NCLEX PN 2024-2025 / PN NCLEX EXAM NEWEST
ACTUAL EXAM 160 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
In which situation should the nurse accept an assignment but complete a protest of assignment?
A. Floating to another unit
B. Insufficient staffing
C. Strike
D. Mass disaster - answer-B. Insufficient staffing
If an assignment is to care for clients than what is reasonable, it needs to be brought to the attention of
nursing manager/and or supervisor. Protest of assignment do not relief a nurse of their responsibility but
the nurse is attempting to act reasonable.
A patient is ordered metformin 1000mg twice a day for his diabetes. While talking with the patient he
states "I never eat breakfast so I take a ½ tablet at lunch and a whole tablet at supper because I don't
want my blood sugar to drop." As his primary care nurse you: A. Tell him he has made a good decision
and to continue
B. Tell him to take a whole tablet with lunch and with supper
C. Tell him to skip the morning dose and just take the dose at supper
D.Tell him to take one tablet in the morning and one tablet in the evening as ordered - answer-D. Tell
him to take one tablet in the morning and one tablet in the evening as ordered.
The patient should take the metformin as ordered. Metformin does not cause low blood sugars due to
the way it is metabolized.
A patient calls his primary care physicians office requesting an appointment. While talking with the
patient he reports that about 5 weeks ago he experienced a TIA. He reports that he was discharged from
the hospital with plavix 75mg. He states he took one tablet daily as prescribed and completed all 30
tablets. You do the following:
A. Schedule the patient ASAP to resume Plavix
B. Inform the patient that a 30 day course of plavix is the usual course of treatment post TIA
C.Schedule the patient for a 6 month follow up appointment
,D. Advise the patient that no follow up is needed unless he is having a problem - answer-A. Schedule
the patient ASAP to resume Plavix.
Plavix is an anti- platelet that is needed in order to prevent further TIAs or CVA and should be continued.
A patient presents with a 2 week history of progressive increase in SOB with activity, increase in chest
congestion and episodes of sweating so much that his shirt is soaked. He reports a productive cough of
large amounts of green sputum. Upon assessment: T=98.2, P=110, R=24, B/P=138/70, POX=85% on RA.
Lungs with inspiratory and expiratory wheezes. He appears to be in no distress. You anticipate the
following orders:
A. PO antibiotics and discharge to home
B. Breathing treatment, CXR, IV antibiotic, oxygen, hospital admission
C. Prepare for intubation or BiPap
D. Home oxygen order - answer-B.. Breathing treatment, CXR, IV antibiotic, oxygen, hospital
admission.
The patient is exhibiting signs of a respiratory infection such as pneumonia or exacerbation of COPD. The
episodes of sweating indicate fever.
A patient presents with complaints of generally not feeling well for 2 weeks, fatigue and occasional
dizziness. The patient is placed on a cardiac monitor which shows a regular ventricular rate of 33 and
more P waves than QRS complexes that do not seem to be associated. The patient is most likely
experiencing:
A. 1st degree heart block
B. Sinus bradycardia
C. 3rd degree heart block
D. Junctional rhythm - answer-C. 3rd degree heart block
In 3rd degree heart block there are more P waves than QRS complexes and there is no association
between the P waves (atrial contraction) and QRS complexes (ventricular contraction).
A patient presents for a 2 week blood pressure check after his metoprolol tartrate was increased to 50
mg in the morning and 25mg in the evening. The patient's blood pressure is 150/78. He denies any signs
of hypertension. Prior to the patient having any further adjustments in his medication what additional
information is needed?
A. Nothing
,B. Pulse rate
C. Labs
D. Orhtostatic blood pressures - answer-B. Pulse rate.
Metoprolol slows the heart rate and any further increase could not be made if the patient's heart rate is
low.
A patient presents requesting a nicotine replacement patch for smoking cessation. He reports that he is a
long time smoker of 1 pack per day and that he is usually up once a night to smoke a cigarette. Based on
this information the patient:
A.Can quit cold turkey without any problems
B. Requires a low dose patch
C. Has a high level of nicotine addiction
D. Will not be able to stop smoking - answer-C. Has a high level of nicotine addiction.
A patient waking up at night for a cigarette indicates a higher level of addiction to nicotine.
A patient with COPD is given a Z-Pak for an exacerbation. He has an albuterol inhaler (MDI) at home
ordered as 2 puffs 4 times a day as needed. The patient was instructed to use his MDI 2 puffs four times
a day on schedule until he completes his antibiotic. The patient states I only use the inhaler when I go for
a walk because I don't want to get hooked on it. You reply:
A.You're correct; don't use the inhaler unless you absolutely have to use it.
B. You will not become addicted if you stop using the inhaler 4 times a day as soon as you're antibiotic is
done.
C. The inhaler is not addictive when taken with an antibiotic
D. The inhaler is not addictive at all and should be used more frequently during an exacerbation of COPD.
- answer-D. The inhaler is not addictive at all and should be used more frequently during an
exacerbation of COPD.
Albuterol is not addictive. It will help with SOB, coughing and clearing of secretions. It should be used
more frequently and even on schedule during an exacerbation of COPD.
Patient presents with right sided rib pain after a fall. He complains of constant pain that is worse with
deep inspiration. The CXR reveals a 5th right rib fracture. He is on 24 hour oxygen therapy and a history
of asthma and chronic bronchitis. The physican orders pain medication. As a nursing measure you
perform the following:
, A. Provide the patient with an incentive spirometer and teach him to perform incentive spirometry every
hour while awake.
B. Nothing further is needed.
C. Instruct the patient to take his pain medication only at night so that he can sleep.
D. Instruct the patient to move as little as possible to decrease pain. - answer-A. Provide the patient
with an incentive spirometer and teach him to perform incentive spirometry every hour while awake.
The patient has comprised lung function causing increased risk for respiratory complications. The rib
fracture pain will cause the patient to take more shallow breaths. Incentive spirometry will cause the
patient to take deep breaths to prevent respiratory complications such as pneumonia.
A patient presents with a one week history of dizziness, left lower quadrant abdominal discomfort and 2
or 3 three black stools. You anticipate the following orders: A. Pain medication, PO antibiotics, discharge
home.
B. Home occult blood test for the stool, increase in fluids, return in one week for re-evaluation.
C. CBC and CT scan to rule out diverticulitis.
D. Bed rest, IV fluids, admission for observation. - answer-C. CBC and CT scan to rule out diverticulitis
Left lower quadrant pain and signs of GI bleeding may indicate diverticulitis. A CBC would assist in
determining not only anemia but infection as well.
An 82 year old female is brought to the ER with new onset of confusion. She typically lives alone and is
independent. She does have incontinence and wears depends. What orders do you anticipate? A. CBC,
U/A, IV antibiotic
B. CT of head
C. Admission for observation and neurology evaluation
D. New diagnosis of dementia - answer-A. CBC, U/A, IV antibiotic
In the elderly, confusion may be the only sign of a UTI. Wearing wet depends may increase the risk the
UTI. The CBC will assist in determining if urosepsis is present.
The home hospice nurse visits a patient that is actively dying. The family reports that the patient has
moist rattle with breathing. What medication will help the moist respirations?
A. Roxanol sublingual
ACTUAL EXAM 160 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
In which situation should the nurse accept an assignment but complete a protest of assignment?
A. Floating to another unit
B. Insufficient staffing
C. Strike
D. Mass disaster - answer-B. Insufficient staffing
If an assignment is to care for clients than what is reasonable, it needs to be brought to the attention of
nursing manager/and or supervisor. Protest of assignment do not relief a nurse of their responsibility but
the nurse is attempting to act reasonable.
A patient is ordered metformin 1000mg twice a day for his diabetes. While talking with the patient he
states "I never eat breakfast so I take a ½ tablet at lunch and a whole tablet at supper because I don't
want my blood sugar to drop." As his primary care nurse you: A. Tell him he has made a good decision
and to continue
B. Tell him to take a whole tablet with lunch and with supper
C. Tell him to skip the morning dose and just take the dose at supper
D.Tell him to take one tablet in the morning and one tablet in the evening as ordered - answer-D. Tell
him to take one tablet in the morning and one tablet in the evening as ordered.
The patient should take the metformin as ordered. Metformin does not cause low blood sugars due to
the way it is metabolized.
A patient calls his primary care physicians office requesting an appointment. While talking with the
patient he reports that about 5 weeks ago he experienced a TIA. He reports that he was discharged from
the hospital with plavix 75mg. He states he took one tablet daily as prescribed and completed all 30
tablets. You do the following:
A. Schedule the patient ASAP to resume Plavix
B. Inform the patient that a 30 day course of plavix is the usual course of treatment post TIA
C.Schedule the patient for a 6 month follow up appointment
,D. Advise the patient that no follow up is needed unless he is having a problem - answer-A. Schedule
the patient ASAP to resume Plavix.
Plavix is an anti- platelet that is needed in order to prevent further TIAs or CVA and should be continued.
A patient presents with a 2 week history of progressive increase in SOB with activity, increase in chest
congestion and episodes of sweating so much that his shirt is soaked. He reports a productive cough of
large amounts of green sputum. Upon assessment: T=98.2, P=110, R=24, B/P=138/70, POX=85% on RA.
Lungs with inspiratory and expiratory wheezes. He appears to be in no distress. You anticipate the
following orders:
A. PO antibiotics and discharge to home
B. Breathing treatment, CXR, IV antibiotic, oxygen, hospital admission
C. Prepare for intubation or BiPap
D. Home oxygen order - answer-B.. Breathing treatment, CXR, IV antibiotic, oxygen, hospital
admission.
The patient is exhibiting signs of a respiratory infection such as pneumonia or exacerbation of COPD. The
episodes of sweating indicate fever.
A patient presents with complaints of generally not feeling well for 2 weeks, fatigue and occasional
dizziness. The patient is placed on a cardiac monitor which shows a regular ventricular rate of 33 and
more P waves than QRS complexes that do not seem to be associated. The patient is most likely
experiencing:
A. 1st degree heart block
B. Sinus bradycardia
C. 3rd degree heart block
D. Junctional rhythm - answer-C. 3rd degree heart block
In 3rd degree heart block there are more P waves than QRS complexes and there is no association
between the P waves (atrial contraction) and QRS complexes (ventricular contraction).
A patient presents for a 2 week blood pressure check after his metoprolol tartrate was increased to 50
mg in the morning and 25mg in the evening. The patient's blood pressure is 150/78. He denies any signs
of hypertension. Prior to the patient having any further adjustments in his medication what additional
information is needed?
A. Nothing
,B. Pulse rate
C. Labs
D. Orhtostatic blood pressures - answer-B. Pulse rate.
Metoprolol slows the heart rate and any further increase could not be made if the patient's heart rate is
low.
A patient presents requesting a nicotine replacement patch for smoking cessation. He reports that he is a
long time smoker of 1 pack per day and that he is usually up once a night to smoke a cigarette. Based on
this information the patient:
A.Can quit cold turkey without any problems
B. Requires a low dose patch
C. Has a high level of nicotine addiction
D. Will not be able to stop smoking - answer-C. Has a high level of nicotine addiction.
A patient waking up at night for a cigarette indicates a higher level of addiction to nicotine.
A patient with COPD is given a Z-Pak for an exacerbation. He has an albuterol inhaler (MDI) at home
ordered as 2 puffs 4 times a day as needed. The patient was instructed to use his MDI 2 puffs four times
a day on schedule until he completes his antibiotic. The patient states I only use the inhaler when I go for
a walk because I don't want to get hooked on it. You reply:
A.You're correct; don't use the inhaler unless you absolutely have to use it.
B. You will not become addicted if you stop using the inhaler 4 times a day as soon as you're antibiotic is
done.
C. The inhaler is not addictive when taken with an antibiotic
D. The inhaler is not addictive at all and should be used more frequently during an exacerbation of COPD.
- answer-D. The inhaler is not addictive at all and should be used more frequently during an
exacerbation of COPD.
Albuterol is not addictive. It will help with SOB, coughing and clearing of secretions. It should be used
more frequently and even on schedule during an exacerbation of COPD.
Patient presents with right sided rib pain after a fall. He complains of constant pain that is worse with
deep inspiration. The CXR reveals a 5th right rib fracture. He is on 24 hour oxygen therapy and a history
of asthma and chronic bronchitis. The physican orders pain medication. As a nursing measure you
perform the following:
, A. Provide the patient with an incentive spirometer and teach him to perform incentive spirometry every
hour while awake.
B. Nothing further is needed.
C. Instruct the patient to take his pain medication only at night so that he can sleep.
D. Instruct the patient to move as little as possible to decrease pain. - answer-A. Provide the patient
with an incentive spirometer and teach him to perform incentive spirometry every hour while awake.
The patient has comprised lung function causing increased risk for respiratory complications. The rib
fracture pain will cause the patient to take more shallow breaths. Incentive spirometry will cause the
patient to take deep breaths to prevent respiratory complications such as pneumonia.
A patient presents with a one week history of dizziness, left lower quadrant abdominal discomfort and 2
or 3 three black stools. You anticipate the following orders: A. Pain medication, PO antibiotics, discharge
home.
B. Home occult blood test for the stool, increase in fluids, return in one week for re-evaluation.
C. CBC and CT scan to rule out diverticulitis.
D. Bed rest, IV fluids, admission for observation. - answer-C. CBC and CT scan to rule out diverticulitis
Left lower quadrant pain and signs of GI bleeding may indicate diverticulitis. A CBC would assist in
determining not only anemia but infection as well.
An 82 year old female is brought to the ER with new onset of confusion. She typically lives alone and is
independent. She does have incontinence and wears depends. What orders do you anticipate? A. CBC,
U/A, IV antibiotic
B. CT of head
C. Admission for observation and neurology evaluation
D. New diagnosis of dementia - answer-A. CBC, U/A, IV antibiotic
In the elderly, confusion may be the only sign of a UTI. Wearing wet depends may increase the risk the
UTI. The CBC will assist in determining if urosepsis is present.
The home hospice nurse visits a patient that is actively dying. The family reports that the patient has
moist rattle with breathing. What medication will help the moist respirations?
A. Roxanol sublingual
