NCSBN NCLEX RN TEST BANK WITH 800 QUESTIONS AND ANSWERS ACTUAL EXAM NEWEST
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY
GRADED A+
Question 1
An LPN/LVN complains to the charge nurse that an unlicensed assistive person (UAP)
consistently leaves the work area untidy and does not restock supplies. What is the best initial
response by the charge nurse?
A) Write down potential solutions to the problems today by the end of the shift
B) Add this concern to the agenda of the next unit meeting
C) Assure the staff nurse that the complaint will be investigated thoroughly
D) Explore for further identification about the nature of the problem
E) Immediately reassign the UAP to a different set of tasks
Correct Answer: D) Explore for further identification about the nature of the problem
Rationale: According to the nursing process, assessment is the first step. The charge nurse
must gather more data to understand the frequency, specific instances, and potential causes
of the UAP's behavior before taking action or suggesting solutions. Jumping to solutions
(Option A) or delegating it to a meeting (Option B) without understanding the root cause is
premature.
Question 2
The nurse assists with the reinforcement of information about breast self-examination (BSE) to a
group of college students. A female student asks when to perform the monthly exam. The
appropriate reply by the nurse should include which statement?
A) "Ovulation, or midcycle, is the best time to detect changes."
B) "Do the exam at the same time every month regardless of your cycle."
C) "Perform the exam right after your period, when your breasts are less tender."
D) "The first of every month is best because it will be easiest to remember."
E) "Perform the exam during your period to ensure consistency."
Correct Answer: C) "Perform the exam right after your period, when your breasts are less
tender."
Rationale: For menstruating women, the best time to perform BSE is 5 to 7 days after the
menstrual period ends. During this time, hormonal stimulation to the breast tissue is at its
lowest, which reduces tenderness and fluid-induced lumps (swelling), making it easier to
identify actual abnormalities.
Question 3
The nurse is caring for a 75-year-old client with type 2 diabetes mellitus. The client should be
instructed to contact the outpatient clinic immediately if which finding is present?
A) An open wound on the heel with minimal discomfort
B) Occasional hiccups and sneezing
C) Sustained insomnia and daytime fatigue
D) Persistent dryness and itching of the perineal area
E) A blood glucose reading of 120 mg/dL before lunch
, Page 2
Correct Answer: A) An open wound on the heel with minimal discomfort
Rationale: Diabetic patients are at high risk for peripheral neuropathy and poor wound
healing. An open wound on the foot, even if painless, can rapidly progress to cellulitis or
gangrene because the patient may not feel the severity of the injury. "Minimal discomfort"
is a warning sign of sensory loss (neuropathy). Options B, C, and D are concerns but not
immediate medical emergencies.
Question 4
A pregnant woman has been advised to increase her intake of protein and vitamin C. Which of
the following meal choices would best meet the needs of the growing fetus?
A) 1 cup of macaroni, 3/4 cup of peas, glass of whole milk, and a medium pear
B) Scrambled egg, hash browned potatoes, 1/2 glass of buttermilk, and a large nectarine
C) 3 oz. chicken breast, 1/2 cup of corn, lettuce salad, and a small banana
D) Beef, 1/2 cup of lima beans, glass of skim milk, and 3/4 cup of strawberries
E) A peanut butter sandwich on white bread with a side of apple slices
Correct Answer: D) Beef, 1/2 cup of lima beans, glass of skim milk, and 3/4 cup of
strawberries
Rationale: Beef and lima beans are excellent sources of high-quality protein. Strawberries
are one of the best sources of Vitamin C (even higher than some citrus). Skim milk provides
additional protein and calcium without excess fat. This combination provides the highest
density of the specific nutrients requested.
Question 5
A nurse is taking a health history from parents of a child admitted with possible Reye's
syndrome. Which recent illness should the nurse recognize as being associated with an increased
risk for the development of Reye's syndrome?
A) Varicella
B) Meningitis
C) Hepatitis
D) Rubeola
E) Bacterial Sinusitis
Correct Answer: A) Varicella
Rationale: Reye's syndrome is a rare but serious condition that causes swelling in the liver
and brain. it most often affects children recovering from a viral infection, specifically
Varicella (chickenpox) or Influenza. The risk is significantly increased if the child was given
aspirin (salicylates) during the viral illness.
Question 6
A Native American chief visits his newborn son and performs a traditional ceremony involving
feathers and chanting. A nurse comments: "I wonder if he has any idea how ridiculous he looks."
This comment is an example of:
A) Prejudice
, Page 3
B) Ethnocentrism
C) Discrimination
D) Stereotyping
E) Cultural Assimilation
Correct Answer: A) Prejudice
Rationale: Prejudice is a preconceived negative judgment or "attitude" toward a group and
its individual members. In this case, the nurse is showing a negative bias toward the chief's
cultural expression. Ethnocentrism (Option B) is the belief that one's own culture is
superior, but "prejudice" specifically describes the negative attitude shown here.
Question 7
A nursing student asks about the primary forces driving healthcare reform. What information
should the nurse emphasize?
A) Increased competition between healthcare insurers
B) Healthcare spending that is growing faster than the overall economy
C) Increase in the population who have healthcare insurance
D) Increase in spending for end-of-life treatment
E) The decreasing cost of pharmaceutical research
Correct Answer: B) Increase in health care spending that's growing faster than the economy
Rationale: The primary driver of healthcare reform is the unsustainable rise in costs. When
healthcare spending consumes an ever-increasing percentage of the GDP (Gross Domestic
Product), it forces governments and private sectors to seek reforms to ensure the financial
viability of the system.
Question 8
A child is admitted with a suspected diagnosis of pertussis (whooping cough). What is the
priority nursing intervention?
A) Maintain hydration and encourage fluids
B) Implement droplet precautions
C) Monitor respiratory rate and oxygen saturation
D) Initiate anti-infective therapy
E) Provide a humidified oxygen tent
Correct Answer: B) Implement droplet precautions
Rationale: Safety and Infection Control are the highest priorities to prevent the spread of
the pathogen to other patients and staff. Pertussis is transmitted via large respiratory
droplets. Therefore, the very first action upon suspicion should be placing the patient on
Droplet Precautions.
Question 9
A client 12 hours post-TURP has an indwelling catheter with continuous bladder irrigation
(CBI). Which finding should be reported to the RN charge nurse immediately?
A) Complaints of a feeling of "pulling" on the catheter
, Page 4
B) Light pink to clear urine in the drainage bag
C) Occasional suprapubic cramping
D) Minimal drainage into the urinary collection bag
E) A bladder that is non-distended on palpation
Correct Answer: D) Minimal drainage into the urinary collection bag
Rationale: In CBI, fluid is constantly running into the bladder. If there is minimal drainage
coming out, it indicates an obstruction (likely a blood clot). This is an emergency because
the bladder can over-distend and rupture or cause severe pain and hemorrhage. Option B
is expected; Option A and C are common side effects of the catheter/procedure.
Question 10
A woman is 2 hours post-vaginal delivery. Her membranes ruptured 36 hours prior to delivery.
Which nursing diagnosis is the priority?
A) Risk for fluid volume deficit
B) Risk for excessive bleeding
C) Risk for infection
D) Altered tissue perfusion
E) Impaired urinary elimination
Correct Answer: C) Risk for infection
Rationale: The rupture of membranes (ROM) acts as a barrier against bacteria. Prolonged
ROM (typically defined as >18–24 hours) significantly increases the risk of ascending
infection (chorioamnionitis or postpartum endometritis) for both the mother and the
newborn.
Question 11
A 14-month-old child accidentally ingests baby aspirin (81 mg) tablets. Which finding should the
nurse expect?
A) Hypothermia
B) Nausea and vomiting
C) Hypoventilation
D) Bradycardia
E) Hyperglycemia
Correct Answer: B) Nausea and vomiting
Rationale: Early signs of salicylate (aspirin) poisoning include gastrointestinal irritation
(nausea, vomiting) and stimulation of the respiratory center (hyperpnea/hyperventilation).
Severe toxicity can lead to metabolic acidosis and tinnitus.
Question 12
A child with a history of tonic-clonic seizures begins having a seizure in class. What is the most
important action for the teacher/nurse to take?
A) Place a folded blanket or hands under the child's head
B) Provide privacy to minimize frightening other children
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES | ALREADY
GRADED A+
Question 1
An LPN/LVN complains to the charge nurse that an unlicensed assistive person (UAP)
consistently leaves the work area untidy and does not restock supplies. What is the best initial
response by the charge nurse?
A) Write down potential solutions to the problems today by the end of the shift
B) Add this concern to the agenda of the next unit meeting
C) Assure the staff nurse that the complaint will be investigated thoroughly
D) Explore for further identification about the nature of the problem
E) Immediately reassign the UAP to a different set of tasks
Correct Answer: D) Explore for further identification about the nature of the problem
Rationale: According to the nursing process, assessment is the first step. The charge nurse
must gather more data to understand the frequency, specific instances, and potential causes
of the UAP's behavior before taking action or suggesting solutions. Jumping to solutions
(Option A) or delegating it to a meeting (Option B) without understanding the root cause is
premature.
Question 2
The nurse assists with the reinforcement of information about breast self-examination (BSE) to a
group of college students. A female student asks when to perform the monthly exam. The
appropriate reply by the nurse should include which statement?
A) "Ovulation, or midcycle, is the best time to detect changes."
B) "Do the exam at the same time every month regardless of your cycle."
C) "Perform the exam right after your period, when your breasts are less tender."
D) "The first of every month is best because it will be easiest to remember."
E) "Perform the exam during your period to ensure consistency."
Correct Answer: C) "Perform the exam right after your period, when your breasts are less
tender."
Rationale: For menstruating women, the best time to perform BSE is 5 to 7 days after the
menstrual period ends. During this time, hormonal stimulation to the breast tissue is at its
lowest, which reduces tenderness and fluid-induced lumps (swelling), making it easier to
identify actual abnormalities.
Question 3
The nurse is caring for a 75-year-old client with type 2 diabetes mellitus. The client should be
instructed to contact the outpatient clinic immediately if which finding is present?
A) An open wound on the heel with minimal discomfort
B) Occasional hiccups and sneezing
C) Sustained insomnia and daytime fatigue
D) Persistent dryness and itching of the perineal area
E) A blood glucose reading of 120 mg/dL before lunch
, Page 2
Correct Answer: A) An open wound on the heel with minimal discomfort
Rationale: Diabetic patients are at high risk for peripheral neuropathy and poor wound
healing. An open wound on the foot, even if painless, can rapidly progress to cellulitis or
gangrene because the patient may not feel the severity of the injury. "Minimal discomfort"
is a warning sign of sensory loss (neuropathy). Options B, C, and D are concerns but not
immediate medical emergencies.
Question 4
A pregnant woman has been advised to increase her intake of protein and vitamin C. Which of
the following meal choices would best meet the needs of the growing fetus?
A) 1 cup of macaroni, 3/4 cup of peas, glass of whole milk, and a medium pear
B) Scrambled egg, hash browned potatoes, 1/2 glass of buttermilk, and a large nectarine
C) 3 oz. chicken breast, 1/2 cup of corn, lettuce salad, and a small banana
D) Beef, 1/2 cup of lima beans, glass of skim milk, and 3/4 cup of strawberries
E) A peanut butter sandwich on white bread with a side of apple slices
Correct Answer: D) Beef, 1/2 cup of lima beans, glass of skim milk, and 3/4 cup of
strawberries
Rationale: Beef and lima beans are excellent sources of high-quality protein. Strawberries
are one of the best sources of Vitamin C (even higher than some citrus). Skim milk provides
additional protein and calcium without excess fat. This combination provides the highest
density of the specific nutrients requested.
Question 5
A nurse is taking a health history from parents of a child admitted with possible Reye's
syndrome. Which recent illness should the nurse recognize as being associated with an increased
risk for the development of Reye's syndrome?
A) Varicella
B) Meningitis
C) Hepatitis
D) Rubeola
E) Bacterial Sinusitis
Correct Answer: A) Varicella
Rationale: Reye's syndrome is a rare but serious condition that causes swelling in the liver
and brain. it most often affects children recovering from a viral infection, specifically
Varicella (chickenpox) or Influenza. The risk is significantly increased if the child was given
aspirin (salicylates) during the viral illness.
Question 6
A Native American chief visits his newborn son and performs a traditional ceremony involving
feathers and chanting. A nurse comments: "I wonder if he has any idea how ridiculous he looks."
This comment is an example of:
A) Prejudice
, Page 3
B) Ethnocentrism
C) Discrimination
D) Stereotyping
E) Cultural Assimilation
Correct Answer: A) Prejudice
Rationale: Prejudice is a preconceived negative judgment or "attitude" toward a group and
its individual members. In this case, the nurse is showing a negative bias toward the chief's
cultural expression. Ethnocentrism (Option B) is the belief that one's own culture is
superior, but "prejudice" specifically describes the negative attitude shown here.
Question 7
A nursing student asks about the primary forces driving healthcare reform. What information
should the nurse emphasize?
A) Increased competition between healthcare insurers
B) Healthcare spending that is growing faster than the overall economy
C) Increase in the population who have healthcare insurance
D) Increase in spending for end-of-life treatment
E) The decreasing cost of pharmaceutical research
Correct Answer: B) Increase in health care spending that's growing faster than the economy
Rationale: The primary driver of healthcare reform is the unsustainable rise in costs. When
healthcare spending consumes an ever-increasing percentage of the GDP (Gross Domestic
Product), it forces governments and private sectors to seek reforms to ensure the financial
viability of the system.
Question 8
A child is admitted with a suspected diagnosis of pertussis (whooping cough). What is the
priority nursing intervention?
A) Maintain hydration and encourage fluids
B) Implement droplet precautions
C) Monitor respiratory rate and oxygen saturation
D) Initiate anti-infective therapy
E) Provide a humidified oxygen tent
Correct Answer: B) Implement droplet precautions
Rationale: Safety and Infection Control are the highest priorities to prevent the spread of
the pathogen to other patients and staff. Pertussis is transmitted via large respiratory
droplets. Therefore, the very first action upon suspicion should be placing the patient on
Droplet Precautions.
Question 9
A client 12 hours post-TURP has an indwelling catheter with continuous bladder irrigation
(CBI). Which finding should be reported to the RN charge nurse immediately?
A) Complaints of a feeling of "pulling" on the catheter
, Page 4
B) Light pink to clear urine in the drainage bag
C) Occasional suprapubic cramping
D) Minimal drainage into the urinary collection bag
E) A bladder that is non-distended on palpation
Correct Answer: D) Minimal drainage into the urinary collection bag
Rationale: In CBI, fluid is constantly running into the bladder. If there is minimal drainage
coming out, it indicates an obstruction (likely a blood clot). This is an emergency because
the bladder can over-distend and rupture or cause severe pain and hemorrhage. Option B
is expected; Option A and C are common side effects of the catheter/procedure.
Question 10
A woman is 2 hours post-vaginal delivery. Her membranes ruptured 36 hours prior to delivery.
Which nursing diagnosis is the priority?
A) Risk for fluid volume deficit
B) Risk for excessive bleeding
C) Risk for infection
D) Altered tissue perfusion
E) Impaired urinary elimination
Correct Answer: C) Risk for infection
Rationale: The rupture of membranes (ROM) acts as a barrier against bacteria. Prolonged
ROM (typically defined as >18–24 hours) significantly increases the risk of ascending
infection (chorioamnionitis or postpartum endometritis) for both the mother and the
newborn.
Question 11
A 14-month-old child accidentally ingests baby aspirin (81 mg) tablets. Which finding should the
nurse expect?
A) Hypothermia
B) Nausea and vomiting
C) Hypoventilation
D) Bradycardia
E) Hyperglycemia
Correct Answer: B) Nausea and vomiting
Rationale: Early signs of salicylate (aspirin) poisoning include gastrointestinal irritation
(nausea, vomiting) and stimulation of the respiratory center (hyperpnea/hyperventilation).
Severe toxicity can lead to metabolic acidosis and tinnitus.
Question 12
A child with a history of tonic-clonic seizures begins having a seizure in class. What is the most
important action for the teacher/nurse to take?
A) Place a folded blanket or hands under the child's head
B) Provide privacy to minimize frightening other children
