Free NCLEX (NCLEX-RN) Certification Sample Questions with Online Practice Test
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Passing the NCLEX-RN exam is a critical milestone in a nurse's career as it is the final step before receiving a nursing license. NCLEX-RN exam is known for its rigor and difficulty level and requires significant preparation and study. Nurses who pass the exam are recognized as competent and knowledgeable professionals who possess the necessary skills to provide safe and effective care to patients.
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The NCLEX-RN® exam is the licensing exam for entry-level nurses. This exam covers the required knowledge, skills, and attitudes to become a licensed registered nurse in the United States. The NCLEX-RN® exam is taken by nurses who are preparing to be licensed as registered nurses. It is taken after graduation from an approved nursing program. Students must have been accepted by an approved school. NCLEX certifications is the pathway to the NCSBN Board Certification in Nursing. ConfidentNursing (CN) certification is the pathway to the Certified Nurse Aide (CNA) credential. Nurse assesses(NARN), and the CNA credential is the pathway to the Certified Nursing Assistant (CNA) credential. Arterial puncture is the pathway to the Registered Respiratory Therapist(RRT). The exam is designed to test your knowledge of the basic concepts of nursing as they apply to nursing practice. NCLEX-RN Dumps is study the required knowledge, skills, and attitudes for the NCLEX-RN® exam. Exam files are made available on the NCSBN website, which is a free service to all who wish to take the exam. Exam sources are included in each file.
NEW QUESTION # 279
A 30-year-old client has been admitted to the psychiatric service with the diagnosis of schizophrenia. He tells the nurse that when the woman he had been dating broke up with him, the CIA had replaced her with an identical twin. The client is experiencing:
- A. Paranoid delusions
- B. Auditory hallucinations
- C. Grandiose delusions
- D. Visual hallucinations
Answer: A
Explanation:
Explanation
(A) There are no indications that the client's thoughts reflect special powers or talents characteristic of grandiosity. (B) The client's thought content is fixed, false, persecutory, and suspicious in nature, which is characteristic of paranoid delusions. (C, D) The client is not demonstrating a sensory experience.
NEW QUESTION # 280
A 24-year-old client presents to the emergency department protesting "I am God." The nurse identifies this as a:
- A. Delusion
- B. Hallucination
- C. Illusion
- D. Conversion
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Delusion is a false belief. (B) Illusion is the misrepresentation of a real, external sensory experience.
(C) Hallucination is a false sensory perception involving any of the senses. (D) Conversion is the expression of intrapsychic conflict through sensory or motor manifestations.
NEW QUESTION # 281
The nurse is caring for a client with pancreatitis. Which of the following IV medications would the nurse expect the physician to prescribe for control of pain in this client?
- A. Promethazine (Phenergan)
- B. Morphine sulfate
- C. Kerolac tromethamine (Toradol)
- D. Meperidine (Demerol)
Answer: D
Explanation:
(A) Morphine sulfate is contraindicated in clients with pancreatitis because it may cause spasms of the sphincter of Oddi and increase pancreatic pain. (B) Ketorolac tromethamine is currently not approved by the Food and Drug Administration for IV use. (C) Promethazine is a medication that has no analgesic properties. (D) Meperidine is the drug of choice for clients with pancreatitis. It will not cause spasms at the sphincter of Oddi, which can lead to increased pancreatic pain.
NEW QUESTION # 282
A primipara is assessed on arrival to the postpartum unit. The nurse finds her uterus to be boggy. The nurse's first action should be to:
- A. Give the prescribed oxytocic drug
- B. Call the physician
- C. Assess her vital signs
- D. Massage her fundus
Answer: D
Explanation:
Section: Questions Set E
Explanation:
(A) The nurse should first implement independent and dependent measures to achieve uterine tone before calling the physician. (B) Assessment of vital signs will not help to restore uterine atony, which is the priority need. (C) Giving a prescribed oxytocic drug would be necessary ifthe uterus did not maintain tone with massage. (D) Fundal massage generally restores uterine tone within a few moments and should be attempted first.
NEW QUESTION # 283
Nursing care of the infant prior to surgical closure of a meningomyelocele would include:
- A. Cover sac with dry sterile dressing
- B. Cover sac with saline-soaked sterile dressing
- C. Aspirate any fluid from sac
- D. Do not apply dressing; keep sac open to air
Answer: B
Explanation:
Explanation
(A) A dry, sterile dressing would adhere to the sac, causing tissue damage. (B) A saline-soaked sterile dressing protects the sac from contamination by air and prevents drying. (C) A sac open to air causes drying and potential for contamination. (D) This intervention is not an independent nursing action.
NEW QUESTION # 284
The nurse is assessing and getting a history from a client treated for depression with a monoamine oxidase (MAO) antidepressant. The most serious side effect associated with this antidepressant and the ingestion of tyramine in aged foods may be:
- A. Severe hypotension
- B. Hypertensive crisis
- C. Severe diarrhea
- D. Severe rash
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) The most serious adverse reactions of MAO inhibitors involve blood pressure and ingestion of tyramine-containing foods, which may provoke a hypertensive crisis. (B) MAO inhibitors cause adverse reactions affecting the central nervous system and serious adverse reactions involving blood pressure. (C) MAO inhibits false neurotransmitters (phenylalanines) and may produce hypotensive reactions from gradual accumulation of these neurotransmitters. (D) The most serious adverse reactions of MAO inhibitors involve blood pressure.
NEW QUESTION # 285
A client has been taking lithium 300 mg po bid for the past two weeks. This morning her lithium level was 1 mEq/L. The nurse should:
- A. Administer the morning lithium dose as scheduled
- B. Notify the physician immediately
- C. Hold the morning lithium dose and continue to observe the client
- D. Obtain an order for benztropine (Cogentin)
Answer: A
Explanation:
Explanation
(A) There is no need to phone the physician because the lithium level is within therapeutic range and because there are no indications of toxicity present. (B) There is no reason to withhold the lithium because the blood level is within therapeutic range. Also, it is necessary to give the medication as scheduled to maintain adequate blood levels. (C) The lab results indicate that the client's lithium level is within therapeutic range (0.2-1.4 mEq/L), so the medication should be given as ordered. (D) Benztropine is an antiparkinsonism drug frequently given to counteractextrapyramidal symptoms associated with the administration of antipsychotic drugs (not lithium).
NEW QUESTION # 286
A 72-year-old male client had the Foley catheter that was inserted during the transurethral resection of his prostate removed today. He is concerned about the urinary incontinence he is having since removal of the Foley catheter. The nurse explains that:
- A. This is related to the bladder spasms and will soon stop
- B. The nurse will keep him dry, and he should notify the nurse when this happens
- C. This is usually temporary
- D. He should not be concerned about it because it will resolve quickly
Answer: C
Explanation:
(A) This problem is temporary, but it may take some time to resolve, especially in an older man. (B) This problem is usually temporary, but it may take some time to resolve. (C) Keeping the client dry will not relieve his anxiety about his incontinence. (D) The bladder spasms are not the cause of the client's incontinence.
NEW QUESTION # 287
Following TURP, which of the following instructions would be appropriate to prevent or alleviate anxiety concerning the client's sexual functioning?
- A. "A transurethral resection does not usually cause impotence."
- B. "You may resume sexual intercourse in 2 weeks."
- C. "Many men experience impotence following TURP."
- D. "Check with your doctor about resuming sexual activity."
Answer: A
Explanation:
(A) Sexual activity should be delayed until cleared by the client's physician. (B) Although many men experience retrograde ejaculation following prostate surgery, potency is seldom affected. (C) Although the client may experience retrograde ejaculation, it will not limit his ability to engage in sexual intercourse. (D) Although the client should obtain clearance from his physician before resuming sexual activity, this statement does not give the client any information or reassurance about future sexual activity or potency that could decrease his anxiety.
NEW QUESTION # 288
A 55-year-old client is admitted with a diagnosis of renal calculi. He presented with severe right flank pain, nausea, and vomiting. The most important nursing action for him at this time is:
- A. Intake and output measurement
- B. Daily weights
- C. Straining of all urine
- D. Administration of O2 therapy
Answer: C
Explanation:
(A) Intake and output measurements are important but must be accompanied by straining urine. (B) Daily weights would not provide for identification of calculi. (C) Straining urine provides for assessment of calculi and evaluation of calculi descent through ureters and urethra. (D) O2therapy should not be necessary for renal calculi.
NEW QUESTION # 289
A 3-year-old child is in the burn unit following a home accident. The first sign of sepsis in burned children is:
- A. Disorientation
- B. Low-grade fever
- C. Diarrhea
- D. Hypertension
Answer: A
Explanation:
Explanation
(A) Disorientation is the first sign of sepsis in burn children. (B) Low-grade fever is not indicative of sepsis.
(C) Diarrhea is not indicative of sepsis. (D) Hypertension is not indicative of sepsis.
NEW QUESTION # 290
An 82-year-old former restaurant owner walks to the nursing station and states, "I have to go. The restaurant opens at 11 am." Which response by the nurse is the most appropriate?
- A. "It is snowing outside. The restaurant is closed."
- B. "Go back to your room. You do not own a restaurant."
- C. "You once owned a restaurant. Tell me about it."
- D. "You are in the hospital now. Calm down."
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) This response cuts off communication with the client. It does not address her feelings. (B) Reality orientation frequently does not work alone. Feelings must be addressed. Telling a client to calm down is frequently ineffective. (C) Reminiscence is used here to reorient and recall past pleasant events. Talking about the restaurant will allay anxiety. (D) This response may confirm to the client that she indeed does still own a restaurant, buying into her confusion. Her feelings and anxiety require nursing intervention.
NEW QUESTION # 291
A client was admitted to the hospital after falling in her home. At the time of admission, her blood alcohol level was 0.27 mg%. Her family indicates that she has been drinking a fifth of vodka a day for the past 9 months.
She had her last drink 30 minutes prior to admission. Alcohol withdrawal symptoms would most likely be exhibited by her:
- A. Six to 8 hours after the last drink
- B. Immediately on admission
- C. Twenty-four hours after the last drink
- D. Two to 4 hours after the last drink
Answer: A
Explanation:
Section: Questions Set D
Explanation:
(A) This answer is incorrect. Alcohol withdrawal usually begins approximately 6-8 hours after the last drink. (B) This answer is correct. It takes approximately 6-8 hours for metabolism of alcohol. (C) This answer is incorrect.
The alcohol is still in the system, as indicated by the high blood alcohol level. (D) This answer is incorrect.
Symptoms of alcohol withdrawal usually begin within 6-8 hours of the last drink.
NEW QUESTION # 292
One week ago, a 21-year-old client with a diagnosis of bipolar disorder was started on lithium 300 mg po qid.
A lithium level is ordered. The client's level is 1.3 mEq/L. The nurse recognizes that this level is considered to be:
- A. Above therapeutic range
- B. Below therapeutic range
- C. At a level of toxic poisoning
- D. Within therapeutic range
Answer: D
Explanation:
Explanation
(A) This answer is correct. The therapeutic range is 1.0-1.5 mEq/L in the acute phase. Maintenance control levels are 0.6-1.2 mEq/L. (B, C) This answer is incorrect. A level of 1.3 mEq/L is within therapeutic range.
(D) This answer is incorrect. Toxic poisoning is usually at the 2.0 level or higher.
NEW QUESTION # 293
An 18-year-old girl is admitted to the hospital with a depressed skull fracture as a result of a car accident. If the nurse were to observe a rising pulse rate and lowering blood pressure, the nurse would suspect that the client:
- A. Is beginning to experience a dangerously high level of anxiety
- B. Has sustained an internal injury in addition to the head injury
- C. Has a sudden and severe increase in intracranial pressure
- D. Is having intracranial bleeding
Answer: B
Explanation:
(A) Widening pulse pressure (high systolic and low diastolic) with compensatory slowing of pulse rate are late signs of increasing ICP. (B) Rising pulse rate and lowering blood pressure are indicative of hypovolemia due to hemorrhage. (C) High anxiety, in the absence of hemorrhage, would result in a high pulse rate and a high blood pressure. (D) Intracranial bleeding results in increased ICP. A change in level of consciousness is an early sign of increasing ICP, and vital sign changes are late signs of increasing ICP.
NEW QUESTION # 294
A client has been diagnosed with thrombophlebitis. She asks, "What is the most likely cause of thrombophlebitis during my pregnancy?" The nurse explains:
- A. An inadequate production of platelets
- B. An increase in fibrinolysis and a decrease in coagulation factors
- C. Increased levels of the coagulation factors and a decrease in fibrinolysis
- D. An inadequate intake of folic acid during pregnancy
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) During pregnancy, the potential for thromboses increases owing to the increased levels of coagulation factors and a decrease in the breakdown of fibrin. (B) An inadequate production of platelets would result in thrombocytopenia with resulting signs and symptoms of bleeding such as petechiae, hematuria, or hematemesis. (C) A deficiency of folic acid during pregnancy produces a megaloblastic anemia. It is usually found in combination with iron deficiency. (D) This combination would result in bleeding disorders because more fibrin would be broken down and fewer clotting factors would be available.
NEW QUESTION # 295
A 40-year-old client has been admitted to the hospital with severe substernal chest pain radiating down his left arm. The nurse caring for the client establishes the following priority nursing diagnosis-Alteration in comfort, pain related to:
- A. Decreased secretion of catecholamines secondary to anxiety
- B. Decreased stimulation of the sympathetic nervous system
- C. Increased blood flow through the coronary arteries
- D. Increased excretion of lactic acid due to myocardial hypoxia
Answer: D
Explanation:
(A) Anaerobic metabolism results because the decreased blood supply to the myocardium causes a release of lactic acid. Lactic acid is an irritant to the myocardial neural receptors, producing chest pain. (B) Chest pain is caused by a decrease in the O2 supply to the myocardial cells. Treatment modalities for chest pain are aimed toward increasing the blood flow through coronary arteries. (C) Chest pain causes an increase in the stimulation of the sympathetic nervous system. This stimulation increases the heart rate and blood pressure, causing an increase in myocardial workload aggravating the chest pain. (D) Chest pain and anxiety cause increased secretion of catecholamines by stimulating the sympathetic nervous system. This stimulation increases chest pain by increasing the workload of the heart.
NEW QUESTION # 296
To facilitate maximum air exchange, the nurse should position the client in:
- A. Prone
- B. Flat-supine
- C. Orthopneic
- D. High Fowler
Answer: C
Explanation:
(A) The high Fowler position does increase air exchange, but not to the extent of orthopneic position. (B) The orthopneic position is a sitting position that allows maximum lung expansion. (C) The prone position places pressure on diaphragm and does not promote maximum air exchange. (D) The flat-supine position places pressure on diaphragm by abdominal organs and does not promote maximum air exchange.
NEW QUESTION # 297
A client has received preoperative teaching for the vertical partial laryngectomy that he is scheduled to have in the morning. The nurse determines that the teaching has been effective when the client states:
- A. "I may also have to have a radical neck dissection done."
- B. "The quality of my voice will be excellent after surgery."
- C. "I know I will need special swallowing training after my surgery."
- D. "I will have very little difficulty swallowing after surgery."
Answer: D
Explanation:
Explanation
(A) A client with a supraglottic (horizontal partial) laryngectomy would require special swallowing training, not a vertical partial laryngectomy. (B) The quality of the client's voice will be altered but adequate for communication. (C) The client will have minimal difficulty swallowing. (D) A radical neck dissection may be done with a total laryngectomy, but not with a partial laryngectomy.
NEW QUESTION # 298
A 15-year-old female adolescent is frequently breaking the rules of the unit. She has left the unit and was found smoking in the bathroom and spending a large amount of time in the male ward. Which statement by the nurse would best explain to the teenager why she must follow the rules of the unit?
- A. "Break the rules, all you want, but don't get caught again!"
- B. "It is not easy, but the rules must be followed so that everyone can get a fair chance."
- C. "If you do not follow the rules, you will be transferred to the closed, locked unit."
- D. "You are not being fair to the other clients by getting them involved in your deviant behavior."
Answer: B
Explanation:
Explanation
(A) This statement acknowledges that it is difficult but is not threatening or punitive. (B) This statement is threatening and describes specific punishment for further deviant behavior. (C) This response elicits shame by blaming her for involving others. (D) This response gives her permission to break the rules but indicates that getting caught is wrong.
NEW QUESTION # 299
Which of the following signs and symptoms indicates a tension pneumothorax as compared to an open pneumothorax?
- A. Decreased tidal volume and tachypnea
- B. Mediastinal tissue and organ shifting
- C. Ventilation-perfusion (V./Q.) mismatch
- D. Hypoxemia and respiratory acidosis
Answer: B
Explanation:
(A, B, D) These occur in both tension pneumothorax and open pneumothorax. (C) The tension pneumothorax acts like a one- way valve so that the pneumothorax increases with each breath. Eventually, it occupies enough space to shift mediastinal tissue toward the unaffected side away from the midline. Tracheal deviation, movement of point of maximum impulse, and decreased cardiac output will occur. The other three options will occur in both types of pneumothorax.
NEW QUESTION # 300
A 40-year-old client is admitted to the hospital for tests to diagnose cancer. Since his admission, he has become dependent and demanding to the nursing staff. The nurse identifies this behavior as which defense mechanism?
- A. Projection
- B. Displacement
- C. Regression
- D. Denial
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Denial is the disowning of consciously intolerable thoughts. (B) Displacement is the referring of a feeling or emotion from one person, object, or idea to another. (C) Regression is returning to an earlier stage of development. (D) Projection is attributing one's own thoughts, feelings, or impulses to another person.
NEW QUESTION # 301
The physician orders haloperidol 5 mg IM stat for a client and tells the nurse that the dose can be repeated in
1-2 hours if needed. The most likely rationale for this order is:
- A. Haloperidol is a minor tranquilizer and will not oversedate the client
- B. The medication will sedate the client until the physician arrives
- C. The client will settle down more quickly if he thinks the staff is medicating him
- D. Rapid neuroleptization is the most effective approach to care for the violent or potentially violent client
Answer: D
Explanation:
Explanation
(A) If the client could think logically, he would not be paranoid. In fact, he is probably suspicious of the staff, too. Newly admitted clients frequently experience high levels of anxiety, which can contribute to delusions.
(B) The goal of pharmacological intervention is to calm the client and assist with reality-based thinking, not to sedate him. (C) Haloperidol is a neuroleptic and antipsychotic drug, not a minor tranquilizer. (D) Haloperidol is a high-potency neuroleptic and first-line choice for rapid neuroleptization, with low potential for sedation.
NEW QUESTION # 302
A 4 days postpartum client who is gravida 3, para 3, isexamined by the home health nurse during her first postpartum home visit. The nurse notes that she has a pink vaginal discharge with a serosanguineous consistency. The nurse would most accurately chart the client's lochia as:
- A. Rubra
- B. Alba
- C. Serosa
- D. Rosa
Answer: C
Explanation:
Explanation
(A) Lochia rubra is bloody with clots and occurs 1-3 days postpartum. (B) There is no such term as lochia rosa. (C) Lochia serosa is a pink-brown discharge with a serosanguineous consistency that occurs 4-9 days postpartum. (D) Lochia alba is yellow to white in color and occurs approximately 10 days postpartum.
NEW QUESTION # 303
In client teaching, the nurse should emphasize that fetal damage occurs more frequently with ingestion of drugs during:
- A. First trimester
- B. Third trimester
- C. Every trimester
- D. Second trimester
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Organogenesis occurs in the first trimester. Fetus is most susceptible to malformation during this period. (B) Organogenesis has occurred by the second trimester. (C) Fetal development is complete by this time. (D) The dangerous period for fetal damage is the first trimester, not the entire pregnancy.
NEW QUESTION # 304
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