1
NCLEX-RN Practice QBank 2025 | 170 Verified
Questions with Detailed Rationales | A+ Score Booster
& Guaranteed Pass
1. A nurse is caring for a client with heart failure who is prescribed
furosemide. Which assessment is most important to perform before
administering the medication?
A. Respiratory rate
B. Serum potassium level
C. Apical pulse
D. Capillary refill time
Correct Answer: B. Serum potassium level
Rationale: Furosemide is a loop diuretic that increases urinary excretion
of potassium, potentially leading to hypokalemia, which can result in
life-threatening cardiac dysrhythmias. Assessing serum potassium
before administration is critical. Low levels (<3.5 mEq/L) should be
corrected or the dose held per protocol. Respiratory rate and pulse are
important, but electrolyte status takes priority due to the direct impact
on cardiac conduction.
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2. A client with type 1 diabetes reports shakiness and sweating. The
nurse finds the client is awake with a blood glucose level of 52
mg/dL. What is the nurse’s priority action?
A. Give the client 15 grams of fast-acting carbohydrate
B. Call the primary healthcare provider
C. Recheck the glucose level in 30 minutes
D. Administer IV insulin per sliding scale
Correct Answer: A. Give the client 15 grams of fast-acting
carbohydrate
Rationale: Symptoms of hypoglycemia include shakiness, sweating,
and irritability. Since the client is conscious and alert, the nurse should
implement the "15-15 rule": administer 15 grams of a fast-acting
carbohydrate (e.g., orange juice, glucose tablets), then recheck glucose
after 15 minutes. Calling the provider delays treatment. Insulin would
worsen the hypoglycemia.
3. A nurse is teaching a client how to use a metered-dose inhaler
(MDI). Which statement indicates the client understands the correct
technique?
A. “I should inhale quickly after pressing the canister.”
B. “I will hold my breath for 10 seconds after inhaling the
medication.”
C. “I’ll breathe out through my nose after using the inhaler.”
D. “I should take the second puff immediately after the first one.”
Correct Answer: B. “I will hold my breath for 10 seconds after
inhaling the medication.”
Rationale: Holding the breath for 10 seconds increases absorption of
the medication deep in the lungs. Inhaling too quickly or not holding the
, 3
breath reduces efficacy. Clients should wait 1–2 minutes between puffs
to allow maximum effect from bronchodilators.
4. A nurse is preparing to administer insulin glargine to a client with
type 2 diabetes. Which action is appropriate?
A. Mix the glargine with NPH insulin in the same syringe
B. Hold the insulin if the client’s blood glucose is 220 mg/dL
C. Administer the glargine in a separate syringe from other insulins
D. Shake the insulin vial to ensure it is mixed well
Correct Answer: C. Administer the glargine in a separate syringe
from other insulins
Rationale: Insulin glargine (Lantus) is a long-acting basal insulin that
should not be mixed with other insulins due to its unique pH and
stability. It is always administered separately. Glargine is a clear solution
and should never be shaken.
5. A nurse receives report on four clients. Which client should the
nurse assess first?
A. A client with COPD who has a pulse oximetry reading of 91%
B. A client who reports pain rated 7/10 after surgery
C. A client with a new-onset change in level of consciousness
D. A client with a blood pressure of 150/92 mm Hg
Correct Answer: C. A client with a new-onset change in level of
consciousness
Rationale: A sudden change in LOC indicates potential neurologic
compromise (e.g., stroke, increased ICP, hypoxia). This is a priority
assessment under the “A-B-C” (Airway, Breathing, Circulation) and
, 4
safety hierarchy of nursing priorities. The other clients are stable or
expected findings.
6. A nurse is caring for a client with end-stage liver disease. Which
lab result is most concerning?
A. AST of 85 U/L
B. INR of 3.2
C. Albumin of 2.9 g/dL
D. Total bilirubin of 2.5 mg/dL
Correct Answer: B. INR of 3.2
Rationale: The liver produces clotting factors; in liver failure, synthesis
decreases, causing elevated INR. An INR of 3.2 indicates a high
bleeding risk, making this the most critical value. While AST, albumin,
and bilirubin are abnormal, they are expected in liver disease and not as
immediately dangerous as an INR >3.
7. A client newly prescribed lithium asks about dietary needs. Which
advice should the nurse provide?
A. “You should limit your salt intake while on lithium.”
B. “Increase caffeine to enhance lithium excretion.”
C. “Maintain a consistent intake of sodium in your diet.”
D. “Avoid all dairy products while taking lithium.”
Correct Answer: C. “Maintain a consistent intake of sodium in your
diet.”
Rationale: Lithium excretion is affected by sodium levels. If sodium
intake drops, the kidneys retain more lithium, increasing the risk of
toxicity. The nurse must teach the client to maintain a consistent sodium
NCLEX-RN Practice QBank 2025 | 170 Verified
Questions with Detailed Rationales | A+ Score Booster
& Guaranteed Pass
1. A nurse is caring for a client with heart failure who is prescribed
furosemide. Which assessment is most important to perform before
administering the medication?
A. Respiratory rate
B. Serum potassium level
C. Apical pulse
D. Capillary refill time
Correct Answer: B. Serum potassium level
Rationale: Furosemide is a loop diuretic that increases urinary excretion
of potassium, potentially leading to hypokalemia, which can result in
life-threatening cardiac dysrhythmias. Assessing serum potassium
before administration is critical. Low levels (<3.5 mEq/L) should be
corrected or the dose held per protocol. Respiratory rate and pulse are
important, but electrolyte status takes priority due to the direct impact
on cardiac conduction.
, 2
2. A client with type 1 diabetes reports shakiness and sweating. The
nurse finds the client is awake with a blood glucose level of 52
mg/dL. What is the nurse’s priority action?
A. Give the client 15 grams of fast-acting carbohydrate
B. Call the primary healthcare provider
C. Recheck the glucose level in 30 minutes
D. Administer IV insulin per sliding scale
Correct Answer: A. Give the client 15 grams of fast-acting
carbohydrate
Rationale: Symptoms of hypoglycemia include shakiness, sweating,
and irritability. Since the client is conscious and alert, the nurse should
implement the "15-15 rule": administer 15 grams of a fast-acting
carbohydrate (e.g., orange juice, glucose tablets), then recheck glucose
after 15 minutes. Calling the provider delays treatment. Insulin would
worsen the hypoglycemia.
3. A nurse is teaching a client how to use a metered-dose inhaler
(MDI). Which statement indicates the client understands the correct
technique?
A. “I should inhale quickly after pressing the canister.”
B. “I will hold my breath for 10 seconds after inhaling the
medication.”
C. “I’ll breathe out through my nose after using the inhaler.”
D. “I should take the second puff immediately after the first one.”
Correct Answer: B. “I will hold my breath for 10 seconds after
inhaling the medication.”
Rationale: Holding the breath for 10 seconds increases absorption of
the medication deep in the lungs. Inhaling too quickly or not holding the
, 3
breath reduces efficacy. Clients should wait 1–2 minutes between puffs
to allow maximum effect from bronchodilators.
4. A nurse is preparing to administer insulin glargine to a client with
type 2 diabetes. Which action is appropriate?
A. Mix the glargine with NPH insulin in the same syringe
B. Hold the insulin if the client’s blood glucose is 220 mg/dL
C. Administer the glargine in a separate syringe from other insulins
D. Shake the insulin vial to ensure it is mixed well
Correct Answer: C. Administer the glargine in a separate syringe
from other insulins
Rationale: Insulin glargine (Lantus) is a long-acting basal insulin that
should not be mixed with other insulins due to its unique pH and
stability. It is always administered separately. Glargine is a clear solution
and should never be shaken.
5. A nurse receives report on four clients. Which client should the
nurse assess first?
A. A client with COPD who has a pulse oximetry reading of 91%
B. A client who reports pain rated 7/10 after surgery
C. A client with a new-onset change in level of consciousness
D. A client with a blood pressure of 150/92 mm Hg
Correct Answer: C. A client with a new-onset change in level of
consciousness
Rationale: A sudden change in LOC indicates potential neurologic
compromise (e.g., stroke, increased ICP, hypoxia). This is a priority
assessment under the “A-B-C” (Airway, Breathing, Circulation) and
, 4
safety hierarchy of nursing priorities. The other clients are stable or
expected findings.
6. A nurse is caring for a client with end-stage liver disease. Which
lab result is most concerning?
A. AST of 85 U/L
B. INR of 3.2
C. Albumin of 2.9 g/dL
D. Total bilirubin of 2.5 mg/dL
Correct Answer: B. INR of 3.2
Rationale: The liver produces clotting factors; in liver failure, synthesis
decreases, causing elevated INR. An INR of 3.2 indicates a high
bleeding risk, making this the most critical value. While AST, albumin,
and bilirubin are abnormal, they are expected in liver disease and not as
immediately dangerous as an INR >3.
7. A client newly prescribed lithium asks about dietary needs. Which
advice should the nurse provide?
A. “You should limit your salt intake while on lithium.”
B. “Increase caffeine to enhance lithium excretion.”
C. “Maintain a consistent intake of sodium in your diet.”
D. “Avoid all dairy products while taking lithium.”
Correct Answer: C. “Maintain a consistent intake of sodium in your
diet.”
Rationale: Lithium excretion is affected by sodium levels. If sodium
intake drops, the kidneys retain more lithium, increasing the risk of
toxicity. The nurse must teach the client to maintain a consistent sodium
