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NCLEX RN COMPREHENSIVE REVIEW EXAM
QUESTION BANK WITH COMPLETE 500 QUESTIONS
AND CORRECT ANSWERS LATEST UPDATE THIS
YEAR
Question: NPO status is imposed 8 hours before the procedure on a client scheduled to undergo
electroconvulsive therapy (ECT) at 1 p.m. On the morning of the procedure, the nurse checks
the client's record and notes that the client routinely takes an oral antihypertensive medication
each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT - CORRECT
ANSWER✔✔A. Administer the antihypertensive with a small sip of water
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours
before treatment to help prevent aspiration. Exceptions include clients who routinely receive
cardiac medications, antihypertensive agents, or histamine (H2) blockers, which should be
administered several hours before treatment with a small sip of water. Withholding the
antihypertensive and administering it at bedtime and withholding the antihypertensive and
resuming administration on the day after the ECT are incorrect actions, because
antihypertensives must be administered on time; otherwise, the risk for rebound hypertension
, Page 2 of 190
exists. The nurse would not administer a medication by way of a route that has not been
prescribed.
Question: A client who recently underwent coronary artery bypass graft surgery comes to the
physician's office for a follow-up visit. On assessment, the client tells the nurse that he is feeling
depressed. Which response by the nurse is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month." - CORRECT
ANSWER✔✔A. "Tell me more about what you're feeling."
Rationale: When a client expresses feelings of depression, it is extremely important for the
nurse to further explore these feelings with the client. In stating, "This is a normal response
after this type of surgery" the nurse provides false reassurance and avoids addressing the
client's feelings. "It will take time, but, I promise you, you will get over the depression" is also a
false reassurance, and it does not encourage the expression of feelings. "Every client who has
this surgery feels the same way for about a month" is a generalization that avoids the client's
feelings.
Question: Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment
does the nurse perform as a priority before administering the medication?
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A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours - CORRECT
ANSWER✔✔A. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat
hypertension. One common side effect is postural hypotension. Therefore the nurse would
check the client's blood pressure immediately before administering each dose. Checking the
client's peripheral pulses, the results of the most recent potassium level, and the intake and
output for the previous 24 hours are not specifically associated with this mediation.
Question: A client is scheduled to undergo an upper gastrointestinal (GI) series, and the
licensed practical nurse reinforces instructions to the client about the test. Which statement by
the client indicates a need for further instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema
on the morning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink
for the test can be constipating." - CORRECT ANSWER✔✔C. "I need to drink citrate of magnesia
the night before the test and give myself a Fleet enema on the morning of the test."
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Rationale: An upper GI series involves visualization of the esophagus, duodenum, and upper
jejunum by means of the use of a contrast medium. It involves swallowing a contrast medium
(usually barium), which is administered in a flavored milkshake. Films are taken at intervals
during the test, which takes about 30 minutes. No special preparation is necessary before a GI
series, except that NPO status must be maintained for 8 hours before the test. After an upper GI
series, the client is prescribed a laxative to hasten elimination of the barium. Barium that
remains in the colon may become hard and difficult to expel, leading to fecal impaction.
Question: A nurse on the evening shift checks a physician's prescriptions and notes that the
dose of a prescribed medication is higher than the normal dose. The nurse calls the physician's
answering service and is told that the physician is off for the night and will be available in the
morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication but consult the physician when he becomes available - CORRECT
ANSWER✔✔B. Ask the answering service to contact the on-call physician
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a
physician's prescription may be in error is responsible for clarifying the prescription before
carrying it out. Therefore the nurse would not administer the medication; instead, the nurse
would withhold the medication until the dose can be clarified. The nurse would not wait until
the next morning to obtain clarification. It is premature to call the nursing supervisor.
NCLEX RN COMPREHENSIVE REVIEW EXAM
QUESTION BANK WITH COMPLETE 500 QUESTIONS
AND CORRECT ANSWERS LATEST UPDATE THIS
YEAR
Question: NPO status is imposed 8 hours before the procedure on a client scheduled to undergo
electroconvulsive therapy (ECT) at 1 p.m. On the morning of the procedure, the nurse checks
the client's record and notes that the client routinely takes an oral antihypertensive medication
each morning. The nurse should:
A. Administer the antihypertensive with a small sip of water
B. Withhold the antihypertensive and administer it at bedtime
C. Administer the medication by way of the intravenous (IV) route
D. Hold the antihypertensive and resume its administration on the day after the ECT - CORRECT
ANSWER✔✔A. Administer the antihypertensive with a small sip of water
Rationale: General anesthesia is required for ECT, so NPO status is imposed for 6 to 8 hours
before treatment to help prevent aspiration. Exceptions include clients who routinely receive
cardiac medications, antihypertensive agents, or histamine (H2) blockers, which should be
administered several hours before treatment with a small sip of water. Withholding the
antihypertensive and administering it at bedtime and withholding the antihypertensive and
resuming administration on the day after the ECT are incorrect actions, because
antihypertensives must be administered on time; otherwise, the risk for rebound hypertension
, Page 2 of 190
exists. The nurse would not administer a medication by way of a route that has not been
prescribed.
Question: A client who recently underwent coronary artery bypass graft surgery comes to the
physician's office for a follow-up visit. On assessment, the client tells the nurse that he is feeling
depressed. Which response by the nurse is therapeutic?
A. "Tell me more about what you're feeling."
B. "That's a normal response after this type of surgery."
C. "It will take time, but, I promise you, you will get over this depression."
D. "Every client who has this surgery feels the same way for about a month." - CORRECT
ANSWER✔✔A. "Tell me more about what you're feeling."
Rationale: When a client expresses feelings of depression, it is extremely important for the
nurse to further explore these feelings with the client. In stating, "This is a normal response
after this type of surgery" the nurse provides false reassurance and avoids addressing the
client's feelings. "It will take time, but, I promise you, you will get over the depression" is also a
false reassurance, and it does not encourage the expression of feelings. "Every client who has
this surgery feels the same way for about a month" is a generalization that avoids the client's
feelings.
Question: Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment
does the nurse perform as a priority before administering the medication?
, Page 3 of 190
A. Checking the client's blood pressure
B. Checking the client's peripheral pulses
C. Checking the most recent potassium level
D. Checking the client's intake-and-output record for the last 24 hours - CORRECT
ANSWER✔✔A. Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat
hypertension. One common side effect is postural hypotension. Therefore the nurse would
check the client's blood pressure immediately before administering each dose. Checking the
client's peripheral pulses, the results of the most recent potassium level, and the intake and
output for the previous 24 hours are not specifically associated with this mediation.
Question: A client is scheduled to undergo an upper gastrointestinal (GI) series, and the
licensed practical nurse reinforces instructions to the client about the test. Which statement by
the client indicates a need for further instruction?
A. "The test will take about 30 minutes."
B. "I need to fast for 8 hours before the test."
C. "I need to drink citrate of magnesia the night before the test and give myself a Fleet enema
on the morning of the test."
D. "I need to take a laxative after the test is completed, because the liquid that I'll have to drink
for the test can be constipating." - CORRECT ANSWER✔✔C. "I need to drink citrate of magnesia
the night before the test and give myself a Fleet enema on the morning of the test."
, Page 4 of 190
Rationale: An upper GI series involves visualization of the esophagus, duodenum, and upper
jejunum by means of the use of a contrast medium. It involves swallowing a contrast medium
(usually barium), which is administered in a flavored milkshake. Films are taken at intervals
during the test, which takes about 30 minutes. No special preparation is necessary before a GI
series, except that NPO status must be maintained for 8 hours before the test. After an upper GI
series, the client is prescribed a laxative to hasten elimination of the barium. Barium that
remains in the colon may become hard and difficult to expel, leading to fecal impaction.
Question: A nurse on the evening shift checks a physician's prescriptions and notes that the
dose of a prescribed medication is higher than the normal dose. The nurse calls the physician's
answering service and is told that the physician is off for the night and will be available in the
morning. The nurse should:
A. Call the nursing supervisor
B. Ask the answering service to contact the on-call physician
C. Withhold the medication until the physician can be reached in the morning
D. Administer the medication but consult the physician when he becomes available - CORRECT
ANSWER✔✔B. Ask the answering service to contact the on-call physician
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes that a
physician's prescription may be in error is responsible for clarifying the prescription before
carrying it out. Therefore the nurse would not administer the medication; instead, the nurse
would withhold the medication until the dose can be clarified. The nurse would not wait until
the next morning to obtain clarification. It is premature to call the nursing supervisor.
