NUR 114
FINAL EXAM
NCLEX Style Questions w/
Rationales & Test Taking Strategies
Jefferson State Community College
This Document Description:
❖ This document contains NCLEX-style Exam
questions tailored to the NUR 114 course at
Jefferson State Community College.
❖ It covers core topics assessed in the course
and reflects the actual exam format and question style.
❖ Each question is followed by a correct answer, rationale, and
test-taking strategy to support exam preparation.
,A client with atrial fibrillation who is receiving maintenance therapy
of warfarin sodium has a prothrombin time (PT) of 35 seconds. On
the basis of these laboratory values, the nurse anticipates which
prescription?
1. Adding a dose of heparin sodium
2. Holding the next dose of warfarin
3. Increasing the next dose of warfarin
4. Administering the next dose of warfarin
Answer: 2
Rationale: The normal PT is 11 to 12.5 seconds (conventional therapy
and SI units). A therapeutic PT level is 1.5 to 2 times higher than the
normal level. Because the value of 35 seconds is high, the nurse would
anticipate that the client would not receive further doses at this time.
Therefore, the prescriptions noted in the remaining options are
incorrect.
Test-Taking Strategy: Focus on the subject, a PT of 35 seconds. Recall
the normal range for this value and remember that a PT greater than 25
seconds places the client at risk for bleeding; this will direct you to the
correct option.
The nurse is caring for a client with a diagnosis of breast cancer who
is immunosuppressed. The nurse would implement neutropenic
precautions if the client's white blood cell count was which value?
1. 2000 mm3 (2.0 × 109/L)
,2. 5800 mm3 (5.8 × 109/L)
3. 8400 mm (8.4 × 109/L)
4. 11,500 mm3 (11.5 × 109/L)
Answer: 1
Rationale: The normal WBC count ranges from 5000 to 10,000 mm3 (5
to 10 × 109/L). The client who has a decrease in the number of
circulating WBCs is immunosuppressed. The nurse implements
neutropenic precautions when the client’s values fall sufficiently below
the normal level. The specific value for implementing neutropenic
precautions usually is determined by agency policy. The remaining
options are normal values.
Test-Taking Strategy: Focus on the subject, the need to implement
neutropenic precautions. Recalling what neutropenic precautions
involve and that the normal WBC count is 5000 to 10,000 mm3 (5 to 10
× 109/L) will direct you to the correct option.
A client has been admitted to the hospital for gastroenteritis and
dehydration. The nurse determines that the client has received
adequate volume replacement if the blood urea nitrogen (BUN) level
drops to which value?
1. 3 mg/dL (1.08 mmol/L)
2. 15 mg/dL (5.4 mmol/L)
3. 29 mg/dL (10.44 mmol/L)
4. 35 mg/dL (12.6 mmol/L)
, Answer: 2
Rationale: The normal BUN level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L).
Values of 29 mg/dL (10.44 mmol/L) and 35 mg/ dL (12.6 mmol/L)
reflect continued dehydration. A value of 3 mg/dL (1.08 mmol/L)
reflects a lower-than-normal value, which may occur with fluid volume
overload, among other conditions.
Test-Taking Strategy: Focus on the subject, adequate fluid replacement
and the normal BUN level. The correct option is the only option that
identifies a normal value.
A client is receiving a continuous intravenous infusion of heparin
sodium to treat deep vein thrombosis. The client's activated partial
thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that
which action is needed?
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
Answer: 4
Rationale: The normal aPTT varies between 30 and 40 seconds (30 and
40 seconds), depending on the type of activator used in testing. The
therapeutic dose of heparin for treatment of deep vein thrombosis is to
keep the aPTT between 1.5 times (45 to 60) and 2.5 times (75 to 100)
FINAL EXAM
NCLEX Style Questions w/
Rationales & Test Taking Strategies
Jefferson State Community College
This Document Description:
❖ This document contains NCLEX-style Exam
questions tailored to the NUR 114 course at
Jefferson State Community College.
❖ It covers core topics assessed in the course
and reflects the actual exam format and question style.
❖ Each question is followed by a correct answer, rationale, and
test-taking strategy to support exam preparation.
,A client with atrial fibrillation who is receiving maintenance therapy
of warfarin sodium has a prothrombin time (PT) of 35 seconds. On
the basis of these laboratory values, the nurse anticipates which
prescription?
1. Adding a dose of heparin sodium
2. Holding the next dose of warfarin
3. Increasing the next dose of warfarin
4. Administering the next dose of warfarin
Answer: 2
Rationale: The normal PT is 11 to 12.5 seconds (conventional therapy
and SI units). A therapeutic PT level is 1.5 to 2 times higher than the
normal level. Because the value of 35 seconds is high, the nurse would
anticipate that the client would not receive further doses at this time.
Therefore, the prescriptions noted in the remaining options are
incorrect.
Test-Taking Strategy: Focus on the subject, a PT of 35 seconds. Recall
the normal range for this value and remember that a PT greater than 25
seconds places the client at risk for bleeding; this will direct you to the
correct option.
The nurse is caring for a client with a diagnosis of breast cancer who
is immunosuppressed. The nurse would implement neutropenic
precautions if the client's white blood cell count was which value?
1. 2000 mm3 (2.0 × 109/L)
,2. 5800 mm3 (5.8 × 109/L)
3. 8400 mm (8.4 × 109/L)
4. 11,500 mm3 (11.5 × 109/L)
Answer: 1
Rationale: The normal WBC count ranges from 5000 to 10,000 mm3 (5
to 10 × 109/L). The client who has a decrease in the number of
circulating WBCs is immunosuppressed. The nurse implements
neutropenic precautions when the client’s values fall sufficiently below
the normal level. The specific value for implementing neutropenic
precautions usually is determined by agency policy. The remaining
options are normal values.
Test-Taking Strategy: Focus on the subject, the need to implement
neutropenic precautions. Recalling what neutropenic precautions
involve and that the normal WBC count is 5000 to 10,000 mm3 (5 to 10
× 109/L) will direct you to the correct option.
A client has been admitted to the hospital for gastroenteritis and
dehydration. The nurse determines that the client has received
adequate volume replacement if the blood urea nitrogen (BUN) level
drops to which value?
1. 3 mg/dL (1.08 mmol/L)
2. 15 mg/dL (5.4 mmol/L)
3. 29 mg/dL (10.44 mmol/L)
4. 35 mg/dL (12.6 mmol/L)
, Answer: 2
Rationale: The normal BUN level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L).
Values of 29 mg/dL (10.44 mmol/L) and 35 mg/ dL (12.6 mmol/L)
reflect continued dehydration. A value of 3 mg/dL (1.08 mmol/L)
reflects a lower-than-normal value, which may occur with fluid volume
overload, among other conditions.
Test-Taking Strategy: Focus on the subject, adequate fluid replacement
and the normal BUN level. The correct option is the only option that
identifies a normal value.
A client is receiving a continuous intravenous infusion of heparin
sodium to treat deep vein thrombosis. The client's activated partial
thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that
which action is needed?
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
Answer: 4
Rationale: The normal aPTT varies between 30 and 40 seconds (30 and
40 seconds), depending on the type of activator used in testing. The
therapeutic dose of heparin for treatment of deep vein thrombosis is to
keep the aPTT between 1.5 times (45 to 60) and 2.5 times (75 to 100)
