NCLEX-RN Exam 2025 Version 6| with 75 Real
Exam Questions and Correct Answers Graded A+
1. 1. Question
A client is admitted to the hospital with a diagnosis of primary
hyperparathyroidism. A nursing practitioner checking the client’s
lab results would expect which of the following changes in
laboratory findings?
o A. Elevated serum calcium
o B. Low serum parathyroid hormone (PTH)
o C. Elevated serum vitamin D
o D. Low urine calcium
o
, associated hypercalcemia are known to have cancer,
or cancer is readily detectable on initial evaluation,
and PTH levels will be suppressed.
o Option C: Parathyroid hormone levels may be high or
normal but not low. The body will lower the level of
vitamin D in an attempt to lower calcium.
o Option D: Urine calcium may be elevated, with
calcium spilling over from elevated serum levels. This
may cause renal stones. A review of previous medical
records can often be of significant value in
establishing the cause of hypercalcemia. Most clients
with hyperparathyroidism have persistent or
intermittent hypercalcemia for many years before a
definitive diagnosis is established.
• 2. Question
A client with Addison’s disease asks a nursing practitioner for
nutrition and diet advice. Which of the following diet
modifications is not recommended?
o A. A diet high in grains.
o B. A diet with adequate caloric intake.
o C. A high protein diet.
o D. A restricted sodium diet.
o
, client should include complex carbohydrates in his
diet, including grains.
o Option B: A high protein diet is recommended for the
client with Addison’s disease. The adrenal fatigue diet
aims to stabilize blood sugar and balance cortisol
levels by limiting sugar while increasing the intake of
protein, healthy fats, veggies, and whole grains.
Healthy fats and high-quality proteins slow the blood
sugar rollercoaster and promote stable blood sugar
levels throughout the day.
o Option C: Adequate caloric intake is recommended.
Refined carbohydrates quickly break down into sugar
after you ingest them, which causes a spike in blood
sugar followed by a steep decline. The diet
discourages foods that are inflammatory or hard to
digest and may contribute to gut health issues. The
adrenal fatigue diet is more about eating more foods
that make the client feel good and nourish the body
versus restricting.
• 3. Question
A client with a history of diabetes mellitus is in the second
postoperative day following cholecystectomy. She has
complained of nausea and isn’t able to eat solid foods. The
nursing practitioner enters the room to find the client confused
and shaky. Which of the following is the most likely explanation
for the client’s symptoms?
o A. Anesthesia reaction
o B. Hyperglycemia
o C. Hypoglycemia
o D. Diabetic ketoacidosis
Correct Answer: C. Hypoglycemia
A postoperative diabetic client who is unable to eat is likely to be
suffering from hypoglycemia. The actual treatment
recommendations for a given client should be individualized,
based on diabetes classification, usual diabetes regimen, state of
, glycemic control, nature and extent of surgical procedure, and
available expertise.
o Option A: An anesthesia reaction would not occur on
the second postoperative day. Anesthesia and surgery
cause a stereotypical metabolic stress response that
could overwhelm homeostatic mechanisms in clients
with pre-existing abnormalities of glucose metabolism.
The invariant features of the metabolic stress
response include release of the catabolic hormones
epinephrine, norepinephrine, cortisol, glucagons, and
growth hormone and inhibition of insulin secretion and
action.
o Option B: Confusion is a late sign of hyperglycemia.
Shakiness is not one of its symptoms. The
management approach in these categories of clients
always includes insulin therapy in combination with
dextrose and potassium infusion. Major surgery is
defined as one requiring general anesthesia of ?1 h. At
a minimum, blood glucose should be monitored before
and immediately after surgery in all clients. Those
undergoing extensive procedures should have hourly
glucose monitoring during and immediately following
surgery.
o Option D: Symptoms of DKA include excessive thirst,
frequent urination, abdominal pain, fruity-scented
breath, confusion, and shortness of breath. However,
shakiness is not a sign of DKA. The stress of surgery
itself results in metabolic perturbations that alter
glucose homeostasis, and persistent hyperglycemia is
a risk factor for endothelial dysfunction, postoperative
sepsis, impaired wound healing, and cerebral
ischemia. The stress response itself may precipitate
diabetic crises (diabetic ketoacidosis [DKA].
• 4. Question
A nursing practitioner assigned to the emergency department
evaluates a client who underwent fiberoptic colonoscopy 18
hours previously. The client reports increasing abdominal pain,
fever, and chills. Which of the following conditions poses
the most immediate concern?
Exam Questions and Correct Answers Graded A+
1. 1. Question
A client is admitted to the hospital with a diagnosis of primary
hyperparathyroidism. A nursing practitioner checking the client’s
lab results would expect which of the following changes in
laboratory findings?
o A. Elevated serum calcium
o B. Low serum parathyroid hormone (PTH)
o C. Elevated serum vitamin D
o D. Low urine calcium
o
, associated hypercalcemia are known to have cancer,
or cancer is readily detectable on initial evaluation,
and PTH levels will be suppressed.
o Option C: Parathyroid hormone levels may be high or
normal but not low. The body will lower the level of
vitamin D in an attempt to lower calcium.
o Option D: Urine calcium may be elevated, with
calcium spilling over from elevated serum levels. This
may cause renal stones. A review of previous medical
records can often be of significant value in
establishing the cause of hypercalcemia. Most clients
with hyperparathyroidism have persistent or
intermittent hypercalcemia for many years before a
definitive diagnosis is established.
• 2. Question
A client with Addison’s disease asks a nursing practitioner for
nutrition and diet advice. Which of the following diet
modifications is not recommended?
o A. A diet high in grains.
o B. A diet with adequate caloric intake.
o C. A high protein diet.
o D. A restricted sodium diet.
o
, client should include complex carbohydrates in his
diet, including grains.
o Option B: A high protein diet is recommended for the
client with Addison’s disease. The adrenal fatigue diet
aims to stabilize blood sugar and balance cortisol
levels by limiting sugar while increasing the intake of
protein, healthy fats, veggies, and whole grains.
Healthy fats and high-quality proteins slow the blood
sugar rollercoaster and promote stable blood sugar
levels throughout the day.
o Option C: Adequate caloric intake is recommended.
Refined carbohydrates quickly break down into sugar
after you ingest them, which causes a spike in blood
sugar followed by a steep decline. The diet
discourages foods that are inflammatory or hard to
digest and may contribute to gut health issues. The
adrenal fatigue diet is more about eating more foods
that make the client feel good and nourish the body
versus restricting.
• 3. Question
A client with a history of diabetes mellitus is in the second
postoperative day following cholecystectomy. She has
complained of nausea and isn’t able to eat solid foods. The
nursing practitioner enters the room to find the client confused
and shaky. Which of the following is the most likely explanation
for the client’s symptoms?
o A. Anesthesia reaction
o B. Hyperglycemia
o C. Hypoglycemia
o D. Diabetic ketoacidosis
Correct Answer: C. Hypoglycemia
A postoperative diabetic client who is unable to eat is likely to be
suffering from hypoglycemia. The actual treatment
recommendations for a given client should be individualized,
based on diabetes classification, usual diabetes regimen, state of
, glycemic control, nature and extent of surgical procedure, and
available expertise.
o Option A: An anesthesia reaction would not occur on
the second postoperative day. Anesthesia and surgery
cause a stereotypical metabolic stress response that
could overwhelm homeostatic mechanisms in clients
with pre-existing abnormalities of glucose metabolism.
The invariant features of the metabolic stress
response include release of the catabolic hormones
epinephrine, norepinephrine, cortisol, glucagons, and
growth hormone and inhibition of insulin secretion and
action.
o Option B: Confusion is a late sign of hyperglycemia.
Shakiness is not one of its symptoms. The
management approach in these categories of clients
always includes insulin therapy in combination with
dextrose and potassium infusion. Major surgery is
defined as one requiring general anesthesia of ?1 h. At
a minimum, blood glucose should be monitored before
and immediately after surgery in all clients. Those
undergoing extensive procedures should have hourly
glucose monitoring during and immediately following
surgery.
o Option D: Symptoms of DKA include excessive thirst,
frequent urination, abdominal pain, fruity-scented
breath, confusion, and shortness of breath. However,
shakiness is not a sign of DKA. The stress of surgery
itself results in metabolic perturbations that alter
glucose homeostasis, and persistent hyperglycemia is
a risk factor for endothelial dysfunction, postoperative
sepsis, impaired wound healing, and cerebral
ischemia. The stress response itself may precipitate
diabetic crises (diabetic ketoacidosis [DKA].
• 4. Question
A nursing practitioner assigned to the emergency department
evaluates a client who underwent fiberoptic colonoscopy 18
hours previously. The client reports increasing abdominal pain,
fever, and chills. Which of the following conditions poses
the most immediate concern?
