NCLEX PN Review 21-30

Passing the NCLEX PN Review is a step toward a fulfilling career in the field of nursing.

21. The 57-year-old male client has elected to have epidural anesthesia as the anesthetic during a hernia repair. If the client experiences hypotension, the nurse would:

A. Place him in the Trendelenburg position
B. Obtain an order for Benedryl
C. Administer oxygen per nasal cannula
D. Speed the IV infusion of normal saline

22. A client has cancer of the pancreas. The nurse should be most concerned with which nursing diagnosis?

A. Alteration in nutrition
B. Alteration in bowel elimination
C. Alteration in skin integrity
D. Ineffective individual coping

23. NCLEX PN Review about the nurse who is caring for a client with ascites. Which is the best method to use for determining early ascites?

A. Inspection of the abdomen for enlargement
B. Bimanual palpation for hepatomegaly
C. Daily measurement of abdominal girth
D. Assessment for a fluid wave

24. The client arrives in the emergency department after a motor vehicle accident. Nursing assessment findings include BP 80/34, pulse rate 120, and respirations 20. Which is the client’s most appropriate priority nursing diagnosis?

A. Alteration in cerebral tissue perfusion
B. Fluid volume deficit
C. Ineffective airway clearance
D. Alteration in sensory perception

25. Which information obtained from the visit to a client with hemophilia would cause the most concern? The client:

A. Likes to play football
B. Drinks several carbonated drinks per day
C. Has two sisters with sickle cell tract
D. Is taking acetaminophen to control pain

26. NCLEX PN Review about the nurse on oncology who is caring for a client with a white blood count of 800, a platelet count of 150,000, and a red blood cell count of 250,000. During evening visitation, a visitor is noted to be coughing and sneezing. What action should the nurse take?

A. Ask the visitor to wash his hands
B. Document the visitor’s condition in the chart
C. Ask the visitor to leave and not return until the client’s white blood cell count is 1,000
D. Provide the visitor with a mask and gown

27. The nurse is caring for the client admitted after trauma to the neck in an automobile accident. The client suddenly becomes unresponsive and pale, with a BP of 60 systolic. The initial nurse’s action should be to:

A. Place the client in Trendelenburg position
B. Increase the infusion of normal saline
C. Administer atropine IM
D. Obtain a crash cart

28. Immediately following the removal of a chest tube, the nurse would:

A. Order a chest x-ray
B. Take the blood pressure
C. Cover the insertion site with a Vaseline gauze
D. Ask the client to perform the Valsalva maneuver

29. A client being treated with sodium warfarin has an INR of 9.0. Which intervention would be most important to include in the nursing care plan?

A. Assess for signs of abnormal bleeding
B. Anticipate an increase in the dosage
C. Instruct the client regarding the drug therapy
D. Increase the frequency of neurological assessments

30. Which snack selection by a client with osteoporosis indicates that the client understands the dietary management of the disease?

A. A glass of orange juice
B. A blueberry muffin
C. A cup of yogurt
D. A banana




NCLEX PN Review Answers

21) D
- If the client experiences hypotension after an injection of epidural anesthetic, the nurse should turn him to the left side if possible, apply oxygen by mask, and speed the IV infusion. Epinephrine, not Benedryl, in answer B, should be kept for emergency administration. A is incorrect because placing the client in Trendelenburg position (head down) will allow the anesthesia to move up above the respiratory center, thereby decreasing the diaphragm’s ability to move up and down, ventilating the client. Answer C is incorrect because the oxygen should be applied by mask, not cannula.

22) A
- Cancer of the pancreas frequently leads to severe nausea and vomiting. Answers B, C, and D are incorrect because although they are a concern to the client, they are not the priority nursing diagnosis.

23) C

- NCLEX PN Review Rationale: Measuring the girth daily with a paper tape measure and marking the area that is measured is the most objective method of estimating ascites. Inspection, in answer A, and checking for fluid waves, in answer D, are more subjective and not correct. Palpation of the liver will not tell the amount of ascites, so answer B is incorrect.

24) B

- The vital signs indicate hypovolemic shock, so checking for fluid volume deficit is the appropriate action. Answers A, C, and D do not indicate cerebral tissue perfusion, airway clearance, or sensory perception alterations, and are incorrect.

25) A

- The client with hemophilia is likely to experience bleeding episodes if he participates in contact sports. Drinking several carbonated drinks per day, as in answer B, has no bearing on the hemophiliac’s condition. Having two sisters with sickle cell, as in answer C, is not information that would cause concern. Taking acetaminophen for pain, as in answer D, is an accepted practice and does not cause concern.

26) D

- NCLEX PN Review Rationale: The client with neutropenia should not have visitors with any type of infection, so the best action by the nurse is to give the visitor a mask and a gown. Asking the visitor to wash his hands is good but will not help prevent the infection from spreading by droplets; therefore, answer A is incorrect. Answer B is incorrect because documenting the visitor’s condition is not enough action for the nurse to take. Answer C is incorrect because asking the visitor to leave and not return until the client’s white blood cell count is 1,000 is an insuffient intervention. The normal WBC is 5,000–10,000, so a WBC of 1,000 is not high enough to prevent the client from contracting infections.

27) B

- For some clients with trauma to the neck, the answer would be A; however, in this situation, it is incorrect because lowering the head of the bed could further interfere with the airway. Increasing the infusion and placing the client in supine position is better. If atropine is administered to the client, it should be given IV, not IM, and there is no need for this action at present, as stated in answer C. Answer D is not necessary at this time.

28) C

- When a chest tube is removed, the hole should be immediately covered with a Vaseline gauze to prevent air from rushing into the chest and causing the lung to collapse. The doctor, not the nurse, will order a chest x-ray; therefore, answer A is incorrect. Taking the BP in answer B is good but is not the priority action. Answer D is incorrect because the Valsalva maneuver is done during removal of the tube, not afterward.

29) A

- The normal international normalizing ratio (INR) is 2–3. A 9 might indicate spontaneous bleeding. Answer B is an incorrect action at this time. Answer C is incorrect because just instructing the client regarding his medication is not enough. Answer D is incorrect because increasing the frequency of neurological assessment will not prevent bleeding caused by the prolonged INR.

30) C

- The food with the most calcium is the yogurt. The others are good choices, but not as good as the yogurt, which has approximately 400mg of calcium. Therefore, answers A, B, and D are incorrect.



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NCLEX PN Review 1-10


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NCLEX PN Review 31-40

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NCLEX PN Practice Questions 11-20

Read each NCLEX PN Practice Questions carefully and choose the best answer.

11. The client has an order for gentamycin to be administered. Which lab results should be reported to the doctor before beginning the medication?

A. Hematocrit
B. Creatinine
C. White blood cell count
D. Erythrocyte count

12. The nurse is caring for the client with a mastectomy. Which action would be contraindicated?

A. Taking the blood pressure in the side of the mastectomy
B. Elevating the arm on the side of the mastectomy
C. Positioning the client on the unaffected side
D. Performing a dextrostix on the unaffected side

13. NCLEX PN Practice Questions about the charge nurse who is making assignments for the day. After accepting the assignment to a client with leukemia, the nurse tells the charge nurse that her child has chickenpox. Which action should the charge nurse take?

A. Change the nurse’s assignment to another client
B. Explain to the nurse that there is no risk to the client
C. Ask the nurse if the chickenpox have scabbed
D. Ask the nurse if she has ever had the chickenpox

14. The client with brain cancer refuses to care for herself. Which action by the nurse would be best?

A. Alternate nurses caring for the client so that the staff will not get tired of caring for this client
B. Talk to the client and explain the need for self-care
C. Explore the reason for the lack of motivation seen in the client
D. Talk to the doctor about the client’s lack of motivation

15. The nurse is caring for the client who has been in a coma for 2 months. He has signed a donor card, but the wife is opposed to the idea of organ donation. How should the nurse handle the topic of organ donation with the wife?

A. Contact organ retrieval to come talk to the wife
B. Tell her that because her husband signed a donor card, the hospital has the right to take the organs upon the death of her husband
C. Drop the subject until a later time
D. Refrain from talking about the subject until after the death of her husband

16. NCLEX PN Practice Questions about the nurse who is assessing the abdomen. The nurse knows the best sequence to perform the assessment is:

A. Inspection, auscultation, palpation
B. Auscultation, palpation, inspection
C. Palpation, inspection, auscultation
D. Inspection, palpation, auscultation

17. The nurse is assisting in the assessment of the patient admitted with abdominal pain. Why should the nurse ask about medications that the client is taking?

A. Interactions between medications can be identified.
B. Various medications taken by mouth can affect the alimentary tract.
C. This will provide an opportunity to educate the patient regarding the medications used.
D. The types of medications might be attributable to an abdominal pathology not already identified.

18. The nurse is asked by the nurse aide, “Are peptic ulcers really caused by stress?” The nurse would be correct in replying with which of the following:

A. “Peptic ulcers result from overeating fatty foods.”
B. “Peptic ulcers are always caused from exposure to continual stress.”
C. “Peptic ulcers are like all other ulcers, which all result from stress.”
D. “Peptic ulcers are associated with H. pylori, although there are other ulcers that are associated with stress.”

19. The client is newly diagnosed with juvenile onset diabetes. Which of the following nursing diagnoses is a priority?

A. Anxiety
B. Pain
C. Knowledge deficit
D. Altered thought process

20. The nurse understands that the diagnosis of oral cancer is confirmed with:
A. Biopsy
B. Gram Stain
C. Scrape cytology
D. Oral washings for cytology



Answers to NCLEX PN Practice Questions

11) B
- Gentamycin is a drug from the aminoglycocide classification. These drugs are toxic to the auditory nerve and the kidneys. The hematocrit is not of significant consideration in this client; therefore, answer A is incorrect. Answer C is incorrect because we would expect the white blood cell count to be elevated in this client because gentamycin is an antibiotic. Answer D is incorrect because the erythrocyte count is also particularly significant

12) A
- The nurse should not take the blood pressure on the affected side. Also, venopunctures and IVs should not be used in the affected area. Answers B, C, and D are all indicated for caring for the client. The arm should be elevated to decrease edema. It is best to position the client on the unaffected side and perform a dextrostix on the unaffected side.

13) D

- NCLEX PN Practice Questions Rationale: The nurse who has had the chickenpox has immunity to the illness. Answer A is incorrect because more information is needed to determine whether a change in assignment is necessary.Answer B is incorrect because there could be a risk to the immune-suppressed client. Answer C is incorrect because the client who is immune-suppressed could still be at risk from the nurse’s exposure to the chickenpox, even if scabs are present.

14) C

- The nurse should explore the cause for the lack of motivation. The client might be anemic and lack energy, might be in pain, or might be depressed. Alternating staff, as stated in answer A, will prevent a bond from being formed with the nurse. Answer B is not enough, and answer D is not necessary.

15) A

- Contacting organ retrieval to talk to the family member is the best choice because a trained specialist has the knowledge to assist the wife with making the decision to donate or not to donate the client’s organs. The hospital will certainly honor the wishes of family members even if the patient has signed a donor card. Answer B is incorrect; answer C might be done, but there might not be time; and answer D is not good nursing etiquette and, therefore, is incorrect.

16) A

- NCLEX PN Practice Questions Rationale: The nurse should inspect first, then auscultate, and finally palpate. If the nurse palpates first, the assessment might be unreliable. Therefore, answers B, C, and D are incorrect.

17) B
- Many medications can irritate the stomach and contribute to abdominal pain. For answer A, the primary reason for asking about medications is not to identify interactions between medication. Although this might provide an opportunity for teaching, this is not the best time to teach. Therefore, answers C and D are incorrect.

18) D

- H. pylori bacteria and stress are directly related to peptic ulcers. Answers A and B are incorrect because peptic ulcers are not caused by overeating or always caused by continued stress. Answer C is incorrect because peptic ulcers are related to but not directly caused by stress.

19) C

- The new diabetic has a knowledge deficit. Answers A, B, and D are not supported within the stem and so are incorrect.

20) A

- The best diagnostic tool for cancer is the biopsy. Other assessment includes checking the lymph nodes. Answers B, C, and D will not confirm a diagnosis of oral cancer.


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NCLEX PN Practice Questions 1-10


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NCLEX PN Practice Questions 21-30

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NCLEX PN Practice Questions 1-10

Are you looking for NCLEX PN Practice Questions? We are here to help!

1. The client is receiving peritoneal dialysis. If the dialysate returns cloudy, the nurse should:

A. Document the finding
B. Send a specimen to the lab
C. Strain the urine
D. Obtain a complete blood count

2. NCLEX PN Practice Questions about the client with cirrhosis of the liver who is receiving Lactulose. The nurse is aware that the rationale for the order for Lactulose is:

A. To lower the blood glucose level
B. To lower the uric acid level
C. To lower the ammonia level
D. To lower the creatinine level

3. The client with diabetes is preparing for discharge. During discharge teaching, the nurse assesses the client’s ability to care for himself. Which statement made by the client would indicate a need for follow-up after discharge?

A. “I live by myself.”
B. “I have trouble seeing.”
C. “I have a cat in the house with me.”
D. “I usually drive myself to the doctor.”

4. The client is receiving total parenteral nutrition (TPN). Which lab test should be evaluated while the client is receiving TPN?

A. Hemoglobin
B. Creatinine
C. Blood glucose
D. White blood cell count

5. NCLEX PN Practice Questions about the client with a myocardial infarction who comes to the nurse’s station stating that he is ready to go home because there is nothing wrong with him. Which defense mechanism is the client using?

A. Rationalization
B. Denial
C. Projection
D. Conversion reaction

6. Which laboratory test would be the least effective in making the diagnosis of a myocardial infarction?

A. AST
B. Troponin
C. CK-MB
D. Myoglobin

7. The licensed practical nurse assigned to the post-partal unit is preparing to administer Rhogam to a postpartum client. Which woman is not a candidate for RhoGam?

A. A gravida IV para 3 that is Rh negative with an Rh-positive baby
B. A gravida I para 1 that is Rh negative with an Rh-positive baby
C. A gravida II para 0 that is Rh negative admitted after a stillbirth delivery
D. A gravida IV para 2 that is Rh negative with an Rh-negative baby

8. NCLEX PN Practice Questions about the first exercise that should be performed by the client who had a mastectomy is:

A. Walking the hand up the wall
B. Sweeping the floor
C. Combing her hair
D. Squeezing a ball

9. The client is scheduled for a Tensilon test to check for Myasthenia Gravis. Which medication should be kept available during the test?

A. Atropine sulfate
B. Furosemide
C. Prostigmin
D. Promethazine

10. The client is scheduled for a pericentesis. Which instruction should be given to the client before the exam?

A. “You will need to lay flat during the exam.”
B. “You need to empty your bladder before the procedure.”
C. “You will be asleep during the procedure.”
D. “The doctor will inject a medication to treat your illness during the procedure.”




Answers of NCLEX PN Practice Questions

1) B
- If the dialysate returns cloudy, infection might be present and must be evaluated. Documenting the finding, as stated in answer A, is not enough; straining the urine, in answer C, is incorrect; and dialysate, in answer D, is not urine at all. However, the physician might order a white blood cell count.

2) C
- Lactulose is administered to the client with cirrhosis to lower ammonia levels. Answers A, B, and D are incorrect because this does not have an effect on the other lab values.

3) B
- NCLEX PN Practice Questions Rationale: A client with diabetes who has trouble seeing would require follow-up after discharge. The lack of visual acuity for the client preparing and injecting insulin might require help. Answers A, C, and D will not prevent the client from being able to care for himself and, thus, are incorrect.

4) C
- When the client is receiving TPN, the blood glucose level should be drawn. TPN is a solution that contains large amounts of glucose. Answers A, B, and D are not directly related to the question and are incorrect.

5) B
- The client who says he has nothing wrong is in denial about his myocardial infarction. Rationalization is making excuses for what happened, projection is projecting feeling or thoughts onto others, and conversion reaction is converting a psychological trauma into a physical illness; thus, answers A, C, and D are incorrect.

6) A
-  NCLEX PN Practice Questions Rationale: Answer A, AST, is not specific for myocardial infarction. Troponin, CK-MB, and myoglobin, in answers B, C, and D, are more specific, although myoglobin is also elevated in burns and trauma to muscles.

7) D
- The mothers in answers A, B, and C all require RhoGam and, thus, are incorrect. The mother in answer D is the only one who does not require a RhoGam injection.

8) D
- The first exercise that should be done by the client with a mastectomy is squeezing the ball. Answers A, B, and C are incorrect as the first step; they are implemented later.

9) A
- NCLEX PN Practice Questions Rationale: Atropine sulfate is the antidote for Tensilon and is given to treat cholenergic crises. Furosemide (answer B) is a diuretic, Prostigmin (answer C) is the treatment for myasthenia gravis, and Promethazine (answer D) is an antiemetic, antianxiety medication. Thus, answers B, C, and D are incorrect.

10) B
- The client scheduled for a pericentesis should be told to empty the bladder, to prevent the risk of puncturing the bladder when the needle is inserted. A pericentesis is done to remove fluid from the peritoneal cavity. The client will be positioned sitting up or leaning over a table, making answer A incorrect. The client is usually awake during the procedure, and medications are not commonly inserted into the peritoneal cavity during this procedure; thus, answers C and D are incorrect (although this could depend on the circumstances).


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NCLEX PN Practice Questions 11-20

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