2025 RN test 3 NCLEX questions
1. A college student visits the school's health center reporting extreme fatigue and slight
restlessness. The student states, "Exams are right around the corner, and all I feel like doing
is sleeping." There are no abnormal physical assessment findings. How does the nurse best
help the student frame their desire to sleep?
a. Asking the student if they are worried about failing exams
b. Telling them they must strive to sleep 7 to 9 hours nightly
c. Evaluating their use of recreational drugs
d. Explaining that some people use sleep as a coping mechanism - ANS-a. Fatigue and mild
anxiety are often handled without conscious thought through the use of coping mechanisms,
such as sleeping. These coping mechanisms are protective behaviors used to decrease
stress and anxiety.
\1. A group of nursing students in a leadership course are studying the ANA position
regarding assisted suicide. The professor asks the students for the best response to a note
written by a ventilator-dependent patient "help me end my suffering, I don't want to live
anymore." Which nursing response is consistent with the ANA's position?
a. "I will do everything possible to keep you comfortable but will not administer medication to
cause your death."
b. "Being removed from the ventilator is a form of active euthanasia, which is not supported
by the nurses' code of ethics."
c. After exhausting every intervention to keep a dying patient comfortable, the nurse says,
"Let's talk about when and how you want to die."
d. "I'm personally opposed to assisted suicide, but I'll find you a colleague who can help
you." - ANS-a. The ANA Code of Ethics states that the nurse "should provide interventions to
relieve pain and other symptoms in the dying patient consistent with palliative care practice
standards and may not act with the sole intent to end life" (2015, p. 3). Removing
mechanical ventilation or other life support at the patient's request or request of the
surrogate when treatment is futile is not performed with the sole intent to end life but to
promote dignity and comfort. Nurses should be prepared to respond to the request: "Nurse,
please help me die...."
\1. A home health care nurse has been caring for a patient with advanced AIDS who is
working through the stages of death and dying. The nurse documents the patient has
entered the acceptance phase of death when the patient makes which statement?
a. "I've made peace with everyone, and I'm actually ready to move on."
b. "God cannot possibly be good if He allows people to get this horrible disease."
c. "I just want to get better. A friend of mine had success with a plant-based diet."
d. "The test results must be mixed up with someone else's; I feel better now." - ANS-a.
According to Kübler-Ross, when the patient reaches the stage of acceptance, they feel
tranquil. This patient has accepted the reality of death and is prepared for the transition to
death.
\1. A hospice nurse who cared for a dying patient and their family documents that the family
is experiencing a period of mourning. Which behaviors would the nurse expect to see at this
stage? Select all that apply.
a. The family arranges for a funeral for their loved one.
,b. The family arranges for a memorial scholarship for their loved one.
c. The coroner pronounces the patient's death.
d. The family arranges for hospice for their loved one.
e. The patient is diagnosed with terminal cancer.
f. The patient's daughter writes a poem expressing her sorrow. - ANS-a, b, f. Mourning refers
to the actions and expressions of grief, including the symbols and ceremonies (e.g., a
funeral or final celebration of life) that make up the outward expressions of grief. It is a period
of grief and acceptance, as the person learns to deal with their loss. A diagnosis of cancer
and the coroner's pronouncing the patient's death are not behaviors of the family during a
period of mourning. Arranging for hospice care precedes a patient's death.
\1. A nurse at a health fair calculates the body mass index (BMI) of a person who weighs 68
kg and is 165 cm (1.65 m) tall. How will the nurse document the BMI?
a. 25 kg/m2
b. 46 kg/m2
c. 68 kg/m2
d. 165 kg/m2 - ANS-Example: Weight = 68 kg, height = 165 cm (1.65 m), Calculation: 68 ÷
(1.65)2 = 24.98
\1. A nurse at the university health clinic has assessed a student reporting an inability to
concentrate and a pounding heart. The student states, "my boyfriend just dumped me out of
the blue. They were supposed to be my date at my sister's wedding this weekend. How can I
go now?" Which response would the nurse make?
a. "Can you tell me what part of this is most problematic right now?"
b. "What alternatives can you think of at this late date?"
c. "You might start by evaluating your relationship."
"It may be best to not think about this person until after the wedding." - ANS-a. Although
identifying the problem may be difficult, a solution to a crisis situation is impossible until the
problem is identified.
\1. A nurse caring for an older adult living in a long-term care facility uses reminiscence to
help the patient adapt to the changes of aging. The nurse uses which question to encourage
reminiscence?
a. "Tell me about how you celebrated Christmas when you were young."
b. "Tell me how you plan to spend your time this weekend."
c. "Did you enjoy the choral group that performed here yesterday?
d. "Why don't you want to talk about your feelings?" - ANS-a. Use of life review or
reminiscence encourages reflection; the older adult can restructure life experiences and
better adapt to life circumstances. Asking about a recent event, upcoming plans, or feelings
would be unlikely to encourage reminiscence.
\1. A nurse caring for older adults in a provider's office researches aging theories to help
determine why some people age more rapidly than others. Which statements describe the
immunity theory of the aging process? Select all that apply.
a. Immunosenescence likely promotes the increase in infections in the older adult.
b. Free radicals have adverse effects on adjacent molecules.
c. Decreases in size and function of the thymus result in more infections.
d. Nutrition likely plays an important role in maintaining the immune response.
e. Lifespan depends to a great extent on genetic factors.
f. Organisms wear out from increased metabolic functioning. - ANS-a, c, d. The immunity
theory of aging focuses on the functions of the immune system and states that the immune
response declines steadily after younger adulthood as the thymus loses size and function,
,resulting in more infections. Vitamin supplements (such as vitamin E) may improve immune
function. The cross-linkage theory proposed that a chemical reaction produces damage to
the DNA and cell death. The free radical theory states that free radicals—molecules with
separated high-energy electrons—formed during cellular metabolism can have adverse
effects on adjacent molecules. The genetic theory of aging holds that lifespan depends to a
great extent on genetic factors. According to the wear-and-tear theory, organisms wear out
from increased metabolic functioning, and cells become exhausted from continual energy
depletion from adapting to stressors.
\1. A nurse in a long-term care facility is caring for patient with a spinal cord injury affecting
their sensory and motor reflexes below the waist. Based on the patient's condition, what
would be a priority intervention for this patient?
a. Taking care with hot beverages to prevent burns
b. Providing adequate pain relief measures to reduce stress
c. Monitoring for depression related to social isolation
d. Offering meals high in carbohydrates to promote healing - ANS-a. A patient with a
damaged neurologic reflex arc has a diminished pain reflex response. This diminished
sensation and motor response places the patient at risk for burns. All patients should be
provided adequate pain relief, but this is not a priority. Monitoring for depression would be an
intervention for this patient but is not related to the damaged neurologic reflex arc. A patient
who is immobile should eat a well-balanced diet.
\1. A nurse in a medical practice has assessed a patient reporting abdominal pain, diarrhea,
and anxiety. When the health care provider finds no identifiable cause for the symptoms,
which actions would the nurse recommend? Select all that apply.
a. Keeping a diary identifying sources of stress
b. Sleeping 4 hours per night
c. Considering previous strengths and coping
d. Asking whom the patient relies on for support
e. Asking if the patient's partner is abusive
f. Assessing for prior psychiatric conditions - ANS-a, c, d. The sympathetic nervous system
reacts to stress with the fight-or-flight response. This response causes increased the heart
rate, muscle strength, cardiac output, blood glucose levels, and mental alertness. Increased
peristalsis is brought on by the parasympathetic nervous system under normal conditions
and at rest.
\1. A nurse in a medical practice has assessed a patient reporting abdominal pain, diarrhea,
and anxiety. With no identifiable cause for the pain, which actions to reduce stress would the
nurse recommend? Select all that apply.
a. Keeping a diary identifying sources of stress
b. Sleeping 4 hours per night
c. Considering previous strengths and coping mechanisms
d. Asking whom the patient relies on for support
e. Asking if their partner is abusive
f. Assessing for prior psychiatric conditions - ANS-a, c, d. Keeping a diary of sources of
stress can help identify the problem, which is the first step in stress management. The nurse
can help the patient identify supports and their strengths. The nurse should recommend
sleeping 7 to 9 hours nightly. The nurse would not infer there is a problem of abuse or a
psychiatric condition as a cause of their symptoms. Abuse is assessed for routinely, often at
the start of the interview, but not in the context of this situation.
, \1. A nurse in a rehabilitation facility is evaluating patients with chronic pain to develop an
interprofessional plan of care. Which patients would the nurse identify who could benefit
from a multimodal approach to pain management? Select all that apply.
a. Patient receiving chemotherapy for bladder cancer
b. Adolescent who had an appendectomy
c. Patient who is experiencing a ruptured aneurysm
d. Patient with fibromyalgia requesting pain medication
e. Patient having back pain related to an accident that occurred last year
f. Patient experiencing pain from second-degree burns - ANS-a, d, e. Chronic pain is pain
that may be limited, intermittent, or persistent but that lasts beyond the normal healing
period. Examples are cancer pain, fibromyalgia pain, and back pain. Acute pain is generally
rapid in onset and varies in intensity from mild to severe, as occurs with an emergency
appendectomy, a ruptured aneurysm, and pain from burns.
\1. A nurse in the emergency department receives a patient rescued from a building fire. The
firefighter giving the handoff report tells the nurse the building collapsed immediately after
they removed the patient from the building. The nurse notes the patient is experiencing the
alarm phase of the fight-or-flight response. What assessment findings support the nurse's
observation? Select all that apply.
a. Rapid breathing
b. Hypotension
c. Restlessness
d. Withdrawn demeanor
e. Tachycardia - ANS-a, c, e. The sympathetic nervous system initiates the fight-or-flight
response, preparing the body to fight a stressor or run from it. This phase of the alarm
reaction, called the shock phase, is characterized by an increase in energy levels, oxygen
intake, cardiac output, blood pressure, and mental alertness. During the second phase,
called the countershock phase, there is a reversal of body changes. Hypotension and
withdrawn demeanor represent the countershock phase.
\1. A nurse in the intensive care unit is preparing a patient's family for terminal weaning from
mechanical ventilation. What nursing actions would facilitate this process? Select all that
apply.
a. Offering the family information about the advantages and disadvantages of continued
ventilatory support
b. Explaining to the family what will happen at each phase of the weaning and offer support
c. Validating orders for sedation and analgesia to promote comfort and dignity
d. Explaining that death occurs quickly after the patient is removed from the ventilator
e. Teaching the family that the decision for terminal weaning must be made by the primary
care provider
f. Arranging mandatory counseling for the patient and family to assist them in making this
end-of-life decision - ANS-a, b, c. A nurse's role in terminal weaning is to assist patients and
families in the decision-making process by offering helpful information about the benefits and
burdens of continued ventilation. The nurse teaches what to expect if terminal weaning is
initiated, including the use of sedation and analgesia for patient comfort. Supporting the
patient and family and managing sedation and analgesia are critical nursing responsibilities.
In some cases, competent patients decide that they want to discontinue their ventilatory
support; more often, the surrogate decision makers determine that continued ventilatory
support is futile. The nurse would not predict the time until death. Once removed from the
ventilator, a patient may not resume spontaneous breathing or may breathe on their own,
1. A college student visits the school's health center reporting extreme fatigue and slight
restlessness. The student states, "Exams are right around the corner, and all I feel like doing
is sleeping." There are no abnormal physical assessment findings. How does the nurse best
help the student frame their desire to sleep?
a. Asking the student if they are worried about failing exams
b. Telling them they must strive to sleep 7 to 9 hours nightly
c. Evaluating their use of recreational drugs
d. Explaining that some people use sleep as a coping mechanism - ANS-a. Fatigue and mild
anxiety are often handled without conscious thought through the use of coping mechanisms,
such as sleeping. These coping mechanisms are protective behaviors used to decrease
stress and anxiety.
\1. A group of nursing students in a leadership course are studying the ANA position
regarding assisted suicide. The professor asks the students for the best response to a note
written by a ventilator-dependent patient "help me end my suffering, I don't want to live
anymore." Which nursing response is consistent with the ANA's position?
a. "I will do everything possible to keep you comfortable but will not administer medication to
cause your death."
b. "Being removed from the ventilator is a form of active euthanasia, which is not supported
by the nurses' code of ethics."
c. After exhausting every intervention to keep a dying patient comfortable, the nurse says,
"Let's talk about when and how you want to die."
d. "I'm personally opposed to assisted suicide, but I'll find you a colleague who can help
you." - ANS-a. The ANA Code of Ethics states that the nurse "should provide interventions to
relieve pain and other symptoms in the dying patient consistent with palliative care practice
standards and may not act with the sole intent to end life" (2015, p. 3). Removing
mechanical ventilation or other life support at the patient's request or request of the
surrogate when treatment is futile is not performed with the sole intent to end life but to
promote dignity and comfort. Nurses should be prepared to respond to the request: "Nurse,
please help me die...."
\1. A home health care nurse has been caring for a patient with advanced AIDS who is
working through the stages of death and dying. The nurse documents the patient has
entered the acceptance phase of death when the patient makes which statement?
a. "I've made peace with everyone, and I'm actually ready to move on."
b. "God cannot possibly be good if He allows people to get this horrible disease."
c. "I just want to get better. A friend of mine had success with a plant-based diet."
d. "The test results must be mixed up with someone else's; I feel better now." - ANS-a.
According to Kübler-Ross, when the patient reaches the stage of acceptance, they feel
tranquil. This patient has accepted the reality of death and is prepared for the transition to
death.
\1. A hospice nurse who cared for a dying patient and their family documents that the family
is experiencing a period of mourning. Which behaviors would the nurse expect to see at this
stage? Select all that apply.
a. The family arranges for a funeral for their loved one.
,b. The family arranges for a memorial scholarship for their loved one.
c. The coroner pronounces the patient's death.
d. The family arranges for hospice for their loved one.
e. The patient is diagnosed with terminal cancer.
f. The patient's daughter writes a poem expressing her sorrow. - ANS-a, b, f. Mourning refers
to the actions and expressions of grief, including the symbols and ceremonies (e.g., a
funeral or final celebration of life) that make up the outward expressions of grief. It is a period
of grief and acceptance, as the person learns to deal with their loss. A diagnosis of cancer
and the coroner's pronouncing the patient's death are not behaviors of the family during a
period of mourning. Arranging for hospice care precedes a patient's death.
\1. A nurse at a health fair calculates the body mass index (BMI) of a person who weighs 68
kg and is 165 cm (1.65 m) tall. How will the nurse document the BMI?
a. 25 kg/m2
b. 46 kg/m2
c. 68 kg/m2
d. 165 kg/m2 - ANS-Example: Weight = 68 kg, height = 165 cm (1.65 m), Calculation: 68 ÷
(1.65)2 = 24.98
\1. A nurse at the university health clinic has assessed a student reporting an inability to
concentrate and a pounding heart. The student states, "my boyfriend just dumped me out of
the blue. They were supposed to be my date at my sister's wedding this weekend. How can I
go now?" Which response would the nurse make?
a. "Can you tell me what part of this is most problematic right now?"
b. "What alternatives can you think of at this late date?"
c. "You might start by evaluating your relationship."
"It may be best to not think about this person until after the wedding." - ANS-a. Although
identifying the problem may be difficult, a solution to a crisis situation is impossible until the
problem is identified.
\1. A nurse caring for an older adult living in a long-term care facility uses reminiscence to
help the patient adapt to the changes of aging. The nurse uses which question to encourage
reminiscence?
a. "Tell me about how you celebrated Christmas when you were young."
b. "Tell me how you plan to spend your time this weekend."
c. "Did you enjoy the choral group that performed here yesterday?
d. "Why don't you want to talk about your feelings?" - ANS-a. Use of life review or
reminiscence encourages reflection; the older adult can restructure life experiences and
better adapt to life circumstances. Asking about a recent event, upcoming plans, or feelings
would be unlikely to encourage reminiscence.
\1. A nurse caring for older adults in a provider's office researches aging theories to help
determine why some people age more rapidly than others. Which statements describe the
immunity theory of the aging process? Select all that apply.
a. Immunosenescence likely promotes the increase in infections in the older adult.
b. Free radicals have adverse effects on adjacent molecules.
c. Decreases in size and function of the thymus result in more infections.
d. Nutrition likely plays an important role in maintaining the immune response.
e. Lifespan depends to a great extent on genetic factors.
f. Organisms wear out from increased metabolic functioning. - ANS-a, c, d. The immunity
theory of aging focuses on the functions of the immune system and states that the immune
response declines steadily after younger adulthood as the thymus loses size and function,
,resulting in more infections. Vitamin supplements (such as vitamin E) may improve immune
function. The cross-linkage theory proposed that a chemical reaction produces damage to
the DNA and cell death. The free radical theory states that free radicals—molecules with
separated high-energy electrons—formed during cellular metabolism can have adverse
effects on adjacent molecules. The genetic theory of aging holds that lifespan depends to a
great extent on genetic factors. According to the wear-and-tear theory, organisms wear out
from increased metabolic functioning, and cells become exhausted from continual energy
depletion from adapting to stressors.
\1. A nurse in a long-term care facility is caring for patient with a spinal cord injury affecting
their sensory and motor reflexes below the waist. Based on the patient's condition, what
would be a priority intervention for this patient?
a. Taking care with hot beverages to prevent burns
b. Providing adequate pain relief measures to reduce stress
c. Monitoring for depression related to social isolation
d. Offering meals high in carbohydrates to promote healing - ANS-a. A patient with a
damaged neurologic reflex arc has a diminished pain reflex response. This diminished
sensation and motor response places the patient at risk for burns. All patients should be
provided adequate pain relief, but this is not a priority. Monitoring for depression would be an
intervention for this patient but is not related to the damaged neurologic reflex arc. A patient
who is immobile should eat a well-balanced diet.
\1. A nurse in a medical practice has assessed a patient reporting abdominal pain, diarrhea,
and anxiety. When the health care provider finds no identifiable cause for the symptoms,
which actions would the nurse recommend? Select all that apply.
a. Keeping a diary identifying sources of stress
b. Sleeping 4 hours per night
c. Considering previous strengths and coping
d. Asking whom the patient relies on for support
e. Asking if the patient's partner is abusive
f. Assessing for prior psychiatric conditions - ANS-a, c, d. The sympathetic nervous system
reacts to stress with the fight-or-flight response. This response causes increased the heart
rate, muscle strength, cardiac output, blood glucose levels, and mental alertness. Increased
peristalsis is brought on by the parasympathetic nervous system under normal conditions
and at rest.
\1. A nurse in a medical practice has assessed a patient reporting abdominal pain, diarrhea,
and anxiety. With no identifiable cause for the pain, which actions to reduce stress would the
nurse recommend? Select all that apply.
a. Keeping a diary identifying sources of stress
b. Sleeping 4 hours per night
c. Considering previous strengths and coping mechanisms
d. Asking whom the patient relies on for support
e. Asking if their partner is abusive
f. Assessing for prior psychiatric conditions - ANS-a, c, d. Keeping a diary of sources of
stress can help identify the problem, which is the first step in stress management. The nurse
can help the patient identify supports and their strengths. The nurse should recommend
sleeping 7 to 9 hours nightly. The nurse would not infer there is a problem of abuse or a
psychiatric condition as a cause of their symptoms. Abuse is assessed for routinely, often at
the start of the interview, but not in the context of this situation.
, \1. A nurse in a rehabilitation facility is evaluating patients with chronic pain to develop an
interprofessional plan of care. Which patients would the nurse identify who could benefit
from a multimodal approach to pain management? Select all that apply.
a. Patient receiving chemotherapy for bladder cancer
b. Adolescent who had an appendectomy
c. Patient who is experiencing a ruptured aneurysm
d. Patient with fibromyalgia requesting pain medication
e. Patient having back pain related to an accident that occurred last year
f. Patient experiencing pain from second-degree burns - ANS-a, d, e. Chronic pain is pain
that may be limited, intermittent, or persistent but that lasts beyond the normal healing
period. Examples are cancer pain, fibromyalgia pain, and back pain. Acute pain is generally
rapid in onset and varies in intensity from mild to severe, as occurs with an emergency
appendectomy, a ruptured aneurysm, and pain from burns.
\1. A nurse in the emergency department receives a patient rescued from a building fire. The
firefighter giving the handoff report tells the nurse the building collapsed immediately after
they removed the patient from the building. The nurse notes the patient is experiencing the
alarm phase of the fight-or-flight response. What assessment findings support the nurse's
observation? Select all that apply.
a. Rapid breathing
b. Hypotension
c. Restlessness
d. Withdrawn demeanor
e. Tachycardia - ANS-a, c, e. The sympathetic nervous system initiates the fight-or-flight
response, preparing the body to fight a stressor or run from it. This phase of the alarm
reaction, called the shock phase, is characterized by an increase in energy levels, oxygen
intake, cardiac output, blood pressure, and mental alertness. During the second phase,
called the countershock phase, there is a reversal of body changes. Hypotension and
withdrawn demeanor represent the countershock phase.
\1. A nurse in the intensive care unit is preparing a patient's family for terminal weaning from
mechanical ventilation. What nursing actions would facilitate this process? Select all that
apply.
a. Offering the family information about the advantages and disadvantages of continued
ventilatory support
b. Explaining to the family what will happen at each phase of the weaning and offer support
c. Validating orders for sedation and analgesia to promote comfort and dignity
d. Explaining that death occurs quickly after the patient is removed from the ventilator
e. Teaching the family that the decision for terminal weaning must be made by the primary
care provider
f. Arranging mandatory counseling for the patient and family to assist them in making this
end-of-life decision - ANS-a, b, c. A nurse's role in terminal weaning is to assist patients and
families in the decision-making process by offering helpful information about the benefits and
burdens of continued ventilation. The nurse teaches what to expect if terminal weaning is
initiated, including the use of sedation and analgesia for patient comfort. Supporting the
patient and family and managing sedation and analgesia are critical nursing responsibilities.
In some cases, competent patients decide that they want to discontinue their ventilatory
support; more often, the surrogate decision makers determine that continued ventilatory
support is futile. The nurse would not predict the time until death. Once removed from the
ventilator, a patient may not resume spontaneous breathing or may breathe on their own,
