100 Random NCLEX Practice Questions

1. A client is newly diagnosed with chronic obstructive pulmonary disease (COPD). The client returns home after a short hospitalization. The home care nurse should most importantly plan teaching strategies that are designed to do what?

2. The nurse is caring for a hospitalized client who is having a prescribed dosage of clonazepam adjusted. Because of the adjustment in the medication administration, which priority safety activity should the nurse plan to implement?

3. The nurse is monitoring a client in the telemetry unit who has recently been admitted with the diagnosis of chest pain and notes this heart rate pattern on the monitoring strip (refer to figure). What is the initial action to be taken by the nurse?

4. The nurse is reviewing the results of the rubella screening (titer) with a pregnant client. The test results are positive, and the client asks if it is safe for her toddler to receive the vaccine. Which response by the nurse is most appropriate?

5. A teenager returns to the gynecological clinic for a follow-up visit for a sexually transmitted infection (STI). Which statement by the teenager indicates the need for further teaching?

6. Which nursing assessment finding indicates the presence of an inguinal hernia on a child?

7. A client with a diagnosis of subarachnoid hemorrhage secondary to ruptured cerebral aneurysm has been placed on aneurysm precautions. To promote safety, the nurse should ensure that which intervention is provided to the client?

8. An adolescent is hospitalized with a diagnosis of Rocky Mountain spotted fever (RMSF). The nurse anticipates that which medication will be prescribed?

9. A client diagnosed with a recent complete T4 spinal cord transection tells the nurse that he will walk again as soon as the spinal shock resolves. Which statement provides the most accurate basis for planning a response to the client?

10. A client who survived a house fire is experiencing respiratory distress, and an inhalation injury is suspected. What should the nurse monitor to determine the presence of carbon monoxide poisoning?

11. A client diagnosed with gestational hypertension has just been admitted and is in early active labor. Which assessment finding should the nurse most likely expect to note?

12. . The nurse is applying electrocardiogram (ECG) electrodes to a diaphoretic client. Which intervention should the nurse take to keep the electrodes securely in place?

13. The significant other of a client diagnosed with Graves’ disease expresses concern regarding the client’s bursts of temper, nervousness, and an inability to concentrate on even trivial tasks. On the basis of this information, the nurse should identify which concern for the client?

14. A primipara is being evaluated in the clinic during her second trimester of pregnancy. The nurse checks the fetal heart rate (FHR) and notes that it is 190 beats/min. What is the appropriate initial nursing action?

15. The nurse is assigned to care for a client with a chest tube attached to closed chest drainage. Which assessment data should the nurse identify as an indicator that the client’s lung has completely expanded?

16. Which piece of equipment will the nurse routinely use to assess the fetal heart rate of a woman at 16 weeks’ gestation?

17. A client receiving prescribed heparin therapy for a diagnosis of an acute myocardial infarction has an activated partial thromboplastin time (aPTT) value of 100 seconds. Before reporting the results to the primary health care provider, the nurse verifies that which medication is available for use if prescribed?

18. A client diagnosed with acquired immunodeficiency syndrome (AIDS) gets recurrent Candida infections of the mouth (thrush). The nurse has given the client instructions to minimize the occurrence of thrush and determines that the client understands the instructions if which statement is made by the client?

19. The nurse is planning the hospital discharge of a young client who has been newly diagnosed with type 1 diabetes mellitus. The client expresses concern about self-administering insulin while in school with other students around. Which statement by the nurse best supports the client’s need for support at this time?

20. An English-speaking Hispanic client has a newly applied long leg cast to stabilize a right proximal fractured tibia. During rounds at night, the nurse finds the client restless, withdrawn, and unusually quiet. Which nursing statement would be most appropriate?

21. The nurse is preparing to administer a first dose of prescribed pentamidine isethionate intravenously to a client. Before administering the dose, which safety measure should the nurse consider for this client?

22. The camp nurse provides instructions regarding skin protection from the sun to the parents who are preparing their children for a camping adventure. Which statement by a parent indicates a need for further instructions?

23. A client is scheduled for a subtotal gastrectomy (Billroth II procedure). The nurse explains that the procedure will have which surgical results?

24. A client is diagnosed with a flail chest. Which characteristics related to breathing should the nurse observe for in the client?

25. The nurse is assessing a 3-day-old preterm neonate with a diagnosis of respiratory distress syndrome (RDS). Which assessment finding indicates that the neonate’s respiratory condition is improving?

26. The registered nurse instructs the new nurse that a variance analysis is performed on all clients with respect to which time frame?

27. The nurse is caring for a client at risk for suicide. Which client behavior best indicates that the client may be contemplating suicide?

28. A client who is admitted to the hospital for an unrelated medical problem is diagnosed with urethritis caused by chlamydial infection. The unlicensed assistive personnel (UAP) assigned to the client asks the nurse what measures are necessary to prevent contraction of the infection during care. The nurse tells the UAP that which intervention is needed for infection control?

29. The nurse is teaching a client with a right-leg fracture who has a prescription for partial weight-bearing status how to ambulate with crutches. The nurse determines that the client demonstrates compliance with this restriction to prevent complications of the fracture if the client follows which direction?

30. A client diagnosed with Parkinson’s disease is having difficulty adjusting to the disorder. The nurse provides education to the family that focuses on addressing the client’s activities of daily living. Which statement indicates that the teaching has been effective?

31. The nurse receives a telephone call from a client who states that he wants to kill himself and has a loaded gun on the table. Which intervention best assures the client’s safety?

32. A client who has undergone successful femoral-popliteal bypass grafting of the leg states to the nurse, “I hope everything goes well after this and that I don’t lose my leg. I’m so afraid that I’ll have gone through this for nothing.” Which most therapeutic response should the nurse make to the client?

33. The nurse is caring for a client diagnosed with acute pulmonary edema. Which psychosocial strategy should the nurse plan to incorporate into the care of the client?

34. The nurse is conducting a health history on a client diagnosed with hyperparathyroidism. Which question asked of the client would elicit information about this condition?

35. A client experiencing empyema is to have a bedside thoracentesis performed. The nurse plans to have which equipment available in the event that the procedure is not effective?

36. A 17-year-old client is discharged to home with her newborn baby after the nurse provides information about home safety for children. Which statement by the client should alert the nurse that further teaching is required regarding home safety?

37. A client is to have arterial blood gases drawn. While the nurse is performing Allen’s test, the client states to the nurse, “What are you doing? No one else has done that!” Which response the nurse makes to the client is most therapeutic?

38. A client diagnosed with left pleural effusion has just been admitted for treatment. The nurse should plan to have which procedure tray available for use at the bedside?

39. A primary health care provider is inserting a chest tube. Which materials should the nurse have available to be used as the first layer of the dressing at the chest tube insertion site?

40. The nurse is caring for a client who is of Asian descent and is assessing for client perceptions regarding nutrition. Which, in addition to the impact of food on disease and illness, should the nurse consider in order to provide culturally competent care?

41. The nurse performs an Allen’s test before blood is drawn from the radial artery for an arterial blood gas (ABG) assessment. This intervention is done to determine the collateral circulatory adequacy of which arterial vessel?

42. A client was just told by the primary care primary health care provider that he will have an exercise stress test to evaluate his status after recent episodes of severe chest pain. As the nurse enters the examining room, the client states, “Maybe I shouldn’t bother going. I wonder if I should just take more medication instead.” Which therapeutic response should the nurse make to the client?

43. To ensure that the client self-administers medications safely in the home, which action plan should the nurse implement?

44. A 16-year-old client with Crohn’s disease is hospitalized. Which statement by the client would alert the nurse to a potential developmental problem?

45. The nurse is receiving a client from the emergency department who has a diagnosis of Guillain-Barré syndrome. The client’s chief sign/symptom is an ascending paralysis that has reached the level of the waist. Which items should the nurse plan to have available for emergency use?

46. A client diagnosed with both a wound infection and osteomyelitis is to receive hyperbaric oxygen therapy. During the therapy, which priority intervention should the nurse implement?

47. What is the nurse’s priority for the postprocedure care of a client who has just returned to the unit after a scheduled intravenous pyelogram (IVP)?

48. The nurse is monitoring the nutritional status of a client who is receiving enteral nutrition. Which should the nurse monitor as the best clinical indicator of the client’s nutritional status?

49. A community health nurse working in an industrial setting has received a memo indicating that a large number of employees will be laid off during the next 2 weeks. An analysis of previous layoffs suggested that workers experienced role crises, indecision, and depression. Using this information, which actions should the nurse implement to begin assisting employees?

50. The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in approximately how many hours following administration?

51. The nurse admits a client with a suspected diagnosis of bulimia nervosa. While performing the admission assessment, the nurse expects to elicit which data about the client’s beliefs?

52. Cholestyramine is prescribed, and the nurse provides instructions to the client about the medication. Which client statement indicates a need for further teaching?

53. The home care nurse provides instructions about the management of pruritus to a client diagnosed with jaundice. Which statement made by the client suggests to the nurse that the client needs further teaching?

54. The nurse is caring for a young adult client diagnosed with sarcoidosis. The client is angry and tells the nurse that there is no point in learning disease management because there is no possibility of ever being cured. Based on the client’s statement, the nurse determines that the client is experiencing which potential problem?

55. The nurse is teaching the parents of a child diagnosed with celiac disease about dietary measures. The nurse should instruct the parents to take which measure?

56. To assure the desired results, how should the nurse instruct the client prescribed oral bisacodyl to take the medication?

57. The nurse administers digoxin 0.25 mg by mouth rather than the prescribed dose of 0.125 mg to the client. After assessing the client and notifying the health care provider, which action should the nurse implement first?

58. The nurse has applied the patch electrodes of an automatic external defibrillator (AED) to the chest of a client who is pulseless. The defibrillator has interpreted the rhythm to be ventricular fibrillation. Which priority action should the nurse prepare to implement next?

59. The nurse provides discharge instructions to the mother of a child who was hospitalized for heart surgery. Which instruction should the nurse provide to the mother?

60. The community health is conducting a health screening clinic. The nurse interprets that which client participating in the screening is the highest priority client to provide instruction to lower the risk of developing respiratory disease?

61. The nurse is preparing to administer oxygen to a client with a diagnosis of chronic obstructive pulmonary disease (COPD) and is at risk for carbon dioxide narcosis. The nurse should check to see that the oxygen flow rate is prescribed at which rate?

62. The nurse is working in the emergency department of a small local hospital when a client with multiple stab wounds arrives by ambulance. Which action by the nurse is contraindicated when handling potential legal evidence?

63. The nurse providing emergency treatment for a client in ventricular tachycardia is preparing to defibrillate the client. Which nursing action provides for the safest environment during a defibrillation attempt?

64. A home care nurse is assigned to visit a preschooler who has a diagnosis of scarlet fever and is on bed rest. What data obtained by the nurse would indicate that the child is coping with the illness and bed rest?

65. The nurse caring for a client immediately following transurethral resection of the prostate (TURP) notices that the client has suddenly become confused and disoriented. The nurse determines that this may be a result of which potential complication of this surgical procedure?

66. A perinatal home care nurse has just assessed the fetal status of a client with a diagnosis of partial placental abruption of 20 weeks’ gestation. The client is experiencing new bleeding and reports less fetal movement. The nurse informs the client that the primary health care provider will be contacted for possible hospital admission. The client begins to cry quietly while holding her abdomen with her hands. She murmurs, “No, no, you can’t go, my little man.” The nurse should recognize the client’s behavior as an indication of which psychosocial reaction?

67. The nurse creates a plan of care for a client with a spica cast that covers a lower extremity. Which action should the nurse include in the plan of care to promote bowel elimination?

68. An adult client has undergone a lumbar puncture to obtain cerebrospinal fluid (CSF) for analysis. After reviewing the results of the analysis, the nurse recognizes that the CSF is normal when which element is negative?

69. The nurse is caring for a client who is in seclusion. Which client statement indicates to the nurse that the seclusion is no longer necessary?

70. The rehabilitation nurse witnessed a postoperative client who had a coronary artery bypass graft and his spouse arguing after a rehabilitation session. Which would be the most appropriate therapeutic statement for the nurse to make to identify the feelings of the client?

71. A client receiving total parenteral nutrition (TPN) reports nausea, polydipsia, and polyuria. To determine the cause of the client’s report, the nurse should assess which client data?

72. A client had a colon resection. A nasogastric tube was in place when a regular diet was brought to the client’s room. The client did not want to eat solid food and asked that the primary health care provider be called. The nurse insisted that the solid food was the correct diet. The client ate and subsequently required additional surgery as a result of complications. The determination of negligence is based on which premise in this situation?

73. A client diagnosed with hyperaldosteronism has developed kidney failure and states to the nurse, “This means that I will die very soon.” Which is the most appropriate therapeutic response for the nurse to make to the client?

74. A registered nurse (RN) is orienting an unlicensed assistive personnel (UAP) to the clinical nursing unit. The RN determines that the UAP needs further teaching if which action is performed by the UAP during a routine hand-washing procedure?

75. The nurse is evaluating the effects of care for the client with nephrotic syndrome. Which diagnostic result demonstrates the least amount of improvement over 2 days of care?

76. A client has become physically aggressive toward staff and other clients. What action by the nurse will best assure the safety of the milieu while preserving the client’s rights?

77. A client seeks medical attention for intermittent signs and symptoms that suggest a diagnosis of Raynaud’s disease. The nurse should assess the trigger of these signs/symptoms by asking which question?

78. A nurse working in the neonatal intensive care unit (NICU) teaches hand- washing techniques to the parents of an infant who is receiving antibiotic treatment for a neonatal infection. The nurse determines that the parents understand the primary purpose of hand washing if which statement is made?

79. The nurse should tell a client who is scheduled for a bone marrow biopsy that the specimen can be withdrawn from which site?

80. A client is admitted to a surgical unit with a diagnosis of cancer. The client is scheduled for surgery in the morning. When the nurse enters the room and begins the surgical preparation, the client states, “I’m not having surgery. You must have the wrong person! My test results were negative. I’ll be going home tomorrow.” The nurse recognizes the client’s statement as indicative of which defense mechanism?

81. The nurse obtains a finger-stick glucose of 400 mg/dL (22.85 mmol/L) for a client who receives total parenteral nutrition (TPN). Which follow-up intervention should the nurse implement?

82. The nurse is performing an assessment on a postterm infant. Which physical characteristic should the nurse expect to observe in this infant?

83. A preschooler with a history of cleft palate repair comes to the clinic for a routine well-child checkup. To determine whether this child is experiencing a long-term effect of cleft palate, which question should the nurse ask the parent?

84. The nurse is planning to instruct a client with a diagnosis of chronic vertigo about safety measures to prevent exacerbation of symptoms or injury. Which instruction is most important for the nurse to incorporate in a teaching plan?

85. Which important parameter should the nurse assess on a daily basis for a client diagnosed with nephrotic syndrome?

86. Which is the most important laboratory result for the nurse to present to the primary health care provider on a client who is receiving total parenteral nutrition (TPN)?

87. An infant has been diagnosed with acute chalasia. During the nursing history, the mother tells the nurse, “I am concerned that I am somehow causing my infant to vomit after feeding her.” Considering this statement, which concern should the nurse identify for the mother?

88. Which nursing assessment question should be asked to help determine the client’s risk for developing malignant hyperthermia in the perioperative period?

89. A newborn diagnosed with respiratory distress syndrome (RDS) is prescribed surfactant replacement therapy. The nurse evaluates the infant 1 hour after the therapy and determines that the infant’s condition has improved somewhat. Which finding indicates improvement?

90. The nurse observes a client during a seizure and notes that the client’s entire body became rigid, and the muscles in all four extremities alternated between relaxation and contraction. Which type of seizure should the nurse document that the client had experienced?

91. A client with peripheral arterial disease has received instructions from the nurse about how to limit the progression of the disease. The nurse determines that the client needs further teaching if which statement was made by the client?

92. A nursing student is preparing to conduct a clinical conference regarding cerebral palsy. Which characteristic related to this disorder should the student plan to include in the discussion?

93. The nurse reviews the serum laboratory results for a client prescribed hydrochlorothiazide. Which most frequent side effect of this medication should the nurse specifically monitor for?

94. A client states to the nurse, “I don’t do anything right. I’m such a loser.” Which therapeutic statement should the nurse make to the client?

95. The nurse has developed a plan of care for a client with a diagnosis of anterior cord syndrome. Which intervention should the nurse include in the plan of care to minimize the client’s long-term risk for injury?

96. The home care nurse is doing an assessment interview with an older adult client who asks the nurse to buy some groceries for her because she is not feeling well today. Which statement should the nurse use in response?

97. A pregnant client tells the nurse that she felt wetness on her peripad and found some clear fluid. The nurse inspects the perineum and notes the presence of the umbilical cord. What is the immediate nursing action?

98. A client with a spinal cord injury is at risk of developing footdrop. What intervention should the nurse use as a preventive measure?

99. The nurse provides home care instructions to the mother of a child with a diagnosis of chickenpox about preventing the transmission of the virus. Which is the best statement for the nurse to include in the instructions?

100. The nurse is collecting a sputum specimen for culture and sensitivity testing from a client who has a productive cough. Which intervention should the nurse implement to obtain the specimen?