NCLEX Review questions Mark K questions
with complete solutions
Your pt has respiratory acidosis your pt has:
v v v v v v v
(select all that apply) v v v
a) +1 reflexes
v v
b) diarrhea
v
c) a dynamic ileus
v v v
d) spasmv
e) urinary retention
v v
f) paraxysmol atrial tachycardia
v v v
e) 2nd degree, mobitz, type 2 heart block
v v v v v v v
g) hypokalemia - answer-a) +1 reflexes
v v v v v
c) a dynamic ileus
v v v
e) urinary retention
v v
g) 2nd degree, mobitz, type 2 heart block
v v v v v v v
A pt has pneumonia present in 4 lobes, they have a RR of 52, and a SpO2 of 78. What
v v v v v v v v v v v v v v v v v v v
vacid-base imbalance is the patient exhibiting? v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-c) respiratory acidosis
v v v v v v
-the rate is less important than the gas exchange, if the SpO2 is 78 then gas exchange is
v v v v v v v v v v v v v v v v v
vnot good and shows acidosis
v v v v v
-they are under ventilating, under = acidosis
v v v v v v v
-not about rate about SaO2 or SpO2
v v v v v v
If your pt is on a PCA pump, what acid-base imbalance will cause you to take them off of
v v v v v v v v v v v v v v v v v v
vit? v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-c) respiratory acidosis
v v v v v v
-PCA pumps depress respirations = underventilation
v v v v v
If your male pt comes in with hyper-emesis what acid-base imbalance would he have?
v v v v v v v v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
,d) metabolic acidosis - answer-b) metabolic alkalosis
v v v v v v
-vomiting or suctioning = met alkalosis v v v v v
-losing acid v
If a male pt comes in with prolonged hyper-emesis that has lead to dehydration what
v v v v v v v v v v v v v v
vacid-base imbalance would they have? v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-even though the pt is vomiting, they are now dehydrated which is the main take away
v v v v v v v v v v v v v v v
vfrom the question, dehydration = acidosis
v v v v v
If an infant comes in with diarrhea, what acid-base imbalance is anticipated?
v v v v v v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-diarrhea is not vomiting or suctioning so it is not alkalosis
v v v v v v v v v v
-diarrhea leads to dehydration = acidosis v v v v v
If your pt is in kidney failure, what acid-base imbalance do you expect to see?
v v v v v v v v v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-not a lung issue
v v v
-not due to vomiting or suctioning
v v v v v
If a pt has third degree (full thickness) burns over 60% of their body in the first phase,
v v v v v v v v v v v v v v v v v
vwhat acid-base imbalance do you expect to see?
v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-not a lung issue
v v v
-not due to vomiting or suctioning
v v v v v
How often do you suction pts?
v v v v v v
a) every 2 hrs
v v v
b) every 15 min
v v v
c) every hour
v v
d) every 4 hours
v v v v
e) none of the above - answer-e) none of the above
v v v v v v v v v v v
-suction as needed only v v v
,-suctioning is a double edge sword, the more your suction the more secretions are
v v v v v v v v v v v v v
vproduced
You have a type 2 DM, what is the best dietary route to take?
v v v v v v v v v v v v v v
a) restrict their calories
v v v
b) divide their food into 6 feeding/day - answer-a) restrict their calories
v v v v v v v v v v v
**both are needed but since this is a "best" question this is the best option
v v v v v v v v v v v v v v
A young boy with type one diabetes comes into the E.R. with a blood glucose of 800,
v v v v v v v v v v v v v v v v
what is the best question to ask his parents to determine the cause of the DKA?
v v v v v v v v v v v v v v v v v
a) Has your child be involved in high activity today?
v v v v v v v v v
b) Did your child have an extra dose of insulin today?
v v v v v v v v v v v
c) Has your child had an URI in the last two weeks?
v v v v v v v v v v v v
d) Did your child skip a meal today? - answer-c) Has your child had an URI in the last
v v v v v v v v v v v v v v v v v v
two weeks?
v v v
**(A) is correct but not the BEST answer, the most common cause of DKA is upper
v v v v v v v v v v v v v v v
vrespiratory infection v v
--the stress of the illness causes the body to break down fats, leading to ketones
v v v v v v v v v v v v v v
--need to confirm with ketones in the blood, ketonuria can be present without DKA so
v v v v v v v v v v v v v v
vthis is not diagnostic
v v v
In what position should you put an opisthotonus baby?
v v v v v v v v v
a) side v
b) pronev
c) supine
v
d) head elevated (sitting) - answer-a) side
v v v v v v
**opisthotonus is a hyperextention of the neck and back and can occur when an v v v v v v v v v v v v v
velevated bilirubin passes the BBB of a babyv v v v v v v
--important to report immediately as its a sign of impending kernicterus
v v v v v v v v v v
Your Pt has hyperkalemia, select all that apply:
v v v v v v v
a) dynamic ileus
v v
b) obtundant
v v
c) +1 reflex
v v
d) clonus
v v
e) u wave
v v
f) depressed ST
v v
g) polyuria
v
h) bradycardia - answer-d) clonus
v v v v v
h) bradycardia
v v
**-kalemias do the same as the prefix except for the HR and urine output
v v v v v v v v v v v v v
---U wave starts on the baseline and goes down, its a sign of cardiac depression (if you
v v v v v v v v v v v v v v v v
vdon't know what it is on a select all apply then don't pick it)
v v v v v v v v v v v v v
, Your pt has diarrhea, what caused it?
v v v v v v v
a) hyperkalemia
v
b) hypokalemia
v
c) hypocalcemia
v
d) hypomagnesemia - answer-a) hyperkalemia
v v v v
**if a tie and its not muscle or nerves then its always K+
v v v v v v v v v v v v
A student nurse runs to you and says they ran 1L of IV into the pt in 10 min b/c they
v v v v v v v v v v v v v v v v v v v v
forgot to clamp it, what electrolyte imbalance to you expect to see? - answer--
v v v v v v v v v v v v v v
hyponatremia
**would be put on fluid restriction, has fluid overload
v v v v v v v v
Your pt has hypothyroidism, what pre-op order would you question?
v v v v v v v v v v
a) penicillin
v v
b) insulin
v
c) ambien - answer-c) ambien
v v v v v
**pt should not be given sedation medications, can lead to myxedema coma
v v v v v v v v v v v
--their whole body is slowed b/c decreased coma
v v v v v v v
A pt underwent a lumbar laminectomy 10 hours ago, whats the number one problem you
v v v v v v v v v v v v v v
could expect?
v v
a) airway
v
b) breathing
v
c) circulation
v
d) urinary retention - answer-d) urinary retention
v v v v v v
-complications of laminectomies all depend on the location, if a lumbar lam then need to
v v v v v v v v v v v v v v
vlook for issues with the bladder and the legs
v v v v v v v v
>>cervical: breathing and arms v v v
>>thoracic: cough and bowels v v v
You are caring for a pt with a lumbar oligodendrocytoma, what is the number one
v v v v v v v v v v v v v v
vproblem?
a) airway
v
b) ileusv
c) cardiac arrhythmia
v v
d) urinary retention - answer-d) urinary retention
v v v v v v v
-the illness does not determine the answer, the location does, don't worry about what the
v v v v v v v v v v v v v v
vbig word means v v
You are caring for a pt whose lab value for INR came back as a 4.5. Arrange the order of
v v v v v v v v v v v v v v v v v v v
actions you would take from first to last.
v v v v v v v v
a) assess for bleeding
v v v v
b) call physician
v v
with complete solutions
Your pt has respiratory acidosis your pt has:
v v v v v v v
(select all that apply) v v v
a) +1 reflexes
v v
b) diarrhea
v
c) a dynamic ileus
v v v
d) spasmv
e) urinary retention
v v
f) paraxysmol atrial tachycardia
v v v
e) 2nd degree, mobitz, type 2 heart block
v v v v v v v
g) hypokalemia - answer-a) +1 reflexes
v v v v v
c) a dynamic ileus
v v v
e) urinary retention
v v
g) 2nd degree, mobitz, type 2 heart block
v v v v v v v
A pt has pneumonia present in 4 lobes, they have a RR of 52, and a SpO2 of 78. What
v v v v v v v v v v v v v v v v v v v
vacid-base imbalance is the patient exhibiting? v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-c) respiratory acidosis
v v v v v v
-the rate is less important than the gas exchange, if the SpO2 is 78 then gas exchange is
v v v v v v v v v v v v v v v v v
vnot good and shows acidosis
v v v v v
-they are under ventilating, under = acidosis
v v v v v v v
-not about rate about SaO2 or SpO2
v v v v v v
If your pt is on a PCA pump, what acid-base imbalance will cause you to take them off of
v v v v v v v v v v v v v v v v v v
vit? v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-c) respiratory acidosis
v v v v v v
-PCA pumps depress respirations = underventilation
v v v v v
If your male pt comes in with hyper-emesis what acid-base imbalance would he have?
v v v v v v v v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
,d) metabolic acidosis - answer-b) metabolic alkalosis
v v v v v v
-vomiting or suctioning = met alkalosis v v v v v
-losing acid v
If a male pt comes in with prolonged hyper-emesis that has lead to dehydration what
v v v v v v v v v v v v v v
vacid-base imbalance would they have? v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-even though the pt is vomiting, they are now dehydrated which is the main take away
v v v v v v v v v v v v v v v
vfrom the question, dehydration = acidosis
v v v v v
If an infant comes in with diarrhea, what acid-base imbalance is anticipated?
v v v v v v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-diarrhea is not vomiting or suctioning so it is not alkalosis
v v v v v v v v v v
-diarrhea leads to dehydration = acidosis v v v v v
If your pt is in kidney failure, what acid-base imbalance do you expect to see?
v v v v v v v v v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-not a lung issue
v v v
-not due to vomiting or suctioning
v v v v v
If a pt has third degree (full thickness) burns over 60% of their body in the first phase,
v v v v v v v v v v v v v v v v v
vwhat acid-base imbalance do you expect to see?
v v v v v v v
a) respiratory alkalosis
v v
b) metabolic alkalosis
v v
c) respiratory acidosis
v v
d) metabolic acidosis - answer-d) metabolic acidosis
v v v v v v
-not a lung issue
v v v
-not due to vomiting or suctioning
v v v v v
How often do you suction pts?
v v v v v v
a) every 2 hrs
v v v
b) every 15 min
v v v
c) every hour
v v
d) every 4 hours
v v v v
e) none of the above - answer-e) none of the above
v v v v v v v v v v v
-suction as needed only v v v
,-suctioning is a double edge sword, the more your suction the more secretions are
v v v v v v v v v v v v v
vproduced
You have a type 2 DM, what is the best dietary route to take?
v v v v v v v v v v v v v v
a) restrict their calories
v v v
b) divide their food into 6 feeding/day - answer-a) restrict their calories
v v v v v v v v v v v
**both are needed but since this is a "best" question this is the best option
v v v v v v v v v v v v v v
A young boy with type one diabetes comes into the E.R. with a blood glucose of 800,
v v v v v v v v v v v v v v v v
what is the best question to ask his parents to determine the cause of the DKA?
v v v v v v v v v v v v v v v v v
a) Has your child be involved in high activity today?
v v v v v v v v v
b) Did your child have an extra dose of insulin today?
v v v v v v v v v v v
c) Has your child had an URI in the last two weeks?
v v v v v v v v v v v v
d) Did your child skip a meal today? - answer-c) Has your child had an URI in the last
v v v v v v v v v v v v v v v v v v
two weeks?
v v v
**(A) is correct but not the BEST answer, the most common cause of DKA is upper
v v v v v v v v v v v v v v v
vrespiratory infection v v
--the stress of the illness causes the body to break down fats, leading to ketones
v v v v v v v v v v v v v v
--need to confirm with ketones in the blood, ketonuria can be present without DKA so
v v v v v v v v v v v v v v
vthis is not diagnostic
v v v
In what position should you put an opisthotonus baby?
v v v v v v v v v
a) side v
b) pronev
c) supine
v
d) head elevated (sitting) - answer-a) side
v v v v v v
**opisthotonus is a hyperextention of the neck and back and can occur when an v v v v v v v v v v v v v
velevated bilirubin passes the BBB of a babyv v v v v v v
--important to report immediately as its a sign of impending kernicterus
v v v v v v v v v v
Your Pt has hyperkalemia, select all that apply:
v v v v v v v
a) dynamic ileus
v v
b) obtundant
v v
c) +1 reflex
v v
d) clonus
v v
e) u wave
v v
f) depressed ST
v v
g) polyuria
v
h) bradycardia - answer-d) clonus
v v v v v
h) bradycardia
v v
**-kalemias do the same as the prefix except for the HR and urine output
v v v v v v v v v v v v v
---U wave starts on the baseline and goes down, its a sign of cardiac depression (if you
v v v v v v v v v v v v v v v v
vdon't know what it is on a select all apply then don't pick it)
v v v v v v v v v v v v v
, Your pt has diarrhea, what caused it?
v v v v v v v
a) hyperkalemia
v
b) hypokalemia
v
c) hypocalcemia
v
d) hypomagnesemia - answer-a) hyperkalemia
v v v v
**if a tie and its not muscle or nerves then its always K+
v v v v v v v v v v v v
A student nurse runs to you and says they ran 1L of IV into the pt in 10 min b/c they
v v v v v v v v v v v v v v v v v v v v
forgot to clamp it, what electrolyte imbalance to you expect to see? - answer--
v v v v v v v v v v v v v v
hyponatremia
**would be put on fluid restriction, has fluid overload
v v v v v v v v
Your pt has hypothyroidism, what pre-op order would you question?
v v v v v v v v v v
a) penicillin
v v
b) insulin
v
c) ambien - answer-c) ambien
v v v v v
**pt should not be given sedation medications, can lead to myxedema coma
v v v v v v v v v v v
--their whole body is slowed b/c decreased coma
v v v v v v v
A pt underwent a lumbar laminectomy 10 hours ago, whats the number one problem you
v v v v v v v v v v v v v v
could expect?
v v
a) airway
v
b) breathing
v
c) circulation
v
d) urinary retention - answer-d) urinary retention
v v v v v v
-complications of laminectomies all depend on the location, if a lumbar lam then need to
v v v v v v v v v v v v v v
vlook for issues with the bladder and the legs
v v v v v v v v
>>cervical: breathing and arms v v v
>>thoracic: cough and bowels v v v
You are caring for a pt with a lumbar oligodendrocytoma, what is the number one
v v v v v v v v v v v v v v
vproblem?
a) airway
v
b) ileusv
c) cardiac arrhythmia
v v
d) urinary retention - answer-d) urinary retention
v v v v v v v
-the illness does not determine the answer, the location does, don't worry about what the
v v v v v v v v v v v v v v
vbig word means v v
You are caring for a pt whose lab value for INR came back as a 4.5. Arrange the order of
v v v v v v v v v v v v v v v v v v v
actions you would take from first to last.
v v v v v v v v
a) assess for bleeding
v v v v
b) call physician
v v
