NCLEX FULL FINAL REAL ACTUAL (2025-2026) EXAM ALL
330 QUESTIONS AND CORRECT ANSWERS VERIFIED WITH
RATIONALES| ALREADY GRADED A+| GURANTEED
PASS !!!!.
NCLEX
1. A patient has an allergy to procaine [Novocain]. What local anesthetic would be
safe to administer to this patient?
A. Cocaine
B. Benzocaine [Americaine]
C. Lidocaine [Xylocaine]
D. Tetracaine - - ANS - -Answer: C
2. Rationale: Individuals who are allergic to procaine should be considered
allergic to all other ester-type anesthetics but not to the amides. Procaine,
benzocaine, cocaine, and tetracaine are all esters. Lidocaine is an amide.
3. Which patient would be at highest risk for systemic toxicity from the topical
administration of a local anesthetic?
A. A 42-year-old patient who receives epinephrine with a local anesthetic
B. A 72-year-old patient who receives a local anesthetic that is
topically applied to intact skin
C. A 58-year-old patient who receives a local anesthetic to a 10×20-cm
abrasion
D. A 34-year-old patient given an injection of bupivacaine as a nerve block - -
ANS - -Answer: C
Rationale: The risk of toxicity is less if epinephrine is administered, because
blood flow will be decreased (vasoconstriction), thus delaying the systemic
, absorption of the anesthetic. The risk of toxicity increases with a large surface
area or an abraded area.
4. A patient receives a bupivacaine [Marcaine] injection for infiltration anesthesia.
When would the nurse expect the onset of local anesthesia to occur?
A. 30 seconds
B. 2 minutes
C. 5 minutes
D. 10 minutes - - ANS - -Answer: C
Rationale: Bupivacaine administered by infiltration anesthesia has an onset of
5 minutes.
5. An adult patient receives lidocaine by injection before a procedure. Which
finding indicates that the patient is experiencing a systemic reaction and
toxicity?
A. Mean arterial pressure of 75 mm Hg
B. Temperature of 100.8º F (38.2º C)
C. Heart rate of 42 beats/min
D. Respiratory rate of 12 breaths/min - - ANS - -Answer: C
Rationale: Absorption into the general circulation can cause systemic toxicity,
and effects on the central nervous system and the heart are of greatest
concern. Central nervous system toxicity manifests as a brief period of
excitement, possibly including convulsions; this is followed by central nervous
system depression, which can result in respiratory depression. Cardiotoxicity
can manifest as bradycardia, atrioventricular heart block, and cardiac arrest.
6. The nurse knows that local anesthetics stop axonal conduction by blocking
what?
A. Potassium channels in the axonal membrane
B. Sodium channels in the axonal membrane
, C. Calcium channels in the axonal membrane
D. Protein channels in the axonal membrane - - ANS - -B
7. The nurse is caring for a patient who is to receive a local anesthetic with
lidocaine and epinephrine. What is the primary purpose of the epinephrine?
A. To reduce the risk of an allergic reaction
B. To improve transport of anesthetic into the axon
C. To delay systemic absorption of the anesthetic
D. To suppress excitability of the myocardium - - ANS - -C
8. Which of these local anesthetic agents is most likely to cause an allergic
response?
A. Procaine [Novocain]
B. Lidocaine [Xylocaine]
C. Bupivacaine [Marcaine]
D. Ropivacaine [Naropin] - - ANS - -A
9. The nurse is caring for a patient who is receiving lidocaine [Xylocaine] by
epidural injection. Which nursing intervention is most important when caring
for this patient?
A. Keeping the patient in a supine position for about 12 hours
B. Monitoring the patient's blood pressure throughout the epidural infusion
C. Preparing a double tourniquet for use during the infusion
D. Reducing the intravenous (IV) infusion rate to prevent hypertension - -
ANS - -B
10. The nurse should monitor for which central nervous system (CNS) adverse
effect that can result when sufficient amounts of local anesthetics are
absorbed systemically?
A. Hallucinations and nightmares
, B. Tremors of the lower extremities
C. Excitation followed by depression
D. Vertigo and nausea/vomiting - - ANS - -C
11. The nurse is explaining differential sensitivity to the nursing student with
regard to the use of local anesthetics. The nurse explains that which
perception is lost first?
A. Pain
B. Cold
C. Warmth
D. Touch - - ANS - -A
12. The healthcare provider orders topical benzocaine spray for a 1-year-old child
with a sunburn. Which action should the nurse take?
A. Question the order for benzocaine.
B. Question the order for further directions.
C. Teach the parent about application of the spray.
D. Apply the spray to the child. - - ANS - -A
13. Which of the following statements about cocaine is true?
A. Cocaine causes intense vasoconstriction.
B. Cocaine has no medicinal applications.
C. Cocaine is a poor local anesthetic.
D. Cocaine has no CNS effects. - - ANS - -A
14. The healthcare provider orders lidocaine inj SC before a skin biopsy. Which
action should the nurse take?
A. Question the order for further instructions.
B. Administer the lidocaine.
C. Refuse to administer the lidocaine.
330 QUESTIONS AND CORRECT ANSWERS VERIFIED WITH
RATIONALES| ALREADY GRADED A+| GURANTEED
PASS !!!!.
NCLEX
1. A patient has an allergy to procaine [Novocain]. What local anesthetic would be
safe to administer to this patient?
A. Cocaine
B. Benzocaine [Americaine]
C. Lidocaine [Xylocaine]
D. Tetracaine - - ANS - -Answer: C
2. Rationale: Individuals who are allergic to procaine should be considered
allergic to all other ester-type anesthetics but not to the amides. Procaine,
benzocaine, cocaine, and tetracaine are all esters. Lidocaine is an amide.
3. Which patient would be at highest risk for systemic toxicity from the topical
administration of a local anesthetic?
A. A 42-year-old patient who receives epinephrine with a local anesthetic
B. A 72-year-old patient who receives a local anesthetic that is
topically applied to intact skin
C. A 58-year-old patient who receives a local anesthetic to a 10×20-cm
abrasion
D. A 34-year-old patient given an injection of bupivacaine as a nerve block - -
ANS - -Answer: C
Rationale: The risk of toxicity is less if epinephrine is administered, because
blood flow will be decreased (vasoconstriction), thus delaying the systemic
, absorption of the anesthetic. The risk of toxicity increases with a large surface
area or an abraded area.
4. A patient receives a bupivacaine [Marcaine] injection for infiltration anesthesia.
When would the nurse expect the onset of local anesthesia to occur?
A. 30 seconds
B. 2 minutes
C. 5 minutes
D. 10 minutes - - ANS - -Answer: C
Rationale: Bupivacaine administered by infiltration anesthesia has an onset of
5 minutes.
5. An adult patient receives lidocaine by injection before a procedure. Which
finding indicates that the patient is experiencing a systemic reaction and
toxicity?
A. Mean arterial pressure of 75 mm Hg
B. Temperature of 100.8º F (38.2º C)
C. Heart rate of 42 beats/min
D. Respiratory rate of 12 breaths/min - - ANS - -Answer: C
Rationale: Absorption into the general circulation can cause systemic toxicity,
and effects on the central nervous system and the heart are of greatest
concern. Central nervous system toxicity manifests as a brief period of
excitement, possibly including convulsions; this is followed by central nervous
system depression, which can result in respiratory depression. Cardiotoxicity
can manifest as bradycardia, atrioventricular heart block, and cardiac arrest.
6. The nurse knows that local anesthetics stop axonal conduction by blocking
what?
A. Potassium channels in the axonal membrane
B. Sodium channels in the axonal membrane
, C. Calcium channels in the axonal membrane
D. Protein channels in the axonal membrane - - ANS - -B
7. The nurse is caring for a patient who is to receive a local anesthetic with
lidocaine and epinephrine. What is the primary purpose of the epinephrine?
A. To reduce the risk of an allergic reaction
B. To improve transport of anesthetic into the axon
C. To delay systemic absorption of the anesthetic
D. To suppress excitability of the myocardium - - ANS - -C
8. Which of these local anesthetic agents is most likely to cause an allergic
response?
A. Procaine [Novocain]
B. Lidocaine [Xylocaine]
C. Bupivacaine [Marcaine]
D. Ropivacaine [Naropin] - - ANS - -A
9. The nurse is caring for a patient who is receiving lidocaine [Xylocaine] by
epidural injection. Which nursing intervention is most important when caring
for this patient?
A. Keeping the patient in a supine position for about 12 hours
B. Monitoring the patient's blood pressure throughout the epidural infusion
C. Preparing a double tourniquet for use during the infusion
D. Reducing the intravenous (IV) infusion rate to prevent hypertension - -
ANS - -B
10. The nurse should monitor for which central nervous system (CNS) adverse
effect that can result when sufficient amounts of local anesthetics are
absorbed systemically?
A. Hallucinations and nightmares
, B. Tremors of the lower extremities
C. Excitation followed by depression
D. Vertigo and nausea/vomiting - - ANS - -C
11. The nurse is explaining differential sensitivity to the nursing student with
regard to the use of local anesthetics. The nurse explains that which
perception is lost first?
A. Pain
B. Cold
C. Warmth
D. Touch - - ANS - -A
12. The healthcare provider orders topical benzocaine spray for a 1-year-old child
with a sunburn. Which action should the nurse take?
A. Question the order for benzocaine.
B. Question the order for further directions.
C. Teach the parent about application of the spray.
D. Apply the spray to the child. - - ANS - -A
13. Which of the following statements about cocaine is true?
A. Cocaine causes intense vasoconstriction.
B. Cocaine has no medicinal applications.
C. Cocaine is a poor local anesthetic.
D. Cocaine has no CNS effects. - - ANS - -A
14. The healthcare provider orders lidocaine inj SC before a skin biopsy. Which
action should the nurse take?
A. Question the order for further instructions.
B. Administer the lidocaine.
C. Refuse to administer the lidocaine.
