1
Kaplan NCLEX-PN Question Trainer Series | 250
Practice Questions and Verified Answers
1. The practical nurse is caring for a client who is 2 days post-op after a total
abdominal hysterectomy. The client suddenly reports a gush of fluid from the
vagina. What should the PN do first?
A. Notify the surgeon immediately.
B. Apply a perineal pad and assess the drainage.
C. Insert a vaginal pack.
D. Reassure the client that this is normal.
: Correct Answer : B
Rationale: First assess the amount, color, and odor of the drainage. The surgeon
should be notified after the initial assessment. A sudden gush could indicate a
fistula, abscess rupture, or dehiscence.
2. The PN is caring for a client with a left leg cast who reports severe pain
unrelieved by medication. Which action should the PN take first?
A. Notify the registered nurse.
B. Elevate the leg on pillows.
C. Perform neurovascular checks on the toes.
D. Apply ice to the cast.
: Correct Answer : C
Rationale: Assess for signs of compartment syndrome (pain, pallor, pulselessness,
paresthesia, paralysis). The PN should complete the assessment and then report
findings to the RN. Elevation may not relieve compartment syndrome.
3. The PN is reinforcing discharge teaching for a client with a new colostomy.
Which statement by the client indicates a correct understanding?
A. "I will clean the skin around the stoma with alcohol."
B. "I will cut the skin barrier to fit exactly around the stoma."
pg. 1
,2
C. "I will expect the stool to be solid like normal."
D. "I should not look at the stoma until it heals."
: Correct Answer : B
Rationale: The pouch opening should be measured and cut to fit the stoma to
prevent skin irritation. Alcohol dries the skin; stool from a colostomy may be
semi-solid but not always; clients should participate in care.
4. The PN is monitoring a client receiving a blood transfusion. The client
develops chills and a fever. What is the priority action?
A. Stop the transfusion.
B. Administer acetaminophen as prescribed.
C. Notify the RN.
D. Slow the transfusion rate.
: Correct Answer : A
Rationale: Chills and fever may indicate a transfusion reaction. The first action is
to stop the infusion and maintain the IV line with normal saline. The RN and blood
bank are notified after stopping the transfusion.
5. The PN is reinforcing teaching for a client who is to collect a 24-hour urine
specimen. Which statement by the client indicates a need for further teaching?
A. "I will discard the first morning void and then collect all urine for the next 24
hours."
B. "I can keep the urine container in the refrigerator."
C. "I will save the first urine specimen of the morning, then collect the rest for 24
hours."
D. "I will label the container with my name and the start and end times."
: Correct Answer : C
Rationale: The 24-hour urine collection begins after discarding the first void, then
collecting all urine for the next 24 hours including the final void at the end time.
pg. 2
,3
6. The PN is caring for a client with a nasogastric tube to low intermittent
suction. Which finding requires immediate intervention?
A. The client's urine output is 50 mL/hour.
B. The NG tube is draining greenish fluid.
C. The client's abdomen is distended and bowel sounds are absent.
D. The client reports a sore throat.
: Correct Answer : C
Rationale: Abdominal distention and absent bowel sounds could indicate a bowel
obstruction or that the NG tube is not functioning. This requires immediate
assessment and reporting to the RN.
7. The PN is preparing to administer digoxin to a client. The client's apical pulse
is 58 beats per minute. What should the PN do?
A. Administer the medication as prescribed.
B. Hold the medication and notify the registered nurse.
C. Recheck the pulse in 30 minutes.
D. Give half the dose.
: Correct Answer : B
Rationale: The standard parameter for digoxin is to hold for a pulse less than 60
bpm and notify the RN or healthcare provider. Administering the drug could
further decrease the heart rate.
8. The PN is caring for a client with heart failure who is receiving furosemide.
Which assessment finding indicates the medication is effective?
A. Increased peripheral edema
B. Weight gain of 2 lbs in 24 hours
C. Decreased crackles in the lung bases
D. Elevated blood pressure
: Correct Answer : C
Rationale: Furosemide reduces fluid overload; decreased crackles indicate less
pulmonary congestion. Weight loss, not gain, should be observed.
pg. 3
, 4
9. The PN is reinforcing teaching about warfarin to a client. Which statement
indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will take aspirin if I have a headache."
C. "I will keep appointments for blood tests."
D. "I will avoid activities that could cause injury."
: Correct Answer : B
Rationale: Aspirin and NSAIDs increase bleeding risk with warfarin.
Acetaminophen is safer but should still be used with caution. The other
statements are correct.
10. The PN is caring for a client in Buck's traction. Which observation indicates
proper traction setup?
A. The weights are resting on the floor.
B. The affected leg is positioned on a pillow.
C. The weights hang freely off the bed.
D. The traction rope is knotted and hangs over the pulley.
: Correct Answer : C
Rationale: Weights must hang freely to maintain the traction force. They should
not rest on the floor or bed. The leg is kept elevated off the bed.
11. A client with a new diagnosis of diabetes mellitus asks the PN, "Why do I
need to rotate injection sites?" The best response is:
A. "It prevents the insulin from absorbing too quickly."
B. "It reduces the risk of skin infection."
C. "It prevents lipodystrophy and ensures consistent absorption."
D. "It helps you use less insulin."
: Correct Answer : C
Rationale: Rotating sites prevents lipohypertrophy (fatty lumps) or lipoatrophy,
pg. 4
Kaplan NCLEX-PN Question Trainer Series | 250
Practice Questions and Verified Answers
1. The practical nurse is caring for a client who is 2 days post-op after a total
abdominal hysterectomy. The client suddenly reports a gush of fluid from the
vagina. What should the PN do first?
A. Notify the surgeon immediately.
B. Apply a perineal pad and assess the drainage.
C. Insert a vaginal pack.
D. Reassure the client that this is normal.
: Correct Answer : B
Rationale: First assess the amount, color, and odor of the drainage. The surgeon
should be notified after the initial assessment. A sudden gush could indicate a
fistula, abscess rupture, or dehiscence.
2. The PN is caring for a client with a left leg cast who reports severe pain
unrelieved by medication. Which action should the PN take first?
A. Notify the registered nurse.
B. Elevate the leg on pillows.
C. Perform neurovascular checks on the toes.
D. Apply ice to the cast.
: Correct Answer : C
Rationale: Assess for signs of compartment syndrome (pain, pallor, pulselessness,
paresthesia, paralysis). The PN should complete the assessment and then report
findings to the RN. Elevation may not relieve compartment syndrome.
3. The PN is reinforcing discharge teaching for a client with a new colostomy.
Which statement by the client indicates a correct understanding?
A. "I will clean the skin around the stoma with alcohol."
B. "I will cut the skin barrier to fit exactly around the stoma."
pg. 1
,2
C. "I will expect the stool to be solid like normal."
D. "I should not look at the stoma until it heals."
: Correct Answer : B
Rationale: The pouch opening should be measured and cut to fit the stoma to
prevent skin irritation. Alcohol dries the skin; stool from a colostomy may be
semi-solid but not always; clients should participate in care.
4. The PN is monitoring a client receiving a blood transfusion. The client
develops chills and a fever. What is the priority action?
A. Stop the transfusion.
B. Administer acetaminophen as prescribed.
C. Notify the RN.
D. Slow the transfusion rate.
: Correct Answer : A
Rationale: Chills and fever may indicate a transfusion reaction. The first action is
to stop the infusion and maintain the IV line with normal saline. The RN and blood
bank are notified after stopping the transfusion.
5. The PN is reinforcing teaching for a client who is to collect a 24-hour urine
specimen. Which statement by the client indicates a need for further teaching?
A. "I will discard the first morning void and then collect all urine for the next 24
hours."
B. "I can keep the urine container in the refrigerator."
C. "I will save the first urine specimen of the morning, then collect the rest for 24
hours."
D. "I will label the container with my name and the start and end times."
: Correct Answer : C
Rationale: The 24-hour urine collection begins after discarding the first void, then
collecting all urine for the next 24 hours including the final void at the end time.
pg. 2
,3
6. The PN is caring for a client with a nasogastric tube to low intermittent
suction. Which finding requires immediate intervention?
A. The client's urine output is 50 mL/hour.
B. The NG tube is draining greenish fluid.
C. The client's abdomen is distended and bowel sounds are absent.
D. The client reports a sore throat.
: Correct Answer : C
Rationale: Abdominal distention and absent bowel sounds could indicate a bowel
obstruction or that the NG tube is not functioning. This requires immediate
assessment and reporting to the RN.
7. The PN is preparing to administer digoxin to a client. The client's apical pulse
is 58 beats per minute. What should the PN do?
A. Administer the medication as prescribed.
B. Hold the medication and notify the registered nurse.
C. Recheck the pulse in 30 minutes.
D. Give half the dose.
: Correct Answer : B
Rationale: The standard parameter for digoxin is to hold for a pulse less than 60
bpm and notify the RN or healthcare provider. Administering the drug could
further decrease the heart rate.
8. The PN is caring for a client with heart failure who is receiving furosemide.
Which assessment finding indicates the medication is effective?
A. Increased peripheral edema
B. Weight gain of 2 lbs in 24 hours
C. Decreased crackles in the lung bases
D. Elevated blood pressure
: Correct Answer : C
Rationale: Furosemide reduces fluid overload; decreased crackles indicate less
pulmonary congestion. Weight loss, not gain, should be observed.
pg. 3
, 4
9. The PN is reinforcing teaching about warfarin to a client. Which statement
indicates a need for further teaching?
A. "I will use a soft-bristled toothbrush."
B. "I will take aspirin if I have a headache."
C. "I will keep appointments for blood tests."
D. "I will avoid activities that could cause injury."
: Correct Answer : B
Rationale: Aspirin and NSAIDs increase bleeding risk with warfarin.
Acetaminophen is safer but should still be used with caution. The other
statements are correct.
10. The PN is caring for a client in Buck's traction. Which observation indicates
proper traction setup?
A. The weights are resting on the floor.
B. The affected leg is positioned on a pillow.
C. The weights hang freely off the bed.
D. The traction rope is knotted and hangs over the pulley.
: Correct Answer : C
Rationale: Weights must hang freely to maintain the traction force. They should
not rest on the floor or bed. The leg is kept elevated off the bed.
11. A client with a new diagnosis of diabetes mellitus asks the PN, "Why do I
need to rotate injection sites?" The best response is:
A. "It prevents the insulin from absorbing too quickly."
B. "It reduces the risk of skin infection."
C. "It prevents lipodystrophy and ensures consistent absorption."
D. "It helps you use less insulin."
: Correct Answer : C
Rationale: Rotating sites prevents lipohypertrophy (fatty lumps) or lipoatrophy,
pg. 4
