NCLEX 75 Questions And Rationale Comprehensive 2026
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A client with Multiple Sclerosis reports a constant, burning, tingling pain in the
shoulders. The nurse anticipates that the physician will order which
medication for this type of pain?
1. alprazolam (Xanax)
2. Corticosteroid injection
3. gabapentin (Neurontin)
4. hydrocodone/acetaminophen (Norco)
1. alprazolam (Xanax)
Incorrect - alprazolam is used to reduce anxiety
2. Corticosteroid injection
Incorrect - Corticosteroid injections are used to reduce inflammation in a localized
area, often due to joint breakdown. In MS patients it is used to treat acute
exacerbations ("flare-ups"), but the symptoms described do not constitute an acute
exacerbation.
3. gabapentin (Neurontin)
Correct - Anticonvulsants like gabapentin are often the first line of treatment for
nerve pain
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4. hydrocodone/acetaminophen (Norco)
Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
A nurse is providing discharge teaching for a patient with severe
Gastroesophogeal Reflux Disease. Which of these statements by the patient
indicates a need for more teaching?
1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion."
2. "I'm going to make sure to remain upright after meals and elevate my head
when I sleep"
3. "I won't be drinking tea or coffee or eating chocolate any more."
4. "I'm going to start trying to lose some weight."
1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion."
CORRECT - Large meals increase the volume and pressure in the stomach and
delay gastric emptying. It's recommended instead to eat 4-6 small meals a day.
2. "I'm going to make sure to remain upright after meals and elevate my head when I
sleep"
Incorrect - This is a correct verbalization of health promotion for GERD.
3. "I won't be drinking tea or coffee or eating chocolate any more."
Incorrect - This is a correct verbalization of health promotion for GERD.
4. "I'm going to start trying to lose some weight."
Incorrect - This is a correct verbalization of health promotion for GERD.
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The nurse in the Emergency Room is treating a patient suspected to have a
Peptic Ulcer. On assessing lab results, the nurse finds that the patient's blood
pressure is 95/60, pulse is 110 beats per minute, and the patient reports
epigastric pain. What is the PRIORITY intervention?
1. Start a large-bore IV in the patient's arm
2. Ask the patient for a stool sample
3. Prepare to insert an NG Tube
4. Administer intramuscular morphine sulphate as ordered
1. Start a large-bore IV in the patient's arm
CORRECT - The nurse should suspect that the patient is haemorrhaging and will
need need a fluid replacement therapy, which requires a large bore IV.
2. Ask the patient for a stool sample
Incorrect - While this is useful in the diagnosis and assessment of Peptic Ulcer
Disease, it is not the priority intervention.
3. Prepare to insert an NG Tube
Incorrect - While this intervention may be used in the later stages of Peptic Ulcer
Disease, it is not the first and priority intervention.
4. Administer intramuscular morphine sulphate as ordered
Incorrect - While this is an important intervention to manage pain, it is not the priority
intervention.
A female patient with atrial fibrillation has the following lab results:
Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and
potassium of 2.7 mEq/L. Which result is critical and should be reported to the
physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L
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1. Hemoglobin 11 g/dl
This is below normal, but a normal female hemoglobin is 12-14. There is a more
critical lab result.
2. Platelet of 150,000
This is also below the normal values, but is not the most critical lab result.
3. INR of 2.5
This is a therapeutic range for a patient who is taking an anticoagulant for atrial
fibrillation
4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a patient with a history of dysrhythmia can
be life-threatening and can lead to cardiac distress.
While receiving normal saline infusions to treat a GI bleed, the nurse notes
that the patient's lower legs have become edematous and auscultates crackles
in the lungs. What should the nurse do first?
1. Stop the saline infusion immediately
2. Notify Physician
3. Elevate the patient's legs
4. Continue the infusion, since these are normal findings
1. Stop the saline infusion immediately
CORRECT - the patient has a fluid volume overload as a result of overly rapid fluid
replacement. The nurse should stop the infusion and notify the physician.
2. Notify Physician
This is not the first action the nurse should take.
3. Elevate the patient's legs
This would help with the edema, but is not a priority
4. Continue the infusion, since these are normal findings
This is not a normal finding