Sarah Michelle Crash Course Progress 148/150
SARAH MICHELLE NCLEX® CRASH COURSE
SARAH MICHELLE CRASH COURSE STUDY GUIDE
SOLUTION
2026/2027 | NEW UPDATE | 150 COMPREHENSIVE QUESTIONS | GRADED A+ | 100%
VERIFIED
150 Questions NGN Item Types Updated 2026/2027 NCLEX-RN/PN
Pharmacology Medical-Surgical Maternal-Newborn Pediatric Psychiatric Fluid & Electrolytes NGN Case Studies
Sarah Michelle NCLEX® Crash Course Comprehensive Study Guide
Core Domains Study Guide Structure
● Pharmacology (Drug Classifications, Mechanisms, Adverse Effects) ✓ Comprehensive content review by NCLEX test plan
● Medical-Surgical Nursing (All Body Systems) ✓ High-yield summary tables and memory tricks
● Maternal-Newborn Nursing (Antepartum to Newborn) ✓ Pharmacology flashcards and drug reviews
● Pediatric Nursing (Growth & Development) ✓ Practice questions with detailed rationales
● Psychiatric Mental Health Nursing ✓ NGN case studies and innovative item types
● Fluid & Electrolyte Balance, Acid-Base ✓ Prioritization and delegation scenarios
● Dosage Calculations ✓ Dosage calculation practice
● Prioritization & Delegation ✓ Test-taking strategies for NCLEX success
● Next Generation NCLEX (NGN) Item Types
Answer Format
All questions are presented in bold text for clear distinction and readability.
All correct answers are presented in bold and lime green, followed by clearly defined, clinically focused rationales in italic
format that reinforce nursing concepts, pharmacological principles, patient safety, clinical judgment, and NCLEX test-taking
strategies required for examination success.
, Pharmacology
1
A nurse is administering furosemide (Lasix) to a patient with heart failure. Which laboratory
value should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: B) Potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium loss. Hypokalemia can lead to life-threatening
cardiac dysrhythmias, especially in patients with heart failure. Potassium levels must be monitored regularly, and
supplementation may be needed.
Med-Surg
2
A patient with COPD is receiving oxygen at 2 L/min via nasal cannula. The nurse understands
that increasing the oxygen flow rate could cause which complication?
A) Oxygen toxicity
B) Loss of hypoxic drive
C) Respiratory alkalosis
D) Pulmonary edema
Correct Answer: B) Loss of hypoxic drive
Rationale: Patients with chronic COPD may rely on hypoxic drive (low oxygen levels) rather than hypercapnic drive to
stimulate breathing. Excessive oxygen can suppress this drive, leading to respiratory depression and CO2 narcosis.
Oxygen should be titrated carefully.
Pharmacology
3
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory test
monitors therapeutic effectiveness?
A) aPTT
B) PT/INR
C) Platelet count
D) Hemoglobin
Correct Answer: B) PT/INR
Rationale: Warfarin therapy is monitored using PT/INR. The therapeutic INR range for atrial fibrillation is typically
2.0-3.0. aPTT monitors heparin therapy. Regular monitoring prevents bleeding complications and ensures therapeutic
anticoagulation.
Maternal
4
A pregnant client at 32 weeks gestation reports sudden severe headache and visual changes.
Which condition should the nurse suspect?
A) Gestational diabetes
B) Preeclampsia
, C) Placenta previa
D) Hyperemesis gravidarum
Correct Answer: B) Preeclampsia
Rationale: Sudden severe headache, visual changes, and elevated blood pressure are classic signs of preeclampsia. This
is a medical emergency requiring immediate assessment of blood pressure, proteinuria, and fetal status. Magnesium
sulfate may be indicated to prevent seizures.
Pediatric
5
A nurse is assessing a 6-month-old infant. Which developmental milestone should the infant
have achieved?
A) Walking independently
B) Sitting without support
C) Speaking two-word phrases
D) Using a pincer grasp
Correct Answer: B) Sitting without support
Rationale: By 6 months, infants should be able to sit without support. Walking occurs around 12 months, two-word
phrases around 18-24 months, and pincer grasp around 9-10 months. Developmental milestones help identify potential
delays.
Psychiatric
6
A patient with depression is prescribed fluoxetine (Prozac). Which statement by the patient
indicates understanding of the medication?
A) 'I will stop taking it when I feel better'
B) 'It may take 4-6 weeks to feel the full effect'
C) 'I can drink alcohol while taking this'
D) 'I should take it at bedtime only'
Correct Answer: B) 'It may take 4-6 weeks to feel the full effect'
Rationale: SSRIs like fluoxetine take 4-6 weeks to reach full therapeutic effect. Patients should not stop abruptly (risk of
discontinuation syndrome). Alcohol should be avoided. Morning dosing is often preferred to prevent insomnia.
Fluid/Electrolyte
7
A patient has a serum potassium level of 2.8 mEq/L. Which ECG change should the nurse
anticipate?
A) Peaked T waves
B) U waves
C) Widened QRS
D) ST elevation
Correct Answer: B) U waves
Rationale: Hypokalemia causes U waves on ECG, along with flattened T waves and ST depression. Peaked T waves and
widened QRS occur with hyperkalemia. Severe hypokalemia can cause life-threatening dysrhythmias requiring
immediate treatment.
, NGN Item
8
NGN Case Study: A patient post-op day 1 from hip replacement has increased pain, swelling,
and warmth in the calf. Select all findings that indicate DVT.
A) Unilateral leg swelling
B) Bilateral leg swelling
C) Warmth and redness
D) Cool, pale extremity
E) Positive Homan's sign
Correct Answer: A) Unilateral leg swelling
Rationale: DVT presents with unilateral leg swelling, warmth, redness, and possibly positive Homan's sign (though
unreliable). Bilateral swelling suggests other causes. Cool, pale extremity indicates arterial insufficiency. DVT requires
anticoagulation and monitoring for PE.
Pharmacology
9
A patient is receiving morphine via PCA. Which assessment is the priority?
A) Pain level
B) Respiratory rate
C) Blood pressure
D) Urine output
Correct Answer: B) Respiratory rate
Rationale: Respiratory depression is the most serious complication of opioid PCA. Respiratory rate and sedation level
must be monitored frequently. If respiratory rate is <12 or patient is overly sedated, PCA should be held and provider
notified immediately.
Med-Surg
10
A patient with type 1 diabetes has a blood glucose of 45 mg/dL. Which intervention should the
nurse implement first?
A) Administer insulin
B) Give 15g fast-acting carbohydrate
C) Call the physician
D) Document the finding
Correct Answer: B) Give 15g fast-acting carbohydrate
Rationale: Blood glucose <70 mg/dL indicates hypoglycemia requiring immediate treatment with 15g fast-acting
carbohydrate (juice, glucose tablets). Recheck in 15 minutes. If unconscious, give glucagon. Never give insulin for
hypoglycemia.
Maternal
11
A newborn is 1 minute old. Which APGAR score finding requires immediate intervention?
A) Heart rate 120 bpm
B) Respiratory effort weak
SARAH MICHELLE NCLEX® CRASH COURSE
SARAH MICHELLE CRASH COURSE STUDY GUIDE
SOLUTION
2026/2027 | NEW UPDATE | 150 COMPREHENSIVE QUESTIONS | GRADED A+ | 100%
VERIFIED
150 Questions NGN Item Types Updated 2026/2027 NCLEX-RN/PN
Pharmacology Medical-Surgical Maternal-Newborn Pediatric Psychiatric Fluid & Electrolytes NGN Case Studies
Sarah Michelle NCLEX® Crash Course Comprehensive Study Guide
Core Domains Study Guide Structure
● Pharmacology (Drug Classifications, Mechanisms, Adverse Effects) ✓ Comprehensive content review by NCLEX test plan
● Medical-Surgical Nursing (All Body Systems) ✓ High-yield summary tables and memory tricks
● Maternal-Newborn Nursing (Antepartum to Newborn) ✓ Pharmacology flashcards and drug reviews
● Pediatric Nursing (Growth & Development) ✓ Practice questions with detailed rationales
● Psychiatric Mental Health Nursing ✓ NGN case studies and innovative item types
● Fluid & Electrolyte Balance, Acid-Base ✓ Prioritization and delegation scenarios
● Dosage Calculations ✓ Dosage calculation practice
● Prioritization & Delegation ✓ Test-taking strategies for NCLEX success
● Next Generation NCLEX (NGN) Item Types
Answer Format
All questions are presented in bold text for clear distinction and readability.
All correct answers are presented in bold and lime green, followed by clearly defined, clinically focused rationales in italic
format that reinforce nursing concepts, pharmacological principles, patient safety, clinical judgment, and NCLEX test-taking
strategies required for examination success.
, Pharmacology
1
A nurse is administering furosemide (Lasix) to a patient with heart failure. Which laboratory
value should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Correct Answer: B) Potassium
Rationale: Furosemide is a loop diuretic that causes significant potassium loss. Hypokalemia can lead to life-threatening
cardiac dysrhythmias, especially in patients with heart failure. Potassium levels must be monitored regularly, and
supplementation may be needed.
Med-Surg
2
A patient with COPD is receiving oxygen at 2 L/min via nasal cannula. The nurse understands
that increasing the oxygen flow rate could cause which complication?
A) Oxygen toxicity
B) Loss of hypoxic drive
C) Respiratory alkalosis
D) Pulmonary edema
Correct Answer: B) Loss of hypoxic drive
Rationale: Patients with chronic COPD may rely on hypoxic drive (low oxygen levels) rather than hypercapnic drive to
stimulate breathing. Excessive oxygen can suppress this drive, leading to respiratory depression and CO2 narcosis.
Oxygen should be titrated carefully.
Pharmacology
3
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which laboratory test
monitors therapeutic effectiveness?
A) aPTT
B) PT/INR
C) Platelet count
D) Hemoglobin
Correct Answer: B) PT/INR
Rationale: Warfarin therapy is monitored using PT/INR. The therapeutic INR range for atrial fibrillation is typically
2.0-3.0. aPTT monitors heparin therapy. Regular monitoring prevents bleeding complications and ensures therapeutic
anticoagulation.
Maternal
4
A pregnant client at 32 weeks gestation reports sudden severe headache and visual changes.
Which condition should the nurse suspect?
A) Gestational diabetes
B) Preeclampsia
, C) Placenta previa
D) Hyperemesis gravidarum
Correct Answer: B) Preeclampsia
Rationale: Sudden severe headache, visual changes, and elevated blood pressure are classic signs of preeclampsia. This
is a medical emergency requiring immediate assessment of blood pressure, proteinuria, and fetal status. Magnesium
sulfate may be indicated to prevent seizures.
Pediatric
5
A nurse is assessing a 6-month-old infant. Which developmental milestone should the infant
have achieved?
A) Walking independently
B) Sitting without support
C) Speaking two-word phrases
D) Using a pincer grasp
Correct Answer: B) Sitting without support
Rationale: By 6 months, infants should be able to sit without support. Walking occurs around 12 months, two-word
phrases around 18-24 months, and pincer grasp around 9-10 months. Developmental milestones help identify potential
delays.
Psychiatric
6
A patient with depression is prescribed fluoxetine (Prozac). Which statement by the patient
indicates understanding of the medication?
A) 'I will stop taking it when I feel better'
B) 'It may take 4-6 weeks to feel the full effect'
C) 'I can drink alcohol while taking this'
D) 'I should take it at bedtime only'
Correct Answer: B) 'It may take 4-6 weeks to feel the full effect'
Rationale: SSRIs like fluoxetine take 4-6 weeks to reach full therapeutic effect. Patients should not stop abruptly (risk of
discontinuation syndrome). Alcohol should be avoided. Morning dosing is often preferred to prevent insomnia.
Fluid/Electrolyte
7
A patient has a serum potassium level of 2.8 mEq/L. Which ECG change should the nurse
anticipate?
A) Peaked T waves
B) U waves
C) Widened QRS
D) ST elevation
Correct Answer: B) U waves
Rationale: Hypokalemia causes U waves on ECG, along with flattened T waves and ST depression. Peaked T waves and
widened QRS occur with hyperkalemia. Severe hypokalemia can cause life-threatening dysrhythmias requiring
immediate treatment.
, NGN Item
8
NGN Case Study: A patient post-op day 1 from hip replacement has increased pain, swelling,
and warmth in the calf. Select all findings that indicate DVT.
A) Unilateral leg swelling
B) Bilateral leg swelling
C) Warmth and redness
D) Cool, pale extremity
E) Positive Homan's sign
Correct Answer: A) Unilateral leg swelling
Rationale: DVT presents with unilateral leg swelling, warmth, redness, and possibly positive Homan's sign (though
unreliable). Bilateral swelling suggests other causes. Cool, pale extremity indicates arterial insufficiency. DVT requires
anticoagulation and monitoring for PE.
Pharmacology
9
A patient is receiving morphine via PCA. Which assessment is the priority?
A) Pain level
B) Respiratory rate
C) Blood pressure
D) Urine output
Correct Answer: B) Respiratory rate
Rationale: Respiratory depression is the most serious complication of opioid PCA. Respiratory rate and sedation level
must be monitored frequently. If respiratory rate is <12 or patient is overly sedated, PCA should be held and provider
notified immediately.
Med-Surg
10
A patient with type 1 diabetes has a blood glucose of 45 mg/dL. Which intervention should the
nurse implement first?
A) Administer insulin
B) Give 15g fast-acting carbohydrate
C) Call the physician
D) Document the finding
Correct Answer: B) Give 15g fast-acting carbohydrate
Rationale: Blood glucose <70 mg/dL indicates hypoglycemia requiring immediate treatment with 15g fast-acting
carbohydrate (juice, glucose tablets). Recheck in 15 minutes. If unconscious, give glucagon. Never give insulin for
hypoglycemia.
Maternal
11
A newborn is 1 minute old. Which APGAR score finding requires immediate intervention?
A) Heart rate 120 bpm
B) Respiratory effort weak
