150 Random NCLEX Practice Questions

1. The home care nurse is preparing to visit a client diagnosed with Ménière’s disease. The nurse reviews the primary health care provider prescriptions and expects to educate the client on which dietary measure?

2. A client develops an irregular heart rate. Which statement made by the client who has developed an irregular heart rate indicates to the nurse that the client is ready for learning?

3. The nurse is administering epoetin alfa to a client diagnosed with chronic kidney disease (CKD). For which adverse effect of this therapy should the nurse monitor the client?

4. 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?

5. A client diagnosed with cancer of the bladder is fearful of the potential outcomes of an upcoming cystectomy and urinary diversion. Which statement made to the nurse indicates the client’s fear?

6. The nurse caring for a client with Graves’ disease is concerned about the client’s calorie intake because of the resulting hypercatabolic state of the disorder. Which situation indicates a successful outcome for this concern?

7. A client is receiving intravenous (IV) antibiotic therapy at home via an intermittent IV catheter. In order to facilitate the early detection of IV therapy complications, which intervention should be included in the client’s education?

8. The nurse is reviewing the results of a sweat test performed on a child diagnosed with cystic fibrosis (CF). Which finding should the nurse identify as supporting this diagnosis?

9. A nursing student is asked to conduct a clinical conference about autism. Which characteristic associated with autism should the student plan to include?

10. Ethics; Health Care Law

11. A client diagnosed with trigeminal neuralgia asks the nurse what can be done to minimize the episodes of pain. The nurse’s response is based on an understanding that what can trigger the pain?

12. The nurse provides instructions regarding home care to a parent of a 3-year- old child who has been hospitalized with hemophilia. Which statement by the parent indicates the need for further teaching?

13. The nurse has given instructions to the client diagnosed with chronic kidney disease about reducing pruritus from uremia. The nurse determines that the client needs further teaching if the client states the intention to use which item for skin care?

14. 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?

15. The nurse is preparing a plan of care for a child diagnosed with leukemia who is beginning chemotherapy. Which intervention should the nurse include?

16. A toddler with suspected conjunctivitis is crying and refuses to sit still during the eye examination. Which is the most appropriate statement for the nurse to make to the child?

17. The nurse is monitoring a client diagnosed with hypercalcemia. Which assessment finding indicates a need for follow-up?

18. Which action is included in the accurate procedure for administering heparin sodium subcutaneously?

19. The nurse in an ambulatory clinic administers a tuberculin skin test to a client on a Monday. When should the nurse tell the client to return to the clinic to have the results read?

20. The nurse assists a postoperative client from a lying to a sitting position to prepare for ambulation. Which nursing action is most appropriate initially to maintain the safety of the client?

21. The nurse is creating a teaching plan for the client with Raynaud’s disease.Which instruction should the nurse include?

22. The nurse is preparing a woman in labor for an amniotomy. Which priority
data should the nurse assess before the procedure?

23. The nurse manager is observing the interaction between a new staff nurse and a client currently receiving hemodialysis. Which intervention should the nurse manager implement when the nurse and client are both drinking coffee and discussing the client’s feeling about the procedure?

24. The nurse is about to administer a prescribed intravenous dose of tobramycin when the client reports vertigo and ringing in the ears. Which action should the nurse take next?

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

26. The nurse caring for a client diagnosed with a neurological disorder is planning care to maintain nutritional status. The nurse is concerned about the client’s swallowing ability. Which food item should the nurse eliminate from this client’s diet?

27. While in the hospital, a client was diagnosed with coronary artery disease (CAD). Which question by the nurse is likely to elicit the most useful response for determining the client’s degree of adjustment to the new diagnosis?

28. The nurse caring for an infant demonstrating diarrhea should monitor the infant for which early sign of dehydration?

29. A client has been diagnosed with terminal cancer and is using opioid analgesics for pain relief. Which action by the home care nurse would best allay the client’s anxiety about becoming addicted to the pain medication?

30. A client diagnosed with pneumonia reports a decreased sense of taste that has greatly affected the motivation to eat and drink. Which intervention should the nurse implement to help increase the client’s appetite?

31. A parent reports that her child has developed a bloody nose. Which action should the nurse instruct the parent to take to control the bleeding?

32. The nurse is caring for a client with a diagnosis of Parkinson’s disease who is taking benztropine mesylate daily. When assessing the client, what should the nurse specifically monitor for to determine if the client is experiencing a side effect of this medication?

33. The nurse is caring for a client diagnosed with type 1 diabetes mellitus. Because the client is at risk for hypoglycemia, which instructions should the nurse teach the client to follow?

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

35. The nurse is caring for an older client who has been placed in Buck’s extension traction after a hip fracture. During the assessment of the client, the nurse notes that the client is disoriented. Which is the most appropriate nursing intervention for this client?

36. The nurse is caring for a newly delivered breast-feeding infant. Which intervention performed by the nurse would best prevent jaundice in this infant?

37. A client who is receiving total parenteral nutrition (TPN) tells the nurse, “I’m not sure that I want to receive an infusion of lipids because it could make me obese.” Which initial action should the nurse take?

38. 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?

39. A client having premature ventricular contractions states to the nurse, “I’m so afraid that something bad will happen.” Which action by the nurse provides the most immediate help to the client?

40. The nurse instructs a parent regarding the appropriate actions to take when the toddler has a temper tantrum. Which statement by the parent indicates a successful outcome of the teaching?

41. A client diagnosed with acquired immunodeficiency syndrome (AIDS) is being admitted to the hospital for treatment of a Pneumocystis jiroveci respiratory infection. Which intervention should the nurse include in the plan of care to assist in maintaining the comfort of this client?

42. The nurse is assisting with providing a form of psychotherapy in which the client acts out situations that are of emotional significance. Based on this assessment data, which form of therapy should the nurse expect the primary health care provider has prescribed?

43. What is the smallest gauge catheter that the nurse can use to administer blood?

44. A client diagnosed with cardiomyopathy stops eating, takes long naps, and turns away from the nurse when the nurse talks to the client. The nurse should make which interpretation about this behavior?

45. The nurse reviews the record of a client who is receiving external radiation therapy and notes documentation of a skin finding as moist desquamation. Which finding on assessment of the client should the nurse expect to observe?

46. A client who is scheduled for an abdominal peritoneoscopy states to the home care nurse, “The surgeon told me to restrict food and liquids for at least 8 hours before this procedure and to use a Fleet enema 4 hours before entering the hospital. Do people ever get into trouble after this procedure?” Which is the most appropriate therapeuticresponse the nurse should make to the client?

47. The nurse is planning preoperative teaching with a client scheduled for a transurethral resection of the prostate (TURP). Which most frequent cause of postoperative pain should the nurse plan to include in the discussion?

48. The nurse is caring for a client who is recovering from an episode of autonomic hyperreflexia. Which statement should the nurse make to the client to most encourage therapeutic communication?

49. A client is admitted after attempting suicide by ingesting a prescribed antipsychotic medication. What is the most important piece of information the nurse should obtain initially?

50. The nurse is assigned to care for a child diagnosed with juvenile idiopathic arthritis (JIA). What is the child’s priority problem?

51. A client seeks treatment in an ambulatory clinic for hoarseness that has persisted for 8 weeks. Based on the symptom, the nurse interprets that the client is at risk for which disorder?

52. 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?

53. A client previously well controlled with glyburide has recently begun reporting fasting blood glucose to be 180 to 200 mg/dL (10.28 – 11.42 mmol/L). Which medication, noted in the client’s record, may be contributing to the elevated blood glucose level?

54. The nurse is conducting a health screening on a client with a family history of hypertension. Which assessment finding should alert the nurse to the need for further teaching related to stroke (brain attack) prevention?

55. The nurse is preparing to administer prescribed heparin sodium 5000 units subcutaneously. Which action should the nurse take to safely administer the medication?

56. 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?

57. A client with a diagnosis of trigeminal neuralgia is started on a regimen of carbamazepine. The nurse provides instructions to the client about the medication. What statement by the client indicates that the client understands the instructions?

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

59. Which clinical situation should the nurse identify as an example of slander?

60. The nurse prepares for a client in leg traction to be admitted to the nursing unit. The nurse asks the unlicensed assistive personnel to obtain which essential item that will be needed to assist the client to move in bed while in leg traction?

61. A client diagnosed with diabetes mellitus is at 36 weeks’ gestation. The client has had weekly reactive nonstress tests for the last 3 weeks. This week, the nonstress test was nonreactive after 40 minutes. Based on these results, the nurse should prepare the client for which intervention?

62. A client has a positive sputum culture for Mycobacterium tuberculosis and is prescribed streptomycin as part of the treatment. The nurse determines that the client is experiencing a toxic effect of the medication when which test result is abnormal?

63. The nurse is observing an unlicensed assistive personnel (UAP) care for an older client who had surgery (insertion of a prosthesis) following a hip fracture 4 days ago. To prevent client injury, the nurse should intervene in the care when which action is performed by the UAP?

64. The nurse notes that a postoperative client has not been obtaining relief from pain with the prescribed opioid analgesics when a particular licensed coworker is assigned to the client. Which action is most appropriate for the nurse to implement initially?

65. A client diagnosed with acute respiratory failure has an oral endotracheal tube attached to a mechanical ventilator and is about to begin the weaning process. The nurse determines that which item, that was previously used to minimize the client’s anxiety, should now be limited?

66. An older client had an open reduction with internal fixation (ORIF) for a hip fracture 4 days ago. Which measure should the nurse implement to provide safe care?

67. In which situation is the nurse manager utilizing an autocratic leadership style?

68. The nurse is teaching a client how to mix regular and NPH insulins in the same syringe. Which action should the nurse instruct the client to take?

69. The nursing student is listening to a lecture on correcting errors in a written narrative on a medical record. Which statement by the nursing student indicates that the teaching has been effective?

70. A client is intubated and receiving mechanical ventilation. The primary health care provider has added 7 cm of positive end-expiratory pressure (PEEP) to the client’s ventilator settings. The nurse should assess for which expected but adverse effect of PEEP?

71. A client diagnosed with anxiety disorder is prescribed buspirone orally. When the client reports that it is difficult to swallow the tablets, the nurse provides which instruction to promote compliance?

72. The nurse is giving a client diagnosed with heart failure home care instructions for use after hospital discharge. The client interrupts, saying, “What’s the use? I’ll never remember all of this, and I’ll probably die anyway!” The nurse determines that the client’s statement is most likely due to which psychosocial concern?

73. A client experiencing trigeminal neuralgia (tic douloureux) asks the nurse for a snack and something to drink. Which is the best selection the nurse should provide for the client?

74. A client diagnosed with a thrombotic stroke experiences periods of emotional lability. What should the nurse interpret this behavior as indicating?

75. The nurse is performing pin-site care on a client in skeletal traction. Which normal finding should the nurse expect to note when assessing the pin sites?

76. The nurse has given medication instructions to a client receiving lovastatin. The nurse determines that the client understands the effects of the medication if the client stated the need to adhere to the periodic evaluation of which laboratory test?

77. The nurse develops a plan of care for a 1-month-old infant diagnosed with intussusception. Which nursing measure would be most effective to provide psychosocial support for the parent–child relationship?

78. The nurse is caring for a client immediately after a bronchoscopy. The client received intravenous sedation and a topical anesthetic for the procedure. Which priority nursing intervention should the nurse perform to provide a safe environment for the client at this time?

79. An adult client has been placed on a fluid restriction of 1200 mL per day. The nurse discusses the fluid restriction with the dietitian and then plans to allow the client to have how many milliliters of fluid from 7:00 am to 3:00 pm?

80. A client has been prescribed metoprolol for hypertension. The nurse monitors client compliance carefully because of which common side effect of the medication?

81. A client has urinary calculi that are composed of uric acid, and the nurse teaches the client dietary measures to prevent the further development of the calculi. The nurse determines that the client understands the dietary measures if the client states that it is necessary to avoid consuming what food products?

82. A client diagnosed with myasthenia gravis is reporting vomiting, abdominal cramps, and diarrhea. The nurse notes that the client is hypotensive and experiencing facial muscle twitching. Which possible situation does this assessment data support?

83. A client prescribed albuterol sulfate by inhalation cannot cough up secretions. The nurse should teach the client which action to best help clear the bronchial secretions?

84. 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?

85. The nurse is assessing a client suspected of having a rib fracture. Which typical signs/symptoms should the nurse observe for?

86. The nurse is monitoring a client who is receiving an oxytocin infusion for the induction of labor. The nurse should suspect water intoxication if which sign or symptom is noted?

87. The nurse is caring for a client with a diagnosis of a mild cerebral bleed resulting from a small cerebral aneurysm rupture. The client reports feeling anxious and restless about family visiting soon. Which comment by the client should assist the nurse in identifying the reason for the anxiety?

88. The nurse is teaching umbilical cord care to a new mother. What information should the nurse provide to the mother related to cord care?

89. A primigravida client who came to the clinic has been diagnosed with a urinary tract infection. She repeatedly verbalizes concern regarding the safety of the fetus. Which should the nurse address first?

90. A client diagnosed with Raynaud’s disease tells the nurse that he has a stressful job and does not handle stressful situations well. Which life change should the nurse teach the client to consider to help alleviate his stress?

91. A clinic nurse is assessing a prenatal client who has been diagnosed with heart disease. The nurse carefully assesses the client’s vital signs, weight, and fluid and nutritional status to detect for complications caused by which pregnancy-related concern?

92. Which action by the nursing student, caring for a child who sustained a head injury from a fall, indicates a need for further teaching?

93. An intravenous dose of lorazepam is prescribed for a client. Which data from the client’s history would indicate the need to consult with the primary health care provider before administering the medication

94. The nurse assists the primary health care provider with the removal of a chest tube. During the procedure, the nurse instructs the client to perform which action?

95. Which statement made by a client who has experienced a spinal cord injury resulting in chronic immobility issues warrants immediate follow-up by the nurse to assure client safety?

96. 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?

97. A client is experiencing acute cardiac and cerebral symptoms as a result of an excess fluid volume. Which nursing measure should the nurse implement to increase the client’s comfort until specific therapy is prescribed by the primary health care provider?

98. The nurse performs an initial assessment on a pregnant client and determines that the client is at risk for toxoplasmosis. The nurse provides education to the client on how to prevent the disease. Which statement by the client indicates that teaching has been effective?

99. The nurse is creating a discharge plan for a postoperative client who had a unilateral adrenalectomy. What area of instruction should the nurse include in the plan to minimize the client’s risk for injury?

100. Family members of a client who attempted suicide are tearful. Which statement by the nurse would be most helpful in the management of their concerns?

101. A preschooler has just been diagnosed with impetigo. The child’s mother tells the nurse, “But my children take baths every day.” Which therapeutic response should the nurse make to the mother?

102. A client with the diagnosis of hyperparathyroidism states to the nurse, “I can’t stay on this diet. It is too difficult for me.” Which therapeutic response by the nurse is best when intervening in this situation?

103. The nurse is caring for a client diagnosed with heart failure who has a magnesium level of 0.75 Eq/L (0.375 mmol/L). Which action should the nurse take?

104. The nurse is caring for a client with a nasogastric tube that is attached to low suction. If the client’s HCO3− is 30, which additional value is most likely to be noted in this client?

105. 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?

106. The nurse is caring for a child diagnosed with Reye’s syndrome. The nurse monitors for manifestations of which condition associated with this syndrome?

107. After a cleft lip repair, the nurse instructs the parents about cleaning of the lip repair site. The nurse should plan to use which solution when demonstrating this procedure to the parents?

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

109. 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?

110. Which test result should the nurse review to determine the compatibility of blood from two different donors?

111. The nurse is caring for an infant after a pyloromyotomy is performed to treat hypertrophic pyloric stenosis. In which position should the nurse place the infant after surgery?

112. The nurse has administered a dose of diazepam to the client. Which most important action should the nurse take before leaving the client’s room?

113. During an emergency code situation, a primary health care provider about to defibrillate a client diagnosed in ventricular fibrillation says in a loud voice, “CLEAR!” Which action should the nurse immediately implement?

114. The nurse in a rehabilitation center is planning the client assignments for the day. Which client has needs that can be most safely met by the unlicensed assistive personnel (UAP)?

115. The home care nurse visits a client who is receiving total parenteral nutrition, and the client states, “I really miss eating dinner with my family.” Which statement from the nurse is the most therapeutic?

116. The nurse provides information to a client who is scheduled for the implantation of an implantable cardioverter defibrillator (ICD) regarding care after implantation. The nurse tells the client that there is a need to keep a diary. What information should the nurse provide concerning the primary purpose of the diary?

117. The nurse is caring for a client who is receiving total parenteral nutrition through a central venous catheter. Which action should the nurse plan to implement to decrease the risk of infection in this client?

118. A client who is taking an antipsychotic medication is preparing for discharge. To facilitate health promotion for this client, what instruction should the nurse provide?

119. When the home care nurse arrives, the client with a diagnosis of emphysema is smoking. Which statement by the nurse would be most therapeutic?

120. A coronary care unit (CCU) nurse is caring for a client admitted with acute myocardial infarction (MI). The nurse should monitor the client for which most common complication of MI?

121. The nurse is delivering care to a client who is diagnosed with toxic shock syndrome (TSS). Which complication of this syndrome should the nurse monitor the client for?

122. 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?

123. After a client diagnosed with pleural effusion had a thoracentesis, a sample of fluid was sent to the laboratory. Analysis of the fluid reveals a high red blood cell count. Based on this test result, what was the case of this client’s pleural effusion?

124. The nurse assesses the client’s peripheral intravenous (IV) site and notes that it is cool, pale, and swollen, and the fluid is not infusing. Which condition should the nurse document?

125. The nurse inserts an indwelling urinary catheter into a client. As the catheter moves into the bladder, urine begins to flow into the tubing. Which action should the nurse implement next?

126. An older client has been admitted to the hospital diagnosed with a hip fracture. The nurse prepares a plan of care for the client and identifies desired outcomes related to surgery and impaired physical mobility. Which statement by the client supports a positive adjustment to the surgery and impairment in mobility?

127. A client had arterial blood gases drawn. The results are a pH of 7.34, a partial pressure of carbon dioxide of 37 mm Hg (37 mm Hg), a partial pressure of oxygen of 79 mm Hg (79 mm Hg), and a bicarbonate level of 19 mEq/L (19 mmol/L). Which disorder should the nurse interpret that the client is experiencing?

128. The nurse, while caring for a hospitalized infant being monitored for increased intracranial pressure (ICP), notes that the anterior fontanel bulges when the infant cries. Based on this assessment finding, which conclusion should the nurse draw?

129. 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?

130. A client diagnosed with gastritis asks the nurse at a screening clinic about analgesics that will not cause epigastric distress. The nurse should tell the client to take which medication?

131. 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?

132. The home care nurse is evaluating a client’s understanding of the self- management of trigeminal neuralgia. Which client statement indicates that there is a need for further teaching?

133. The nurse is providing discharge instructions to the mother of an 8-year-old child who had a tonsillectomy. The mother tells the nurse that the child loves tacos and asks when the child can safely eat one. To prevent complications of the surgical procedure, what should be the appropriate response to the mother?

134. What action should the nurse take to assess the pharyngeal reflex on a child?

135. A client tells the clinic nurse that her skin is very dry and irritated. Which product should the nurse suggest that the client apply to the dry skin?

136. The client diagnosed with prostatitis asks the nurse, “Why do I need to take a stool softener? The problem is with my urine, not my bowels!” Which response should the nurse make to the client?

137. A client with superficial varicose veins states to the nurse, “I hate these things. They’re so ugly. I wish I could get them to go away.” Which therapeutic response would be most appropriate for the nurse to make to the client?

138. A client diagnosed with moderate dementia is prescribed oral anticoagulant therapy while hospitalized. The nurse identifies which discharge scenario as being the best support system for successful anticoagulant therapy monitoring

139. A client diagnosed with renal cell carcinoma of the left kidney is scheduled for a nephrectomy. The right kidney appears to be normal at this time. The client is anxious about whether dialysis will ultimately be a necessity. Which information should the nurse initially provide to the client?

140. A client has been taking benzonatate as prescribed. The nurse should tell the client this medication performs which action?

141. When a client’s nasogastric (NG) tube stops draining, which intervention should the nurse implement to maintain client safety?

142. A client who has sustained a burn injury receives a prescription for a regular diet. Which is the best meal for the nurse to provide to the client to promote wound healing?

143. client is scheduled for hydrotherapy for a burn dressing change. Which action should the nurse take to ensure that the client is comfortable during the procedure?

144. The nurse is planning the discharge instructions for an adult client who is a victim of family violence. The nurse should understand that it is most important that which information is included in the discharge plans?

145. A client diagnosed with chronic kidney disease is about to begin hemodialysis therapy. The client asks the nurse about the frequency and scheduling of hemodialysis treatments. What information should the nurse supply to the client regarding the typical hemodialysis schedule?

146. A client is being discharged from the hospital after a bronchoscopy that was performed a day earlier. After the discharge teaching, the client makes the following statements to the nurse. Which statement should the nurse identify as indicating a need for further teaching?

147. During electroconvulsive therapy (ECT), the client receives oxygen by mask via positive pressure ventilation. The nurse understands that positive pressure ventilation is necessary for which reason?

148. The nurse inserted a nasogastric (NG) tube to the level of the oropharynx and has repositioned the client’s head in a flexed-forward position. The client has been asked to begin swallowing, but as the nurse starts to slowly advance the NG tube with each swallow, the client begins to gag. Which action if taken by the nurse at this point would indicate a need for further instruction regarding the insertion of an NG tube?

149. The nurse has been working with a victim of rape in an outpatient setting for the past 4 weeks. The nurse should recognize that which client objective is an unrealistic short-term goal?

150. A postmastectomy client has been found to have an estrogen receptor– positive tumor. The nurse interprets after reading this information in the pathology report that the client will most likely have which common follow- up treatment prescribed?