The Item Writing for Success workshop presented by Rinehart & Associates was a great
experience. The presenters were informed, helpful, and worked well with the faculty. We are
using the test construction hints provided in the workshop to restructure future exams.
Cathy Dearman Ph.D., MSN, RN
Dean, School of Nursing, University of South Alabama
The test construction workshop Item Writing for Success presented by Rinehart &
Associates was excellent. The faculty were very knowledgeable about their content area.
Rosemary Rhodes Ph.D., MSN, RN
University of South Alabama
I would enthusiastically recommend the Rinehart & Associates Item Writing for Success
workshop to all nursing faculty. The expertise and commitment of the workshop faculty to
reach both novice and experienced colleagues was very refreshing! We plan to include
them in our faculty development plan every year.
Linda Whitenton, RN, MSN, CS
Nursing Program Director, Okaloosa-Walton Community College, Niceville, Florida
What Nursing Students Say About the Authors:
I passed my NCLEX®! I wanted to let you know I passed my NCLEX®, and I’m now an RN.
I can’t thank you and Ms. Sloan enough for providing the content material I needed!
Thank You So Much,
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I just checked online for my results and I passed! Thank you so much for your help. After
being out of school for eight years, I wasn’t sure I could do it. Thank you again; your class
was wonderful. I feel really blessed to say I passed the NCLEX®.
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Thank you both so much for the great review course; it was just what I needed. I know
without it there’s no way I would have passed the first time. You guys helped me focus
on the things that I really needed to focus on. I am highly recommending your course to
everyone I know who is getting ready for boards!
Again, thank you both so much.
Lori Marchant, RN
Thank you so much for your expertise. I just received my NCLEX® results and I passed!
I was afraid about them because my test only gave me 80 questions. I truly believe that
taking your course secured my passing.
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I studied nothing but your material for two weeks until I felt prepared to take the NCLEX®.
I took it June 24, and just received my results today. I passed with 75 questions. I just
wanted to say thank you so much for offering your class at Wallace State. Studying your
material gave me the confidence I needed to pass. Thanks again!
Sincerely,
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I wanted to let you know that I took my boards on the 18th, and I found out yesterday that
I passed. I really feel like your class helped me a lot, it was an excellent review, and I think
that it made the difference.
Sincerely,
Tania Salinas
, NCLEX-RN
®
Practice Questions
Fourth Edition
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,Contents at a Glance
Introduction 1
CHAPTER 1 Practice Exam 1 and Rationales 5
CHAPTER 2 Practice Exam 2 and Rationales 87
CHAPTER 3 Practice Exam 3 and Rationales 169
CHAPTER 4 Practice Exam 4 and Rationales 251
CHAPTER 5 Practice Exam 5 and Rationales 335
CHAPTER 6 Alternative Items: Questions and Rationales 419
APPENDIX A Need to Know More? 465
APPENDIX B Things You Forgot 475
APPENDIX C Alphabetical Listing of Nursing Boards in the United States 483
and Protectorates
,Table of Contents
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Welcome to the NCLEX-RN® Practice Questions Exam Cram. . . . . . . 1
Taking the Computerized Adaptive Test . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
The Cost of the Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
How to Prepare for the Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
What You Will Find in This Book. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Hints for Using This Book . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Need Further Study? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Contact the Author. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Chapter 1:
Practice Exam 1 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Quick Answers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Chapter 2:
Practice Exam 2 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Chapter 3:
Practice Exam 3 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Chapter 4:
Practice Exam 4 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251
Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308
Chapter 5:
Practice Exam 5 and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
,vi NCLEX-RN® Practice Questions
Chapter 6:
Alternative Items: Questions and Rationales. . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Quick Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 450
Alternative Items Answers and Rationales . . . . . . . . . . . . . . . . . . . . . . . 451
Appendix A:
Need to Know More? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
Care of the Client with Respiratory Disorders. . . . . . . . . . . . . . . 465
Care of the Client with Genitourinary Disorders . . . . . . . . . . . . 466
Care of the Client with Hematological Disorders . . . . . . . . . . . . 466
Fluid and Electrolytes and Acid/Base Balance . . . . . . . . . . . . . . . 467
Care of the Client with Burns. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467
Care of the Client with Sensory Disorders . . . . . . . . . . . . . . . . . . 468
Care of the Client with Neoplastic Disorders . . . . . . . . . . . . . . . 468
Care of the Client with Gastrointestinal Disorders . . . . . . . . . . . 469
Care of the Client with Musculoskeletal and Connective
Tissue Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469
Care of the Client with Endocrine Disorders. . . . . . . . . . . . . . . . 470
Care of the Client with Cardiac Disorders . . . . . . . . . . . . . . . . . . 470
Care of the Client with Neurological Disorders . . . . . . . . . . . . . 471
Care of the Client with Psychiatric Disorders . . . . . . . . . . . . . . . 471
Maternal-Newborn Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 472
Care of the Pediatric Client . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 472
Cultural Practices Influencing Nursing Care . . . . . . . . . . . . . . . . 472
Legal Issues in Nursing Practice . . . . . . . . . . . . . . . . . . . . . . . . . . 473
Appendix B:
Things You Forgot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475
Therapeutic Drug Levels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475
Vital Signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475
Anticoagulant Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476
Intrapartal Normal Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476
Standard Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477
Airborne Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478
Droplet Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478
Contact Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478
, Contents vii
Revised Life Support Guidelines (American Heart Association) . . . . . 478
Defense Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
Nutrition Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
Immunization Schedule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Appendix C:
Alphabetical Listing of Nursing Boards in the United States
and Protectorates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 483
, About the Authors
Wilda Rinehart received an Associate Degree in Nursing from Northeast
Mississippi Community College in Booneville, Mississippi. After working as a
staff nurse and charge nurse, she became a public health nurse and served in that
capacity for a number of years. In 1975, she received her nurse practitioner cer-
tification in the area of obstetrics-gynecology from the University of Mississippi
Medical Center in Jackson, Mississippi. In 1979, she completed her Bachelor of
Science degree in Nursing from Mississippi University for Women. In 1980, she
completed her Master of Science degree in Nursing from the same university
and accepted a faculty position at Northeast Mississippi Community College,
where she taught medical-surgical nursing and maternal-newborn nursing. In
1982, she founded Rinehart and Associates Nursing Consultants. For the past
26 years, she and her associates have worked with nursing graduates and schools
of nursing to assist graduates to pass the National Council Licensure Exam for
Nursing. She has also worked as a curriculum consultant with faculty to improve
test construction. Ms. Rinehart has served as a convention speaker throughout
the southeastern United States and as a reviewer of medical-surgical and obstet-
ric texts. She has co-authored materials used in seminars presented by Rinehart
and Associates Nursing Review. As the president of Rinehart and Associates, she
serves as the coordinator of a company dedicated to improving the quality of
health through nursing education.
Dr. Diann Sloan received an Associate Degree in Nursing from Northeast
Mississippi Community College, a Bachelor of Science degree in Nursing from
the University of Mississippi, and a Master of Science degree in Nursing from
Mississippi University for Women. In addition to her nursing degrees, she holds
a Master of Science in Counseling Psychology from Georgia State University
and a Doctor of Philosophy in Counselor Education, with minors in both
Psychology and Educational Psychology, from Mississippi State University. She
has completed additional graduate studies in healthcare administration at
Western New England College and the University of Mississippi. Dr. Sloan has
taught pediatric nursing, psychiatric mental health nursing, and medical surgi-
cal nursing in both associate degree and baccalaureate nursing programs. As a
member of Rinehart and Associates Nursing Review, Dr. Sloan has conducted
test construction workshops for faculty and nursing review seminars for both
registered and practical nurse graduates. She has co-authored materials used in
the item-writing workshops for nursing faculty and Rinehart and Associates
Nursing Review. She is a member of Sigma Theta Tau nursing honor society.