**Title:** **The Comprehensive Nursing School
Exit Exam: NCLEX-RN Final Review**
---
### Question 1 of 91
A nurse is assessing a client who is 2 days post-operative following a total hip arthroplasty. Which of the
following findings requires immediate intervention?
A) Pain in the operative hip rated 4/10
B) Mild erythema around the incision
C) Shortness of breath and chest pain
D) Temperature 37.8°C (100.0°F)
💫RATIONALE✔️✔️: Shortness of breath and chest pain (C) after hip surgery indicate possible pulmonary
embolism. Immediate intervention required. Mild pain, erythema, low-grade fever are expected.
💫ANSWER✔️✔️: C) Shortness of breath and chest pain
---
### Question 2 of 91
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. The client asks, "Why do I
need to take insulin instead of pills?" Which response should the nurse give?
A) "Your pancreas is no longer producing insulin, so you need to replace it."
,B) "Pills for diabetes only work for people who are overweight."
C) "Insulin is safer than oral medications for younger adults."
D) "You can switch to pills once your blood sugar is under control."
💫RATIONALE✔️✔️: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells causing
absolute insulin deficiency (A). Oral agents require some endogenous insulin production.
💫ANSWER✔️✔️: A) "Your pancreas is no longer producing insulin, so you need to replace it."
---
### Question 3 of 91
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to a client with heart failure.
Which statements by the client indicate understanding? (Select all that apply.)
A) "I will weigh myself every morning before breakfast."
B) "I will call my doctor if I gain 2-3 pounds in a day."
C) "I can stop my diuretic if I feel short of breath."
D) "I will limit my sodium intake to less than 2,300 mg per day."
E) "I will elevate my legs when sitting."
💫RATIONALE✔️✔️: Daily weights (A), reporting rapid gain (B), sodium restriction (D), leg elevation (E)
correct. Never stop diuretics without provider guidance (C wrong).
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 91
,A nurse is caring for a client who has a chest tube connected to a water-seal drainage system. The nurse
notes continuous bubbling in the water-seal chamber. Which action should the nurse take first?
A) Clamp the chest tube near the insertion site.
B) Check the tubing connections for air leaks.
C) Notify the healthcare provider immediately.
D) Document the finding as normal.
💫RATIONALE✔️✔️: Continuous bubbling indicates an air leak. First check connections (B). Clamping is
dangerous. If leak persists, notify provider.
💫ANSWER✔️✔️: B) Check the tubing connections for air leaks.
---
### Question 5 of 91
A nurse is providing education to a client with a new prescription for warfarin (Coumadin). Which
statement by the client indicates understanding?
A) "I will take ibuprofen for my headaches."
B) "I will have my INR checked regularly as ordered."
C) "I can eat large amounts of spinach and kale."
D) "If I miss a dose, I will take two the next day."
💫RATIONALE✔️✔️: Regular INR monitoring (B) essential. Avoid NSAIDs, consistent vitamin K intake, no
double-dosing.
💫ANSWER✔️✔️: B) "I will have my INR checked regularly as ordered."
---
, ### Question 6 of 91
A nurse is caring for a client who is receiving a blood transfusion. Fifteen minutes after starting, the
client reports low back pain and chills. Which action should the nurse take first?
A) Slow the infusion rate.
B) Stop the transfusion.
C) Administer acetaminophen.
D) Notify the provider.
💫RATIONALE✔️✔️: Low back pain and chills indicate hemolytic reaction. First stop transfusion (B), then
disconnect tubing, maintain IV access, notify provider.
💫ANSWER✔️✔️: B) Stop the transfusion.
---
### Question 7 of 91
**Select-All-That-Apply (SATA):** A nurse is assessing a client with hyperthyroidism. Which findings
should the nurse expect? (Select all that apply.)
A) Weight loss
B) Bradycardia
C) Heat intolerance
D) Exophthalmos
E) Constipation
💫RATIONALE✔️✔️: Hyperthyroidism causes weight loss (A), heat intolerance (C), exophthalmos (D).
Bradycardia and constipation are hypothyroidism.
💫ANSWER✔️✔️: A, C, D
Exit Exam: NCLEX-RN Final Review**
---
### Question 1 of 91
A nurse is assessing a client who is 2 days post-operative following a total hip arthroplasty. Which of the
following findings requires immediate intervention?
A) Pain in the operative hip rated 4/10
B) Mild erythema around the incision
C) Shortness of breath and chest pain
D) Temperature 37.8°C (100.0°F)
💫RATIONALE✔️✔️: Shortness of breath and chest pain (C) after hip surgery indicate possible pulmonary
embolism. Immediate intervention required. Mild pain, erythema, low-grade fever are expected.
💫ANSWER✔️✔️: C) Shortness of breath and chest pain
---
### Question 2 of 91
A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus. The client asks, "Why do I
need to take insulin instead of pills?" Which response should the nurse give?
A) "Your pancreas is no longer producing insulin, so you need to replace it."
,B) "Pills for diabetes only work for people who are overweight."
C) "Insulin is safer than oral medications for younger adults."
D) "You can switch to pills once your blood sugar is under control."
💫RATIONALE✔️✔️: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells causing
absolute insulin deficiency (A). Oral agents require some endogenous insulin production.
💫ANSWER✔️✔️: A) "Your pancreas is no longer producing insulin, so you need to replace it."
---
### Question 3 of 91
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to a client with heart failure.
Which statements by the client indicate understanding? (Select all that apply.)
A) "I will weigh myself every morning before breakfast."
B) "I will call my doctor if I gain 2-3 pounds in a day."
C) "I can stop my diuretic if I feel short of breath."
D) "I will limit my sodium intake to less than 2,300 mg per day."
E) "I will elevate my legs when sitting."
💫RATIONALE✔️✔️: Daily weights (A), reporting rapid gain (B), sodium restriction (D), leg elevation (E)
correct. Never stop diuretics without provider guidance (C wrong).
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 91
,A nurse is caring for a client who has a chest tube connected to a water-seal drainage system. The nurse
notes continuous bubbling in the water-seal chamber. Which action should the nurse take first?
A) Clamp the chest tube near the insertion site.
B) Check the tubing connections for air leaks.
C) Notify the healthcare provider immediately.
D) Document the finding as normal.
💫RATIONALE✔️✔️: Continuous bubbling indicates an air leak. First check connections (B). Clamping is
dangerous. If leak persists, notify provider.
💫ANSWER✔️✔️: B) Check the tubing connections for air leaks.
---
### Question 5 of 91
A nurse is providing education to a client with a new prescription for warfarin (Coumadin). Which
statement by the client indicates understanding?
A) "I will take ibuprofen for my headaches."
B) "I will have my INR checked regularly as ordered."
C) "I can eat large amounts of spinach and kale."
D) "If I miss a dose, I will take two the next day."
💫RATIONALE✔️✔️: Regular INR monitoring (B) essential. Avoid NSAIDs, consistent vitamin K intake, no
double-dosing.
💫ANSWER✔️✔️: B) "I will have my INR checked regularly as ordered."
---
, ### Question 6 of 91
A nurse is caring for a client who is receiving a blood transfusion. Fifteen minutes after starting, the
client reports low back pain and chills. Which action should the nurse take first?
A) Slow the infusion rate.
B) Stop the transfusion.
C) Administer acetaminophen.
D) Notify the provider.
💫RATIONALE✔️✔️: Low back pain and chills indicate hemolytic reaction. First stop transfusion (B), then
disconnect tubing, maintain IV access, notify provider.
💫ANSWER✔️✔️: B) Stop the transfusion.
---
### Question 7 of 91
**Select-All-That-Apply (SATA):** A nurse is assessing a client with hyperthyroidism. Which findings
should the nurse expect? (Select all that apply.)
A) Weight loss
B) Bradycardia
C) Heat intolerance
D) Exophthalmos
E) Constipation
💫RATIONALE✔️✔️: Hyperthyroidism causes weight loss (A), heat intolerance (C), exophthalmos (D).
Bradycardia and constipation are hypothyroidism.
💫ANSWER✔️✔️: A, C, D
