2025 Comprehensive NCLEXRN & Nursing Entrance Exam: 300+
Questions and Answers with Rationales
Question 1
A nurse is caring for a client who has just been started on warfarin therapy. Which laboratory test
should the nurse monitor to evaluate the effectiveness of the medication?
A) Activated partial thromboplastin time (aPTT)
B) Prothrombin time (PT)
C) Platelet count
D) Bleeding time
Answer: B) Prothrombin time (PT)
Rationale: Warfarin affects the clotting factors measured by PT and INR, which are used to monitor
its anticoagulant effect. aPTT is used for heparin monitoring.
Question 2
A client with chronic obstructive pulmonary disease (COPD) is experiencing increased shortness of
breath and wheezing. Which of the following medications should the nurse expect to administer first?
A) Inhaled corticosteroids
B) Shortacting beta2 agonist (SABA)
C) Oral antibiotics
D) Longacting beta2 agonist (LABA)
Answer: B) Shortacting beta2 agonist (SABA)
Rationale: SABAs provide rapid bronchodilation and are the firstline treatment for acute
exacerbations of COPD symptoms.
Question 3
A nurse is teaching a client about insulin administration. Which statement by the client indicates a
need for further teaching?
A) “I will rotate injection sites to prevent lipodystrophy.”
B) “I should inject insulin into the muscle for faster absorption.”
C) “I will check my blood sugar before meals.”
D) “I will store unopened insulin in the refrigerator.”
,Answer: B) “I should inject insulin into the muscle for faster absorption.”
Rationale: Insulin should be injected subcutaneously, not intramuscularly, to ensure proper
absorption and avoid injury.
Question 4
Which of the following is the priority nursing action when a client suddenly develops chest pain and
shortness of breath?
A) Administer prescribed nitroglycerin
B) Obtain vital signs
C) Place the client in a high Fowler’s position
D) Call the healthcare provider
Answer: C) Place the client in a high Fowler’s position
Rationale: High Fowler’s position promotes maximal lung expansion and eases breathing, which is
the immediate priority before other interventions.
Question 5
A client is prescribed digoxin. Which symptom should the nurse instruct the client to report
immediately?
A) Blurred vision and yellow halos
B) Mild nausea after meals
C) Increased urination
D) Mild headache
Answer: A) Blurred vision and yellow halos
Rationale: Visual disturbances such as blurred vision and yellow halos are signs of digoxin toxicity
and require immediate medical attention.
Question 6
A nurse is caring for a client with acute pancreatitis. Which of the following laboratory findings is
most indicative of this condition?
A) Elevated serum amylase and lipase
B) Decreased white blood cell count
C) Elevated blood glucose
D) Decreased serum calcium
,Answer: A) Elevated serum amylase and lipase
Rationale: Elevated amylase and lipase are key enzymes released during pancreatic inflammation and
are diagnostic markers for acute pancreatitis.
Question 7
A client is receiving morphine sulfate for postoperative pain. Which of the following is the priority
nursing assessment?
A) Level of sedation
B) Blood pressure
C) Respiratory rate
D) Urine output
Answer: C) Respiratory rate
Rationale: Morphine can cause respiratory depression; monitoring respiratory rate is critical to
ensure patient safety.
Question 8
Which of the following foods should a nurse recommend to a client with irondeficiency anemia to
increase iron intake?
A) Spinach and red meat
B) Bananas and oranges
C) Milk and cheese
D) White bread and pasta
Answer: A) Spinach and red meat
Rationale: Spinach and red meat are rich in iron, which helps replenish iron stores in clients with
irondeficiency anemia.
Question 9
A nurse is teaching a client about the use of a metereddose inhaler (MDI). Which instruction should
the nurse include?
A) “Shake the inhaler well before each use.”
B) “Exhale forcefully immediately after inhaling the medication.”
C) “Hold your breath for 5 seconds after inhaling the medication.”
D) “Use the inhaler only when you have symptoms.”
, Answer: A) “Shake the inhaler well before each use.”
Rationale: Shaking the inhaler ensures the medication is properly mixed for effective delivery; clients
should hold their breath for about 10 seconds after inhalation.
Question 10
A client with congestive heart failure is prescribed furosemide. Which electrolyte imbalance should
the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, increasing the risk of
hypokalemia.
Question 11
A nurse is caring for a client with heart failure who is receiving digoxin. Which symptom indicates
digoxin toxicity?
A) Bradycardia
B) Diarrhea
C) Blurred vision and yellow halos
D) Hypertension
Answer: C) Blurred vision and yellow halos
Rationale: Visual disturbances like yellow halos are classic signs of digoxin toxicity.
Question 12
Which action should a nurse take when administering a blood transfusion?
A) Use a 25gauge needle for infusion
B) Verify the blood type with another nurse before starting
C) Administer blood over 6 hours
D) Warm the blood before transfusion
Answer: B) Verify the blood type with another nurse before starting
Questions and Answers with Rationales
Question 1
A nurse is caring for a client who has just been started on warfarin therapy. Which laboratory test
should the nurse monitor to evaluate the effectiveness of the medication?
A) Activated partial thromboplastin time (aPTT)
B) Prothrombin time (PT)
C) Platelet count
D) Bleeding time
Answer: B) Prothrombin time (PT)
Rationale: Warfarin affects the clotting factors measured by PT and INR, which are used to monitor
its anticoagulant effect. aPTT is used for heparin monitoring.
Question 2
A client with chronic obstructive pulmonary disease (COPD) is experiencing increased shortness of
breath and wheezing. Which of the following medications should the nurse expect to administer first?
A) Inhaled corticosteroids
B) Shortacting beta2 agonist (SABA)
C) Oral antibiotics
D) Longacting beta2 agonist (LABA)
Answer: B) Shortacting beta2 agonist (SABA)
Rationale: SABAs provide rapid bronchodilation and are the firstline treatment for acute
exacerbations of COPD symptoms.
Question 3
A nurse is teaching a client about insulin administration. Which statement by the client indicates a
need for further teaching?
A) “I will rotate injection sites to prevent lipodystrophy.”
B) “I should inject insulin into the muscle for faster absorption.”
C) “I will check my blood sugar before meals.”
D) “I will store unopened insulin in the refrigerator.”
,Answer: B) “I should inject insulin into the muscle for faster absorption.”
Rationale: Insulin should be injected subcutaneously, not intramuscularly, to ensure proper
absorption and avoid injury.
Question 4
Which of the following is the priority nursing action when a client suddenly develops chest pain and
shortness of breath?
A) Administer prescribed nitroglycerin
B) Obtain vital signs
C) Place the client in a high Fowler’s position
D) Call the healthcare provider
Answer: C) Place the client in a high Fowler’s position
Rationale: High Fowler’s position promotes maximal lung expansion and eases breathing, which is
the immediate priority before other interventions.
Question 5
A client is prescribed digoxin. Which symptom should the nurse instruct the client to report
immediately?
A) Blurred vision and yellow halos
B) Mild nausea after meals
C) Increased urination
D) Mild headache
Answer: A) Blurred vision and yellow halos
Rationale: Visual disturbances such as blurred vision and yellow halos are signs of digoxin toxicity
and require immediate medical attention.
Question 6
A nurse is caring for a client with acute pancreatitis. Which of the following laboratory findings is
most indicative of this condition?
A) Elevated serum amylase and lipase
B) Decreased white blood cell count
C) Elevated blood glucose
D) Decreased serum calcium
,Answer: A) Elevated serum amylase and lipase
Rationale: Elevated amylase and lipase are key enzymes released during pancreatic inflammation and
are diagnostic markers for acute pancreatitis.
Question 7
A client is receiving morphine sulfate for postoperative pain. Which of the following is the priority
nursing assessment?
A) Level of sedation
B) Blood pressure
C) Respiratory rate
D) Urine output
Answer: C) Respiratory rate
Rationale: Morphine can cause respiratory depression; monitoring respiratory rate is critical to
ensure patient safety.
Question 8
Which of the following foods should a nurse recommend to a client with irondeficiency anemia to
increase iron intake?
A) Spinach and red meat
B) Bananas and oranges
C) Milk and cheese
D) White bread and pasta
Answer: A) Spinach and red meat
Rationale: Spinach and red meat are rich in iron, which helps replenish iron stores in clients with
irondeficiency anemia.
Question 9
A nurse is teaching a client about the use of a metereddose inhaler (MDI). Which instruction should
the nurse include?
A) “Shake the inhaler well before each use.”
B) “Exhale forcefully immediately after inhaling the medication.”
C) “Hold your breath for 5 seconds after inhaling the medication.”
D) “Use the inhaler only when you have symptoms.”
, Answer: A) “Shake the inhaler well before each use.”
Rationale: Shaking the inhaler ensures the medication is properly mixed for effective delivery; clients
should hold their breath for about 10 seconds after inhalation.
Question 10
A client with congestive heart failure is prescribed furosemide. Which electrolyte imbalance should
the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, increasing the risk of
hypokalemia.
Question 11
A nurse is caring for a client with heart failure who is receiving digoxin. Which symptom indicates
digoxin toxicity?
A) Bradycardia
B) Diarrhea
C) Blurred vision and yellow halos
D) Hypertension
Answer: C) Blurred vision and yellow halos
Rationale: Visual disturbances like yellow halos are classic signs of digoxin toxicity.
Question 12
Which action should a nurse take when administering a blood transfusion?
A) Use a 25gauge needle for infusion
B) Verify the blood type with another nurse before starting
C) Administer blood over 6 hours
D) Warm the blood before transfusion
Answer: B) Verify the blood type with another nurse before starting
