Final Exam NCLEX Questions (2026)
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Terms in this set (76)
A 38-year-old female is brought to a.) prepare the patient for synchronized
the Emergency Department with cardioversion.
complaints of her "heart beating out
of her chest". She is diaphoretic,
tachypneic and her BP is 70/40. The
cardiac monitor shows
supraventricular tachycardia. Valsalva
maneuvers and three doses of
Adenosine have not been successful.
The nurse should immediately:
a.) prepare the patient for
synchronized cardioversion.
b.) give Epinephrine 1 mg IV and
repeat in 3 minutes.
c.) give Adenosine 6 mg IV per
protocol.
d.) perform unilateral carotid
massage.
,A patient arrives at the emergency Answer: C
department complaining of mid-
sternal chest pain. Which of the The priority nursing action for a patient arriving at
following nursing action should take the ED in distress is always assessment of vital
priority? signs. This indicates the extent of physical
compromise and provides a baseline by which to
A. A complete history with emphasis plan further assessment and treatment. A thorough
on preceding events. medical history, including onset of symptoms, will
B. An electrocardiogram. be necessary and it is likely that an
C. Careful assessment of vital signs. electrocardiogram will be performed as well, but
D. Chest exam with auscultation. these are not the first priority. Similarly, chest exam
with auscultation may offer useful information after
vital signs are assessed.
A nurse is caring for a patient who Answer: D
has had hip replacement. The nurse
should be most concerned about Post-surgical nursing assessment after hip
which of the following findings? replacement should be principally concerned with
the risk of neurovascular complications and the
A. Complaints of pain during development of infection. A temperature of 101.8 F
repositioning. (38.7 C) postoperatively is higher than the low
B. Scant bloody discharge on the grade that is to be expected and should raise
surgical dressing. concern. Some pain during repositioning and
C. Complaints of pain following following physical therapy is to be expected and
physical therapy. can be managed with analgesics. A small amount
D. Temperature of 101.8 F (38.7 C). of bloody drainage on the surgical dressing is a
result of normal healing.
,Emergency department triage is an Answer: C
important nursing function. A nurse
working the evening shift is Emergency triage involves quick patient
presented with four patients at the assessment to prioritize the need for further
same time. Which of the following evaluation and care. Patients with trauma, chest
patients should be assigned the pain, respiratory distress, or acute neurological
highest priority? changes are always classified number one priority.
Though the patient with chest pain presented in the
A. A patient with low-grade fever, question recently ate a spicy meal and may be
headache, and myalgias for the past suffering from heartburn, he also may be having an
72 hours. acute myocardial infarction and require urgent
B. A patient who is unable to bear attention. The patient with fever, headache and
weight on the left foot, with swelling muscle aches (classic flu symptoms) should be
and bruising following a running classified as non-urgent. The patient with the foot
accident. injury may have sustained a sprain or fracture, and
C. A patient with abdominal and the limb should be x-rayed as soon as is practical,
chest pain following a large, spicy but the damage is unlikely to worsen if there is a
meal. delay. The child's chin laceration may need to be
D. A child with a one-inch bleeding sutured but is also non-urgent.
laceration on the chin but otherwise
well after falling while jumping on his
bed.
A nurse cares for a patient who has a Answer: A
nasogastric tube attached to low
suction because of a suspected A patient on nasogastric suction is at risk of
bowel obstruction. Which of the metabolic alkalosis as a result of loss of
following arterial blood gas results hydrochloric acid in gastric fluid. Of the answers
might be expected in this patient? given, only answer A (pH 7.52, PCO2 54 mm Hg)
represents alkalosis. Answer B is a normal blood
A. pH 7.52, PCO2 54 mm Hg. gas. Answer C represents respiratory acidosis.
B. pH 7.42, PCO2 40 mm Hg. Answer D is borderline normal with slightly low
C. pH 7.25, PCO2 25 mm Hg. PCO2.
D. pH 7.38, PCO2 36 mm Hg.
, A patient is admitted to the a.) Hypovolemic
emergency department after
sustaining abdominal injuries and a
broken femur from a motor vehicle
accident. The patient is pale,
diaphoretic, and is not talking
coherently. Vital signs upon
admission are temperature 98 F (36
C), heart rate 130 beats/minute,
respiratory rate 34 breaths/minute,
blood pressure 50/40 mmHg. The
healthcare provider suspects which
type of shock?
a.) Hypovolemic
b.) Cardiogenic
c.) Neurogenic
d.) Septic
The healthcare provider is caring for c.) IV fluids to increase intravascular volume.
a patient who has septic shock.
Which of these should the healthcare Rationale:
provider administer to the patient Circulation and perfusion are addressed first so IV
first? fluids will be started immediately. After blood
cultures are obtained, broad-spectrum antibiotics
a.) Antibiotics to treat the underlying should be administered without delay.
infection. Vasopressors are administered if the patient is not
b.) Corticosteroids to reduce responding to the fluid challenge. Corticosteroids
inflammation. may be considered to address the inflammatory-
c.) IV fluids to increase intravascular induced vasodilation and capillary leakage
volume.
d.) Vasopressors to increase blood
pressure.
comprehensive questions and verified detailed
solutions ( MULTIPLE CHOICES) |100% CORRECT!!
Save
Terms in this set (76)
A 38-year-old female is brought to a.) prepare the patient for synchronized
the Emergency Department with cardioversion.
complaints of her "heart beating out
of her chest". She is diaphoretic,
tachypneic and her BP is 70/40. The
cardiac monitor shows
supraventricular tachycardia. Valsalva
maneuvers and three doses of
Adenosine have not been successful.
The nurse should immediately:
a.) prepare the patient for
synchronized cardioversion.
b.) give Epinephrine 1 mg IV and
repeat in 3 minutes.
c.) give Adenosine 6 mg IV per
protocol.
d.) perform unilateral carotid
massage.
,A patient arrives at the emergency Answer: C
department complaining of mid-
sternal chest pain. Which of the The priority nursing action for a patient arriving at
following nursing action should take the ED in distress is always assessment of vital
priority? signs. This indicates the extent of physical
compromise and provides a baseline by which to
A. A complete history with emphasis plan further assessment and treatment. A thorough
on preceding events. medical history, including onset of symptoms, will
B. An electrocardiogram. be necessary and it is likely that an
C. Careful assessment of vital signs. electrocardiogram will be performed as well, but
D. Chest exam with auscultation. these are not the first priority. Similarly, chest exam
with auscultation may offer useful information after
vital signs are assessed.
A nurse is caring for a patient who Answer: D
has had hip replacement. The nurse
should be most concerned about Post-surgical nursing assessment after hip
which of the following findings? replacement should be principally concerned with
the risk of neurovascular complications and the
A. Complaints of pain during development of infection. A temperature of 101.8 F
repositioning. (38.7 C) postoperatively is higher than the low
B. Scant bloody discharge on the grade that is to be expected and should raise
surgical dressing. concern. Some pain during repositioning and
C. Complaints of pain following following physical therapy is to be expected and
physical therapy. can be managed with analgesics. A small amount
D. Temperature of 101.8 F (38.7 C). of bloody drainage on the surgical dressing is a
result of normal healing.
,Emergency department triage is an Answer: C
important nursing function. A nurse
working the evening shift is Emergency triage involves quick patient
presented with four patients at the assessment to prioritize the need for further
same time. Which of the following evaluation and care. Patients with trauma, chest
patients should be assigned the pain, respiratory distress, or acute neurological
highest priority? changes are always classified number one priority.
Though the patient with chest pain presented in the
A. A patient with low-grade fever, question recently ate a spicy meal and may be
headache, and myalgias for the past suffering from heartburn, he also may be having an
72 hours. acute myocardial infarction and require urgent
B. A patient who is unable to bear attention. The patient with fever, headache and
weight on the left foot, with swelling muscle aches (classic flu symptoms) should be
and bruising following a running classified as non-urgent. The patient with the foot
accident. injury may have sustained a sprain or fracture, and
C. A patient with abdominal and the limb should be x-rayed as soon as is practical,
chest pain following a large, spicy but the damage is unlikely to worsen if there is a
meal. delay. The child's chin laceration may need to be
D. A child with a one-inch bleeding sutured but is also non-urgent.
laceration on the chin but otherwise
well after falling while jumping on his
bed.
A nurse cares for a patient who has a Answer: A
nasogastric tube attached to low
suction because of a suspected A patient on nasogastric suction is at risk of
bowel obstruction. Which of the metabolic alkalosis as a result of loss of
following arterial blood gas results hydrochloric acid in gastric fluid. Of the answers
might be expected in this patient? given, only answer A (pH 7.52, PCO2 54 mm Hg)
represents alkalosis. Answer B is a normal blood
A. pH 7.52, PCO2 54 mm Hg. gas. Answer C represents respiratory acidosis.
B. pH 7.42, PCO2 40 mm Hg. Answer D is borderline normal with slightly low
C. pH 7.25, PCO2 25 mm Hg. PCO2.
D. pH 7.38, PCO2 36 mm Hg.
, A patient is admitted to the a.) Hypovolemic
emergency department after
sustaining abdominal injuries and a
broken femur from a motor vehicle
accident. The patient is pale,
diaphoretic, and is not talking
coherently. Vital signs upon
admission are temperature 98 F (36
C), heart rate 130 beats/minute,
respiratory rate 34 breaths/minute,
blood pressure 50/40 mmHg. The
healthcare provider suspects which
type of shock?
a.) Hypovolemic
b.) Cardiogenic
c.) Neurogenic
d.) Septic
The healthcare provider is caring for c.) IV fluids to increase intravascular volume.
a patient who has septic shock.
Which of these should the healthcare Rationale:
provider administer to the patient Circulation and perfusion are addressed first so IV
first? fluids will be started immediately. After blood
cultures are obtained, broad-spectrum antibiotics
a.) Antibiotics to treat the underlying should be administered without delay.
infection. Vasopressors are administered if the patient is not
b.) Corticosteroids to reduce responding to the fluid challenge. Corticosteroids
inflammation. may be considered to address the inflammatory-
c.) IV fluids to increase intravascular induced vasodilation and capillary leakage
volume.
d.) Vasopressors to increase blood
pressure.
