PN 140 Final Exam NCLEX Practice Exam
PN 140 FINAL EXAM NCLEX PRACTICE EXAM NEWEST 2025/2026
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |BRAND NEW VERSION!!
A client with end-stage kidney disease has been put on fluid restrictions. Which
assessment finding indicates that the client has not adhered to this restriction?
A Blood pressure of 118/78 mm Hg
B Weight loss of 3 pounds during hospitalization
C Dyspnea and anxiety at rest
D Central venous pressure (CVP) of 6 mm Hg
C Dyspnea and anxiety at rest
Dyspnea is a sign of fluid overload and possible pulmonary edema; the nurse
should assist the client in correlating symptoms of fluid overload with
nonadherence to fluid restriction. Nonadherence to fluid restriction results in fluid
volume excess and higher blood pressures; 118/78 mm Hg is a normal blood
pressure. Excess fluid intake and fluid retention are manifested by an elevated CVP
(>8 mm Hg) and weight gain, not weight loss.
Which assessment finding represents a positive response to erythropoietin
(Epogen, Procrit) therapy?
A Hematocrit of 26.7%
B Potassium within normal range
C Absence of spontaneous fractures
D Less fatigue
D Less fatigue
Treatment of anemia with erythropoietin will result in increased hemoglobin and
hematocrit (H&H) and decreased shortness of breath and fatigue. A hematocrit
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, PN 140 Final Exam NCLEX Practice Exam
value of 26.7% is low; erythropoietin should restore the hematocrit to at least
36% to be effective. Erythropoietin causes more red blood cells to be produced,
increasing H&H, not potassium. Calcium supplements and phosphate binders
prevent renal osteodystrophy; erythropoietin treats anemia.
When caring for a client who receives peritoneal dialysis (PD), which finding does
the nurse report to the provider immediately?
A Pulse oximetry reading of 95%
B Sinus bradycardia, rate of 58 beats/min
C Blood pressure of 148/90 mm Hg
D Temperature of 101.2° F (38.4° C)
D Temperature of 101.2° F (38.4° C)
Peritonitis is the major complication of PD, caused by intra-abdominal catheter
site contamination; meticulous aseptic technique must be used when caring for
PD equipment. A pulse oximetry reading of 95% is a normal saturation. Although a
heart rate of 58 beats/min is slightly bradycardic, the provider can be informed
upon visiting the client. Clients with kidney failure tend to have slightly higher
blood pressures due to fluid retention; this is not as serious as a fever.
Which clinical manifestation indicates the need for increased fluids in a client with
kidney failure?
A Increased blood urea nitrogen (BUN)
B Increased creatinine level
C Pale-colored urine
D Decreased sodium level
A Increased blood urea nitrogen (BUN
An increase in BUN can be an indication of dehydration, and an increase in fluids is
needed. Increased creatinine indicates kidney impairment. Urine that is pale in
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, PN 140 Final Exam NCLEX Practice Exam
color is diluted; an increase in fluids is not necessary. Sodium is increased, not
decreased, with dehydration.
A client with acute kidney injury is receiving a fluid challenge of 500 mL of normal
saline over 1 hour. With a drop factor of 20 drops/mL, how many drops per
minute does the nurse infuse?
167 drops/min
20 gtt × 500 mL = 10,000/60 min = 167 drops/min
Which clients are at risk for acute kidney injury (AKI)? (Select all that apply.)
A Football player in preseason practice Correct
B Client who underwent contrast dye radiology Correct
C Accident victim recovering from a severe hemorrhage Correct
D Accountant with diabetes
E Client in the intensive care unit on high doses of antibiotics Correct
F Client recovering from gastrointestinal influenza
A Football player in preseason practice
B Client who underwent contrast dye radiology
C Accident victim recovering from a severe hemorrhage
E Client in the intensive care unit on high doses of antibiotics
F Client recovering from gastrointestinal influenza
To prevent AKI, all people should be urged to avoid dehydration by drinking at
least 2 to 3 liters of fluids daily, especially during strenuous exercise or work
associated with diaphoresis, or when recovering from an illness that reduces
kidney blood flow, such as influenza. Contrast media may cause acute renal
failure, especially in older clients with reduced kidney function. Recent surgery or
trauma, transfusions, or other factors that might lead to reduced kidney blood
flow may cause AKI. Certain antibiotics may cause nephrotoxicity. Diabetes may
cause acute kidney failure superimposed on chronic kidney failure.
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, PN 140 Final Exam NCLEX Practice Exam
The nurse assists a client with acute kidney injury (AKI) to modify the diet in which
ways? (Select all that apply.)
A Restricted protein
B Liberal sodium
C Restricted fluids
D Low potassium
E Low fat
A Restricted protein
C Restricted fluids
D Low potassium
Breakdown of protein leads to azotemia and increased blood urea nitrogen. Fluid
is restricted during the oliguric stage. Potassium intoxication may occur, so dietary
potassium is also restricted. Sodium is restricted during AKI because oliguria
causes fluid retention. Fats may be used for needed calories when proteins are
restricted.
When caring for a client with a left forearm arteriovenous fistula created for
hemodialysis, which actions must the nurse take? (Select all that apply.)
A Check brachial pulses daily.
B Auscultate for a bruit every 8 hours. Correct
C Teach the client to palpate for a thrill over the site. Correct
D Elevate the arm above heart level.
E Ensure that no blood pressures are taken in that arm.
B Auscultate for a bruit every 8 hours.
C Teach the client to palpate for a thrill over the site.
E Ensure that no blood pressures are taken in that arm.
A bruit or swishing sound, and a thrill or buzzing sensation upon palpation should
be present in this client, indicating patency of the fistula. No blood pressure,
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PN 140 FINAL EXAM NCLEX PRACTICE EXAM NEWEST 2025/2026
COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |BRAND NEW VERSION!!
A client with end-stage kidney disease has been put on fluid restrictions. Which
assessment finding indicates that the client has not adhered to this restriction?
A Blood pressure of 118/78 mm Hg
B Weight loss of 3 pounds during hospitalization
C Dyspnea and anxiety at rest
D Central venous pressure (CVP) of 6 mm Hg
C Dyspnea and anxiety at rest
Dyspnea is a sign of fluid overload and possible pulmonary edema; the nurse
should assist the client in correlating symptoms of fluid overload with
nonadherence to fluid restriction. Nonadherence to fluid restriction results in fluid
volume excess and higher blood pressures; 118/78 mm Hg is a normal blood
pressure. Excess fluid intake and fluid retention are manifested by an elevated CVP
(>8 mm Hg) and weight gain, not weight loss.
Which assessment finding represents a positive response to erythropoietin
(Epogen, Procrit) therapy?
A Hematocrit of 26.7%
B Potassium within normal range
C Absence of spontaneous fractures
D Less fatigue
D Less fatigue
Treatment of anemia with erythropoietin will result in increased hemoglobin and
hematocrit (H&H) and decreased shortness of breath and fatigue. A hematocrit
1|Page
, PN 140 Final Exam NCLEX Practice Exam
value of 26.7% is low; erythropoietin should restore the hematocrit to at least
36% to be effective. Erythropoietin causes more red blood cells to be produced,
increasing H&H, not potassium. Calcium supplements and phosphate binders
prevent renal osteodystrophy; erythropoietin treats anemia.
When caring for a client who receives peritoneal dialysis (PD), which finding does
the nurse report to the provider immediately?
A Pulse oximetry reading of 95%
B Sinus bradycardia, rate of 58 beats/min
C Blood pressure of 148/90 mm Hg
D Temperature of 101.2° F (38.4° C)
D Temperature of 101.2° F (38.4° C)
Peritonitis is the major complication of PD, caused by intra-abdominal catheter
site contamination; meticulous aseptic technique must be used when caring for
PD equipment. A pulse oximetry reading of 95% is a normal saturation. Although a
heart rate of 58 beats/min is slightly bradycardic, the provider can be informed
upon visiting the client. Clients with kidney failure tend to have slightly higher
blood pressures due to fluid retention; this is not as serious as a fever.
Which clinical manifestation indicates the need for increased fluids in a client with
kidney failure?
A Increased blood urea nitrogen (BUN)
B Increased creatinine level
C Pale-colored urine
D Decreased sodium level
A Increased blood urea nitrogen (BUN
An increase in BUN can be an indication of dehydration, and an increase in fluids is
needed. Increased creatinine indicates kidney impairment. Urine that is pale in
2|Page
, PN 140 Final Exam NCLEX Practice Exam
color is diluted; an increase in fluids is not necessary. Sodium is increased, not
decreased, with dehydration.
A client with acute kidney injury is receiving a fluid challenge of 500 mL of normal
saline over 1 hour. With a drop factor of 20 drops/mL, how many drops per
minute does the nurse infuse?
167 drops/min
20 gtt × 500 mL = 10,000/60 min = 167 drops/min
Which clients are at risk for acute kidney injury (AKI)? (Select all that apply.)
A Football player in preseason practice Correct
B Client who underwent contrast dye radiology Correct
C Accident victim recovering from a severe hemorrhage Correct
D Accountant with diabetes
E Client in the intensive care unit on high doses of antibiotics Correct
F Client recovering from gastrointestinal influenza
A Football player in preseason practice
B Client who underwent contrast dye radiology
C Accident victim recovering from a severe hemorrhage
E Client in the intensive care unit on high doses of antibiotics
F Client recovering from gastrointestinal influenza
To prevent AKI, all people should be urged to avoid dehydration by drinking at
least 2 to 3 liters of fluids daily, especially during strenuous exercise or work
associated with diaphoresis, or when recovering from an illness that reduces
kidney blood flow, such as influenza. Contrast media may cause acute renal
failure, especially in older clients with reduced kidney function. Recent surgery or
trauma, transfusions, or other factors that might lead to reduced kidney blood
flow may cause AKI. Certain antibiotics may cause nephrotoxicity. Diabetes may
cause acute kidney failure superimposed on chronic kidney failure.
3|Page
, PN 140 Final Exam NCLEX Practice Exam
The nurse assists a client with acute kidney injury (AKI) to modify the diet in which
ways? (Select all that apply.)
A Restricted protein
B Liberal sodium
C Restricted fluids
D Low potassium
E Low fat
A Restricted protein
C Restricted fluids
D Low potassium
Breakdown of protein leads to azotemia and increased blood urea nitrogen. Fluid
is restricted during the oliguric stage. Potassium intoxication may occur, so dietary
potassium is also restricted. Sodium is restricted during AKI because oliguria
causes fluid retention. Fats may be used for needed calories when proteins are
restricted.
When caring for a client with a left forearm arteriovenous fistula created for
hemodialysis, which actions must the nurse take? (Select all that apply.)
A Check brachial pulses daily.
B Auscultate for a bruit every 8 hours. Correct
C Teach the client to palpate for a thrill over the site. Correct
D Elevate the arm above heart level.
E Ensure that no blood pressures are taken in that arm.
B Auscultate for a bruit every 8 hours.
C Teach the client to palpate for a thrill over the site.
E Ensure that no blood pressures are taken in that arm.
A bruit or swishing sound, and a thrill or buzzing sensation upon palpation should
be present in this client, indicating patency of the fistula. No blood pressure,
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