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NCLEX RN 2025 Complete Exam Review Saunders Comprehensive Practice Questions and Answers with Rationales

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This document contains a comprehensive set of NCLEX RN practice questions and answers based on the Saunders review, covering core nursing areas such as medical-surgical care, pharmacology, pediatrics, and mental health. It includes detailed rationales to enhance understanding, clinical judgment, and test-taking strategies. The material is designed to support thorough exam preparation and aligns with NCLEX standards, making it suitable for both revision and self-assessment.

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Med-Surg Certification Practice Questions
EXAM QUESTIONS AND VERIFIED ANSWERS
RECENT AND COMPREHENSIVE VERSION
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A newly diabetic patient will receive instructions from his nurse. Which of the following actions should
the nurse take first?



A. Provide the patient with brochures for making smart choices for cooking/baking.

B. Ask the patient what they know about diabetes.

C. Instruct the patient on exercise or activities that will increase their metabolism.

D. Teach them how to use the glucometer.

B.



First ask the patient what they know about diabetes.



*ACTION questions ask for intervention, NOT assessment




An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient states to
the RN that he is short of breath, has no appetite and hurts everywhere. Which of the following
statements by the nurse is best?

,A. Tell me how your family is coping

B. Show me where it does not hurt

C. I'll teach you relaxation techniques

D. Your physician should increase your pain medication

C




A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages should
the nurse respond to first?



A. A post cervical laminectomy patient complaining of sudden difficulty talking.

B. A patient with multiple sclerosis complaining of change in peripheral vision.

C. A patient with a herniated disc complaining of consistent back pain.

D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes.

A



B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less critical than
A. Best answer is A.




A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which of the
following actions by the nurse is most appropriate?



A. Determine the patient's usual sleeping and waking patterns.

B. Suggest that the client abstain from alcohol and caffeine before bed time.

C. Recommend that client establish a bedtime routine.

D. Ask how much sleep the client required before retirement.

A

,B and C are recommendations that the RN can share after he/she determines the patient's sleeping and
waking patterns. So remove B and C. D is an inquiry, but is concerned about the past (when the person
retired). Remove D. A is the best answer.




The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the patient is
diaphoretic and confused. The vital signs are:

Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects the physician to
order which of the following?



A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.

B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld.

C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and ciprofloxacin (cipro)
500 mg. po bid.

D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl.

B




A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued, is
sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following responses by
the nurse is most appropriate?



A. You will have more energy if you walk 30 min every day.

B. You don't need to worry. Sleeping a lot is good for you.

C. Come in and see your health care provider today.

D. You should eat more green leafy vegetables.

C



Need more info

, The RN performs blood pressure screening at the local community center. Which of the following
individuals is most likely to suffer from a cerebrovascular accident?



A. A 30 year old man who is an account executive

B. A 40 year old man who jogs four times a week.

C. A 60 year old man whose father had a stroke.

D. A 75 year old man who takes multi-vitamins.

C




For the patient with a new tracheostomy, the nurse must be alert to which early complication?



a) Decannulation

b) Infection

c) Bleeding

d) Tracheomalacia

C



Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent structures, and
failure of the chosen technique to achieve successful airway



EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. Infection comes 2-3 days later.




When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85% over 4
hours, the nurse will first:



1. Request an order for stat ABGs

2. Start the patient on oxygen by NC at 2L/minute

3. Notify the physician of the change

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