ESTUDYR
CRAM NCLEX-PN PRACTICE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) | ASSURED SUCCESS
1. The nurse is caring for a client scheduled for removal of a pituitary tumor using the transsphenoidal
approach. The nurse should be particularly alert to:
A. Nasal congestion
B. Abdominal tenderness
C. Muscle tetany
D. Oliguria
Answer: A. Nasal congestion
Rationale: The transsphenoidal approach involves surgery through the nose, so nasal congestion can
interfere with the airway, posing a risk for respiratory complications and should be closely monitored.
2. A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+
1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that the client is experiencing
which of the following?
A. Hypernatremia
B. Hypokalemia
C. Myelosuppression
D. Leukocytosis
Answer: B. Hypokalemia
Rationale: The low potassium level (K+ 1.9) indicates hypokalemia. Other lab values are within normal
limits, making other options incorrect.
3. A 24-year-old female client is scheduled for surgery in the morning. Which of the following is the
primary responsibility of the nurse?
A. Taking the vital signs
B. Obtaining the permit
,ESTUDYR
C. Explaining the procedure
D. Checking the lab work
Answer: A. Taking the vital signs
Rationale: The nurse’s primary responsibility is to assess the client’s physical status, which includes
taking vital signs before surgery. Obtaining the permit, explaining the procedure, and checking lab work
are responsibilities of the surgeon.
4. The nurse is working in the emergency room when a client arrives with severe burns of the left arm,
hands, face, and neck. Which action should receive priority?
A. Starting an IV
B. Applying oxygen
C. Obtaining blood gas
D. Medicating the client for pain
Answer: B. Applying oxygen
Rationale: Clients with burns to the face and neck need airway management first, so applying oxygen is
the priority. After ensuring airway safety, an IV should be started, and pain management can follow.
5. The nurse is visiting a home health client with osteoporosis. The client has a new prescription for
alendronate (Fosamax). Which instructions should be given to the client?
A. Rest in bed after taking the medication for at least 30 minutes
B. Avoid rapid movements after taking the medication
C. Take medication with water only
D. Allow at least 1 hour between taking the medicine and taking other medications
Answer: C. Take medication with water only
Rationale: Fosamax should be taken with water to prevent esophageal irritation. The client should
remain upright for at least 30 minutes after taking the medication, not rest in bed.
6. The nurse is making initial rounds on a client with a C5 fracture and crutchfield tongs. Which
equipment should be kept at the bedside?
A. A pair of forceps
B. A torque wrench
,ESTUDYR
C. A pair of wire cutters
D. A screwdriver
Answer: B. A torque wrench
Rationale: A torque wrench is used to adjust the pressure on the screws of Crutchfield tongs. It should
be kept at the bedside in case adjustments are needed to stabilize the cervical spine.
7. An infant weighs 7 pounds at birth. The expected weight by 1 year should be:
A. 10 pounds
B. 12 pounds
C. 18 pounds
D. 21 pounds
Answer: D. 21 pounds
Rationale: Infants typically triple their birth weight by 1 year, so the expected weight would be
approximately 21 pounds (7 pounds × 3).
8. A client is receiving a blood transfusion and begins to experience fever, chills, and back pain. What
is the nurse's priority action?
A. Stop the transfusion and notify the healthcare provider
B. Administer acetaminophen to reduce fever
C. Monitor vital signs every 15 minutes
D. Administer antihistamines to relieve symptoms
Answer: A. Stop the transfusion and notify the healthcare provider
Rationale: Fever, chills, and back pain may indicate a transfusion reaction. The nurse should
immediately stop the transfusion and notify the healthcare provider for further instructions.
9. Which of the following is the most appropriate nursing intervention for a client with acute
pancreatitis?
A. Administer prescribed analgesics
B. Encourage high-protein, high-fat foods
C. Encourage bed rest with minimal movement
D. Provide frequent oral care
, ESTUDYR
Answer: A. Administer prescribed analgesics
Rationale: Acute pancreatitis is extremely painful, and the nurse should prioritize pain management
with prescribed analgesics. Bed rest is also important but not as immediate a priority as managing pain.
10. A client who is on a low-sodium diet asks the nurse for a snack. Which of the following should the
nurse offer?
A. Cheese and crackers
B. A slice of whole wheat bread with butter
C. A fresh fruit salad
D. A bag of salted pretzels
Answer: C. A fresh fruit salad
Rationale: Fresh fruit is naturally low in sodium and would be the most appropriate snack for a client on
a low-sodium diet. Other options are high in sodium.
11. A nurse is assessing a client who has been on bed rest for several days. Which of the following is
the nurse’s priority assessment?
A. Assessing for signs of dehydration
B. Checking for signs of pressure ulcers
C. Assessing for signs of deep vein thrombosis (DVT)
D. Monitoring for signs of hypoglycemia
Answer: C. Assessing for signs of deep vein thrombosis (DVT)
Rationale: Prolonged bed rest increases the risk of DVT due to decreased circulation. The nurse should
prioritize assessing for DVT, as it can lead to serious complications such as pulmonary embolism.
12. The nurse is caring for a client with Parkinson’s disease who is experiencing a tremor. Which of the
following actions should the nurse take?
A. Offer the client a sedative to relax the muscles
B. Assist the client with fine motor activities using adaptive devices
C. Encourage the client to practice relaxation techniques
D. Decrease the client’s fluid intake to prevent fluid overload
Answer: B. Assist the client with fine motor activities using adaptive devices
CRAM NCLEX-PN PRACTICE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) | ASSURED SUCCESS
1. The nurse is caring for a client scheduled for removal of a pituitary tumor using the transsphenoidal
approach. The nurse should be particularly alert to:
A. Nasal congestion
B. Abdominal tenderness
C. Muscle tetany
D. Oliguria
Answer: A. Nasal congestion
Rationale: The transsphenoidal approach involves surgery through the nose, so nasal congestion can
interfere with the airway, posing a risk for respiratory complications and should be closely monitored.
2. A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+
1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that the client is experiencing
which of the following?
A. Hypernatremia
B. Hypokalemia
C. Myelosuppression
D. Leukocytosis
Answer: B. Hypokalemia
Rationale: The low potassium level (K+ 1.9) indicates hypokalemia. Other lab values are within normal
limits, making other options incorrect.
3. A 24-year-old female client is scheduled for surgery in the morning. Which of the following is the
primary responsibility of the nurse?
A. Taking the vital signs
B. Obtaining the permit
,ESTUDYR
C. Explaining the procedure
D. Checking the lab work
Answer: A. Taking the vital signs
Rationale: The nurse’s primary responsibility is to assess the client’s physical status, which includes
taking vital signs before surgery. Obtaining the permit, explaining the procedure, and checking lab work
are responsibilities of the surgeon.
4. The nurse is working in the emergency room when a client arrives with severe burns of the left arm,
hands, face, and neck. Which action should receive priority?
A. Starting an IV
B. Applying oxygen
C. Obtaining blood gas
D. Medicating the client for pain
Answer: B. Applying oxygen
Rationale: Clients with burns to the face and neck need airway management first, so applying oxygen is
the priority. After ensuring airway safety, an IV should be started, and pain management can follow.
5. The nurse is visiting a home health client with osteoporosis. The client has a new prescription for
alendronate (Fosamax). Which instructions should be given to the client?
A. Rest in bed after taking the medication for at least 30 minutes
B. Avoid rapid movements after taking the medication
C. Take medication with water only
D. Allow at least 1 hour between taking the medicine and taking other medications
Answer: C. Take medication with water only
Rationale: Fosamax should be taken with water to prevent esophageal irritation. The client should
remain upright for at least 30 minutes after taking the medication, not rest in bed.
6. The nurse is making initial rounds on a client with a C5 fracture and crutchfield tongs. Which
equipment should be kept at the bedside?
A. A pair of forceps
B. A torque wrench
,ESTUDYR
C. A pair of wire cutters
D. A screwdriver
Answer: B. A torque wrench
Rationale: A torque wrench is used to adjust the pressure on the screws of Crutchfield tongs. It should
be kept at the bedside in case adjustments are needed to stabilize the cervical spine.
7. An infant weighs 7 pounds at birth. The expected weight by 1 year should be:
A. 10 pounds
B. 12 pounds
C. 18 pounds
D. 21 pounds
Answer: D. 21 pounds
Rationale: Infants typically triple their birth weight by 1 year, so the expected weight would be
approximately 21 pounds (7 pounds × 3).
8. A client is receiving a blood transfusion and begins to experience fever, chills, and back pain. What
is the nurse's priority action?
A. Stop the transfusion and notify the healthcare provider
B. Administer acetaminophen to reduce fever
C. Monitor vital signs every 15 minutes
D. Administer antihistamines to relieve symptoms
Answer: A. Stop the transfusion and notify the healthcare provider
Rationale: Fever, chills, and back pain may indicate a transfusion reaction. The nurse should
immediately stop the transfusion and notify the healthcare provider for further instructions.
9. Which of the following is the most appropriate nursing intervention for a client with acute
pancreatitis?
A. Administer prescribed analgesics
B. Encourage high-protein, high-fat foods
C. Encourage bed rest with minimal movement
D. Provide frequent oral care
, ESTUDYR
Answer: A. Administer prescribed analgesics
Rationale: Acute pancreatitis is extremely painful, and the nurse should prioritize pain management
with prescribed analgesics. Bed rest is also important but not as immediate a priority as managing pain.
10. A client who is on a low-sodium diet asks the nurse for a snack. Which of the following should the
nurse offer?
A. Cheese and crackers
B. A slice of whole wheat bread with butter
C. A fresh fruit salad
D. A bag of salted pretzels
Answer: C. A fresh fruit salad
Rationale: Fresh fruit is naturally low in sodium and would be the most appropriate snack for a client on
a low-sodium diet. Other options are high in sodium.
11. A nurse is assessing a client who has been on bed rest for several days. Which of the following is
the nurse’s priority assessment?
A. Assessing for signs of dehydration
B. Checking for signs of pressure ulcers
C. Assessing for signs of deep vein thrombosis (DVT)
D. Monitoring for signs of hypoglycemia
Answer: C. Assessing for signs of deep vein thrombosis (DVT)
Rationale: Prolonged bed rest increases the risk of DVT due to decreased circulation. The nurse should
prioritize assessing for DVT, as it can lead to serious complications such as pulmonary embolism.
12. The nurse is caring for a client with Parkinson’s disease who is experiencing a tremor. Which of the
following actions should the nurse take?
A. Offer the client a sedative to relax the muscles
B. Assist the client with fine motor activities using adaptive devices
C. Encourage the client to practice relaxation techniques
D. Decrease the client’s fluid intake to prevent fluid overload
Answer: B. Assist the client with fine motor activities using adaptive devices
