NCLEX Practice Questions and Answers
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Practice Questions and Answers for NCLEX
1. A newborn weighed / pounds at birth. At 6 months of age, the infant could be expected to weigh:
A. 14 pounds
B. 18 pounds
C. 25 pounds
D. 30 pounds
2. The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath is recommended for the first 2 weeks of life because:
A. New parents need time to learn how to hold the baby.
B. The umbilical cord needs time to separate.
C. Newborn skin is easily traumatized by washing.
D. The chance of chilling the baby outweighs the benefits of bathing.
3. A client who is withdrawing from alcohol says to the nurse, “There are snakes on the wall.” Which action should the nurse take initially?
A. Reassure the client that there are no snakes
B. Turn the lights on brighter
C. Tell the client that while he may see snakes, there are really no snakes
D. Reassure the client that the snakes will not hurt him
4. An adult has received an injection of immunoglobulin. The client asks what this injection will do for him. The nurse’s reply includes the information that he will develop which type of immunity as a result of this injection?
A. Active natural immunity
B. Active artificial immunity
C. Passive natural immunity
D. Passive artificial immunity
5. An elderly man has just returned from the operating room where he spent several hours in lithotomy position during a perineal prostatectomy. Which assessment should the nurse make because the client was in lithotomy position during surgery?
A. Lower extremity pulses, paresthesias, and pain
B. The presence of bowel sounds
C. Radial pulse, sensation, and movement of the arms
D. Palpation of the bladder
6. A 38-year-old client who has mitral stenosis is hospitalized for a valve replacement. Which condition is the client most likely to report having had earlier in life?
A. Meningitis
B. Syphilis
C. Rheumatic fever
D. Rubella
7. Assuming that all have achieved normal cognitive and emotional development, which of the following children is at greatest risk for accidental poisoning?
A. A 6-month-old
B. A 4-year-old
C. A 12-year-old
D. A 13-year-old
8. The nurse is providing home care to a 78-yearold woman who has early dementia. The client tells the nurse, “My daughter is mean to me.” What should the nurse do initially?
A. Report suspected elder abuse to the supervisor
B. Report elder abuse to the authorities
C. Ask the daughter about the mother’s comment
D. Ask the client to describe what the daughter does to be mean to her
9. The nurse is giving home care to a 69-year-old client who has severe arthritis. Which comment made by the client would indicate to the nurse that the client is experiencing normal changes associated with the aging process?
A. “I have such a hard time with the pain in my feet and knees.”
B. “I have had loose stools for the last few months.”
C. “My children say I keep my apartment too warm.”
D. “I have a hard time at night because the lights are all big and fuzzy.”
10. A client with a diagnosis of HPV is at risk for which of the following?
A. Hodgkin’s lymphoma
B. Cervical cancer
C. Multiple myeloma
D. Ovarian cancer
11. The physician’s orders include warm compresses to the left leg three times a day for treatment of an open wound. Which action is appropriate when carrying out these orders?
A. Use medical aseptic technique.
B. Leave the wet compress open to the air.
C. Place both a dry covering and waterproof material over the compress.
D. Remove the compress after five minutes.
12. The client returns to the recovery room following repair of an abdominal aneurysm. Which finding would require further investigation?
A. Pedal pulses regular
B. Urinary output 20mL in the past hour
C. Blood pressure 108/50
D. Oxygen saturation 97%
13. The nurse is taking the vital signs of the client admitted with cancer of the pancreas. The nurse is aware that the fifth vital sign is:
A. Anorexia
B. Pain
C. Insomnia
D. Fatigue
14. A client with sickle cell disease is admitted in active labor. Which nursing intervention would be most helpful in preventing a sickling crisis?
A. Obtaining blood pressures every 2 hours
B. Administering pain medication every 3-4 hours as ordered
C. Monitoring arterial blood gas results
D. Administering IV fluids at ordered rate of 200mL/hr
15. The physician has diagnosed a client with cirrhosis characterized by asterixis. If the nurse assesses the client with asterixis, he can expect to find:
A. Irregular movement of the wrist
B. Enlargement of the breasts
C. Dilated veins around the umbilicus
D. Redness of the palmar surfaces
16. The nurse is teaching circumcision care to the mother of a newborn. Which statement indicates that the mother needs further teaching?
A. “l will apply a petroleum gauze to the area with each diaper change.”
B. “I will clean the area carefully with each diaper change.”
C. “l can place a heat lamp to the area to speed up the healing process.”
D. “I should carefully observe the area for signs of infection.”
17. A 20-year-old woman is admitted to the hospital following an accident. Her uncle, a physician from out of state, visits her and asks to see her chart. How should the nurse respond?
A. Comply with the request and give the chart to the physician
B. Explain that written permission from his niece is needed first
C. Suggest that he discuss the case with the attending physician
D. Give him the chart but do not let him remove it from the nurse’s station
18. The nurse is assessing a Client who had a colon resection 2 days ago. The client states, “I feel like my stitches have burst loose.” Upon further assessment, dehiscence of the wound is noted. The nurse should:
A. Place the client in the prone position
B. Apply a sterile, saline-moistened dressing to the wound
C. Administer atropine to decrease abdominal secretions
D. Wrap the abdomen with an ACE bandage
19. A client with B negative blood requires a blood transfusion during surgery. If no B negative blood is available, the client should be transfused with:
A. A positive blood
B. B positive blood
C. O negative blood
D. AB negative blood
20. A client is admitted to the surgical unit following a transurethral prostactectomy (TURP). The nurse administers a B&O suppository to help prevent bladder spasms. The nurse would observe the client for:
A. Insomnia and hyperactivity
B. Physiological dependence on the drug
C. Nausea and vomiting
D. Diarrhea and abdominal cramping
21. The nurse is to open a sterile package. How should the nurse plan to open the first flap?
A. Toward the nurse
B. Away from the nurse
C. To the right side
D. To the left side
22. An obstetrical client with diabetes has an amniocentesis at 28 weeks gestation. Which test indicates the degree of fetal lung maturity?
A. Alpha-fetoprotein
B. Estriol level
C. Indirect Coomb’s
D. Lecithin sphingomyelin ratio
23. The nurse is performing a history on a client admitted for surgery in the morning. Which long-term medication in the client’s history would be most important to report to the physician?
A. Prednisone
B. Lisinopril (Zestril)
C. Docusate (Colace)
D. Oscal D
24. Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis?
A. Brushing the teeth
B. Drinking a glass of juice
C. Holding a cup of coffee
D. Brushing the hair
25. The client has an order for heparin to prevent post-surgical thrombi. Immediately following a heparin injection, the nurse should:
A. Aspirate for blood
B. Check the pulse rate
C. Massage the site
D. Check the site for bleeding
26. An adult who has just been diagnosed with diverticulitis asks the nurse if she will need a special diet. The nurse knows that the client should follow which type of diet?
A. High protein, high calorie
B. Low residue
C. Low fat
D. Full liquid
27. An adult is receiving lithium carbonate 600 mg tid. Which of the following observations is of greatest concern to the nurse?
A. The serum lithium level is 1.0 mEd/L.
B. The client states that she is going to go on a low-sodium diet.
C. The client has gained 10 Ib in the last three months.
D. The client says, “I always drink a lot of water when I take the pills.”
28. A nurse is caring for a client whose cultural background is different from her own. Which actions are appropriate for the nurse? Select all that apply.
A. Consider that nonverbal cues such as eye contact may have a different meaning in different cultures.
B. Respect the client’s cultural beliefs.
C. Ask the client if he has cultural or religious requirements that should be considered in his care.
D. Explain the nurse’s beliefs so that the client will understand the differences.
E. Understand that all cultures experience pain in the same way.
29. The nurse is caring for a client with suspected endometrial cancer. Which symptom is associated with endometrial cancer?
A. Frothy vaginal discharge
B. Thick, white vaginal discharge
C. Purulent vaginal discharge
D. Watery vaginal discharge
30. A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
A. Uses an electric blanket at night
B. Dresses in extra layers of clothing
C. Applies a heating pad to her feet
D. Takes a hot bath morning and evening
31. A young woman who is at 32 weeks gestation reports to the physician’s office for a routine prenatal visit. Which comment by the woman must be reported to the physician?
A. “I had to stop wearing my rings because my fingers are swollen.”
B. “I seem to be hotter than everyone else.”
C. “My feet tend to swell in the hot weather.”
D. “My breasts are so big and tender.”
32. The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?
A. Macaroni and cheese
B. Shrimp with rice
C. Turkey breast
D. Spaghetti with meat sauce
33. A 33-year-old male is being evaluated for possible acute leukemia. Which of the following findings is most likely related to the diagnosis of leukemia?
A. The client collects stamps as a hobby.
B. The client recently lost his job as a postal worker.
C. The client had radiation for treatment of Hodgkin’s disease as a teenager.
D. The client’s brother had leukemia as a child.
34. The nurse is caring for a client who had a myocardial infarction yesterday and received alteplase (tPA). The client’s spouse asks the nurse why that medication was given. What should the nurse include when replying?
A. Alteplase (tPA) is given to relieve the pain of a heart attack.
B. Alteplase (tPA) dissolves the clot that is blocking a coronary artery.
C. Alteplase (tPA) prevents new clots from forming and existing clots from getting bigger.
D. Alteplase (tPA) helps the heart muscle to repair itself.
35. The nurse is performing the skill of intramuscular injection by the Z track method. Which technique would the nurse utilize to prevent tracking of the medication?
A. Inject the medication in the deltoid muscle
B. Use a 22-gauge needle
C. Omit aspirating for blood before injecting
36. Draw up 0.2mL of air after the proper medication dose. The nurse is preparing to administer preoperative medication of meperidine and atropine to an elderly adult who is scheduled for surgery. The client tells the nurse that he has glaucoma and wants to take his eye drops before going to the operating room. What is the best action for the nurse to take?
A. Administer medication as ordered and encourage the client to take his eye drops
B. Check with the physician before administering preoperative medication
C. Administer preoperative medication as ordered and suggest the client not take his eye drops
D. Administer the meperidine, withhold atropine, and suggest the client take his eye drops
37. An adult is admitted for surgery today. Immediately after administering the preoperative medications of meperidine and atropine, the nurse notes that the operative permit has not been signed. Which action should the nurse take?
A. Have the client sign the operative permit immediately before the medications take effect
B. Have the client’s next of kin sign the permission form
C. Ask the client if he/she is willing to undergo surgery, sign the form for the client, and indicate the nurse’s name as witness to the client’s verbal consent
D. Report it to the physician so the surgery can be delayed until the client can legally sign a consent form
38. The LPN/LVN has delegated basic hygienic care of several clients to a certified nursing assistant. Which action by the nurse will ensure that the clients receive the best care?
A. Observe the nursing assistant during the performance of all care
B. Ask the nursing assistant if there were any problems
C. Check the nursing assistant’s charting
D. Observe the clients following administration of care by the nursing assistants
39. The LPN is caring for a woman who delivered a healthy 7-lb baby boy 24 hours ago. Baseline vital signs were blood pressure (BP) = 90/64, temperature (T) = 97.6°F, pulse (P) = 72, and respirations (R) = 14. Which finding is of greatest concern?
A. The woman has red vaginal drainage on her perineal pad.
B. The woman complains of uterine cramping.
C. The woman is drinking large amounts of water.
40. The woman’s vital signs are now BP = 129/82, T = 98.4°F, P = 76, and R = 16. After passing a nasogastric (NG) tube in an adult, the nurse checks for proper placement by doing which of the following?
A. Injecting air into the NG tube and listening with a stethoscope over the stomach for a “swoosh”
B. Putting the end of the NG tube in a glass of water and observing for bubbles
C. Asking the client if the tube is comfortable
D. Aspirating contents and checking the pH”
41. “The nurse is caring for several clients. When thinking about long-term goals, the nurse knows that which of these clients has the best prognosis?
A. A young adult who has stage I Hodgkin’s lymphoma
B. A young adult who has leukemia
C. A young adult who has osteosarcoma
D. A 50-year-old who has multiple myeloma
42. The nurse is caring for a client with osteoporosis who is being discharged on (alendronate) Fosamax. Which statement would indicate a need for further teaching?
A. “I should take the medication immediately before bedtime.”
B. “I should remain in an upright position for 30 minutes after taking the medication.”
C. “The medication should be taken by mouth with water.”
D. “I should not have any food with this medication.”
43. A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood-tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are consistent with a diagnosis of:
A. Pneumonia
B. Reaction to antiviral medication
C. Tuberculosis
D. Superinfection due to low CD4 count
44. The nurse in a long-term care facility observes a nursing assistant caring for a resident who has a hearing aid and dentures. Which action by the nursing assistant should be corrected?
A. The nursing assistant places a washcloth in the sink before brushing the client’s dentures.
B. The nursing assistant uses toothpaste to clean the dentures.
C. The nursing assistant uses alcohol to wipe off the exterior of the hearing aid.
D. The nursing assistant wipes the exterior of the hearing aid with a damp cloth.
45. The nurse is performing a breast exam on a client when she discovers a mass. Which characteristic of the mass would most indicate a reason for concern?
A. Tender to touch
B. Regular shape
C. Moves easily
D. Firm to the touch
46. A client admitted to the psychiatric unit claims to be the Pope and insists that he will not be kept away from his subjects. The most likely explanation for the client’s delusion is:
A. A reaction formation
B. A stressful event
C. Low self-esteem
D. Overwhelming anxiety
47. The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor?
A. Blood pressure of 126/80
B. Blood glucose of 110mg/dL
C. Heart rate of 60 bpm
D. Respiratory rate of 30 per minute
48. The nurse is planning care for a client who must remain in bed for several weeks. Which action will do most to prevent the development of pressure ulcers?
A. Performing range-of-motion exercises
B. Deep breathing and coughing
C. Keeping the feet against a footboard
D. Changing position in bed frequently
49. If the nurse is unable to elicit the deep tendon reflexes of the patella, the nurse should ask the client to:
A. Pull against the palms
B. Grimace the facial muscles
C. Cross the legs at the ankles
D. Perform Valsalva maneuver
50. A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer?
A. A family history of laryngeal cancer
B. Chronic inhalation of noxious fumes
C. Frequent straining of the vocal cords
D. A history of frequent alcohol and tobacco use
51. An adult is admitted to the psychiatric unit with a severe phobia. She develops severe anxiety when she crosses any type of bridge. She can no longer go to work or go shopping at the mall. The day after admission, she develops a panic attack and refuses to go to occupational therapy because she has to cross a bridge-like structure to go from one area of the hospital to another. How should the nurse respond to this situation?
A. Accompany the client as she goes to occupational therapy
B. Request that she be excused from occupational therapy until she is less anxious
C. Have a staff member walk her to occupational therapy by a different route that does not cross a bridge-like structure
D. Tell her that facing her fears is the only way to conquer them and that the nurse will help her do that
52. The nurse has just received the shift report and is preparing to make rounds. Which client should be seen first?
A. The client with a history of a cerebral aneurysm with an oxygen saturation rate of 99%
B. The client three days post—-coronary artery bypass graft with a temperature of 100.2°F
C. The client admitted 1 hour ago with shortness of breath
D. The client being prepared for discharge following a femoral popliteal bypass graft
53. A client with hepatitis C is scheduled for a liver biopsy. Which would the nurse include in the teaching plan for this client?
A. The client should lie on the left side after the procedure.
B. Cleansing enemas should be given the morning of the procedure.
C. Blood coagulation studies might be done before the biopsy.
D. The procedure is noninvasive and causes no pain.
54. The nurse is caring for a client who is on bed rest for an extended period of time. When planning care, the nurse knows that which nursing action will do most to help prevent muscle atrophy?
A. Perform passive range-of-motion exercises on the client
B. Turn the client at two-hour intervals
C. Encourage the client to change positions frequently
D. Assist the client in the performance of active exercises
55. The chart of a client hospitalized for a total hip repair reveals that the client is colonized with MRSA. The nurse understands that the client:
A. Will not display symptoms of infection
B. Is less likely to have an infection
C. Can be placed in the room with others
D. Cannot colonize others with MRSA
56. A low-purine diet is ordered for a client who has uric acid kidney stones. Which foods should the client avoid? Select all that apply.
A. Eggs
B. Chicken
C. Liver
D. Oats
E. Lentils
F. Lobster
57. “The nurse is caring for a client who recently had a kidney transplant. Which comments the client makes indicate understanding of the ongoing treatment?
A. “We have put hand sanitizer all over the house.”
B. “I will be glad when I no longer have to take all this antirejection medicine.”
C. “I will be glad when I have had the kidney for six months and the risk of rejection is over.”
D. “I am eager to go back to work at the daycare center.”
58. A nurse is preparing to mix and administer chemotherapy. What equipment would be unnecessary to obtain?
A. Surgical gloves
B. Luerlok fitting IV tubing
C. Surgical hat cover
D. Disposable long-sleeve gown
59. A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:
A. Determine whether the ear infection has affected her hearing
B. Make sure that she has taken all the antibiotic
C. Document that the infection has completely cleared
D. Obtain a new prescription, in case the infection recurs
60. The nurse is caring for an adult who has had nausea and vomiting for several days and is being admitted to the nursing care unit. The client can follow directions. IV fluids were started in the emergency department. Which action is the highest priority for the nurse at this time?
A. Offer oral fluids every hour.
B. Turn every two hours.
C. Monitor urine output.
D. Put client in a supine position.
61. Which nursing assessment indicates that involutional changes have occurred in a client who is 3 days postpartum?
A. The fundus is firm and 3 finger widths below the umbilicus.
B. The client has a moderate amount of lochia serosa.
C. The fundus is firm and even with the umbilicus.
D. The uterus is approximately the size of a small grapefruit.
62. The nurse is performing discharge diet teaching to a client with a Stage 1 decubitus ulcer on the coccyx. Which diet selection by this client would indicate that the client has a clear understanding of the proper diet for healing of a decubitus ulcer?
A. Tossed salad, milk, and a slice of caramel cake
B. Vegetable soup and crackers, and a glass of tea
C. Baked chicken breast, broccoli, wheat roll, and an Orange
D. Hamburger, French fries, and corn on the cob
63. A client is diagnosed with stage || Hodgkin’s lymphoma. The nurse recognizes that the client has involvement:
A. In a single lymph node or single site
B. In more than one node or single organ on the same side of the diaphragm
C. In lymph nodes on both sides of the diaphragm
D. In disseminated organs and tissues
64. A client with Addison’s disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol). Which of the following interventions would the nurse implement?
A. Glucometer readings as ordered
B. Intake/output measurements
C. Evaluate the sodium and potassium levels
D. Daily weights
65. The nurse is caring for a client who has bleeding esophageal varices. What should the nurse expect might develop in this client? Select all that apply.
A. Confusion
B. Tarry stools
C. Lower abdominal pain and pressure
D. High blood pressure
E. Tremors
F. Hallucinations
66. An alert adult who has terminal cancer says to the home care nurse, ““When the time comes for me to go, I don’t want to be in pain and I don’t want you to try to resuscitate me. Please promise me you won’t.” How should the nurse respond?
A. “Of course, I will do as you wish.”
B. “I am obligated to try and preserve life.”
C. “Do you have advance directives? These need to be in your record.”
D. “Be sure to tell each nurse your desires.”
67. “An adult is prescribed sulfisoxazole (Gantrisin) for a urinary tract infection. Which comment by the client indicates understanding of the treatment regimen?
A. “When I feel better, I can stop taking the medicine.”
B. “I will stay out of the sun when I am taking this drug.”
C. “I should restrict fluids during the evening as long as I am on the medicine.”
D. “I will bring in a urine specimen every day while I am taking the drug.”
68. At 10:00 A.M., the nurse discovers a 75-year-old woman who is hospitalized with congestive heart failure on the floor beside the bed. She has a bruise on her leg, but x-rays reveal no fractures. How should the nurse record the incident in the client’s chart?
A. “Client fell out of bed at 10 A.M. Physician notified. Incident report completed.”
B. “Client found on floor beside bed at 10 A.M. Alert and oriented times 3. States she slipped as she was standing up. Bruise (3 inches by 2 inches) on left hip. Denies pain. Dr. examined client. X-rays taken.”
C. “Client fell while getting out of bed. Seems okay. Charge nurse examined client. Doctor notified and incident report fi led.”
D. “Found client on floor beside bed. Responds to questions. Red area on left hip. Notified charge nurse and physician.”
69. A client with rheumatoid arthritis is beginning to develop flexion contractures of the knees. The nurse should tell the client to:
A. Lie prone and let her feet hang over the mattress edge
B. Lie supine, with her feet rotated inward
C. Lie on her right side and point her toes downward
D. Lie on her left side and allow her feet to remain in a neutral position
70. A 15-month old is admitted in sickle crisis. The parents ask why the child did not have any symptoms until now. What should be included in the nurse’s response?
A. The child was probably not exposed to it until recently.
B. Antibodies from the mother are present for the first year of life.
C. The symptoms do not manifest until the child is no longer breastfeeding.
D. High fetal hemoglobin levels prevent symptoms for the first year of life.
71. The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s disease. Which side effect is most often associated with this drug?
A. Urinary incontinence
B. Headaches
C. Confusion
D. Nausea
72. The physician has ordered Basalgel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include:
A. Constipation
B. Urinary retention
C. Diarrhea
D. Confusion
