Page 1 of 298
NCLEX-RN EXAM REAL EXAM STUDY GUIDE COMPLETE 500
QUESTIONS WITH CORRECT DETAILED ANSWERS LATEST
UPDATE THIS YEAR - JUST RELEASED
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.
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?
A. Perform gastric lavage
B. Administer acetylcysteine (Mucomyst) orally
C. Start an IV with Dextrose 5% and 0.33% normal saline
D. Have the patient drink activated charcoal mixed with water
E. Conduct a psychiatric evaluation.
F. Apply wrist restraints to prevent further self-ha
B
A 68-year-old male with a history of hypertension and diabetes has undergone 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
1
,Page 2 of 298
antihistamines. The procedure was successful, but the patient experienced brief hypotension
during the administration 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?
A. Persistent angina despite being at rest and receiving nitroglycerin
B. Thrombus formation leading to decreased peripheral pulses and cyanosis
C. Dizziness accompanied by a sudden drop in blood pressure when standing
D. Gradual decrease in blood pressure with no
B
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?
A. Decreasing amounts of body fat and muscle mass
B. Little change in body appearance from year to year
C. Progressive height increase of 4 inches each year
D. Yearly weight gain of about 5.5 pounds per year
D
A 62-year-old client arrives at a community health fair where the nurse is offering blood
pressure screenings. Upon assessment, the nurse notes that the client's blood pressure is
2
,Page 3 of 298
160/96 mmHg. The client claims that their blood pressure is "usually much lower" and they
recently started new medication for arthritis. What would the nurse advise the client to do?
A. Go get a blood pressure check within the next 15 minutes
B. Check blood pressure again in two (2) months
C. See the healthcare provider immediately
D. Visit the health care provider within one (1) week for a BP check
A
It’s a busy evening shift, and the hospital has just sounded an alarm for a disaster drill. The
unit manager informs the nurse that they need to make room for potential mass casualty
admissions. The nurse is given four clients and must decide who to prioritize for discharge to
accommodate new admissions. Who should be considered FIRST for discharge?
A. A middle-aged client with a history of being ventilator dependent for over seven (7) years
and admitted with bacterial pneumonia five days ago.
B. A young adult with diabetes mellitus Type 2 for over ten (10) years and admitted with
antibiotic-induced diarrhea 24 hours ago.
C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and was
admitted with Stevens-Johnson syndrome that morning.
D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg 48
hours ago.
A
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, Page 4 of 298
A 25-year-old male is seen in the endocrinology clinic for unexplained fatigue, weight gain,
and low energy levels. After a series of diagnostic tests, he is diagnosed with hypothyroidism.
The healthcare provider prescribes levothyroxine (Synthroid) 50 mcg/day by mouth. As the
nurse educates the client about this medication, which point should be emphasized?
A. Should be taken in the morning
B. May decrease the client’s energy level
C. Must be stored in a dark container
D. Will decrease the client’s heart rate
A
A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that
include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning
forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse
do first?
A. Prepare the child for X-ray of upper airways
B. Examine the child’s throat
C. Collect a sputum specimen
D. Notify the healthcare provider of the child’s status
D
4
NCLEX-RN EXAM REAL EXAM STUDY GUIDE COMPLETE 500
QUESTIONS WITH CORRECT DETAILED ANSWERS LATEST
UPDATE THIS YEAR - JUST RELEASED
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.
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?
A. Perform gastric lavage
B. Administer acetylcysteine (Mucomyst) orally
C. Start an IV with Dextrose 5% and 0.33% normal saline
D. Have the patient drink activated charcoal mixed with water
E. Conduct a psychiatric evaluation.
F. Apply wrist restraints to prevent further self-ha
B
A 68-year-old male with a history of hypertension and diabetes has undergone 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
1
,Page 2 of 298
antihistamines. The procedure was successful, but the patient experienced brief hypotension
during the administration 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?
A. Persistent angina despite being at rest and receiving nitroglycerin
B. Thrombus formation leading to decreased peripheral pulses and cyanosis
C. Dizziness accompanied by a sudden drop in blood pressure when standing
D. Gradual decrease in blood pressure with no
B
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?
A. Decreasing amounts of body fat and muscle mass
B. Little change in body appearance from year to year
C. Progressive height increase of 4 inches each year
D. Yearly weight gain of about 5.5 pounds per year
D
A 62-year-old client arrives at a community health fair where the nurse is offering blood
pressure screenings. Upon assessment, the nurse notes that the client's blood pressure is
2
,Page 3 of 298
160/96 mmHg. The client claims that their blood pressure is "usually much lower" and they
recently started new medication for arthritis. What would the nurse advise the client to do?
A. Go get a blood pressure check within the next 15 minutes
B. Check blood pressure again in two (2) months
C. See the healthcare provider immediately
D. Visit the health care provider within one (1) week for a BP check
A
It’s a busy evening shift, and the hospital has just sounded an alarm for a disaster drill. The
unit manager informs the nurse that they need to make room for potential mass casualty
admissions. The nurse is given four clients and must decide who to prioritize for discharge to
accommodate new admissions. Who should be considered FIRST for discharge?
A. A middle-aged client with a history of being ventilator dependent for over seven (7) years
and admitted with bacterial pneumonia five days ago.
B. A young adult with diabetes mellitus Type 2 for over ten (10) years and admitted with
antibiotic-induced diarrhea 24 hours ago.
C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and was
admitted with Stevens-Johnson syndrome that morning.
D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg 48
hours ago.
A
3
, Page 4 of 298
A 25-year-old male is seen in the endocrinology clinic for unexplained fatigue, weight gain,
and low energy levels. After a series of diagnostic tests, he is diagnosed with hypothyroidism.
The healthcare provider prescribes levothyroxine (Synthroid) 50 mcg/day by mouth. As the
nurse educates the client about this medication, which point should be emphasized?
A. Should be taken in the morning
B. May decrease the client’s energy level
C. Must be stored in a dark container
D. Will decrease the client’s heart rate
A
A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that
include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning
forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse
do first?
A. Prepare the child for X-ray of upper airways
B. Examine the child’s throat
C. Collect a sputum specimen
D. Notify the healthcare provider of the child’s status
D
4
