NCLEX-PN Practice Questions: Complete Review
with Rationales
QUESTION 1
The nurse is caring for a client scheduled for removal of a pituitary tumor using
the transsphenoidal approach. The nurse should be particularly alert to:
✅ Correct Answer: A. Nasal congestion
Rationale: Removal of the pituitary gland using the transsphenoidal approach is
performed through the nose. Nasal congestion would further interfere with the
airway, making this a critical assessment priority.
QUESTION 2
A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb
12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse
evaluates that the client is experiencing which of the following?
✅ Correct Answer: B. Hypokalemia
Rationale: Hypokalemia is evident from the potassium level of 1.9 (normal range 3.5-
5.0). All other laboratory findings are within normal limits, making answers A, C, and
D incorrect.
QUESTION 3
,A 24-year-old female client is scheduled for surgery in the morning. Which of
the following is the primary responsibility of the nurse?
✅ Correct Answer: A. Taking the vital signs
Rationale: The primary responsibility of the nurse before surgery is to take vital
signs. Obtaining the permit, explaining the procedure, and checking lab work are
responsibilities of the physician.
QUESTION 4
The nurse is working in the emergency room when a client arrives with severe
burns of the left arm, hands, face, and neck. Which action should receive
priority?
✅ Correct Answer: B. Applying oxygen
Rationale: The client with burns to the neck requires airway assessment and
supplemental oxygen, making this the priority action. The next actions should be
starting an IV and medicating for pain.
QUESTION 5
The nurse is visiting a home health client with osteoporosis. The client has a
new prescription for alendronate (Fosamax). Which instructions should be
given to the client?
✅ Correct Answer: C. Take medication with water only
Rationale: Fosamax should be taken with water only. The client should also remain
upright for at least 30 minutes after taking the medication to prevent esophageal
irritation.
QUESTION 6
,The nurse is making initial rounds on a client with a C5 fracture and Crutchfield
tongs. Which equipment should be kept at the bedside?
✅ Correct Answer: B. A torque wrench
Rationale: A torque wrench is kept at the bedside to tighten and loosen the screws
of Crutchfield tongs. This wrench controls the amount of pressure placed on the
screws.
QUESTION 7
An infant weighs 7 pounds at birth. The expected weight by 1 year should be:
✅ Correct Answer: D. 21 pounds
Rationale: An infant typically triples birth weight by 1 year of age. A birth weight of 7
pounds would indicate 21 pounds at 1 year.
QUESTION 8
A client is admitted with Ewing's sarcoma. Which symptoms would be expected
due to this tumor's location?
✅ Correct Answer: D. Bone Pain
Rationale: Sarcoma is a type of bone cancer; therefore, bone pain would be
expected.
QUESTION 9
The nurse is caring for a client with epilepsy who is being treated with
carbamazepine (Tegretol). Which laboratory value might indicate a serious side
effect of this drug?
✅ Correct Answer: C. WBC 2,000 per cubic millimeter
, Rationale: Tegretol can suppress the bone marrow and decrease the white blood cell
count. A WBC of 2,000 per cubic millimeter (normal ~5,000-10,000) indicates a
serious side effect.
QUESTION 10
A 6-month-old client is admitted with possible intussusception. Which question
during the nursing history is least helpful in obtaining information regarding
this diagnosis?
✅ Correct Answer: C. "Describe his usual diet."
Rationale: The least helpful question is describing the usual diet. Questions about
pain, vomit appearance, and changes in stools are useful in determining the extent of
the disease process.
QUESTION 11
The nurse is assisting a client with diverticulosis to select appropriate foods.
Which food should be avoided?
✅ Correct Answer: C. Cucumber salad
Rationale: The client with diverticulitis should avoid foods with seeds. Cucumber
salad contains seeds and should be avoided.
QUESTION 12
A client has rectal cancer and is scheduled for an abdominal perineal resection.
What should be the priority nursing care during the post-op period?
✅ Correct Answer: D. Facilitating perineal wound drainage
with Rationales
QUESTION 1
The nurse is caring for a client scheduled for removal of a pituitary tumor using
the transsphenoidal approach. The nurse should be particularly alert to:
✅ Correct Answer: A. Nasal congestion
Rationale: Removal of the pituitary gland using the transsphenoidal approach is
performed through the nose. Nasal congestion would further interfere with the
airway, making this a critical assessment priority.
QUESTION 2
A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb
12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse
evaluates that the client is experiencing which of the following?
✅ Correct Answer: B. Hypokalemia
Rationale: Hypokalemia is evident from the potassium level of 1.9 (normal range 3.5-
5.0). All other laboratory findings are within normal limits, making answers A, C, and
D incorrect.
QUESTION 3
,A 24-year-old female client is scheduled for surgery in the morning. Which of
the following is the primary responsibility of the nurse?
✅ Correct Answer: A. Taking the vital signs
Rationale: The primary responsibility of the nurse before surgery is to take vital
signs. Obtaining the permit, explaining the procedure, and checking lab work are
responsibilities of the physician.
QUESTION 4
The nurse is working in the emergency room when a client arrives with severe
burns of the left arm, hands, face, and neck. Which action should receive
priority?
✅ Correct Answer: B. Applying oxygen
Rationale: The client with burns to the neck requires airway assessment and
supplemental oxygen, making this the priority action. The next actions should be
starting an IV and medicating for pain.
QUESTION 5
The nurse is visiting a home health client with osteoporosis. The client has a
new prescription for alendronate (Fosamax). Which instructions should be
given to the client?
✅ Correct Answer: C. Take medication with water only
Rationale: Fosamax should be taken with water only. The client should also remain
upright for at least 30 minutes after taking the medication to prevent esophageal
irritation.
QUESTION 6
,The nurse is making initial rounds on a client with a C5 fracture and Crutchfield
tongs. Which equipment should be kept at the bedside?
✅ Correct Answer: B. A torque wrench
Rationale: A torque wrench is kept at the bedside to tighten and loosen the screws
of Crutchfield tongs. This wrench controls the amount of pressure placed on the
screws.
QUESTION 7
An infant weighs 7 pounds at birth. The expected weight by 1 year should be:
✅ Correct Answer: D. 21 pounds
Rationale: An infant typically triples birth weight by 1 year of age. A birth weight of 7
pounds would indicate 21 pounds at 1 year.
QUESTION 8
A client is admitted with Ewing's sarcoma. Which symptoms would be expected
due to this tumor's location?
✅ Correct Answer: D. Bone Pain
Rationale: Sarcoma is a type of bone cancer; therefore, bone pain would be
expected.
QUESTION 9
The nurse is caring for a client with epilepsy who is being treated with
carbamazepine (Tegretol). Which laboratory value might indicate a serious side
effect of this drug?
✅ Correct Answer: C. WBC 2,000 per cubic millimeter
, Rationale: Tegretol can suppress the bone marrow and decrease the white blood cell
count. A WBC of 2,000 per cubic millimeter (normal ~5,000-10,000) indicates a
serious side effect.
QUESTION 10
A 6-month-old client is admitted with possible intussusception. Which question
during the nursing history is least helpful in obtaining information regarding
this diagnosis?
✅ Correct Answer: C. "Describe his usual diet."
Rationale: The least helpful question is describing the usual diet. Questions about
pain, vomit appearance, and changes in stools are useful in determining the extent of
the disease process.
QUESTION 11
The nurse is assisting a client with diverticulosis to select appropriate foods.
Which food should be avoided?
✅ Correct Answer: C. Cucumber salad
Rationale: The client with diverticulitis should avoid foods with seeds. Cucumber
salad contains seeds and should be avoided.
QUESTION 12
A client has rectal cancer and is scheduled for an abdominal perineal resection.
What should be the priority nursing care during the post-op period?
✅ Correct Answer: D. Facilitating perineal wound drainage
