75 Random NCLEX Practice Questions

1. A pregnant client at 32 weeks’ gestation is admitted to the obstetrical unit for observation after a motor vehicle crash. When the client begins experiencing slight vaginal bleeding and mild cramps, which action should the nurse take to support the viability of the fetus?

2. A new mother was administered methylergonovine maleate intramuscularly after delivery. The nurse understands that this medication was administered for which action?

3. After undergoing a thyroidectomy, a client is monitored for signs of damage to the parathyroid glands postoperatively. The nurse would determine which finding suggests damage to the parathyroid glands?

4. During the postoperative period, the client who underwent a pelvic exenteration reports pain in the calf area. What action should the nurse take?

5. Chemical cardioversion is prescribed for the client diagnosed with atrial fibrillation. The nurse who is assisting in preparing the client should expect that which medication specific for chemical cardioversion would be prescribed?

6. A 9-year-old child is hospitalized in traction for 2 months after a car accident. Which intervention should the nurse plan to use to best promote psychosocial development?

7. The nurse is teaching a client diagnosed with chronic obstructive pulmonary disease (COPD) how to do pursed-lip breathing. Evaluation of understanding is evident if the client performs which action?

8. The nurse evaluates the arterial blood gas (ABG) results of a client who is receiving supplemental oxygen. Which Po2 finding would indicate that the oxygen level was adequate?

9. The nurse is assessing a client who is suspected of having a diagnosis of testicular cancer. Which data will be most helpful for determining the client’s risk for this type of cancer?

10. The nurse assessing the vital signs of a 3-year-old child hospitalized with a diagnosis of croup notes that the respiratory rate is 28 breaths per minute. Based on this finding, which nursing action is appropriate?

11. 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?

12. The nurse teaches a preoperative client about the nasogastric (NG) tube that will be inserted in preparation for surgery. The nurse determines that the client understands when the tube will be removed during the postoperative period based on which statement by the client?

13. Which explanation by the nurse should best alleviate anxiety in a client with coronary artery disease about having a 12-lead electrocardiogram (ECG) diagnostic procedure?

14. Which manifestations associated with thyroid storm indicate the need for immediate nursing intervention?

15. Which sign/symptom is an indication that the client experiencing postoperative blood loss is anemic?

16. 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?

17. The nurse assesses a client with hepatic encephalopathy for the presence of asterixis. What should the nurse do to appropriately test for asterixis?

18. 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?

19. A client diagnosed with chronic respiratory failure is dyspneic. The client becomes anxious, which worsens the feelings of dyspnea. The nurse teaches the client which method to best interrupt the dyspnea–anxiety–dyspnea cycle?

20. A client who has a history of depression has been prescribed nadolol for the management of angina pectoris. Which consideration is most important when the nurse plans to counsel this client about the effects of this medication?

21. A client who underwent peripheral arterial bypass surgery 16 hours ago reports that there is increasing pain in the leg that worsens with movement and is accompanied by paresthesias. Based on these data, which action should the nurse take?

22. The nurse is providing home care dietary instructions to a client who has been hospitalized for pancreatitis. Which food should the nurse instruct the client to avoid to prevent recurrence?

23. 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?

24. The nurse admits a client who is demonstrating right-sided weakness, aphasia, and urinary incontinence. The woman’s daughter states, “If this is a stroke, it’s the kiss of death.” What initial response should the nurse make?

25. A client is prescribed lansoprazole for the chronic management of Zollinger-Ellison syndrome. The nurse determines that the client best understands this disorder and the medication regimen when the client reports taking which product for pain?

26. The mother whose child is generally alert and participates well in classroom activities is concerned that the teacher now reported that the child has frequent periods during the day when he appears to be staring off into space. The nurse should suspect that the child has which problem?

27. The nurse is assigned to care for a client experiencing hypertonic labor contractions. The nurse plans to conserve the client’s energy and promote rest by performing which intervention?

28. The nurse cared for a client who died a few minutes ago. Which event supports the nurse’s belief that the client died with dignity?

29. 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?

30. The nurse is caring for a client who is receiving tobramycin sulfate intravenously every 8 hours. Which result should indicate to the nurse that the client is experiencing an adverse effect of the medication?

31. A client is scheduled to have a serum digoxin level obtained. The nurse determines that the blood sample should be drawn at which time in relationship to the administration of digoxin?

32. A client diagnosed with acute respiratory distress syndrome has a prescription to be placed on a continuous positive airway pressure (CPAP) face mask. What intervention should the nurse implement for this procedure to be beneficial?

33. The nurse is instructing a pregnant client regarding measures to prevent a recurrent episode of preterm labor. Which statement by the client indicates the need for further teaching?

34. A client is diagnosed with thromboangiitis obliterans (Buerger ’s disease). The nurse places priority on teaching the client about modifications of which risk factor related to this disorder?

35. 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?

36. The nurse assesses a client after abdominal surgery who has a nasogastric (NG) tube in place that is connected to suction. Which observation by the nurse indicates most reliably that the tube is functioning properly?

37. A registered nurse is a preceptor for a new nurse and is observing the new nurse organize the client assignments and prioritize daily tasks. The registered nurse should intervene if the new nurse implements which action?

38. 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?

39. A client who sustained a thoracic cord injury a year ago returns to the clinic for a follow-up visit, and the nurse notes a small reddened area on the coccyx. The client is not aware of the reddened area. After counseling the client to relieve pressure on the area by adhering to a turning schedule, which action by the nurse is most appropriate?

40. 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?

41. The nurse should give which medication instructions to the client prescribed quinapril hydrochloride?

42. The nurse provides a class to new mothers on newborn care. When teaching cord care, the nurse should instruct mothers to take which action?

43. The nurse has completed tracheostomy care for a client whose tracheostomy tube has a nondisposable inner cannula. Which intervention will the nurse implement immediately before reinserting the inner cannula?

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

45. The nurse is developing a plan of care for an older client diagnosed with dementia. The nurse develops which realistic outcome for the client?

46. A client has a hip fracture repair with a prosthetic implant placed. On the day after the implant, the nurse finds the client surrounded by papers from his briefcase and planning a phone meeting. The nurse plans to discuss activities with the client and should base the discussion on which information?

47. 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?

48. The nurse reviews the pattern of a nonstress test performed on a pregnant client and interprets the finding as which result? (Refer to figure.)

49. The nurse reviews the client’s most recent blood gas results that include a pH of 7.43, Pco2 of 31 mm Hg, and HCO3 of 21 mEq/L. Based on these results, the nurse determines that which acid-base imbalance is present?

50. The nurse assessing the apical heart rates of several different newborn infants notes that which heart rate is normal for this newborn population?

51. 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?

52. 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?

53. The nurse manager reviewing the purposes for applying restraints to a client determines that further education is necessary when a nursing staff member makes which statement supporting the use of a restraint?

54. The nurse determines that the client with atherosclerosis understands dietary modifications to lower the risk of heart disease if which food selection is made

55. A client with a colostomy complains to the nurse of appliance odor. The nurse recommends that the client take in which deodorizing foods?

56. Which prescribed procedure should the nurse withhold until a comatose client is properly intubated?

57. The nurse is obtaining a health history from an adolescent. Which statement by the adolescent indicates a need for follow-up assessment and intervention

58. A child is seen in the health care clinic, and testing for human immunodeficiency virus (HIV) is performed because of the child’s exposure to HIV infection. Which home care instruction should the nurse provide to the parents of the child?

59. The nurse is assisting a client diagnosed with hepatic encephalopathy to fill out the dietary menu. The nurse advises the client to avoid which entree item?

60. A client diagnosed with myasthenia gravis is ready to return home. The client confides that she is concerned that her significant other will no longer find her physically attractive. Which client-focused action should the nurse encourage in the plan of care?

61. An adult client who has a severe neurocognitive impairment is scheduled for gallbladder surgery. With regard to the informed consent, which should the nurse implement first to facilitate the scheduled surgery?

62. A client has received a dose of dimenhydrinate. The nurse determines that the medication is effective when the client obtains relief of which problem?

63. A client experiencing a mild panic attack has the following arterial blood gas (ABG) results: pH 7.49, Pco2 31 mm Hg, Pao2 97 mm Hg, HCO3 22 mEq/L. The nurse reviews the results and determines that the client has which acid- base disturbance?

64. A client comes into the emergency department demonstrating manifestations indicative of a severe state of anxiety. What is the priority nursing intervention at this time?

65. The nurse is caring for a client who is receiving tacrolimus daily. Which finding indicates to the nurse that the client is experiencing an adverse effect of the medication?

66. The nurse is caring for a client who has been placed in skin traction. Which action by the nurse provides for countertraction to reduce shear and friction?

67. The nurse is providing instructions to the parent of a child who had a myringotomy with insertion of tympanostomy tubes. Which instructions should the nurse provide the parent in case the tubes fall out?

68. A client who underwent surgical repair of an abdominal aortic aneurysm is 1 day postoperative. The nurse performs an abdominal assessment and notes the absence of bowel sounds. What action should the nurse take?

69. The nurse is preparing to suction an adult client with a tracheostomy who has copious amounts of secretions. Which action should the nurse take to accomplish this procedure safely and effectively?

70. During a follow-up visit 2 weeks after pneumonectomy, the client reports numbness and tenderness at the surgical site. Which statement should the nurse make to accurately address the client’s concerns?

71. The nurse is assessing a 39-year-old Caucasian client with a blood pressure (BP) of 152/92 mm Hg at rest, a total cholesterol level of 180 mg/dL (4.5 mmol/L), and a fasting blood glucose level of 90 mg/dL (5.14 mmol/L). On which risk factor for coronary artery disease should the nurse place priority?

72. The nurse is preparing to ambulate a client with a diagnosis of Parkinson’s disease who has recently been prescribed levodopa. Which information is most important for the nurse to assess before ambulating the client?

73. 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?

74. 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?

75. A 9-year-old child is newly diagnosed with type 1 diabetes mellitus. The nurse is planning for home care with the child and the family and determines that which is an age-appropriate activity for health maintenance?