NCLEX RN ACTUALL QUESTIONS AND ANSWERS
,1. A 65-year-old patient with chronic obstructive pulmonary disease (COPD) presents with
increased shortness of breath and a productive cough. Which intervention should the nurse
prioritize?
a) Encourage increased fluid intake
b) Administer prescribed bronchodilator
c) Place the patient in a supine position
d) Restrict oxygen therapy to 1 L/min
Answer: b) Administer prescribed bronchodilator
Strategy: Prioritize interventions that relieve airway constriction and improve breathing. Bronchodilators
open airways, reducing shortness of breath. Fluid intake is important but secondary. Oxygen should be
administered carefully but not restricted unnecessarily.
2. SATA: Which of the following are signs of hypoglycemia in a diabetic patient?
a) Sweating
b) Confusion
c) Polyuria
d) Tremors
e) Dry mouth
Answer: a) Sweating, b) Confusion, d) Tremors
Strategy: Hypoglycemia presents with neurogenic symptoms like sweating, tremors, and confusion due to
low blood sugar. Polyuria and dry mouth are more typical of hyperglycemia.
3. Case Study: A patient is admitted with acute myocardial infarction (MI). Which lab value
indicates myocardial damage?
a) Elevated hemoglobin
b) Increased troponin levels
c) Low white blood cell count
d) Decreased potassium levels
Answer: b) Increased troponin levels
Strategy: Troponin is a cardiac biomarker released during myocardial injury, making it the most specific
indicator of MI.
,4. A nurse is reviewing the ECG of a patient with palpitations. The ECG shows a regular rhythm
with a rate of 150 bpm and no visible P waves. What is the likely rhythm?
a) Sinus tachycardia
b) Atrial fibrillation
c) Supraventricular tachycardia (SVT)
d) Ventricular tachycardia
Answer: c) Supraventricular tachycardia (SVT)
Strategy: SVT is characterized by a rapid regular rhythm with absent or hidden P waves due to rapid atrial
rate.
5. What is the priority nursing action for a client experiencing an anaphylactic reaction after
administration of penicillin?
a) Administer epinephrine
b) Apply ice packs to injection site
c) Encourage deep breathing exercises
d) Provide oral antihistamines
Answer: a) Administer epinephrine
Strategy: Epinephrine is the first-line treatment for anaphylaxis to reverse airway constriction and shock.
6. SATA: Which of the following medications require monitoring of potassium levels?
a) Furosemide
b) Spironolactone
c) Lisinopril
d) Metformin
e) Digoxin
Answer: a) Furosemide, b) Spironolactone, c) Lisinopril, e) Digoxin
Strategy: These drugs affect potassium balance either by causing loss (furosemide), retention
(spironolactone), or altering renal function (lisinopril). Digoxin toxicity risk increases with hypokalemia.
7. A patient with chronic kidney disease reports fatigue and pallor. Which lab value should the nurse
review to assess for anemia?
a) Hemoglobin
b) Blood urea nitrogen (BUN)
, c) Creatinine
d) Platelet count
Answer: a) Hemoglobin
Strategy: Anemia is common in CKD due to reduced erythropoietin; hemoglobin levels indicate anemia
severity.
8. A client with heart failure is prescribed a low-sodium diet. Which food choice indicates
understanding of the diet?
a) Canned soup
b) Fresh apple
c) Salted nuts
d) Processed cheese
Answer: b) Fresh apple
Strategy: Fresh fruits and vegetables are low in sodium; processed and canned foods are typically high in
sodium.
9. The nurse is caring for a patient post-thyroidectomy. Which sign indicates a potential
complication?
a) Hypotension
b) Hoarseness and difficulty breathing
c) Increased appetite
d) Warm, flushed skin
Answer: b) Hoarseness and difficulty breathing
Strategy: These symptoms may indicate airway obstruction or recurrent laryngeal nerve damage, which is
an emergency.
10. SATA: Which of the following are appropriate actions when caring for a patient with
neutropenia?
a) Encourage visitors to wear masks
b) Restrict fresh fruits and vegetables
c) Administer antibiotics prophylactically
d) Use sterile technique for invasive procedures
e) Allow unwashed flowers in the room
Answer: a) Encourage visitors to wear masks, b) Restrict fresh fruits and vegetables, c) Administer
antibiotics prophylactically, d) Use sterile technique for invasive procedures
,1. A 65-year-old patient with chronic obstructive pulmonary disease (COPD) presents with
increased shortness of breath and a productive cough. Which intervention should the nurse
prioritize?
a) Encourage increased fluid intake
b) Administer prescribed bronchodilator
c) Place the patient in a supine position
d) Restrict oxygen therapy to 1 L/min
Answer: b) Administer prescribed bronchodilator
Strategy: Prioritize interventions that relieve airway constriction and improve breathing. Bronchodilators
open airways, reducing shortness of breath. Fluid intake is important but secondary. Oxygen should be
administered carefully but not restricted unnecessarily.
2. SATA: Which of the following are signs of hypoglycemia in a diabetic patient?
a) Sweating
b) Confusion
c) Polyuria
d) Tremors
e) Dry mouth
Answer: a) Sweating, b) Confusion, d) Tremors
Strategy: Hypoglycemia presents with neurogenic symptoms like sweating, tremors, and confusion due to
low blood sugar. Polyuria and dry mouth are more typical of hyperglycemia.
3. Case Study: A patient is admitted with acute myocardial infarction (MI). Which lab value
indicates myocardial damage?
a) Elevated hemoglobin
b) Increased troponin levels
c) Low white blood cell count
d) Decreased potassium levels
Answer: b) Increased troponin levels
Strategy: Troponin is a cardiac biomarker released during myocardial injury, making it the most specific
indicator of MI.
,4. A nurse is reviewing the ECG of a patient with palpitations. The ECG shows a regular rhythm
with a rate of 150 bpm and no visible P waves. What is the likely rhythm?
a) Sinus tachycardia
b) Atrial fibrillation
c) Supraventricular tachycardia (SVT)
d) Ventricular tachycardia
Answer: c) Supraventricular tachycardia (SVT)
Strategy: SVT is characterized by a rapid regular rhythm with absent or hidden P waves due to rapid atrial
rate.
5. What is the priority nursing action for a client experiencing an anaphylactic reaction after
administration of penicillin?
a) Administer epinephrine
b) Apply ice packs to injection site
c) Encourage deep breathing exercises
d) Provide oral antihistamines
Answer: a) Administer epinephrine
Strategy: Epinephrine is the first-line treatment for anaphylaxis to reverse airway constriction and shock.
6. SATA: Which of the following medications require monitoring of potassium levels?
a) Furosemide
b) Spironolactone
c) Lisinopril
d) Metformin
e) Digoxin
Answer: a) Furosemide, b) Spironolactone, c) Lisinopril, e) Digoxin
Strategy: These drugs affect potassium balance either by causing loss (furosemide), retention
(spironolactone), or altering renal function (lisinopril). Digoxin toxicity risk increases with hypokalemia.
7. A patient with chronic kidney disease reports fatigue and pallor. Which lab value should the nurse
review to assess for anemia?
a) Hemoglobin
b) Blood urea nitrogen (BUN)
, c) Creatinine
d) Platelet count
Answer: a) Hemoglobin
Strategy: Anemia is common in CKD due to reduced erythropoietin; hemoglobin levels indicate anemia
severity.
8. A client with heart failure is prescribed a low-sodium diet. Which food choice indicates
understanding of the diet?
a) Canned soup
b) Fresh apple
c) Salted nuts
d) Processed cheese
Answer: b) Fresh apple
Strategy: Fresh fruits and vegetables are low in sodium; processed and canned foods are typically high in
sodium.
9. The nurse is caring for a patient post-thyroidectomy. Which sign indicates a potential
complication?
a) Hypotension
b) Hoarseness and difficulty breathing
c) Increased appetite
d) Warm, flushed skin
Answer: b) Hoarseness and difficulty breathing
Strategy: These symptoms may indicate airway obstruction or recurrent laryngeal nerve damage, which is
an emergency.
10. SATA: Which of the following are appropriate actions when caring for a patient with
neutropenia?
a) Encourage visitors to wear masks
b) Restrict fresh fruits and vegetables
c) Administer antibiotics prophylactically
d) Use sterile technique for invasive procedures
e) Allow unwashed flowers in the room
Answer: a) Encourage visitors to wear masks, b) Restrict fresh fruits and vegetables, c) Administer
antibiotics prophylactically, d) Use sterile technique for invasive procedures
