NGN/NCLEX PREP EXAM 2025
QUESTIONS AND ANSWERS
The nurse notes the presence of a P wave, QRS complex, flattened T waves, and occasional U
waves on a client's cardiac monitor screen. Fill in the correct missing information by choosing
from the lists of options in the drop-down menus. - ANS The nurse should suspect
Your Answer: hypokalemiaCorrect Answer: hypokalemia
because of the
Your Answer: flattened T waves and occasional U wavesCorrect Answer: flattened T waves and
occasional U waves
Rationale:Cardiac changes in hypokalemia include impaired repolarization, resulting in a
flattening of the T wave and eventually the emergence of a U wave. Therefore, the nurse
should suspect hypokalemia. The incidence of potentially lethal ventricular dysrhythmias is
increased in hypokalemia. The nurse should immediately assess the client's vital signs and
cardiac status for signs of hypokalemia. The nurse should also check the client's most recent
serum potassium level and then contact the primary health care provider to report the findings
and obtain prescriptions to treat the hypokalemic state.
The nurse is preparing a client for a chest x-ray and notes that the client is wearing a religious
medal on a chain around the neck. What should the nurse do with regard to this personal item?
Click to highlight the correct answer from the options provided. - ANS The nurse should:
(Select 1 option)
✓Ask the client if the chain and medal can be removed during the procedure.
Because: (Select 1 option)
✓The chain and medal may have cultural significance.
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,Rationale:Before certain diagnostic procedures, it is typical to have a client remove personal
objects that are worn on the body because of client safety and the possibility of compromising
test results. Therefore, the nurse should ask the client about the significance of such an item
and its removal because it may have cultural or spiritual significance. If so, the nurse should ask
the client if the item can be either removed temporarily or placed on another part of the body
during the procedure if appropriate.
While preparing a client for surgery scheduled in 1 hour, the client states to the nurse: "I have
changed my mind. I don't want this surgery." Click to highlight the correct answer from the
options provided. - ANS The nurse should: (Select 1 option)
Cancel the surgery.
Contact the surgeon.
✓Discuss the client's concerns.
Call the identified support person.
Because: (Select 1 option)
Client consent is required prior to any procedure.
✓Further questions or concerns should be determined and addressed.
Ethical considerations are important for a client undergoing surgery.
The nursing scope of practice places limitations on how the nurse can respond.
Rationale:If the client indicates that he or she does not want a prescribed therapy, treatment,
or procedure such as surgery, the nurse should further investigate the client's request. If the
client indicates that he or she has changed his or her mind about surgery, the nurse should
assess the client and explore with the client his or her concerns about not wanting the surgery.
The nurse would then withhold further surgical preparation and contact the surgeon to report
the client's request so that the surgeon can discuss the consequences of not having the surgery
with the client. Further assessment and follow-up related to the client's request need to be
done. It is the client's right to refuse treatment; however, further investigation is needed so the
interventions can be tailored to specific needs.
The nurse notes that there has been an increase in the number of intravenous (IV) site
infections that developed in the clients being cared for on the nursing unit. How should the
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, nurse proceed to implement a quality improvement program?For each action, click to specify
whether the action would be:
Indicated: an action that the nurse should take to resolve the problem
Non-essential: an action that the nurse could take without harming the client, but the action
would not be likely to address the problem
Contraindicated: an action that could harm the client and should not be taken - ANS Collect
identifying patient information
Contraindicated
Note the mental status of the client
Non-essential
Note primary and secondary diagnoses of clients affected
Indicated
Note the type of IV catheter used
Indicated
Note the type of IV site dressings being used
Indicated
Note the medication types being infused
Non-essential
Note frequency of assessments of IV sites
Indicated
Note the expected duration of the IV site
Non-essential
Note care procedures to the IV site
Indicated
Note frequency of changing IV sites
Indicated
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 3
QUESTIONS AND ANSWERS
The nurse notes the presence of a P wave, QRS complex, flattened T waves, and occasional U
waves on a client's cardiac monitor screen. Fill in the correct missing information by choosing
from the lists of options in the drop-down menus. - ANS The nurse should suspect
Your Answer: hypokalemiaCorrect Answer: hypokalemia
because of the
Your Answer: flattened T waves and occasional U wavesCorrect Answer: flattened T waves and
occasional U waves
Rationale:Cardiac changes in hypokalemia include impaired repolarization, resulting in a
flattening of the T wave and eventually the emergence of a U wave. Therefore, the nurse
should suspect hypokalemia. The incidence of potentially lethal ventricular dysrhythmias is
increased in hypokalemia. The nurse should immediately assess the client's vital signs and
cardiac status for signs of hypokalemia. The nurse should also check the client's most recent
serum potassium level and then contact the primary health care provider to report the findings
and obtain prescriptions to treat the hypokalemic state.
The nurse is preparing a client for a chest x-ray and notes that the client is wearing a religious
medal on a chain around the neck. What should the nurse do with regard to this personal item?
Click to highlight the correct answer from the options provided. - ANS The nurse should:
(Select 1 option)
✓Ask the client if the chain and medal can be removed during the procedure.
Because: (Select 1 option)
✓The chain and medal may have cultural significance.
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 1
,Rationale:Before certain diagnostic procedures, it is typical to have a client remove personal
objects that are worn on the body because of client safety and the possibility of compromising
test results. Therefore, the nurse should ask the client about the significance of such an item
and its removal because it may have cultural or spiritual significance. If so, the nurse should ask
the client if the item can be either removed temporarily or placed on another part of the body
during the procedure if appropriate.
While preparing a client for surgery scheduled in 1 hour, the client states to the nurse: "I have
changed my mind. I don't want this surgery." Click to highlight the correct answer from the
options provided. - ANS The nurse should: (Select 1 option)
Cancel the surgery.
Contact the surgeon.
✓Discuss the client's concerns.
Call the identified support person.
Because: (Select 1 option)
Client consent is required prior to any procedure.
✓Further questions or concerns should be determined and addressed.
Ethical considerations are important for a client undergoing surgery.
The nursing scope of practice places limitations on how the nurse can respond.
Rationale:If the client indicates that he or she does not want a prescribed therapy, treatment,
or procedure such as surgery, the nurse should further investigate the client's request. If the
client indicates that he or she has changed his or her mind about surgery, the nurse should
assess the client and explore with the client his or her concerns about not wanting the surgery.
The nurse would then withhold further surgical preparation and contact the surgeon to report
the client's request so that the surgeon can discuss the consequences of not having the surgery
with the client. Further assessment and follow-up related to the client's request need to be
done. It is the client's right to refuse treatment; however, further investigation is needed so the
interventions can be tailored to specific needs.
The nurse notes that there has been an increase in the number of intravenous (IV) site
infections that developed in the clients being cared for on the nursing unit. How should the
Copyright ©2025 BRIGHTSTARS ALL RIGHTS RESERVED 2
, nurse proceed to implement a quality improvement program?For each action, click to specify
whether the action would be:
Indicated: an action that the nurse should take to resolve the problem
Non-essential: an action that the nurse could take without harming the client, but the action
would not be likely to address the problem
Contraindicated: an action that could harm the client and should not be taken - ANS Collect
identifying patient information
Contraindicated
Note the mental status of the client
Non-essential
Note primary and secondary diagnoses of clients affected
Indicated
Note the type of IV catheter used
Indicated
Note the type of IV site dressings being used
Indicated
Note the medication types being infused
Non-essential
Note frequency of assessments of IV sites
Indicated
Note the expected duration of the IV site
Non-essential
Note care procedures to the IV site
Indicated
Note frequency of changing IV sites
Indicated
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