# Evolve NCLEX Nursing
Sciences – Latest Edition
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**01.** A nurse is caring for a client who has a prescription for furosemide. Which laboratory value
should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
🔍 RATIONALE💡-- Furosemide is a loop diuretic that causes excretion of potassium, leading to
hypokalemia. Hypokalemia can cause cardiac dysrhythmias and should be monitored closely.
ANSWER💫✔️-- B) Serum potassium
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**02.** A nurse is providing discharge teaching to a client with a new prescription for warfarin. Which
statement by the client indicates understanding?
A) “I will take ibuprofen for headaches.”
B) “I will have my INR checked regularly.”
C) “I will eat more leafy green vegetables.”
D) “I will stop warfarin if I see bruising.”
,🔍 RATIONALE💡-- Warfarin requires regular INR monitoring to maintain therapeutic range (2‑3).
Ibuprofen increases bleeding risk. Consistent vitamin K intake is important, not increased. Bruising is
expected, not a reason to stop.
ANSWER💫✔️-- B) “I will have my INR checked regularly.”
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**03.** A nurse is assessing a client who is 2 hours post‑operative following a thyroidectomy. Which
finding requires immediate intervention?
A) Hoarse voice
B) Serosanguineous drainage on dressing
C) Tingling around the mouth
D) Pain rated 4 on a 0‑10 scale
🔍 RATIONALE💡-- Tingling around the mouth indicates hypocalcemia from accidental parathyroid
injury, which can lead to laryngeal spasm and respiratory arrest. Hoarse voice is expected from
intubation.
ANSWER💫✔️-- C) Tingling around the mouth
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**04.** A nurse is caring for a client with a chest tube connected to a water‑seal drainage system. The
nurse notes continuous bubbling in the water seal chamber. Which action should the nurse take?
A) Clamp the chest tube near the insertion site
B) Increase the suction pressure
C) Check the system for an air leak
D) Document the finding as normal
,🔍 RATIONALE💡-- Continuous bubbling indicates an air leak. The nurse should check all connections for
loose fittings. Clamping can cause tension pneumothorax. Tidaling, not bubbling, is normal.
ANSWER💫✔️-- C) Check the system for an air leak
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**05.** A nurse is preparing to administer a blood transfusion. Which IV solution should be used to
prime the tubing?
A) Lactated Ringer’s solution
B) 5% dextrose in water
C) 0.9% sodium chloride
D) 0.45% sodium chloride
🔍 RATIONALE💡-- Only normal saline (0.9% NaCl) is compatible with blood products; dextrose can cause
hemolysis, and other solutions may cause clotting.
ANSWER💫✔️-- C) 0.9% sodium chloride
---
**06.** A nurse is caring for a client who is receiving total parenteral nutrition (TPN) through a central
line. Which finding requires immediate action?
A) Blood glucose 150 mg/dL
B) Temperature 38.9°C (102°F)
C) Weight gain 0.5 kg in 24 hours
D) TPN bag that will run out in 2 hours
🔍 RATIONALE💡-- Fever suggests catheter‑related bloodstream infection, which can rapidly progress to
sepsis. Notify provider immediately.
, ANSWER💫✔️-- B) Temperature 38.9°C (102°F)
---
**07.** A nurse is teaching a client with a new diagnosis of type 1 diabetes about insulin administration.
Which site has the fastest absorption?
A) Thigh
B) Abdomen
C) Deltoid
D) Buttock
🔍 RATIONALE💡-- The abdomen has the fastest and most consistent insulin absorption due to higher
blood flow and less variable adipose tissue.
ANSWER💫✔️-- B) Abdomen
---
**08.** A nurse is assessing a client with a potassium level of 6.0 mEq/L. Which ECG change is
expected?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Prolonged QT interval
🔍 RATIONALE💡-- Hyperkalemia causes peaked (tented) T waves. Flattened T waves and U waves are
seen in hypokalemia.
ANSWER💫✔️-- C) Peaked T waves
Sciences – Latest Edition
---
**01.** A nurse is caring for a client who has a prescription for furosemide. Which laboratory value
should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
🔍 RATIONALE💡-- Furosemide is a loop diuretic that causes excretion of potassium, leading to
hypokalemia. Hypokalemia can cause cardiac dysrhythmias and should be monitored closely.
ANSWER💫✔️-- B) Serum potassium
---
**02.** A nurse is providing discharge teaching to a client with a new prescription for warfarin. Which
statement by the client indicates understanding?
A) “I will take ibuprofen for headaches.”
B) “I will have my INR checked regularly.”
C) “I will eat more leafy green vegetables.”
D) “I will stop warfarin if I see bruising.”
,🔍 RATIONALE💡-- Warfarin requires regular INR monitoring to maintain therapeutic range (2‑3).
Ibuprofen increases bleeding risk. Consistent vitamin K intake is important, not increased. Bruising is
expected, not a reason to stop.
ANSWER💫✔️-- B) “I will have my INR checked regularly.”
---
**03.** A nurse is assessing a client who is 2 hours post‑operative following a thyroidectomy. Which
finding requires immediate intervention?
A) Hoarse voice
B) Serosanguineous drainage on dressing
C) Tingling around the mouth
D) Pain rated 4 on a 0‑10 scale
🔍 RATIONALE💡-- Tingling around the mouth indicates hypocalcemia from accidental parathyroid
injury, which can lead to laryngeal spasm and respiratory arrest. Hoarse voice is expected from
intubation.
ANSWER💫✔️-- C) Tingling around the mouth
---
**04.** A nurse is caring for a client with a chest tube connected to a water‑seal drainage system. The
nurse notes continuous bubbling in the water seal chamber. Which action should the nurse take?
A) Clamp the chest tube near the insertion site
B) Increase the suction pressure
C) Check the system for an air leak
D) Document the finding as normal
,🔍 RATIONALE💡-- Continuous bubbling indicates an air leak. The nurse should check all connections for
loose fittings. Clamping can cause tension pneumothorax. Tidaling, not bubbling, is normal.
ANSWER💫✔️-- C) Check the system for an air leak
---
**05.** A nurse is preparing to administer a blood transfusion. Which IV solution should be used to
prime the tubing?
A) Lactated Ringer’s solution
B) 5% dextrose in water
C) 0.9% sodium chloride
D) 0.45% sodium chloride
🔍 RATIONALE💡-- Only normal saline (0.9% NaCl) is compatible with blood products; dextrose can cause
hemolysis, and other solutions may cause clotting.
ANSWER💫✔️-- C) 0.9% sodium chloride
---
**06.** A nurse is caring for a client who is receiving total parenteral nutrition (TPN) through a central
line. Which finding requires immediate action?
A) Blood glucose 150 mg/dL
B) Temperature 38.9°C (102°F)
C) Weight gain 0.5 kg in 24 hours
D) TPN bag that will run out in 2 hours
🔍 RATIONALE💡-- Fever suggests catheter‑related bloodstream infection, which can rapidly progress to
sepsis. Notify provider immediately.
, ANSWER💫✔️-- B) Temperature 38.9°C (102°F)
---
**07.** A nurse is teaching a client with a new diagnosis of type 1 diabetes about insulin administration.
Which site has the fastest absorption?
A) Thigh
B) Abdomen
C) Deltoid
D) Buttock
🔍 RATIONALE💡-- The abdomen has the fastest and most consistent insulin absorption due to higher
blood flow and less variable adipose tissue.
ANSWER💫✔️-- B) Abdomen
---
**08.** A nurse is assessing a client with a potassium level of 6.0 mEq/L. Which ECG change is
expected?
A) Flattened T waves
B) Prominent U waves
C) Peaked T waves
D) Prolonged QT interval
🔍 RATIONALE💡-- Hyperkalemia causes peaked (tented) T waves. Flattened T waves and U waves are
seen in hypokalemia.
ANSWER💫✔️-- C) Peaked T waves
