50 Random NCLEX Practice Questions

1. A client diagnosed with chronic kidney disease (CKD) has been told that hemodialysis will be required. The client becomes angry and states, “I’ll never be the same now.” Based on this information, which should the nurse identify as the client’s primary concern?

2. 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?

3. A client admitted to the hospital with a diagnosis of Pneumocystis jiroveci pneumonia is prescribed intravenous (IV) pentamidine. What intervention should the nurse plan to implement to safely administer the medication?

4. 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?

5. Which nursing assessment findings indicate normal vital signs in a newborn infant?

6. 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?

7. The nurse has completed discharge teaching with a client who has had surgery for lung cancer. The nurse determines that the client needs additional teaching about the elements of home management if the client verbalizes the need to follow which instruction?

8. Allopurinol has been prescribed for a client to treat gouty arthritis. The nurse teaches the client to anticipate which prescription if an acute attack occurs?

9. Which action by the new nurse when initiating continuous electrocardiogram (ECG) monitoring on a client should indicate to the registered nurse the need for further teaching?

10. The nurse monitors a client for brachial plexus compromise after shoulder arthroplasty and is checking the status of the ulnar nerve. Which technique should the nurse use to assess the status of this nerve?

11. In preparing a plan of care, which is the priority intervention to address the needs of a client recently assaulted sexually?

12. The client prescribed phenelzine sulfate suddenly exhibits signs of hypertensive crisis. Which medication should the nurse plan to prepare?

13. 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?

14. The nurse developing a plan of care for a postterm small-for-gestational- age (SGA) newborn should identify which assessment as the priority to monitor?

15. 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?

16. The nurse providing care to a client with a leg fracture ensures that which intervention is first implemented before the fracture is reduced in the casting room?

17. The nurse has completed instructions regarding diet and fluid restriction for the client diagnosed with chronic kidney disease. The nurse determines that the client understands the information presented if the client selected which dessert from the dietary menu?

18. After cardiac surgery to treat coronary artery disease, both the client and the family express anxiety regarding how to cope with the recovering process after discharge. Which available resource should the nurse plan to tell the client and family about to best address their concerns?

19. 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?

20. 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?

21. A client with schizophrenia is admitted to the inpatient mental health unit. When asked her name, she responds, “I am Elizabeth, the Queen of England.” Which should the nurse recognize this client’s statement is indicating?

22. The home care nurse assesses the client’s environment for potential safety hazards. Which observation requires the nurse to counsel the client and family about the potential for injury?

23. A client has a prescription for valproic acid 250 mg once daily. To maximize the client’s safety, which time is best for the nurse to schedule administration of the medication?

24. A client has received a prescription for lisinopril. The nurse teaches the client that which frequent side effect may occur?

25. The nurse in the newborn nursery is planning for the admission of a large for gestational age (LGA) infant. In preparing to care for this infant, the nurse should obtain equipment to perform which diagnostic test?

26. A client diagnosed with angina pectoris appears to be very anxious and states, “So, I had a heart attack, right?” Which response should the nurse make to the client?

27. A client has received electroconvulsive therapy (ECT). What intervention should the nurse perform first in the posttreatment area and upon the client’s awakening?

28. 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?

29. The nurse has taught a client with a below-the-knee amputation about home care and about monitoring for and preventing complications related to prosthesis and residual limb care. The nurse determines that the client has understood the instructions if the client stated that which action should be taken?

30. The nurse is developing a plan of care for a client scheduled for an above- the-knee leg amputation. Which action should the nurse include in the plan of care when addressing the psychosocial needs of the client?

31. The nurse has provided instructions to a client who is receiving external radiation therapy. Which statement by the client indicates a need for further teaching regarding self-care related to the radiation therapy?

32. The nurse is caring for a client with a diagnosis of pemphigus vulgaris. On assessment of the client, the nurse should look for which sign characteristic of this condition?

33. The nurse is reviewing the record of a client with a disorder involving the inner ear. Which finding should the nurse most likely note as an assessment finding in this client?

34. The nurse is caring for a client during a precipitous labor. The nurse should anticipate that the client will require care for which emotional need?

35. The nurse is caring for a postpartum client with thromboembolytic disease. Which intervention is most important to include when planning care to prevent the complication of pulmonary embolism?

36. A client who has a history of chronic ulcerative colitis is diagnosed with anemia. The nurse interprets that which factor is most likely responsible for the anemia?

37. The home health nurse is performing an initial assessment on a client who has been discharged after an insertion of a permanent pacemaker. Which client statement indicates that an understanding of self-care is evident?

38. A client with the diagnosis of leukemia is receiving chemotherapy. When the registered nurse (RN) notes that the white blood cell (WBC) count is 4000 mm3 (4 × 109/L), the new nurse caring for the client is informed about the results. Which intervention identified by the new nurse indicates a need for further teaching?

39. 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?

40. The registered nurse (RN) planning the assignments for the day is leading a team composed of a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Based on licensure, which client is most appropriate to assign to the LPN?

41. The nurse is planning interventions for counseling a maternal client who has been newly diagnosed with sickle cell anemia. Which would be the most important psychosocial intervention at this time?

42. In preparation to administer an intermittent tube feeding, the nurse aspirates 40 mL of undigested formula from the client’s nasogastric tube. Which intervention should the nurse implement as a result of this finding?

43. 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?

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

45. A female victim of a sexual assault is being seen in the crisis center for a third visit. She states that although the rape occurred nearly 2 months ago, she still feels “as though the rape just happened yesterday.” Which statement is most appropriate for the nurse to use as a response?

46. A client diagnosed with multiple myeloma is receiving intravenous hydration at 100 mL per hour. Which finding indicates to the nurse that the client is experiencing a positive response to the treatment plan?

47. A client with the diagnosis of mania is placed in a seclusion room after an outburst of violent behavior that involved a physical assault on another client. Which intervention should the nurse include in the plan of care before seclusion?

48. The nurse is assessing a client with a lower leg cast who has just been measured and fitted for crutches. Which observation should help the nurse determine if the client’s crutches are fitted correctly?

49. A client who experienced repeated pleural effusions from inoperable lung cancer is to undergo pleurodesis. What intervention should the nurse plan to implement after the primary health care provider injects the sclerosing agent through the chest tube to help assure the effectiveness of the procedure?

50. A client’s telemetry monitor displays ventricular tachycardia. Upon reaching the client’s bedside, which action should the nurse take first?