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Kaplan NCLEX Readiness Exam: 180 Questions & Verified Answers (Graded A+), Exams of Nursing

Chamberlain College of NursingNursing

This comprehensive resource features 180 challenging NCLEX-style practice questions across all major nursing domains (Medical-Surgical, Pediatrics, Maternity, Mental Health, Pharmacology, and Fundamentals), complete with detailed rationales for correct and incorrect answers. Each question is designed to mirror the NCLEX format and difficulty level, with expert explanations highlighting clinical judgment priorities, delegation principles, and critical interventions. Perfect for nursing students seeking to assess exam readiness, identify knowledge gaps, and master test-taking strategies with verified A+ quality answers.

Typology: Exams

2024/2025

Available from 06/19/2025

NurseChantelle
NurseChantelle 🇺🇸

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LATEST KAPLAN NCLEX READINESS
EXAM 180 QUESTIONS AND CORRECT
ANSWERS ALREADY GRADED A+
A 7-year-old boy is brought to the emergency room by his mother following a fall
from his bicycle. X-ray reveals healed fractures of the ribs. The child's mother
states, "My son is such a careless child; he's always having accidents or fights with
his brother." Which response by the nurse would be MOST appropriate?
1. "When I document information about these injuries, it will be on your son's
hospital record forever."
2. "How would you describe your son's relationship with his brothers and sisters?"
3. "What I see suggests that someone has been abusing your son."
4. "I will need to talk to the nurse manager about this situation before you leave." -
ANSWER ✔✔- 1) Implementation: outcome not desired and not priority;
documentation of suspected abuse should contain facts and be nonjudgmental
2) Assessment: outcome not priority; priority action is to report potential abuse to
nurse manager
3) Implementation: outcome not desired; close-ended statement; confrontational
4) CORRECT-Implementation: outcome desired; follows chain of command;
potential abuse situation
The parents of a newborn boy ask the nurse whether they should have their son
circumcised. Which response by the nurse is MOST appropriate?
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Download Kaplan NCLEX Readiness Exam: 180 Questions & Verified Answers (Graded A+) and more Exams Nursing in PDF only on Docsity!

LATEST KAPLAN NCLEX READINESS

EXAM 180 QUESTIONS AND CORRECT

ANSWERS ALREADY GRADED A+

A 7-year-old boy is brought to the emergency room by his mother following a fall from his bicycle. X-ray reveals healed fractures of the ribs. The child's mother states, "My son is such a careless child; he's always having accidents or fights with his brother." Which response by the nurse would be MOST appropriate?

  1. "When I document information about these injuries, it will be on your son's hospital record forever."
  2. "How would you describe your son's relationship with his brothers and sisters?"
  3. "What I see suggests that someone has been abusing your son."
  4. "I will need to talk to the nurse manager about this situation before you leave." - ANSWER ✔✔- 1) Implementation: outcome not desired and not priority; documentation of suspected abuse should contain facts and be nonjudgmental
  1. Assessment: outcome not priority; priority action is to report potential abuse to nurse manager
  2. Implementation: outcome not desired; close-ended statement; confrontational
  3. CORRECT-Implementation: outcome desired; follows chain of command; potential abuse situation The parents of a newborn boy ask the nurse whether they should have their son circumcised. Which response by the nurse is MOST appropriate?
  1. "The benefits of the procedure usually outweigh the risks of bleeding and infection."
  2. "You should ask your obstetrician or pediatrician to advise you."
  3. "It is not mandatory that your son have a circumcision. What are your concerns?"
  4. "Some parents worry about the pain associated with circumcision, but there is actually very little discomfort." - ANSWER ✔✔- 1) Implementation: outcome not desired; program of good hygiene provides advantages without risks of circumcision 2 ) Implementation: outcome not desired; passing the buck
  1. CORRECT-Assessment: outcome priority; open communication; initial assessment: acknowledges parents' feelings
  2. Implementation: outcome not desired; closed communication; nurse assumes that pain is the issue The home health nurse is planning client visits for the day. Which of the following clients should the nurse see FIRST?
  1. A 70-year-old diabetic with fasting blood glucose readings of 240-260 mg/dL for 1 week.
  2. A 65-year-old discharged from the hospital 2 days ago following coronary artery bypass graft surgery (CABG).
  3. A 55-year-old with congestive heart failure who gained 3 lbs in the last 24 hours.
  1. CORRECT-Implementation: outcome desired; good source of potassium, decreased potassium can predispose to digitalis toxicity Heparin 5,000 units subcutaneously is ordered every 12 hours for a client. The result of the client's most recent PTT is 55 seconds. Which action by the nurse is MOST appropriate?
  1. Document the result and administer the heparin.
  2. Withhold the heparin.
  3. Notify the healthcare provider.
  4. Have the test repeated. - ANSWER ✔✔- 1) CORRECT- Implementation: outcome desired; PTT lower limit of normal 20 - 25 seconds, upper limit of normal 32 to 39 seconds, therapeutic range 1.5 to 2 times normal, 5 seconds is within therapeutic range
  1. Implementation: outcome medication should be given; PTT is in therapeutic range
  2. Implementation: outcome not desired; unnecessary
  3. Implementation: outcome not desired; unnecessary The nurse cares for a client diagnosed with a complete spinal cord injury 12 weeks ago due to compression fractures of the 5th and 6th cervical vertebrae. The client reports a sudden onset of sweating and has a flushed face and chest. Which action should the nurse take FIRST?
  1. Perform a digital rectal examination.
  2. Check the color and temperature of the extremities.
  3. Place the client in high-Fowler's position.
  4. Administer hydralazine (Apresoline) 20 mg intravenously. - ANSWER ✔✔- 1) Assessment: outcome not priority; immediate action to decrease blood pressure is priority; rectal stimulation may increase autonomic dysreflexia
  1. Assessment: outcome not priority; immediate need is to reduce blood pressure and prevent hemorrhage
  2. CORRECT-Implementation: outcome desired; immediate effect; decrease venous return to heart, decrease stroke volume, and decrease in blood pressure
  3. Implementation: outcome not desired as initial action; causes vasodilation; more immediate effect with position change; if cause of autonomic dysreflexia removed, sudden drop in blood pressure could occur A man is returned to his room in stable condition after a transurethral prostatectomy (TURP). He has continuous bladder irrigation through a 3-way urinary drainage catheter with a 30-mL balloon tip. Tension has been applied to the catheter. The client reports that he feels pressure in his bladder and rectum, and feels as though he has to urinate. Which action should the nurse take FIRST?
  1. Check the patency of the catheter.
  2. Assess residual urine volume using bladder ultrasonography.
  3. Assess the amount of drainage in the urinary drainage bag.
  4. Decrease the tension on the catheter. - ANSWER ✔✔- 1) CORRECT- Assessment: outcome priority; catheter may be blocked or client may be having bladder spasms

The nurse cares for an 80-year-old client taking medication for the treatment of hypertension and heart failure. Which action is MOST important for the nurse to take?

  1. Check the client's blood pressure and heart rate immediately after ambulation.
  2. Instruct the client to use a walker at all times during ambulation.
  3. Encourage the client to walk with the feet as close together as possible.
  4. Instruct the client to sit on the edge of the bed for 3 to 5 minutes before arising.
  • ANSWER ✔✔- 1) Assessment: outcome not desired; blood pressure and heart rate should be assessed prior to ambulation; more important to assess for shortness of breath and activity tolerance
  1. Implementation: outcome not desired; avoid soft-soled shoes; remove barriers; orthostatic precautions are priority; no indication in the question that a walker is needed
  2. Implementation: outcome not desired; should have wide-based gait to distribute center of gravity; may be unsafe ambulation
  3. CORRECT-Implementation: outcome desired and priority; elderly have decreased cerebral perfusion; antihypertensives and medications used to treat heart failure cause vasodilation The nurse monitors the activities of a 9-year-old girl with juvenile rheumatoid arthritis (JA). Which activity is MOST appropriate?
  1. The girl is jumping rope.
  2. The girl is skipping.
  3. The girl jumps off the end of a slide.
  1. The girl participates on a swim team. - ANSWER ✔✔- 1) Implementation: outcome not desired; too traumatic to the joints
  1. Implementation: outcome not desired; too traumatic to the joints
  2. Implementation: outcome not desired; too traumatic to the joints
  3. CORRECT-Implementation: outcome desired; good moving and stretching activity; also, throwing or kicking a ball, riding a bicycle, swimming The nurse cares for a client diagnosed with depression. Which statement by the client indicates improvement?
  1. "I have been sleeping 6 hours at night."
  2. "I have lost 2 lbs in the past week."
  3. "Lately, I have trouble watching television."
  4. "I have much less muscle tension now." - ANSWER ✔✔- 1) CORRECT - Assessment: outcome desired; clients with depression may have increased or decreased sleep time
  1. Assessment: outcome not desired; lack of appetite is a frequent sign of depression
  2. Assessment: outcome not desired; lack of concentration is sign of depression
  3. Assessment: outcome not desired; is a sign of anxiety
  1. "Take this doll and show me where the operation will be done." - ANSWER ✔✔- 1) Implementation: outcome not desired; parents are encouraged to remain with child
  1. Implementation: outcome not desired; appropriate only for school-aged and adolescent children
  2. Implementation: outcome not desired; not appropriate
  3. CORRECT - Implementation: outcome desired; encourage expression of feelings (e.g., anger); fear mutilation; allow child to play with models of equipment The nurse cares for a client diagnosed with Alzheimer's disease. The client is confused and incontinent of urine. What is the MOST important action for the nurse to take?
  1. Insert an indwelling urinary drainage catheter.
  2. Perform intermittent catheterization every 4 hours.
  3. Offer the bedpan to the client every 2 hours.
  4. Assist the client to a bedside commode every 2 hours. - ANSWER ✔✔- 1) Implementation: outcome not desired; increases risk of infection; catheter-related infections are most common hospital-acquired infection
  1. Implementation: outcome not desired; increases chance of infection
  2. Implementation: outcome appropriate but not priority; does not keep client independent and active
  1. CORRECT - Implementation: outcome desired; keeps client active and independent The nurse cares for a client with a history of type 1 diabetes mellitus who has just returned to the surgical acute-care unit after a right below-knee amputation. The client's capillary blood glucose is 480 mg/dL. The postoperative orders indicate 6 units of regular insulin subcutaneously should be administered. Which of the following is the FIRST action the nurse should take?
  1. Check the client records to see if insulin was given prior to surgery.
  2. Administer the 6 units of regular insulin subcutaneously.
  3. Administer the insulin when oral fluids are tolerated.
  4. Contact the healthcare provider. - ANSWER ✔✔- 1) Assessment: outcome desired but not priority; client needs insulin coverage now
  1. CORRECT - Implementation: outcome desired; sliding scale-receives predetermined amount of insulin according to glucose level; surgery and infection increase insulin needs
  2. Implementation: outcome not desired; needs insulin regardless of oral intake due to elevated blood glucose
  3. Implementation: outcome not desired; no reason to contact healthcare provider; order is valid and appropriate for situation The nurse cares for a client with a cuffed tracheostomy tube. Before performing oral care, the nurse notes that the client's tracheostomy cuff is inflated. Which of the following is the MOST appropriate action for the nurse to take?
  1. CORRECT - Assessment: outcome priority; shallow respirations seen; impaired alveolar gas exchange and possible respiratory arrest
  2. Assessment: outcome not priority; most important to assess airway and breathing
  3. Assessment: outcome not priority but may be appropriate; drowsiness and euphoria may be seen; not priority The client tells the clinic nurse that the client is thinking about using nicotine polacrilex (Nicorette). Which question is MOST important for the nurse to ask?
  1. "Have you tried other methods to stop smoking?"
  2. "How long have you been smoking?"
  3. "Have you ever had chest pain?"
  4. "Do you have a partial dental bridge?" - ANSWER ✔✔- 1) Assessment: outcome not priority but may be appropriate; can be asked as part of assessment
  1. Assessment: outcome not priority but may be appropriate; should be assessed for further teaching
  2. CORRECT - Assessment: outcome priority; action of nicotine is vasoconstriction; increases heart rate and myocardial oxygen consumption; increased risk of angina and myocardial infarction
  3. Assessment: outcome may be appropriate but not priority; gum is place between cheek and gums; may stain dental work

The nurse cares for the client with a client controlled analgesia (PCA) pump. The nurse determines that the client has pressed the button 11 times and received 6 doses of morphine during the last hour. Which is the MOST appropriate action for the nurse to take?

  1. Assess the patency of the PCA IV tubing.
  2. Determine the client's understanding of the PCA pump function.
  3. Obtain an order to begin a PCA infusion of fentanyl.
  4. Ask the client to describe the pain. - ANSWER ✔✔- 1) Assessment: outcome not priority but may be appropriate; if tubing is obstructed, alarm is activated
  1. Assessment: outcome may be appropriate but not priority; more important to determine pain level, description of the pain, region and radiation of the pain, and relieving factors
  2. Implementation: outcome not desired; more important to assess severity of pain and pain relief first
  3. CORRECT - Assessment: outcome priority; must validate that client is in pain before implementation A pregnant woman receives an epidural anesthetic. After administration of the epidural anesthetic, the client's blood pressure changes from 120/84 to 94/50. Which action by the nurse is MOST appropriate?
  1. Place the client flat on her back.
  2. Elevate the head of the bed 30 degrees.
  3. Place the client on her left side with her legs flexed.

The nurse prepares to administer the initial dose of oral enalapril (Vasotec) 20 mg in the morning. Which medication should the nurse question giving to the client?

  1. 20 mg oral escitalopram (Celexa) in the morning.
  2. 40 mg oral furosemide (Lasix) in the morning.
  3. 300 mg of oral gabapentin (Neurontin) twice daily.
  4. 10 mg zolpidem (Ambien) at bedtime. - ANSWER ✔✔- 1) Implementation: outcome not a problem; no interaction with ACE inhibitors; is an SSRI antidepressant
  1. CORRECT - Implementation: outcome potential problem; may promote significant diuresis; first dose of ACE inhibitors increases risk of "first dose" phenomenon due to vasodilation; combination of vasodilation and diuresis increases risk of orthostatic hypotension
  2. Implementation: outcome not a problem; no interaction; gabapentin classified as antiseizure medication; off-label use for neuropathic pain
  3. Implementation: outcome not a problem; is a hypnotic; no interaction with ACE inhibitors The home care nurse visits a client with a halo fixator traction device. Which client statement MOST concerns the nurse?
  1. "My wife looks at the pin sites every day."
  2. "I like to bathe in the tub."
  1. "I drove to the library yesterday."
  2. "I drink with a straw." - ANSWER ✔✔- 1) Assessment: outcome desired; risk of infection at pin sites; client should be taught signs of inflammation and infection
  1. Implementation: outcome desired; showers increase risk of infection at pin sites
  2. CORRECT - Implementation: outcome not desired and may be a problem; client is not able to turn with halo device; increases the risk of injury to self and others
  3. Implementation: outcome desired; difficulty manipulating cup or glass due to immobilized neck During the admission interview, the client reports a red, itchy raised rash on the chest and lip swelling after use of aspirin and penicillin. The admission orders include bed rest, soft diet as tolerated, naproxen (Naprosyn), and cefaclor (Ceclor). Which is the BEST description of expected breath sounds heard during auscultation?
  1. Administer the Ceclor as ordered; do not administer the naproxen.
  2. Administer the naproxen as ordered; do not administer the Ceclor.
  3. Administer both the Ceclor and naproxen as ordered; document the client's response.
  4. Do not administer the Ceclor or naproxen; notify the healthcare provider. - ANSWER ✔✔- 1) Implementation: outcome not desired; cephalosporins have cross-allergies with penicillins
  1. Implementation: outcome not desired; NSAIDs should be used cautiously with aspirin allergies
  1. Continuous, high-pitched musical sounds heard on expiration.
  2. Soft, high-pitched interrupted sounds heard on inspiration.
  3. Deep, low-pitched rumbling sounds are heard mainly on expiration.
  4. Harsh, grating sounds heard best during inspiration. - ANSWER ✔✔- 1) Assessment: outcome not expected; sibilant wheezes, heard with asthma, caused by narrow bronchioles
  1. Assessment: outcome not expected; crackles, heard with pneumonia and CHF, caused by fluid in the alveoli
  2. CORRECT - Assessment: outcome expected; sonorous wheezes or rhonchi, caused by mucus in the airways; excessive mucous production is primary symptom
  3. Assessment: outcome not expected; pericardial friction rub, caused by inflamed pleura or pericarditis The nurse prepares to administer gentamicin (Garamycin) to the 65-year-old client. Which is the MOST important action for the nurse to take prior to administration of the medication?
  1. Request a daily hemoglobin and hematocrit test.
  2. Monitor the serum BUN and creatinine.
  3. Request a highly-sensitive C-reactive protein (hs-CRP) test.
  4. Monitor the erythrocyte sedimentation rate (ESR). - ANSWER ✔✔- 1) Assessment: outcome not priority; may cause anemia, but not usually seen
  1. CORRECT - Assessment: outcome priority; nephrotoxic; will see proteinuria, oliguria, hematuria, thirst, increased BUN, decreased creatine clearance
  2. Assessment: outcome not priority; will be increased in inflammation and rheumatoid arthritis
  3. Assessment: outcome not priority; will be increased with any inflammatory process The nurse cares for the client in the labor unit. During the transitional phase of labor, the umbilical cord becomes prolapsed. It is MOST important for the nurse to take which action?
  1. Place the client on her back with thighs flexed on her abdomen.
  2. Place the client on her left side with legs flexed.
  3. Place the client supine with the head of the bed elevated 30°.
  4. Place the client supine with the foot of the bed elevated. - ANSWER ✔✔- 1) Implementation: outcome not desired; lithotomy position; will not decrease pressure on umbilical cord
  1. Implementation: outcome not desired; position used to remove weight of fetus from vena cava to prevent maternal hypotension; will not help with prolapsed cord
  2. Implementation: outcome not desired; would aggravate prolapsed cord pressure
  3. CORRECT - Implementation: outcome desired; Trendelenburg or knee chest position desired to decrease pressure on umbilical cord