NCLEX Review Questions (Mark K) – Latest
Update 2026 | Exam Prep PDF | Graded A+
Your pt has respiratory acidosis your pt has:
(select all that apply)
a) +1 reflexes
b) diarrhea
c) a dynamic ileus
d) spasm
e) urinary retention
f) paraxysmol atrial tachycardia
e) 2nd degree, mobitz, type 2 heart block
g) hypokalemia - correct answera) +1 reflexes
c) a dynamic ileus
e) urinary retention
g) 2nd degree, mobitz, type 2 heart block
A pt has pneumonia present in 4 lobes, they have a RR of 52, and a SpO2 of 78. What
acid-base imbalance is the patient exhibiting?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerc) respiratory acidosis
-the rate is less important than the gas exchange, if the SpO2 is 78 then gas exchange
is not good and shows acidosis
-they are under ventilating, under = acidosis
-not about rate about SaO2 or SpO2
If your pt is on a PCA pump, what acid-base imbalance will cause you to take them off
of it?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerc) respiratory acidosis
-PCA pumps depress respirations = underventilation
If your male pt comes in with hyper-emesis what acid-base imbalance would he have?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerb) metabolic alkalosis
-vomiting or suctioning = met alkalosis
,-losing acid
If a male pt comes in with prolonged hyper-emesis that has lead to dehydration what
acid-base imbalance would they have?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-even though the pt is vomiting, they are now dehydrated which is the main take away
from the question, dehydration = acidosis
If an infant comes in with diarrhea, what acid-base imbalance is anticipated?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-diarrhea is not vomiting or suctioning so it is not alkalosis
-diarrhea leads to dehydration = acidosis
If your pt is in kidney failure, what acid-base imbalance do you expect to see?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-not a lung issue
-not due to vomiting or suctioning
If a pt has third degree (full thickness) burns over 60% of their body in the first phase,
what acid-base imbalance do you expect to see?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-not a lung issue
-not due to vomiting or suctioning
How often do you suction pts?
a) every 2 hrs
b) every 15 min
c) every hour
d) every 4 hours
e) none of the above - correct answere) none of the above
-suction as needed only
-suctioning is a double edge sword, the more your suction the more secretions are
produced
,You have a type 2 DM, what is the best dietary route to take?
a) restrict their calories
b) divide their food into 6 feeding/day - correct answera) restrict their calories
**both are needed but since this is a "best" question this is the best option
A young boy with type one diabetes comes into the E.R. with a blood glucose of 800,
what is the best question to ask his parents to determine the cause of the DKA?
a) Has your child be involved in high activity today?
b) Did your child have an extra dose of insulin today?
c) Has your child had an URI in the last two weeks?
d) Did your child skip a meal today? - correct answerc) Has your child had an URI in the
last two weeks?
**(A) is correct but not the BEST answer, the most common cause of DKA is upper
respiratory infection
--the stress of the illness causes the body to break down fats, leading to ketones
--need to confirm with ketones in the blood, ketonuria can be present without DKA so
this is not diagnostic
In what position should you put an opisthotonus baby?
a) side
b) prone
c) supine
d) head elevated (sitting) - correct answera) side
**opisthotonus is a hyperextention of the neck and back and can occur when an
elevated bilirubin passes the BBB of a baby
--important to report immediately as its a sign of impending kernicterus
Your Pt has hyperkalemia, select all that apply:
a) dynamic ileus
b) obtundant
c) +1 reflex
d) clonus
e) u wave
f) depressed ST
g) polyuria
h) bradycardia - correct answerd) clonus
h) bradycardia
**-kalemias do the same as the prefix except for the HR and urine output
---U wave starts on the baseline and goes down, its a sign of cardiac depression (if you
don't know what it is on a select all apply then don't pick it)
Your pt has diarrhea, what caused it?
a) hyperkalemia
b) hypokalemia
, c) hypocalcemia
d) hypomagnesemia - correct answera) hyperkalemia
**if a tie and its not muscle or nerves then its always K+
A student nurse runs to you and says they ran 1L of IV into the pt in 10 min b/c they
forgot to clamp it, what electrolyte imbalance to you expect to see? - correct answer-
hyponatremia
**would be put on fluid restriction, has fluid overload
Your pt has hypothyroidism, what pre-op order would you question?
a) penicillin
b) insulin
c) ambien - correct answerc) ambien
**pt should not be given sedation medications, can lead to myxedema coma
--their whole body is slowed b/c decreased coma
A pt underwent a lumbar laminectomy 10 hours ago, whats the number one problem
you could expect?
a) airway
b) breathing
c) circulation
d) urinary retention - correct answerd) urinary retention
-complications of laminectomies all depend on the location, if a lumbar lam then need to
look for issues with the bladder and the legs
>>cervical: breathing and arms
>>thoracic: cough and bowels
You are caring for a pt with a lumbar oligodendrocytoma, what is the number one
problem?
a) airway
b) ileus
c) cardiac arrhythmia
d) urinary retention - correct answerd) urinary retention
-the illness does not determine the answer, the location does, don't worry about what
the big word means
You are caring for a pt whose lab value for INR came back as a 4.5. Arrange the order
of actions you would take from first to last.
a) assess for bleeding
b) call physician
c) stop Warfarin/coumadin
d) prepare vitamin K antidote - correct answerc) stop Warfarin/coumadin
a) assess for bleeding
Update 2026 | Exam Prep PDF | Graded A+
Your pt has respiratory acidosis your pt has:
(select all that apply)
a) +1 reflexes
b) diarrhea
c) a dynamic ileus
d) spasm
e) urinary retention
f) paraxysmol atrial tachycardia
e) 2nd degree, mobitz, type 2 heart block
g) hypokalemia - correct answera) +1 reflexes
c) a dynamic ileus
e) urinary retention
g) 2nd degree, mobitz, type 2 heart block
A pt has pneumonia present in 4 lobes, they have a RR of 52, and a SpO2 of 78. What
acid-base imbalance is the patient exhibiting?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerc) respiratory acidosis
-the rate is less important than the gas exchange, if the SpO2 is 78 then gas exchange
is not good and shows acidosis
-they are under ventilating, under = acidosis
-not about rate about SaO2 or SpO2
If your pt is on a PCA pump, what acid-base imbalance will cause you to take them off
of it?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerc) respiratory acidosis
-PCA pumps depress respirations = underventilation
If your male pt comes in with hyper-emesis what acid-base imbalance would he have?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerb) metabolic alkalosis
-vomiting or suctioning = met alkalosis
,-losing acid
If a male pt comes in with prolonged hyper-emesis that has lead to dehydration what
acid-base imbalance would they have?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-even though the pt is vomiting, they are now dehydrated which is the main take away
from the question, dehydration = acidosis
If an infant comes in with diarrhea, what acid-base imbalance is anticipated?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-diarrhea is not vomiting or suctioning so it is not alkalosis
-diarrhea leads to dehydration = acidosis
If your pt is in kidney failure, what acid-base imbalance do you expect to see?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-not a lung issue
-not due to vomiting or suctioning
If a pt has third degree (full thickness) burns over 60% of their body in the first phase,
what acid-base imbalance do you expect to see?
a) respiratory alkalosis
b) metabolic alkalosis
c) respiratory acidosis
d) metabolic acidosis - correct answerd) metabolic acidosis
-not a lung issue
-not due to vomiting or suctioning
How often do you suction pts?
a) every 2 hrs
b) every 15 min
c) every hour
d) every 4 hours
e) none of the above - correct answere) none of the above
-suction as needed only
-suctioning is a double edge sword, the more your suction the more secretions are
produced
,You have a type 2 DM, what is the best dietary route to take?
a) restrict their calories
b) divide their food into 6 feeding/day - correct answera) restrict their calories
**both are needed but since this is a "best" question this is the best option
A young boy with type one diabetes comes into the E.R. with a blood glucose of 800,
what is the best question to ask his parents to determine the cause of the DKA?
a) Has your child be involved in high activity today?
b) Did your child have an extra dose of insulin today?
c) Has your child had an URI in the last two weeks?
d) Did your child skip a meal today? - correct answerc) Has your child had an URI in the
last two weeks?
**(A) is correct but not the BEST answer, the most common cause of DKA is upper
respiratory infection
--the stress of the illness causes the body to break down fats, leading to ketones
--need to confirm with ketones in the blood, ketonuria can be present without DKA so
this is not diagnostic
In what position should you put an opisthotonus baby?
a) side
b) prone
c) supine
d) head elevated (sitting) - correct answera) side
**opisthotonus is a hyperextention of the neck and back and can occur when an
elevated bilirubin passes the BBB of a baby
--important to report immediately as its a sign of impending kernicterus
Your Pt has hyperkalemia, select all that apply:
a) dynamic ileus
b) obtundant
c) +1 reflex
d) clonus
e) u wave
f) depressed ST
g) polyuria
h) bradycardia - correct answerd) clonus
h) bradycardia
**-kalemias do the same as the prefix except for the HR and urine output
---U wave starts on the baseline and goes down, its a sign of cardiac depression (if you
don't know what it is on a select all apply then don't pick it)
Your pt has diarrhea, what caused it?
a) hyperkalemia
b) hypokalemia
, c) hypocalcemia
d) hypomagnesemia - correct answera) hyperkalemia
**if a tie and its not muscle or nerves then its always K+
A student nurse runs to you and says they ran 1L of IV into the pt in 10 min b/c they
forgot to clamp it, what electrolyte imbalance to you expect to see? - correct answer-
hyponatremia
**would be put on fluid restriction, has fluid overload
Your pt has hypothyroidism, what pre-op order would you question?
a) penicillin
b) insulin
c) ambien - correct answerc) ambien
**pt should not be given sedation medications, can lead to myxedema coma
--their whole body is slowed b/c decreased coma
A pt underwent a lumbar laminectomy 10 hours ago, whats the number one problem
you could expect?
a) airway
b) breathing
c) circulation
d) urinary retention - correct answerd) urinary retention
-complications of laminectomies all depend on the location, if a lumbar lam then need to
look for issues with the bladder and the legs
>>cervical: breathing and arms
>>thoracic: cough and bowels
You are caring for a pt with a lumbar oligodendrocytoma, what is the number one
problem?
a) airway
b) ileus
c) cardiac arrhythmia
d) urinary retention - correct answerd) urinary retention
-the illness does not determine the answer, the location does, don't worry about what
the big word means
You are caring for a pt whose lab value for INR came back as a 4.5. Arrange the order
of actions you would take from first to last.
a) assess for bleeding
b) call physician
c) stop Warfarin/coumadin
d) prepare vitamin K antidote - correct answerc) stop Warfarin/coumadin
a) assess for bleeding
