NCLEX-RN ADVANCED COMPREHENSIVE
PRACTICE EXAM 1
3. A 68-year-old male with a history of hypertension and diabetes has
undergone a cardiac catheterization to evaluate potential coronary artery
disease. He has a known allergy to iodine-based contrast agents, which
required premedication with corticosteroids and antihistamines. The
procedure was successful, but the patient experienced brief hypotension
during the administration of the contrast material. The patient has been
transferred to the cardiac step-down unit for observation, and the nurse is
aware of the potential complications that can arise in the initial 24 hours
post-procedure. Which complication should the nurse monitor closely
during this period?
A. Persistent angina despite being at rest and receiving nitroglycerin
B. Thrombus formation leading to decreased peripheral pulses and
cyanosis
C. Dizziness accompanied by a sudden drop in blood pressure when
standing D. Gradual decrease in blood pressure with no other symptoms
1.During a community health assessment at a local school’s parent-teacher
conference, the nurse encounters several parents and caregivers. Based on
their shared histories and lifestyles, the nurse determines the risk factors
for hypertension among them. Which of the following individuals is at the
HIGHEST risk for developing hypertension?
,A. A 45-year-old African-American attorney with a family history of
hypertension, who has a sedentary lifestyle, consumes a diet high in
sodium, and recently had a significant weight gain.
B. A 60-year-old Asian-American shop owner with a BMI of 28, who has
well-managed type 2 diabetes, takes medications for high cholesterol,
and engages in regular physical activity.
C. A 40-year-old Caucasian nurse who is a vegetarian, has a healthy BMI, is
a non-smoker but reports high levels of work-related stress and
consumes excessive amounts of caffeine.
D. A 55-year-old Hispanic teacher who smokes occasionally, has a healthy
BMI, participates in a moderate-intensity exercise program, and recently
started taking oral contraceptives.
E. A 50-year-old Middle Eastern engineer with a BMI of 26, who has a
family history of cardiovascular diseases, does not engage in any form of
exercise, and has recently been diagnosed with obstructive sleep apnea.
F. A 52-year-old Native American artist with a family history of kidney
disease, who smokes a pack of cigarettes daily, drinks alcohol
excessively, and reports infrequent physical activity.
G. A 43-year-old European baker who has a BMI of 30, often deals with job-
related stress, consumes a
diet rich in pastries and sweets, and has a sedentary lifestyle due to long
work hours.
2. A 15-year-old female with a history of depression is brought to the
emergency department.
Nurse’s Notes:
, 1115: A 15-year-old female with a history of depression and recent
relationship troubles with her close friends is brought to the emergency
department by her concerned parents after they found an empty bottle of
maximum-strength acetaminophen in her room. Upon questioning, the
patient tearfully admits to ingesting 15 tablets of the medication 45 minutes
ago. She is visibly anxious and frequently looks at the marks on her wrists,
which seem to be superficial scratches.
Vital signs as of 1115:
Blood pressure: 120/70
Heart rate: 88 bpm
Respiratory rate: 18 bpm
Oxygen saturation: 98% on room air
As the nurse prepares to address the situation, several orders from the
primary care provider come in. Which of the following orders should the
nurse prioritize and carry out first?
A. Perform gastric lavage
B. Administer acetylcysteine (Mucomyst) orally
C. Start an IV with Dextrose 5% and 0.33% normal saline D. Have the
patient drink activated charcoal mixed with water
E. Conduct a psychiatric evaluation.
F. Apply wrist restraints to prevent further self-harm.
PRACTICE EXAM 1
3. A 68-year-old male with a history of hypertension and diabetes has
undergone a cardiac catheterization to evaluate potential coronary artery
disease. He has a known allergy to iodine-based contrast agents, which
required premedication with corticosteroids and antihistamines. The
procedure was successful, but the patient experienced brief hypotension
during the administration of the contrast material. The patient has been
transferred to the cardiac step-down unit for observation, and the nurse is
aware of the potential complications that can arise in the initial 24 hours
post-procedure. Which complication should the nurse monitor closely
during this period?
A. Persistent angina despite being at rest and receiving nitroglycerin
B. Thrombus formation leading to decreased peripheral pulses and
cyanosis
C. Dizziness accompanied by a sudden drop in blood pressure when
standing D. Gradual decrease in blood pressure with no other symptoms
1.During a community health assessment at a local school’s parent-teacher
conference, the nurse encounters several parents and caregivers. Based on
their shared histories and lifestyles, the nurse determines the risk factors
for hypertension among them. Which of the following individuals is at the
HIGHEST risk for developing hypertension?
,A. A 45-year-old African-American attorney with a family history of
hypertension, who has a sedentary lifestyle, consumes a diet high in
sodium, and recently had a significant weight gain.
B. A 60-year-old Asian-American shop owner with a BMI of 28, who has
well-managed type 2 diabetes, takes medications for high cholesterol,
and engages in regular physical activity.
C. A 40-year-old Caucasian nurse who is a vegetarian, has a healthy BMI, is
a non-smoker but reports high levels of work-related stress and
consumes excessive amounts of caffeine.
D. A 55-year-old Hispanic teacher who smokes occasionally, has a healthy
BMI, participates in a moderate-intensity exercise program, and recently
started taking oral contraceptives.
E. A 50-year-old Middle Eastern engineer with a BMI of 26, who has a
family history of cardiovascular diseases, does not engage in any form of
exercise, and has recently been diagnosed with obstructive sleep apnea.
F. A 52-year-old Native American artist with a family history of kidney
disease, who smokes a pack of cigarettes daily, drinks alcohol
excessively, and reports infrequent physical activity.
G. A 43-year-old European baker who has a BMI of 30, often deals with job-
related stress, consumes a
diet rich in pastries and sweets, and has a sedentary lifestyle due to long
work hours.
2. A 15-year-old female with a history of depression is brought to the
emergency department.
Nurse’s Notes:
, 1115: A 15-year-old female with a history of depression and recent
relationship troubles with her close friends is brought to the emergency
department by her concerned parents after they found an empty bottle of
maximum-strength acetaminophen in her room. Upon questioning, the
patient tearfully admits to ingesting 15 tablets of the medication 45 minutes
ago. She is visibly anxious and frequently looks at the marks on her wrists,
which seem to be superficial scratches.
Vital signs as of 1115:
Blood pressure: 120/70
Heart rate: 88 bpm
Respiratory rate: 18 bpm
Oxygen saturation: 98% on room air
As the nurse prepares to address the situation, several orders from the
primary care provider come in. Which of the following orders should the
nurse prioritize and carry out first?
A. Perform gastric lavage
B. Administer acetylcysteine (Mucomyst) orally
C. Start an IV with Dextrose 5% and 0.33% normal saline D. Have the
patient drink activated charcoal mixed with water
E. Conduct a psychiatric evaluation.
F. Apply wrist restraints to prevent further self-harm.
