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NCLEX-RN Exam 1 Test Bank: Comprehensive
Practice Questions with Verified Rationales for
2025/2026 - Master Key Concepts and Pass on Your
First Try.
The primary healthcare provider has prescribed phenytoin 100 mg
intravenous push (IVP) stat for an adult client. What is the least amount
of time that the nurse can safely administer this medication?
1. 1 minute
2. 2 minutes
3. 5 minutes
4. 10 minutes - ANSWER-2. Correct: The rate of IV administration
should not exceed 50 mg/min. for adults and 1-3 mg/kg/min (or 50
mg/min, whichever is slower) in pediatric clients because of the risk of
severe hypotension and cardiac arrhythmias. So 100 mg can safely be
delivered over a period of at least 2 minutes.
1. Incorrect: The rate of IV administration should not exceed 50 mg/min.
for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac
arrhythmias. So 100 mg can safely be delivered over a period of at least
2 minutes. Giving this dose over only one minute could lead to these or
other potential harmful effects.
3. Incorrect: The rate of IV administration should not exceed 50 mg/min.
for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac
arrhythmias. So 100 mg can safely be delivered over a period of at least
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2 minutes. Five minutes would be longer than required to be able to
safely administer the medication.
4. Incorrect: The rate of IV administration should not exceed 50 mg/min.
for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac
arrhythmias. So 100 mg can safely be delivered over a period of at least
2 minutes. Ten minutes is much longer than required to be able to safely
administer the medication.
A client, hospitalized with possible acute pancreatitis secondary to
chronic cholecystitis, has severe abdominal pain and nausea. The client
is kept NPO, an NG tube is inserted, and IV fluids are being
administered. What is the rationale for the client being NPO with an NG
tube to low suction?
1. Relieve nausea
2. Reduce pancreatic secretions
3. Control fluid and electrolyte imbalance
4. Remove the precipitating irritants - ANSWER-2. Correct: In clients
with pancreatitis, the pancreatic enzymes cannot exit the pancreas. These
enzymes, when activated, begin to digest the pancreas itself. The
enzymes become activated in the pancreas when fluid or food
accumulates in the stomach. The goal in treating this client is to stop the
activation of the pancreatic enzymes. Treatment is focused on keeping
the stomach empty and dry. This allows the pancreas time to rest and
heal. Note: Autodigestion (pancreas digesting itself) is painful for the
client and can lead to other problems such as bleeding.
1. Incorrect: The primary purpose of the NG tube to suction is to keep
the stomach empty and dry to decrease pancreatic enzyme production,
not to relieve nausea.
3. Incorrect: Because gastric contents are removed, the NG tube to
suction may lead to fluid and electrolyte disturbances rather than helping
to control them.
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4. Incorrect: Although the food in the stomach causes the pancreatic
enzymes to become activated in the pancreas due to the obstruction, the
food is not considered an irritant. Precipitating irritants are not a part of
the pathophysiology occurring with pancreatitis.
The nurse is working with a committee at the local school to develop an
emergency preparedness plan for tornados. What should be included in
the plan?
1. Identification of safe zones.
2. Methods for accounting for all people present in the building.
3. Warning system activation.
4. Identification of the gymnasium as the routine safe place.
5. Regular practice protocols. - ANSWER-1., 2., 3. & 5. Correct:
Everyone should be aware of safe zones within the school. Personnel
should be given this information and signs posted in safe zones. There
must be systems in place to accurately determine the number of people
in the building at any given time. There also must be a system in place to
alert personnel and students of tornado warnings. Regular practice
prepares everyone for an actual event.
4. Incorrect: Gymnasiums are not considered safe places due to wide
expanse of roof. Safe zones should be on interior walls, no windows, and
a strong concrete floor if possible.
What should a nurse teach family members prior to them entering the
room of a client who has agranulocytosis?
1. Meticulous hand washing is needed.
2. Do not visit if you have any infection.
3. The client must wear a mask.
4. Children under 12 may not visit.
5. Flowers are not allowed in the room. - ANSWER-1., 2., 4., & 5.
Correct: Protective isolation is needed for this client because of the
presence of a low white blood cell count. We are protecting the client
from acquiring an infection. So any visitors will need to have meticulous
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hand washing prior to entering. The visitor should not enter if he or she
has any type of infection. To decrease the risk of infection, small
children should not visit. Even the mildest symptom of infection could
be detrimental to the client. Flowers have bacteria and should not be
brought into the room.
3. Incorrect: A mask must be worn by the visitor, not the client. The
mask is worn by visitors to prevent a possible spread of an airborne
infection to the immunocompromised client.
A client diagnosed with major depression has been taking a selective
serotonin reuptake inhibitor for the past 6 weeks. When visiting the
mental health center, the nurse discusses the medication and response
with the client. The nurse's assessment reveals that the client is confused
about the date and about the prescribed dosage of the medication. Which
question would be most important for the nurse to ask to further assess
the situation?
1. Are you having trouble sleeping at night?
2. Do you have periods of muscle jerking?
3. Are you having any sexual dysfunction?
4. Is your mood improving? - ANSWER-2. Correct: Myoclonus, high
body temperature, shaking, chills, and mental confusion are some of the
symptoms of serotonin syndrome. This client may be having symptoms
of this adverse reaction which, if severe, can be fatal.
1. Incorrect: Sleep disturbances are common with depression. Selective
serotonin reuptake inhibitors (SSRIs) may cause insomnia; however,
there is a more pertinent question needed for assessment of this client.
You should be concerned with the more serious or life-threatening issue.
3. Incorrect: Sexual dysfunction may occur with the SSRIs; however, the
client is exhibiting significant symptoms of an adverse reaction which
would take priority.
NCLEX-RN Exam 1 Test Bank: Comprehensive
Practice Questions with Verified Rationales for
2025/2026 - Master Key Concepts and Pass on Your
First Try.
The primary healthcare provider has prescribed phenytoin 100 mg
intravenous push (IVP) stat for an adult client. What is the least amount
of time that the nurse can safely administer this medication?
1. 1 minute
2. 2 minutes
3. 5 minutes
4. 10 minutes - ANSWER-2. Correct: The rate of IV administration
should not exceed 50 mg/min. for adults and 1-3 mg/kg/min (or 50
mg/min, whichever is slower) in pediatric clients because of the risk of
severe hypotension and cardiac arrhythmias. So 100 mg can safely be
delivered over a period of at least 2 minutes.
1. Incorrect: The rate of IV administration should not exceed 50 mg/min.
for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac
arrhythmias. So 100 mg can safely be delivered over a period of at least
2 minutes. Giving this dose over only one minute could lead to these or
other potential harmful effects.
3. Incorrect: The rate of IV administration should not exceed 50 mg/min.
for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac
arrhythmias. So 100 mg can safely be delivered over a period of at least
,2|Page
2 minutes. Five minutes would be longer than required to be able to
safely administer the medication.
4. Incorrect: The rate of IV administration should not exceed 50 mg/min.
for adults and 1-3 mg/kg/min (or 50 mg/min, whichever is slower) in
pediatric clients because of the risk of severe hypotension and cardiac
arrhythmias. So 100 mg can safely be delivered over a period of at least
2 minutes. Ten minutes is much longer than required to be able to safely
administer the medication.
A client, hospitalized with possible acute pancreatitis secondary to
chronic cholecystitis, has severe abdominal pain and nausea. The client
is kept NPO, an NG tube is inserted, and IV fluids are being
administered. What is the rationale for the client being NPO with an NG
tube to low suction?
1. Relieve nausea
2. Reduce pancreatic secretions
3. Control fluid and electrolyte imbalance
4. Remove the precipitating irritants - ANSWER-2. Correct: In clients
with pancreatitis, the pancreatic enzymes cannot exit the pancreas. These
enzymes, when activated, begin to digest the pancreas itself. The
enzymes become activated in the pancreas when fluid or food
accumulates in the stomach. The goal in treating this client is to stop the
activation of the pancreatic enzymes. Treatment is focused on keeping
the stomach empty and dry. This allows the pancreas time to rest and
heal. Note: Autodigestion (pancreas digesting itself) is painful for the
client and can lead to other problems such as bleeding.
1. Incorrect: The primary purpose of the NG tube to suction is to keep
the stomach empty and dry to decrease pancreatic enzyme production,
not to relieve nausea.
3. Incorrect: Because gastric contents are removed, the NG tube to
suction may lead to fluid and electrolyte disturbances rather than helping
to control them.
,3|Page
4. Incorrect: Although the food in the stomach causes the pancreatic
enzymes to become activated in the pancreas due to the obstruction, the
food is not considered an irritant. Precipitating irritants are not a part of
the pathophysiology occurring with pancreatitis.
The nurse is working with a committee at the local school to develop an
emergency preparedness plan for tornados. What should be included in
the plan?
1. Identification of safe zones.
2. Methods for accounting for all people present in the building.
3. Warning system activation.
4. Identification of the gymnasium as the routine safe place.
5. Regular practice protocols. - ANSWER-1., 2., 3. & 5. Correct:
Everyone should be aware of safe zones within the school. Personnel
should be given this information and signs posted in safe zones. There
must be systems in place to accurately determine the number of people
in the building at any given time. There also must be a system in place to
alert personnel and students of tornado warnings. Regular practice
prepares everyone for an actual event.
4. Incorrect: Gymnasiums are not considered safe places due to wide
expanse of roof. Safe zones should be on interior walls, no windows, and
a strong concrete floor if possible.
What should a nurse teach family members prior to them entering the
room of a client who has agranulocytosis?
1. Meticulous hand washing is needed.
2. Do not visit if you have any infection.
3. The client must wear a mask.
4. Children under 12 may not visit.
5. Flowers are not allowed in the room. - ANSWER-1., 2., 4., & 5.
Correct: Protective isolation is needed for this client because of the
presence of a low white blood cell count. We are protecting the client
from acquiring an infection. So any visitors will need to have meticulous
, 4|Page
hand washing prior to entering. The visitor should not enter if he or she
has any type of infection. To decrease the risk of infection, small
children should not visit. Even the mildest symptom of infection could
be detrimental to the client. Flowers have bacteria and should not be
brought into the room.
3. Incorrect: A mask must be worn by the visitor, not the client. The
mask is worn by visitors to prevent a possible spread of an airborne
infection to the immunocompromised client.
A client diagnosed with major depression has been taking a selective
serotonin reuptake inhibitor for the past 6 weeks. When visiting the
mental health center, the nurse discusses the medication and response
with the client. The nurse's assessment reveals that the client is confused
about the date and about the prescribed dosage of the medication. Which
question would be most important for the nurse to ask to further assess
the situation?
1. Are you having trouble sleeping at night?
2. Do you have periods of muscle jerking?
3. Are you having any sexual dysfunction?
4. Is your mood improving? - ANSWER-2. Correct: Myoclonus, high
body temperature, shaking, chills, and mental confusion are some of the
symptoms of serotonin syndrome. This client may be having symptoms
of this adverse reaction which, if severe, can be fatal.
1. Incorrect: Sleep disturbances are common with depression. Selective
serotonin reuptake inhibitors (SSRIs) may cause insomnia; however,
there is a more pertinent question needed for assessment of this client.
You should be concerned with the more serious or life-threatening issue.
3. Incorrect: Sexual dysfunction may occur with the SSRIs; however, the
client is exhibiting significant symptoms of an adverse reaction which
would take priority.
