurologic
manifestations (eg, hyperreflexia, clonus) may indicate worsening preeclampsia and
can precede seizure activity (Option 4). This client is at the most immediate risk of harm and is
the priority to report to the health care provider.
Clients with gestational diabetes mellitus are more susceptible to infection (eg, urinary tract
infection, vaginal yeast infection). Although the client's report of dysuria may indicate a urinary
tract infection, the assessment findings do not indicate immediate risk
After addressing a group of female high school students about sexual health and hygiene, the
nurse recognizes that teaching about human papillomavirus (HPV) and genital warts has been
effective when hearing which of the following client statements? Select all that apply.
1. "A person's genital warts may come back again, even after receiving treatment."
3."Infection with HPV increases my risk of cervical cancer."
