Comprehensive NCLEX-RN Practice Exam #1
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1. During a community health assessment at a local school's parent-teacher
conference, the nurse encounters several parents and caregivers. Based on
their shared histories and lifestyles, the nurse determines the risk factors
for hypertension among them. Which of the following individuals is at the
HIGHEST risk for developing hypertension?: Correct Answer: A 45-year-old
African-American attorney with a family history of hypertension, who has a seden-
tary lifestyle and consumes a diet high in sodium.
African-American adults have a higher prevalence of hypertension compared to
other racial and ethnic groups in the United States. This individual also has a family
history of hypertension, a sedentary lifestyle, and a diet high in sodium, which are
all risk factors for hypertension. Therefore, this individual is at the greatest risk for
developing hypertension among the given choices.
2. A 15-year-old female with a history of depression is brought to the emer-
gency department.
Nurse's Notes:1115: A 15-year-old female with a history of depression and
recent relationship troubles with her close friends is brought to the emergency
department by her concerned parents after they found an empty bottle of
maximum-strength acetaminophen in her room. Upon questioning, the patient
tearfully admits to ingesting 15 tablets of the medication 45 minutes ago. She
is visibly anxious and frequently looks at the marks on her wrists, which seem
to be superficial scratches.
Vital signs as of 1115:
Blood pressure: 120/70
Heart rate: 88 bpm
Respiratory rate: 18 bpm
Oxygen saturation: 98% on room air
As the nurse prepares to address the situation, several orders from the
primary care provider come in. Which of the following orders should the
nurse prioritize and carry out first?: Correct Answer: Administer acetylcysteine
(Mucomyst) orally
Although gastric lavage can help remove any remaining acetaminophen from the
stomach, it is not the priority intervention in this situation. Administering the antidote,
acetylcysteine (Mucomyst), should be the primary focus to counteract the toxic
effects of acetaminophen on the liver. Acetylcysteine is the antidote for aceta-
minophen toxicity and should be administered as soon as possible to maximize its
effectiveness in preventing liver damage.
Related topics:
Acetaminophen Overdose
Acetaminophen Nursing Considerations
, Comprehensive NCLEX-RN Practice Exam #1
Study online at https://quizlet.com/_g53x1u
3. A 68-year-old male with a history of hypertension and diabetes has under-
gone a cardiac catheterization to evaluate potential coronary artery disease.
He has a known allergy to iodine-based contrast agents, which required
premedication with corticosteroids and antihistamines. The procedure was
successful, but the patient experienced brief hypotension during the admin-
istration of the contrast material. The patient has been transferred to the
cardiac step-down unit for observation, and the nurse is aware of the potential
complications that can arise in the initial 24 hours post-procedure. Which
complication should the nurse monitor closely during this period?: Correct
Answer: Thrombus formation leading to decreased peripheral pulses and cyanosis
In the initial 24 hours after a cardiac catheterization, the nurse should closely
monitor for thrombus formation. Thrombus formation at the catheterization site can
lead to serious complications, such as decreased blood flow to the extremities or
embolization to other parts of the body. While the other options (angina at rest,
dizziness, and falling blood pressure) can be potential concerns, thrombus formation
is the most critical complication to monitor for during the immediate post-procedure
period.
4. A 43-year-old male with a history of recurrent renal calculi is admitted to
the emergency department presenting with severe left flank pain radiating to
the groin, nausea, and an episode of vomiting. He also reports burning and ur-
gency during urination. His vital signs reveal a temperature of 100.8ºF (38.2ºC),
blood pressure of 145/90 mmHg, pulse of 100 beats/min, and respiratory rate
of 20 breaths/min. The client is visibly anxious and uncomfortable due to the
severity of the pain. The nurse is assigned to care for the patient and must
prioritize the nursing goals to ensure optimal care. Which nursing goal should
be the top priority for this client?: Correct Answer: Manage pain
Managing pain is always a priority because it ultimately improves the quality of life.
The cornerstone of ureteral colic management is analgesia, which can be achieved
most expediently with parenteral narcotics or nonsteroidal anti-inflammatory drugs
(NSAIDs).
5. During a school screening program for children aged 6-12, a nurse is tasked
with evaluating their growth parameters. She encounters a 9-year-old girl who
is shorter than her peers and seems to have less muscle development. To align
her observations with typical growth expectations for school-age children,
what would the nurse expect to see?: Correct Answer: Yearly weight gain of about
5.5 pounds per year
School-age children gain about 5.5 pounds each year and increase about 2 inches
in height. Between ages 2 to 10 years, a child will grow at a steady pace.
Study online at https://quizlet.com/_g53x1u
1. During a community health assessment at a local school's parent-teacher
conference, the nurse encounters several parents and caregivers. Based on
their shared histories and lifestyles, the nurse determines the risk factors
for hypertension among them. Which of the following individuals is at the
HIGHEST risk for developing hypertension?: Correct Answer: A 45-year-old
African-American attorney with a family history of hypertension, who has a seden-
tary lifestyle and consumes a diet high in sodium.
African-American adults have a higher prevalence of hypertension compared to
other racial and ethnic groups in the United States. This individual also has a family
history of hypertension, a sedentary lifestyle, and a diet high in sodium, which are
all risk factors for hypertension. Therefore, this individual is at the greatest risk for
developing hypertension among the given choices.
2. A 15-year-old female with a history of depression is brought to the emer-
gency department.
Nurse's Notes:1115: A 15-year-old female with a history of depression and
recent relationship troubles with her close friends is brought to the emergency
department by her concerned parents after they found an empty bottle of
maximum-strength acetaminophen in her room. Upon questioning, the patient
tearfully admits to ingesting 15 tablets of the medication 45 minutes ago. She
is visibly anxious and frequently looks at the marks on her wrists, which seem
to be superficial scratches.
Vital signs as of 1115:
Blood pressure: 120/70
Heart rate: 88 bpm
Respiratory rate: 18 bpm
Oxygen saturation: 98% on room air
As the nurse prepares to address the situation, several orders from the
primary care provider come in. Which of the following orders should the
nurse prioritize and carry out first?: Correct Answer: Administer acetylcysteine
(Mucomyst) orally
Although gastric lavage can help remove any remaining acetaminophen from the
stomach, it is not the priority intervention in this situation. Administering the antidote,
acetylcysteine (Mucomyst), should be the primary focus to counteract the toxic
effects of acetaminophen on the liver. Acetylcysteine is the antidote for aceta-
minophen toxicity and should be administered as soon as possible to maximize its
effectiveness in preventing liver damage.
Related topics:
Acetaminophen Overdose
Acetaminophen Nursing Considerations
, Comprehensive NCLEX-RN Practice Exam #1
Study online at https://quizlet.com/_g53x1u
3. A 68-year-old male with a history of hypertension and diabetes has under-
gone a cardiac catheterization to evaluate potential coronary artery disease.
He has a known allergy to iodine-based contrast agents, which required
premedication with corticosteroids and antihistamines. The procedure was
successful, but the patient experienced brief hypotension during the admin-
istration of the contrast material. The patient has been transferred to the
cardiac step-down unit for observation, and the nurse is aware of the potential
complications that can arise in the initial 24 hours post-procedure. Which
complication should the nurse monitor closely during this period?: Correct
Answer: Thrombus formation leading to decreased peripheral pulses and cyanosis
In the initial 24 hours after a cardiac catheterization, the nurse should closely
monitor for thrombus formation. Thrombus formation at the catheterization site can
lead to serious complications, such as decreased blood flow to the extremities or
embolization to other parts of the body. While the other options (angina at rest,
dizziness, and falling blood pressure) can be potential concerns, thrombus formation
is the most critical complication to monitor for during the immediate post-procedure
period.
4. A 43-year-old male with a history of recurrent renal calculi is admitted to
the emergency department presenting with severe left flank pain radiating to
the groin, nausea, and an episode of vomiting. He also reports burning and ur-
gency during urination. His vital signs reveal a temperature of 100.8ºF (38.2ºC),
blood pressure of 145/90 mmHg, pulse of 100 beats/min, and respiratory rate
of 20 breaths/min. The client is visibly anxious and uncomfortable due to the
severity of the pain. The nurse is assigned to care for the patient and must
prioritize the nursing goals to ensure optimal care. Which nursing goal should
be the top priority for this client?: Correct Answer: Manage pain
Managing pain is always a priority because it ultimately improves the quality of life.
The cornerstone of ureteral colic management is analgesia, which can be achieved
most expediently with parenteral narcotics or nonsteroidal anti-inflammatory drugs
(NSAIDs).
5. During a school screening program for children aged 6-12, a nurse is tasked
with evaluating their growth parameters. She encounters a 9-year-old girl who
is shorter than her peers and seems to have less muscle development. To align
her observations with typical growth expectations for school-age children,
what would the nurse expect to see?: Correct Answer: Yearly weight gain of about
5.5 pounds per year
School-age children gain about 5.5 pounds each year and increase about 2 inches
in height. Between ages 2 to 10 years, a child will grow at a steady pace.
