[Apr-2025] Latest NCLEX NCLEX-RN Certification Practice Test Questions
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NCLEX-RN exam covers a wide range of nursing topics, including patient care, pharmacology, nursing procedures, health promotion, and disease prevention. It is a comprehensive and rigorous exam that assesses not only a nurse's knowledge, but also their critical thinking, problem-solving, and decision-making abilities. Passing the NCLEX-RN is a significant milestone in a nurse's career, as it demonstrates their competence and readiness to provide safe and effective patient care. NCLEX-RN exam is recognized by all 50 US states and the District of Columbia, as well as several US territories and Canadian provinces, making it a critical step in the nursing licensure process.
NEW QUESTION # 126
Azulfidine (Sulfasalazine) may be ordered for a client who has ulcerative colitis. Which of the following is a nursing implication for this drug?
- A. Administer 2 hours before meals.
- B. Observe for skin rash and diarrhea.
- C. Limit fluids to 500 mL/day.
- D. Monitor blood pressure, pulse.
Answer: B
Explanation:
(A) Fluids up to 2500-3000 mL/day are needed to prevent kidney stones. (B) The client should be instructed to take oral preparations with meals or snacks to lessen gastric irritation. (C) Sulfasalazine causes skin rash and diarrhea. (D) Blood pressure and pulse are not altered by sulfasalazine.
NEW QUESTION # 127
The cardiac client who exhibits the symptoms of disorientation, lethargy, and seizures may be exhibiting a toxic reaction to:
- A. Digoxin (Lanoxin)
- B. Quinidine gluconate or sulfate (Quinaglute,Quinidex)
- C. Nitroglycerin IV (Tridil)
- D. Lidocaine (Xylocaine)
Answer: D
Explanation:
Section: Questions Set A
Explanation:
(A) Side effects of digoxin include headache, hypotension, AV block, blurred vision, and yellow-green halos. (B) Side effects of lidocaine include heart block, headache, dizziness, confusion, tremor, lethargy, and convulsions.
(C) Side effects of quinidine include heart block, hepatotoxicity, thrombocytopenia, and respiratory depression.
(D) Side effects of nitroglycerin include postural hypotension, headache, dizziness, and flushing.
NEW QUESTION # 128
When administering phenytoin (Dilantin) to a child, the nurse should be aware that a toxic effect of phenytoin therapy is:
- A. Stephens-Johnson syndrome
- B. Leukopenic aplastic anemia
- C. Granulocytosis and nephrosis
- D. Folate deficiency
Answer: A
Explanation:
Explanation
(A) Stephens-Johnson syndrome is a toxic effect of phenytoin. (B) Folate deficiency is a side effect of phenytoin, but not a toxic effect. (C) Leukopenic aplastic anemia is a toxic effect of carbamazepine (Tegretol).
(D) Granulocytosis and nephrosis are toxic effects of trimethadione (Tridione).
NEW QUESTION # 129
The nurse notes multiple bruises on the arms and legs of a newly admitted client with lupus. The client states, "I get them whenever I bump into anything." The nurse would expect to note a decrease in which of the following laboratory tests?
- A. Number of lymphocytes
- B. Hemoglobin level
- C. WBC count
- D. Number of platelets
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Thrombocytopenia, a decrease in platelets, occurs in lupus and causes a decrease in blood coagulation and thrombus formation. (B) Clients with lupus will have a decrease in the WBC count decreasing their resistance to infection. (C) Clients with lupus may have a decrease in the hemoglobin level causing anemia. (D) Leukopenia, a decrease in white blood cells, is seen in lupus and decreases resistance to infection.
NEW QUESTION # 130
A 19-year-old male client arrived via ambulance to the emergency room following a motorcycle accident.
He is comatose. His face has evidence of dried blood. On assessment, the nurse notes an obvious injury to his left eye. The preferred positioning for a client with an obvious eye injury is:
- A. Any position in which the client is comfortable
- B. Sitting with head support
- C. Reclining to control bleeding
- D. Side-lying, either left or right
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) A reclining position can cause a penetrating object to advance further into the eye. (B) Prevention of further injury is the priority, not comfort. (C) A side-lying position may increase intraocular and intracranial pressure if an accompanying head injury is suspected. (D) A sitting position with the head supported will prevent further injury while allowing injury care to take place.
NEW QUESTION # 131
The pediatrician has diagnosed tinea capitis in an 8- year-old girl and has placed her on oral griseofulvin.
The nurse should emphasize which of these instructions to the mother and/or child?
- A. May discontinue medication when the child experiences symptomatic relief.
- B. Administer oral griseofulvin on an empty stomach for best results.
- C. Observe for headaches, dizziness, and anorexia.
- D. Discontinue drug therapy if food tastes funny.
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Giving the drug with or after meals may allay gastrointestinal discomfort. Giving the drug with a fatty meal (ice cream or milk) increases absorption rate. (B) Griseofulvin may alter taste sensations and thereby decrease the appetite. Monitoring of food intake is important, and inadequate nutrient intake should be reported to the physician. (C) The child may experience symptomatic relief after 48-96 hours of therapy. It is important to stress continuing the drug therapy to prevent relapse (usually about 6 weeks). (D) The incidence of side effects is low; however, headaches are common. Nausea, vomiting, diarrhea, and anorexia may occur. Dizziness, although uncommon, should be reported to the physician.
NEW QUESTION # 132
A client is diagnosed with organic brain disorder. The nursing care should include:
- A. Challenging educational programs
- B. Organized, safe environment
- C. Long, extended family visits
- D. Detailed explanations of procedures
Answer: B
Explanation:
(A) A priority nursing goal is attending to the client's safety and well-being. Reorient frequently, remove dangerous objects, and maintain consistent environment. (B) Short, frequent visits are recommended to avoid overstimulation and fatigue. (C) Short, concise, simple explanations are easier to understand. (D) Mental capability and attention span deficits make learning difficult and frustrating.
NEW QUESTION # 133
Dietary planning is an essential part of the diabetic client's regimen. The American Diabetes Association recommends which of the following caloric guidelines for daily meal planning?
- A. 60% complex carbohydrate, 12%-15% protein, 20%-25% fat
- B. 50% complex carbohydrate, 20%-25% protein, 20%-25% fat
- C. 70% complex carbohydrate, 20%-30% protein, 10%-20% fat
- D. 45% complex carbohydrate, 25%-30% protein, 30%-35% fat
Answer: A
Explanation:
Section: Questions Set A
Explanation:
(A) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney as it is metabolized. (B) The percentage of carbohydrates is too low to maintain blood sugar levels. The percent range of protein is too high and may cause extra workload on the kidney. (C) The percentage of carbohydrates is too high; the percent range of protein is too high, and of fat, too low. (D) This combination provides enough carbohydrates to maintain blood glucose levels, enough protein to maintain body repair, and enough fat to ensure palatability.
NEW QUESTION # 134
The initial focus when providing nursing care for a child with rheumatic fever during the acute phase of the illness should be to:
- A. Maintain contact with her parents
- B. Provide a nutritious diet
- C. Provide for physical and psychological rest
- D. Maintain her interest in school
Answer: C
Explanation:
Section: Questions Set G
Explanation:
(A) This goal is helpful, but rest is essential during the acute phase. (B) Rest is essential for healing to occur and for pain to be relieved. (C) This goal is important, but rest is essential. (D) This goal should be part of the plan of care, but it is not the priority during the acute phase.
NEW QUESTION # 135
In cleansing the perineal area around the site of catheter insertion, the nurse would:
- A. Apply a small amount of talcum powder after drying the perineal area
- B. Gently insert the catheter another 1⁄2 inch after cleansing to prevent irritation from the balloon
- C. Wipe the catheter toward the urinary meatus
- D. Wipe the catheter away from the urinary meatus
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Wiping toward the urinary meatus would transport microorganisms from the external tubing to the urethra, thereby increasing the risk of bladder infection. (B) Wiping away from the urinary meatus would remove microorganisms from the point of insertion of the catheter, thereby decreasing the risk of bladder infection. (C) Talcum powder should not be applied following catheter care, because powders contribute to moisture retention and infection likelihood. (D) The catheter should never be inserted further into the urethra, because this would serve no useful purpose and would increase the risk of infection.
NEW QUESTION # 136
A family by court order undergoes treatment by a family therapist for child abuse. The nurse, who is the child's case manager knows that treatment has been effective when:
- A. The child's parents can identify appropriate behaviors for children in his age group
- B. The child's parents identify the ways in which he is different from the rest of the family
- C. The child is removed from the home and placed in foster care
- D. The child's father is arrested for child abuse
Answer: A
Explanation:
Explanation
(A) Removing an abused child from the home and placement in a foster home are not the desired outcome of treatment. (B) Children who are perceived as "different" from the rest of the family are more likely to be abused. (C) Although legal action may be taken against abusive parents, it is not an indicator of an effective treatment program. (D) Identification of age-appropriate behaviors is essential to the role of parents, because misunderstanding children's normal developmental needs often contributes to abuse or neglect.
NEW QUESTION # 137
A 52-year-old client's abdominal aortic aneurysm ruptured. She received rapid massive blood transfusions for bleeding. One potential complication of blood administration for which she is especially at risk is:
- A. Hypocalcemia
- B. Air embolus
- C. Hypokalemia
- D. Circulatory overload
Answer: A
Explanation:
Section: Questions Set C
Explanation:
(A) Air embolism is a potential complication of blood administration, but it is fairly rare and can be prevented by using good IV technique. (B) Circulatory overload is a potential complication of blood administration, but because this client is actively bleeding, she is not at high risk for overload. (C) Hypocalcemia is a potential complication of blood administration that occurs in situations where massive transfusion has occurred over a short period of time. It occurs because the citrate in stored blood binds with the client's calcium. Another potential complication for which this client is especially at risk is hypothermia, which can be prevented by using a blood warmer to administer the blood. (D) Hypokalemia is not a complication of blood administration.
NEW QUESTION # 138
A 2-year-old toddler is hospitalized with epiglottitis. In assessing the toddler, the nurse would expect to find:
- A. Crackles in the lower lobes
- B. A productive cough
- C. Drooling
- D. Expiratory stridor
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) A productive cough is not associated with epiglottitis. (B) Children with epiglottitis seldom have expiratory stridor. Inspiratory stridor is more common due to edema of the supraglottic tissues. (C) Because of difficulty with swallowing, drooling often accompanies epiglottitis. (D) Crackles are not heard in the lower lobes with epiglottitis because the infection is usually confined to the supraglottic structures.
NEW QUESTION # 139
In working with mental health clients who are prescribed medication that must be taken on a routine basis, it is important for education to begin when the drug therapy is initiated. One of the first steps in the teaching process is to:
- A. Discuss the danger of overmedication
- B. Distribute written material to supplement verbal instructions
- C. Explain the side effects of the medication
- D. Explore the client's perception regarding medication therapy
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A, B, C) The nurse must first obtain information regarding the client's perception of the medication regimen. (D) The first step in the teaching process is to determine the client's perception.
NEW QUESTION # 140
A 23-year-old college student seeks medical attention at the college infirmary for complaints of severe fatigue.
Her skin is pale, and she reports exertional dyspnea. She is admitted to the hospital with possible aplastic anemia. Laboratory values reflect anemia, and the client is prepared for a bone marrow biopsy. She refuses to sign the biopsy consent and states, "Can't you just get the doctor to give me a transfusion and let me go. This weekend begins spring break, and I have plans to go to Florida." At this time the nurse's greatest concern is that:
- A. The client does not grasp the full impact of her illness
- B. The causative agent be identified and treatment begun
- C. The client may contract an infection as a result of being exposed to large crowds at spring break
- D. The client may require transfusion before leaving for spring break
Answer: A
Explanation:
Explanation
(A) The client could contract an infection, but at this point it is not the most pertinent issue. (B) The client's statement indicates that she does not grasp the full impact of her illness. Further client education must be given, along with allowing her to express her feelings regarding her illness. (C) The client may require a transfusion, but this is a temporary measure because the causative agent has not been identified. Her feelings regarding her illness must be addressed in order for care to continue. (D) A bone marrow is done first to make a definitive diagnosis; then treatment may begin.
NEW QUESTION # 141
A client returns for her 6-month prenatal checkup and has gained 10 lb in 2 months. The results of her physical examination are normal. How does the nurse interpret the effectiveness of the instruction about diet and weight control?
- A. She needs to increase her caloric intake.
- B. She is compliant with her diet as previously taught.
- C. She needs further instruction and reinforcement.
- D. She needs to be placed on a restrictive diet immediately.
Answer: C
Explanation:
Section: Questions Set A
Explanation:
(A) She is probably not compliant with her diet and exercise program. Recommended weight gain during second and third trimesters is approximately 12 lb. (B) Because of her excessive weight gain of 10 lb in 2 months, she needs re-evaluation of her eating habits and reinforcement of proper dietary habits for pregnancy.
A 2200-calorie diet is recommended for most pregnant women with a weight gain of 27-30 lb over the 9-month period. With rapid and excessive weight gain, PIH should also be suspected. (C) She does not need to increase her caloric intake, but she does need to re-evaluate dietary habits. Ten pounds in 2 months is excessive weight gain during pregnancy, and health teaching is warranted. (D) Restrictive dieting is not recommended during pregnancy.
NEW QUESTION # 142
On admission, the client has signs and symptoms of pulmonary edema. The nurse places the client in the most appropriate position for a client in pulmonary edema, which is:
- A. Sitting in a chair
- B. High Fowler
- C. Supine with feet elevated
- D. Lying on the left side
Answer: B
Explanation:
Explanation
(A) High Fowler position decreases venous return to the heart and permits greater lung expansion so that oxygenation is maximized. (B) Lying on the left side may improve perfusion to the left lung but does not promote lung expansion. (C) Sitting in a chair will decrease venous return and promote maximal lung expansion. However, clients with pulmonary edema can deteriorate quickly and require intubation and mechanical ventilation. If a client is sitting in achair when this deterioration happens, it will be difficult to intervene quickly. (D) The supine with feet elevated position increases venous return and will worsen pulmonary edema.
NEW QUESTION # 143
The nurse has been assigned a client who delivered a 6- lb, 12-oz baby boy vaginally 40 minutes ago. The initial assessment of greatest importance for this client would be:
- A. Amount of IV fluid to be infused
- B. Type of episiotomy
- C. Length of her labor
- D. Character of the fundus
Answer: D
Explanation:
The length of labor has little bearing on the fourth stage of labor. The type of labor and delivery is significant. (B) The type of episiotomy will affect the client's comfort level. However, the nurse's assessment and implementations center on prevention of hemorrhage during the fourthstage of labor. The amount of bleeding from the episiotomy or hematoma formation is of higher priority than the type of episiotomy. (C) The amount of IV fluid to be infused is a nursing function to be attended to; however, it is lower in priority than determining if hemorrhaging is occurring. (D) Character of the fundus would be the priority nursing assessment because changes in uterine tone may identify possible postpartum hemorrhage.
NEW QUESTION # 144
A client tells the nurse that she has had a history of urinary tract infections. The nurse would do further health teaching if she verbalizes she will:
- A. Drink at least 8 oz of cranberry juice daily
- B. Limit her fluid intake after 6 PM so that there is not a great deal of urine in her bladder while she sleeps
- C. Maintain a fluid intake of at least 2000 mL daily
- D. Wash her hands before and after voiding
Answer: B
Explanation:
Section: Questions Set B
Explanation:
(A) Cranberry juice helps to maintain urine acidity, thereby retarding bacterial growth. (B) A generous fluid intake will help to irrigate the bladder and to prevent bacterial growth within the bladder. (C) Hand washing is an effective means of preventing pathogen transmission. (D) Restricting fluid intake would contribute to urinary stasis, which in turn would contribute to bacterial growth.
NEW QUESTION # 145
A six-month-old infant has been admitted to the emergency room with febrile seizures. In the teaching of the parents, the nurse states that:
- A. There is little risk of neurological deficit and mental retardation as sequelae to febrile seizures
- B. Febrile seizures do not usually recur
- C. Febrile seizures are associated with diseases of the central nervous system
- D. Sustained temperature elevation over 103F is generally related to febrile seizures
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) The temperature elevation related to febrile seizures generally exceeds 101F, and seizures occur during the temperature rise rather than after a prolonged elevation. (B) Febrile seizures may recur and are more likely to do so when the first seizure occurs in the 1st year of life. (C) There is little risk of neurological deficit, mental retardation, or altered behavior secondary to febrile seizures. (D) Febrile seizures are associated with disease of the central nervous system.
NEW QUESTION # 146
In performing the initial nursing assessment on a client at the prenatal clinic, the nurse will know that which of the following alterations is abnormal during pregnancy?
- A. Chloasma
- B. Striae gravidarum
- C. Colostrum
- D. Dysuria
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Striae gravidarum are the normal stretch marks that frequently occur on the breasts, abdomen, and thighs as pregnancy progresses. (B) Chloasma is the "mask of pregnancy" that normally occurs in many pregnant women. (C) Dysuria is an abnormal danger sign during pregnancy and may indicate a urinary tract infection. (D) Colostrum is a yellow breast secretion that is normally present during the last trimester of pregnancy.
NEW QUESTION # 147
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