NUR 114
FINAL EXAM
NCLEX Style Questions w/
Rationales & Test Taking Strategies
Jefferson State Community College
This Document Description:
❖ This document contains NCLEX-style Exam
questions tailored to the NUR 114 course at
Jefferson State Community College.
❖ It covers core topics assessed in the course
and reflects the actual exam format and question style.
❖ Each question is followed by a correct answer, rationale, and
test-taking strategy to support exam preparation.
,A client with atrial fibrillation who is receiving maintenance therapy of
warfarin sodium has a prothrombin time (PT) of 35 seconds. On the
basis of these laboratory values, the nurse anticipates which
prescription?
1. Adding a dose of heparin sodium
2. Holding the next dose of warfarin
3. Increasing the next dose of warfarin
4. Administering the next dose of warfarin
Answer: 2
Rationale: The normal PT is 11 to 12.5 seconds (conventional therapy and SI
units). A therapeutic PT level is 1.5 to 2 times higher than the normal level.
Because the value of 35 seconds is high, the nurse would anticipate that the
client would not receive further doses at this time. Therefore, the
prescriptions noted in the remaining options are incorrect.
Test-Taking Strategy: Focus on the subject, a PT of 35 seconds. Recall the
normal range for this value and remember that a PT greater than 25 seconds
places the client at risk for bleeding; this will direct you to the correct option.
The nurse is caring for a client with a diagnosis of breast cancer who is
immunosuppressed. The nurse would implement neutropenic
precautions if the client's white blood cell count was which value?
1. 2000 mm3 (2.0 × 109/L)
2. 5800 mm3 (5.8 × 109/L)
3. 8400 mm (8.4 × 109/L)
4. 11,500 mm3 (11.5 × 109/L)
Answer: 1
Rationale: The normal WBC count ranges from 5000 to 10,000 mm3 (5 to 10
× 109/L). The client who has a decrease in the number of circulating WBCs is
immunosuppressed. The nurse implements neutropenic precautions when the
client’s values fall sufficiently below the normal level. The specific value for
implementing neutropenic precautions usually is determined by agency
policy. The remaining options are normal values.
,Test-Taking Strategy: Focus on the subject, the need to implement neutropenic
precautions. Recalling what neutropenic precautions involve and that the
normal WBC count is 5000 to 10,000 mm3 (5 to 10 × 109/L) will direct you to
the correct option.
A client has been admitted to the hospital for gastroenteritis and
dehydration. The nurse determines that the client has received adequate
volume replacement if the blood urea nitrogen (BUN) level drops to
which value?
1. 3 mg/dL (1.08 mmol/L)
2. 15 mg/dL (5.4 mmol/L)
3. 29 mg/dL (10.44 mmol/L)
4. 35 mg/dL (12.6 mmol/L)
Answer: 2
Rationale: The normal BUN level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L).
Values of 29 mg/dL (10.44 mmol/L) and 35 mg/ dL (12.6 mmol/L) reflect
continued dehydration. A value of 3 mg/dL (1.08 mmol/L) reflects a lower-
than-normal value, which may occur with fluid volume overload, among other
conditions.
Test-Taking Strategy: Focus on the subject, adequate fluid replacement and the
normal BUN level. The correct option is the only option that identifies a
normal value.
A client is receiving a continuous intravenous infusion of heparin sodium
to treat deep vein thrombosis. The client's activated partial
thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that
which action is needed?
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
Answer: 4
, Rationale: The normal aPTT varies between 30 and 40 seconds (30 and 40
seconds), depending on the type of activator used in testing. The therapeutic
dose of heparin for treatment of deep vein thrombosis is to keep the aPTT
between 1.5 times (45 to 60) and 2.5 times (75 to 100) normal. This means
that the client’s value should not be less than 45 sec- onds or greater than 100
seconds. Thus, the client’s aPTT is within the therapeutic range and the dose
should remain unchanged.
Test-Taking Strategy: Focus on the subject, the expected aPTT for a client
receiving a heparin sodium infusion. Remember that the normal range is 30 to
40 seconds and that the aPTT should be between 1.5 and 2.5 times normal
when the client is receiving heparin therapy. Simple multiplication of 1.5 and
2.5 by 30 and 40 will yield a range of 45 to 100 seconds. This client’s value is
65 seconds.
A client with a history of heart failure is due for a morning dose of
furosemide. Which serum potassium level, if noted in the client's
laboratory report, would the nurse report before administering the dose
of furosemide?
1. 3.2 mEq/L (3.2 mmol/L)
2. 3.8 mEq/L (3.8 mmol/L)
3. 4.2 mEq/L (4.2 mmol/L)
4. 4.8 mEq/L (4.8 mmol/L)
Answer: 1
Rationale: The normal serum potassium level in the adult is 3.5 to 5.0 mEq/L
(3.5 to 5.0 mmol/L). The correct option is the only value that falls below the
therapeutic range. Administering furosemide to a client with a low potassium
level and a history of cardiac problems could precipitate ventricular
dysrhythmias. The remaining options are within the normal range.
Test-Taking Strategy: Note the subject of the question, the level that needs to
be reported. This indicates that you are looking for an abnormal level.
Remember, the normal serum potassium level in the adult is 3.5 to 5.0 mEq/L
(3.5 to 5.0 mmol/L). This will direct you to the correct option.
FINAL EXAM
NCLEX Style Questions w/
Rationales & Test Taking Strategies
Jefferson State Community College
This Document Description:
❖ This document contains NCLEX-style Exam
questions tailored to the NUR 114 course at
Jefferson State Community College.
❖ It covers core topics assessed in the course
and reflects the actual exam format and question style.
❖ Each question is followed by a correct answer, rationale, and
test-taking strategy to support exam preparation.
,A client with atrial fibrillation who is receiving maintenance therapy of
warfarin sodium has a prothrombin time (PT) of 35 seconds. On the
basis of these laboratory values, the nurse anticipates which
prescription?
1. Adding a dose of heparin sodium
2. Holding the next dose of warfarin
3. Increasing the next dose of warfarin
4. Administering the next dose of warfarin
Answer: 2
Rationale: The normal PT is 11 to 12.5 seconds (conventional therapy and SI
units). A therapeutic PT level is 1.5 to 2 times higher than the normal level.
Because the value of 35 seconds is high, the nurse would anticipate that the
client would not receive further doses at this time. Therefore, the
prescriptions noted in the remaining options are incorrect.
Test-Taking Strategy: Focus on the subject, a PT of 35 seconds. Recall the
normal range for this value and remember that a PT greater than 25 seconds
places the client at risk for bleeding; this will direct you to the correct option.
The nurse is caring for a client with a diagnosis of breast cancer who is
immunosuppressed. The nurse would implement neutropenic
precautions if the client's white blood cell count was which value?
1. 2000 mm3 (2.0 × 109/L)
2. 5800 mm3 (5.8 × 109/L)
3. 8400 mm (8.4 × 109/L)
4. 11,500 mm3 (11.5 × 109/L)
Answer: 1
Rationale: The normal WBC count ranges from 5000 to 10,000 mm3 (5 to 10
× 109/L). The client who has a decrease in the number of circulating WBCs is
immunosuppressed. The nurse implements neutropenic precautions when the
client’s values fall sufficiently below the normal level. The specific value for
implementing neutropenic precautions usually is determined by agency
policy. The remaining options are normal values.
,Test-Taking Strategy: Focus on the subject, the need to implement neutropenic
precautions. Recalling what neutropenic precautions involve and that the
normal WBC count is 5000 to 10,000 mm3 (5 to 10 × 109/L) will direct you to
the correct option.
A client has been admitted to the hospital for gastroenteritis and
dehydration. The nurse determines that the client has received adequate
volume replacement if the blood urea nitrogen (BUN) level drops to
which value?
1. 3 mg/dL (1.08 mmol/L)
2. 15 mg/dL (5.4 mmol/L)
3. 29 mg/dL (10.44 mmol/L)
4. 35 mg/dL (12.6 mmol/L)
Answer: 2
Rationale: The normal BUN level is 10 to 20 mg/dL (3.6 to 7.1 mmol/L).
Values of 29 mg/dL (10.44 mmol/L) and 35 mg/ dL (12.6 mmol/L) reflect
continued dehydration. A value of 3 mg/dL (1.08 mmol/L) reflects a lower-
than-normal value, which may occur with fluid volume overload, among other
conditions.
Test-Taking Strategy: Focus on the subject, adequate fluid replacement and the
normal BUN level. The correct option is the only option that identifies a
normal value.
A client is receiving a continuous intravenous infusion of heparin sodium
to treat deep vein thrombosis. The client's activated partial
thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that
which action is needed?
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
Answer: 4
, Rationale: The normal aPTT varies between 30 and 40 seconds (30 and 40
seconds), depending on the type of activator used in testing. The therapeutic
dose of heparin for treatment of deep vein thrombosis is to keep the aPTT
between 1.5 times (45 to 60) and 2.5 times (75 to 100) normal. This means
that the client’s value should not be less than 45 sec- onds or greater than 100
seconds. Thus, the client’s aPTT is within the therapeutic range and the dose
should remain unchanged.
Test-Taking Strategy: Focus on the subject, the expected aPTT for a client
receiving a heparin sodium infusion. Remember that the normal range is 30 to
40 seconds and that the aPTT should be between 1.5 and 2.5 times normal
when the client is receiving heparin therapy. Simple multiplication of 1.5 and
2.5 by 30 and 40 will yield a range of 45 to 100 seconds. This client’s value is
65 seconds.
A client with a history of heart failure is due for a morning dose of
furosemide. Which serum potassium level, if noted in the client's
laboratory report, would the nurse report before administering the dose
of furosemide?
1. 3.2 mEq/L (3.2 mmol/L)
2. 3.8 mEq/L (3.8 mmol/L)
3. 4.2 mEq/L (4.2 mmol/L)
4. 4.8 mEq/L (4.8 mmol/L)
Answer: 1
Rationale: The normal serum potassium level in the adult is 3.5 to 5.0 mEq/L
(3.5 to 5.0 mmol/L). The correct option is the only value that falls below the
therapeutic range. Administering furosemide to a client with a low potassium
level and a history of cardiac problems could precipitate ventricular
dysrhythmias. The remaining options are within the normal range.
Test-Taking Strategy: Note the subject of the question, the level that needs to
be reported. This indicates that you are looking for an abnormal level.
Remember, the normal serum potassium level in the adult is 3.5 to 5.0 mEq/L
(3.5 to 5.0 mmol/L). This will direct you to the correct option.
