Saunders Comprehensive
Review for the NCLEX-RN
Examination 9th Edition
1. Physiological Integrity - Cardiovascular System
Question: A client with heart failure is prescribed furosemide (Lasix). The nurse
should monitor for which adverse effect?
A. Hyperkalemia
B. Hypotension
C. Bradycardia
D. Hypertension
Answer: B. Hypotension
Rationale: Furosemide is a loop diuretic that causes fluid loss, which can lead to
dehydration and hypotension.
2. Safe and Effective Care Environment - Prioritization
Question: A nurse receives shift report on four clients. Which client should the nurse
see first?
A. A client who is 2 hours post-appendectomy and reports mild pain.
B. A client with pneumonia who has a respiratory rate of 28 breaths per minute.
C. A client scheduled for a procedure in 30 minutes.
D. A client with a pressure ulcer requiring a dressing change.
Answer: B. A client with pneumonia who has a respiratory rate of 28 breaths per
minute.
Rationale: A respiratory rate of 28 is abnormal and indicates respiratory distress,
requiring immediate attention.
3. Health Promotion and Maintenance - Antepartum Care
,Question: A pregnant client at 12 weeks gestation reports nausea and vomiting.
What is the best recommendation by the nurse?
A. "Eat small, frequent meals throughout the day."
B. "Increase your intake of spicy foods."
C. "Drink a glass of water before eating."
D. "Skip meals to minimize nausea."
Answer: A. "Eat small, frequent meals throughout the day."
Rationale: Eating small, frequent meals helps reduce nausea during pregnancy by
preventing an empty stomach.
4. Psychosocial Integrity - Mental Health
Question: A client with schizophrenia states, "The government is controlling my
mind." What is the most appropriate response by the nurse?
A. "That’s not true. No one is controlling your mind."
B. "I understand that this is very real for you."
C. "Why do you think the government is involved?"
D. "You need to stop thinking like that."
Answer: B. "I understand that this is very real for you."
Rationale: This response acknowledges the client’s feelings without reinforcing or
denying the delusion.
5. Physiological Integrity - Fluid and Electrolyte Balance
Question: A nurse is caring for a client with a serum potassium level of 6.5 mEq/L.
Which intervention should the nurse anticipate?
A. Administering potassium chloride IV.
B. Administering sodium polystyrene sulfonate (Kayexalate).
C. Encouraging intake of potassium-rich foods.
D. Restricting calcium intake.
Answer: B. Administering sodium polystyrene sulfonate (Kayexalate).
,Rationale: Sodium polystyrene sulfonate helps to lower potassium levels by
removing potassium from the body.6. Physiological Integrity – Neurological System
Question: A nurse is caring for a client with increased intracranial pressure (ICP).
Which intervention should the nurse include in the plan of care?
A. Elevate the head of the bed to 30 degrees.
B. Encourage coughing and deep breathing.
C. Position the client in the Trendelenburg position.
D. Administer intravenous fluids rapidly.
Answer: A. Elevate the head of the bed to 30 degrees.
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage
and decreases ICP.
7. Health Promotion and Maintenance – Growth and Development
Question: The nurse is assessing a 12-month-old child during a well-baby visit. Which
milestone should the nurse expect to observe?
A. The child can say two to three words.
B. The child can ride a tricycle.
C. The child can tie their shoelaces.
D. The child can use scissors to cut paper.
Answer: A. The child can say two to three words.
Rationale: By 12 months, a child typically says 2-3 words besides "mama" and
"dada."
8. Safe and Effective Care Environment – Delegation
Question: Which task is appropriate for the nurse to delegate to a licensed practical
nurse (LPN)?
A. Assessing a client admitted with chest pain.
B. Developing a discharge teaching plan for a client.
C. Administering oral medications to stable clients.
D. Evaluating a client's response to pain medication.
, Answer: C. Administering oral medications to stable clients.
Rationale: LPNs can administer oral medications to stable clients under the
supervision of an RN.
9. Physiological Integrity – Pharmacology
Question: A client with atrial fibrillation is receiving warfarin (Coumadin). Which
laboratory value does the nurse monitor to evaluate the medication’s effectiveness?
A. Activated partial thromboplastin time (aPTT).
B. International normalized ratio (INR).
C. Platelet count.
D. Hemoglobin level.
Answer: B. International normalized ratio (INR).
Rationale: The INR is used to monitor the therapeutic effectiveness of warfarin. A
target range is typically 2-3.
10. Psychosocial Integrity – Therapeutic Communication
Question: A client who recently lost a child states, "I don’t know how I will go on
without my baby." What is the nurse’s best response?
A. "Try to stay strong for the rest of your family."
B. "You’ll start to feel better in a few weeks."
C. "It’s hard to imagine the pain you’re feeling right now."
D. "You need to move forward and stay positive."
Answer: C. "It’s hard to imagine the pain you’re feeling right now."
Rationale: This response reflects empathy and allows the client to express emotions
without judgment.
11. Safe and Effective Care Environment – Infection Control
Question: A nurse is caring for a client diagnosed with tuberculosis (TB). Which
infection control precautions should the nurse implement?
Review for the NCLEX-RN
Examination 9th Edition
1. Physiological Integrity - Cardiovascular System
Question: A client with heart failure is prescribed furosemide (Lasix). The nurse
should monitor for which adverse effect?
A. Hyperkalemia
B. Hypotension
C. Bradycardia
D. Hypertension
Answer: B. Hypotension
Rationale: Furosemide is a loop diuretic that causes fluid loss, which can lead to
dehydration and hypotension.
2. Safe and Effective Care Environment - Prioritization
Question: A nurse receives shift report on four clients. Which client should the nurse
see first?
A. A client who is 2 hours post-appendectomy and reports mild pain.
B. A client with pneumonia who has a respiratory rate of 28 breaths per minute.
C. A client scheduled for a procedure in 30 minutes.
D. A client with a pressure ulcer requiring a dressing change.
Answer: B. A client with pneumonia who has a respiratory rate of 28 breaths per
minute.
Rationale: A respiratory rate of 28 is abnormal and indicates respiratory distress,
requiring immediate attention.
3. Health Promotion and Maintenance - Antepartum Care
,Question: A pregnant client at 12 weeks gestation reports nausea and vomiting.
What is the best recommendation by the nurse?
A. "Eat small, frequent meals throughout the day."
B. "Increase your intake of spicy foods."
C. "Drink a glass of water before eating."
D. "Skip meals to minimize nausea."
Answer: A. "Eat small, frequent meals throughout the day."
Rationale: Eating small, frequent meals helps reduce nausea during pregnancy by
preventing an empty stomach.
4. Psychosocial Integrity - Mental Health
Question: A client with schizophrenia states, "The government is controlling my
mind." What is the most appropriate response by the nurse?
A. "That’s not true. No one is controlling your mind."
B. "I understand that this is very real for you."
C. "Why do you think the government is involved?"
D. "You need to stop thinking like that."
Answer: B. "I understand that this is very real for you."
Rationale: This response acknowledges the client’s feelings without reinforcing or
denying the delusion.
5. Physiological Integrity - Fluid and Electrolyte Balance
Question: A nurse is caring for a client with a serum potassium level of 6.5 mEq/L.
Which intervention should the nurse anticipate?
A. Administering potassium chloride IV.
B. Administering sodium polystyrene sulfonate (Kayexalate).
C. Encouraging intake of potassium-rich foods.
D. Restricting calcium intake.
Answer: B. Administering sodium polystyrene sulfonate (Kayexalate).
,Rationale: Sodium polystyrene sulfonate helps to lower potassium levels by
removing potassium from the body.6. Physiological Integrity – Neurological System
Question: A nurse is caring for a client with increased intracranial pressure (ICP).
Which intervention should the nurse include in the plan of care?
A. Elevate the head of the bed to 30 degrees.
B. Encourage coughing and deep breathing.
C. Position the client in the Trendelenburg position.
D. Administer intravenous fluids rapidly.
Answer: A. Elevate the head of the bed to 30 degrees.
Rationale: Elevating the head of the bed to 30 degrees promotes venous drainage
and decreases ICP.
7. Health Promotion and Maintenance – Growth and Development
Question: The nurse is assessing a 12-month-old child during a well-baby visit. Which
milestone should the nurse expect to observe?
A. The child can say two to three words.
B. The child can ride a tricycle.
C. The child can tie their shoelaces.
D. The child can use scissors to cut paper.
Answer: A. The child can say two to three words.
Rationale: By 12 months, a child typically says 2-3 words besides "mama" and
"dada."
8. Safe and Effective Care Environment – Delegation
Question: Which task is appropriate for the nurse to delegate to a licensed practical
nurse (LPN)?
A. Assessing a client admitted with chest pain.
B. Developing a discharge teaching plan for a client.
C. Administering oral medications to stable clients.
D. Evaluating a client's response to pain medication.
, Answer: C. Administering oral medications to stable clients.
Rationale: LPNs can administer oral medications to stable clients under the
supervision of an RN.
9. Physiological Integrity – Pharmacology
Question: A client with atrial fibrillation is receiving warfarin (Coumadin). Which
laboratory value does the nurse monitor to evaluate the medication’s effectiveness?
A. Activated partial thromboplastin time (aPTT).
B. International normalized ratio (INR).
C. Platelet count.
D. Hemoglobin level.
Answer: B. International normalized ratio (INR).
Rationale: The INR is used to monitor the therapeutic effectiveness of warfarin. A
target range is typically 2-3.
10. Psychosocial Integrity – Therapeutic Communication
Question: A client who recently lost a child states, "I don’t know how I will go on
without my baby." What is the nurse’s best response?
A. "Try to stay strong for the rest of your family."
B. "You’ll start to feel better in a few weeks."
C. "It’s hard to imagine the pain you’re feeling right now."
D. "You need to move forward and stay positive."
Answer: C. "It’s hard to imagine the pain you’re feeling right now."
Rationale: This response reflects empathy and allows the client to express emotions
without judgment.
11. Safe and Effective Care Environment – Infection Control
Question: A nurse is caring for a client diagnosed with tuberculosis (TB). Which
infection control precautions should the nurse implement?
