NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2023), Exams of Nursing

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Option C. Grunting occurs when an infant attempts to

maintain an adequate functional residual capacity in the

face of poorly compliant lungs by partial glottic closure.

As the infant prolongs the expiratory phase against this

partially closed glottis, there is a prolonged and

increased residual volume that maintains the airway

opening and also an audible expiratory sound.

Option E: Nasal flaring occurs when the nostrils widen

while breathing and is a sign of troubled breathing or

respiratory distress.

Correct Answers: C, E, F, & G

NCLEX-RN Exam Pack Set 1 (

Questions & Answers Updated 2023)

1. 1. Question

While assessing a one-month-old infant, which of the findings warrants further investigation by the nurse? Select all that apply.

o A. Abdominal respirations

o B. Irregular breathing rate

o C. Inspiratory grunt

o D. Increased heart rate with crying

o E. Nasal flaring

o F. Cyanosis

o G. Asymmetric chest movement

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o Have the client empty the bladder. The first step in the proc

Correct order is shown above.

• 2. Question

A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropisol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a preoperative client. List the order in which the nurse must carry out the following actions prior to the administration of preoperative medications. View Answers:

o Place the call bell within reach

o Raise the side rails on the bed

o Have the client empty bladder

o Instruct the client to remain in bed

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o Option F: Cyanosis refers to the bluish

discoloration of the skin and indicates a

decrease in oxygen attached to the red blood

cells in the bloodstream.

o Option G: Asymmetric chest movement

occurs when the abnormal side of the lungs

expands less and lags behind the normal

side. This indicates respiratory distress.

o Option A: Abdominal respiration is normal

among infants and young children. Since their

intercostal muscles are not yet fully

developed, they use their abdominal muscles

much more to pull the diaphragm down for

breathing.

o Option B: Newborns can have irregular

breathing patterns ranging from 30 to 60

breaths per minute with short periods of

apnea (15 seconds).

o Option D: An increase in heart rate is normal

for an infant during activity (including crying).

2. 3. Question

A 32-year-old pregnant woman comes to the clinic for her prenatal visit. The nurse gathers data about her obstetric history, which includes 3-year-old twins at home and a miscarriage 10 years ago at 12 weeks gestation. How would the nurse accurately document this information? Fill in the blanks. o Answer:

Gravida (3)^ par

a

(1)

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client does not have a catheter, it is important

to empty the bladder before receiving

preoperative medications to prevent bladder

injury (especially in pelvic surgeries). Else, a

straight catheter or an indwelling catheter may

be ordered to ensure the bladder is empty.

o Instruct the client to remain in bed.

Preoperative medications can cause

drowsiness and lightheadedness which may

put the client at risk for injury.

o Raise the side rails on the bed. Raising

the side rails on the bed helps prevent

accidental falls and injury when the client

decides to get out of the bed without

assistance.

o Place the call bell within reach. Call bells

o 4. Question Which individual is at the greatest risk for developing hypertension? o A. 45-year-old African-American attorney

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Correct Answer: Gravida 3 para 1

Gravida is the number of confirmed pregnancies and

each pregnancy is only counted one time, even if the

pregnancy was a multiple gestation (i.e., twins, triplets).

Para (parity) indicates the total number of pregnancies

that have reached viability (20 weeks) regardless of

whether the infants were born alive. Thus, for this

woman, she is now pregnant, had 2 prior pregnancies,

Option A: African-Americans develop high blood pressure at younge

Option B: The incidence of hypertension in Asian- Americans does n

Option C: The racial disparity in hypertension and hypertension-rela

Option D: Hypertension prevalence rates in Hispanics may vary by

Correct Answer: A: 45-year-old African American attorney

o B. 60-year-old Asian-American shop owner o C. 40-year-old Caucasian nurse o D. 55-year-old Hispanic teacher

• 5. Question

A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first? o A. Gastric lavage o B. Administer acetylcysteine (Mucomyst) orally o C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open

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o D. Have the patient drink activated charcoal mixed with water Correct Answer: A. Gastric lavage

o Option A: Acetaminophen overdose is extremely

toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the fluid back out. This procedure is done in life- threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion.

o Option B: The oral formulation of acetylcysteine is

the drug of choice for the treatment of acetaminophen overdose but should be done after GI decontamination with activated charcoal. Liver damage is minimized by giving acetylcysteine (Mucomyst), the antidote for acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts the toxic metabolite of acetaminophen to its nontoxic form. When given within 8 hours of acetaminophen toxicity, acetylcysteine is effective in preventing severe liver injury. It is administered orally or intravenously.

o Option C: Intermittent IV infusion with Dextrose

5% may be considered for late-presenting or chronic ingestion.

o Option D: Oral activated charcoal (AC) avidly

adsorbs acetaminophen and may be administered if the patient presents within 1 hour after ingesting a potentially toxic dose. Charcoal should not be administered immediately before or with antidotes

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since it can effectively adsorb it and neutralize the benefits.

• 6. Question

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Correct Answer: C. Manage pain

Option A: The reported incidence of myocardial infarction with angi

Options C & D: A falling BP and dizziness occur along with hemorrha

Correct Answer: B. Thrombus formation

A thrombus formation may prevent blood from flowing normally through the

Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after the procedure? o A. Angina at rest o B. Thrombus formation o C. Dizziness o D. Falling blood pressure

• 7. Question

A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is: o A. Maintain fluid and electrolyte balance o B. Control nausea o C. Manage pain o D. Prevent urinary tract infection

NCLEX-RN Exam Pack Set 1 (

Correct Answer: D. Yearly weight gain of about

5.5 pounds per year

School-age children gain about 5.5 pounds each year

and increase about 2 inches in height. Between ages 2

to 10 years, a child will grow at a steady pace.

Option A: IV hydration in the setting of acute renal colic is controv

Option B: Because nausea and vomiting frequently accompany acu

Option D: Overuse of the more effective antibiotic agents leaves o

Managing pain is always a priority because it ultimately improves the quali

• 8. Question

What would the nurse expect to see while assessing the growth of children during their school-age years? o A. Decreasing amounts of body fat and muscle mass o B. Little change in body appearance from year to year o C. Progressive height increase of 4 inches each year o D. Yearly weight gain of about 5. pounds per year

NCLEX-RN Exam Pack Set 1 (

Correct Answer: A. Go get a blood pressure

check within the next 15 minutes

The blood pressure reading is moderately high with the

need to have it rechecked after a few minutes to verify.

The client states it is ‘usually much lower.’ Thus a

concern exists for complications such as stroke.

o Options B & D: Waiting 2 months or a

week for follow-up is too long.

o Option C: Immediate check by the provider of

care is not warranted.

• 9. Question

At a community health fair, the blood pressure of a 62-year- old client is 160/96 mmHg. The client states “My blood pressure is usually much lower.” The nurse should tell the client to: o A. Go get a blood pressure check within the next 15 minutes o B. Check blood pressure again in two (2) months o C. See the healthcare provider immediately o D. Visit the health care provider within one (1) week for a BP check

• 10. Question

The hospital has sounded the call for a disaster drill on the evening shift. Which of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission?

NCLEX-RN Exam Pack Set 1 (

o Option A: Decreasing amounts of body

fat and muscle mass are common in

toddlers.

o Option B: A decrease in the change

in body appearance occurs among

young adults.

Option B: The client with antibiotic-induced diarrhea still needs cont

Option C: Stevens-Johnson syndrome (SJS) is a rare, serious disorde

Option D: Cellulitis is often an underestimated complication of HIV d

Correct Answer: A. A middle-aged client with a history of being venti

The best candidate for discharge is one who has had a chronic condition and

o A. A middle-aged client with a history of being ventilator dependent for over seven (7) years and admitted with bacterial pneumonia five days ago. o B. A young adult with diabetes mellitus Type 2 for over ten (10) years and admitted with antibiotic-induced diarrhea 24 hours ago. o C. An elderly client with a history of hypertension, hypercholesterolemia, and lupus, and was admitted with Stevens-Johnson syndrome that morning. o D. An adolescent with a positive HIV test and admitted for acute cellulitis of the lower leg 48 hours ago.

• 11. Question

A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication:

NCLEX-RN Exam Pack Set 1 (

Correct Answer: D. Notify the healthcare

provider of the child’s status

Option A: Levothyroxine (Synthroid) has a side effect of insomnia.

Option B: Some of the side effects of Levothyroxine include hyperac

Option C: Keep this drug in a cool, dark, and dry place.

Option D: A decrease in the heart rate is the desired effect of Levo

Correct Answer: A. Should be taken in the morning

o A. Should be taken in the morning o B. May decrease the client’s energy level o C. Must be stored in a dark container o D. Will decrease the client’s heart rate

• 12. Question

A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first? o A. Prepare the child for X-ray of upper airways o B. Examine the child’s throat o C. Collect a sputum specimen o D. Notify the healthcare provider of the child’s status

NCLEX-RN Exam Pack Set 1 (

Option A: If epiglottitis is seriously considered, no imaging studies

Option B: Examining the child’s throat should not be attempted b

Option C: There are no indications for the collection of sputum spe

These findings suggest a medical emergency and may be due to epiglottit

Option A: Polyphagia or extreme hunger is one of the most common

Option B: Dehydration is not a symptom of type 1 diabetes, but it c

Option D: Unintentional weight loss would develop gradually in a ch

Correct Answer: C. Bedwetting

One of the first symptoms of type 1 diabetes in children is bedwetting. Bedwe

• 13. Question

In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation? o A. Polyphagia o B. Dehydration o C. Bedwetting o D. Weight loss

• 14. Question

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Option B: Chlamydial infections are one of the most frequent cause

Option A: Trichomoniasis is a very common sexually transmitted d

Options C & D: Staphylococcus and streptococcus may cause PID b

Correct Answer: B. Chlamydia

A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection? o A. Trichomoniasis o B. Chlamydia o C. Staphylococcus o D. Streptococcus

• 15. Question

A registered nurse who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN? o A. A middle-aged client who says “I took too many diet pills” and “my heart feels like it is racing out of my chest.” o B. A young adult who says “I hear songs from heaven. I need money for beer. I quit drinking two (2) days ago for my family. Why are my arms and legs jerking?” o C. An adolescent who has been on pain medications terminal cancer with an initial assessment finding pupils and a relaxed respiratory rate of 11,

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Correct Answer: C. Avoiding very heavy meals

Eating large, heavy meals can pull blood away from the

heart for digestion and is dangerous for the client with

coronary artery disease. Too much plaque may

accumulate in the arteries and block the delivery of blood

and oxygen in major organs of the body.

Option A: The client in option A might be experiencing an overdose.

Option B: The client in option B is having withdrawal syndrome.

Option D : The client in option D may experience a decrease in sens

Correct Answer: C. An adolescent who has been on pain medications

Nurses who are floated to other units should be assigned to a client who has

o D. An elderly client who reports having taken a “large crack hit” 10 minutes prior to walking into the emergency room.

• 16. Question

When teaching a client with coronary artery disease about nutrition, the nurse should emphasize: o A. Eating three (3) balanced meals a day o B. Adding complex carbohydrates o C. Avoiding very heavy meals o D. Limiting sodium to 7 gms per day

NCLEX-RN Exam Pack Set 1 (

Option A: Discomfort at the IV insertion site may indicate inflamma

Option B: Morphine is a strong painkiller indicated for severe pain.

Option D: The pump is working correctly if there is only 50 ml left a

Correct Answer: C. The level of the drug is 100 ml at 8 AM and is 80 m

The minimal dose of 10 mL per hour which would be 40 mL given in a four (

• 17. Question

Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working? o A. The client complains of discomfort at the IV insertion site o B. The client states “I just can’t get relief from my pain.” o C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon o D. The level of the drug is 100 ml at 8 AM and is 50 ml at noon

• 18. Question

NCLEX-RN Exam Pack Set 1 (

o Option A: Eating a balanced diet should be

a part of the management of a client with

coronary artery disease.

o Option B: Complex carbohydrates

decrease inflammation and help decrease

the risk of plaque build-up in the arteries.

o Option C: People with cardiovascular

diseases should have a limit of less than 1.

Correct Answer: A. Decrease in the level of

Option A: Too much exposure to electrical energy can become a ha

Option C: Mind-body balance refers to yoga.

Option D: Low-impact aerobic exercises are easier on the joints bu

Correct Answer: B. Spinal column manipulation

The theory underlying chiropractic is that interference with the transmission o

The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse’s response? o A. Electrical energy fields o B. Spinal column manipulation o C. Mind-body balance o D. Exercise of joints

• 19. Question

The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention? o A. Decrease in the level of consciousness o B. Loss of bladder control o C. Altered sensation to stimuli o D. Emotional lability

NCLEX-RN Exam Pack Set 1 (

Correct Answer: C. Moist, productive cough

Noisy respirations and a dry non-productive cough are

commonly the first of the respiratory signs to appear in a

newly diagnosed client with cystic fibrosis (CF). The other

options are the earliest findings. CF is an inherited

(genetic) condition affecting the cells that produce mucus,

sweat, saliva, and digestive juices. Normally, these

Option B: The patient post-stroke may have transient urinary inco

Option C: Altered sensation to stimuli is expected for a patient po

Option D: Depression and anxiety are common responses by a pa

A further decrease in the level of consciousness may indicate an increase in

• 20. Question

A child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time? o A. Positive sweat test o B. Bulky greasy stools o C. Moist, productive cough o D. Meconium ileus

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Correct Answer: B. Send him to the emergency

room for evaluation

This client requires immediate evaluation. A delay in

treatment could result in further deterioration and harm.

Home care nurses must prioritize interventions based on

assessment findings that are in the client’s best interest.

o Option A: Waiting to call for instructions

may delay the diagnosis of the patient.

o Option C: Reassuring the wife is since it

is not a transient symptom.

Option A: A positive sweat test is one of the indications of cystic fi

Option B: A patient with CF experiences frequent greasy, bulky sto

Option D: Meconium ileus is one of the early signs of CF.

causes the secretions to become thick and sticky. Instead of acting as a lub

• 21. Question

The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs two (2) hours ago. The nurse should o A. Place a call to the client’s health care provider for instructions o B. Send him to the emergency room for evaluation o C. Reassure the client’s wife that the symptoms are transient o D. Instruct the client’s wife to call the doctor if his symptoms become worse

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Option A: There is no need to keep the client on NPO before the pro

Option B: Enemas are not recommended for any type of radiograph

Option C: Furosemide (Lasix) is unnecessary for this examination.

Correct Answer: D. No special orders are necessary for this examinat

There are no special orders for this procedure, however, the client must be in

• 22. Question

Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test? o A. Client must be NPO before the examination o B. Enema to be administered prior to the examination o C. Medicate client with furosemide 20 mg IV 30 minutes prior to the examination o D. No special orders are necessary for this examination

• 23. Question

The nurse is giving discharge teaching to a client seven (7) days post-myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question? o A. “You need to regain your strength before attempting such exertion.”

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o Option D: The symptoms are indicative of an

emergency situation so the patient must be

brought to the emergency department

Option A: The instruction in option A is vague and does not specific

Option C: Having a glass of wine is not recommended for a client wh

Option D: Having an active walking program does not guarantee tha

Correct Answer: B. “When you can climb 2 flights of stairs without pr

There is a risk of cardiac rupture at the point of the myocardial infarction for a

o B. “When you can climb 2 flights of stairs without problems, it is generally safe.” o C. “Have a glass of wine to relax you, then you can try to have sex.”

• 24. Question

A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first? o A. A 2-month-old infant with a history of rolling off the bed and has bulging fontanelle with crying o B. A teenager who got a singed beard while camping o C. An elderly client with complaints of frequent liquid brown colored stools o D. A middle-aged client with intermittent pain behind the right scapula

NCLEX-RN Exam Pack Set 1 (75

Option A: When an infant is crying, the fontanels may look like th

Option C: The client in Option C can wait to be seen within the firs

Option D: The client in Option D does not have a life- threatening

Correct Answer: B. A teenager who got a singed beard while campin

This client is in the greatest danger with a potential of respiratory distress. A

Option A: The statement in Option A is correct but pertains to the r

Option B: Setting limits on a toddler may cause frustration instead

Correct Answer: C. “I understand the need to use those new skills.”

Erikson describes the stage of the toddler as being the time when there is nor

• 25. Question

While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age. Which statement by the mother shows that she understands the child’s developmental needs? o A. “I want to protect my child from any falls.” o B. “I will set limits on exploring the house.” o C. “I understand the need to use those new skills.” o D. “I intend to keep control over our child.”

NCLEX-RN Exam Pack Set 1 (75

Option B: It is also important to check that the feeding solution mat

Option C: Aspirating the gastric contents is one of the methods use

Option D: Keep it at room temperature so it would not upset the sto

Correct Answer: A. Verify correct placement of the tube Proper place

• 26. Question

The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is: o A. Verify correct placement of the tube o B. Check that the feeding solution matches the dietary order o C. Aspirate abdominal contents to determine the amount of last feeding remaining in stomach o D. Ensure that feeding solution is at room temperature

• 27. Question

The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq potassium chloride in 1000 ml of 5% dextrose in water IV.

NCLEX-RN Exam Pack Set 1 (75

o Option D: Controlling the child may be harmful

to her development as toddlers should be

developing their autonomy at this stage.

Correct Answer: A. All striated muscles

Option A: Narrow QRS complex indicates fast cardiac rhythms (gene

Option B: A short PR interval (<120 ms) is seen with preexcitation s

Option D: Prominent U waves are characteristic of hypokalemia.

Correct Answer: C. Tall peaked “T” waves

A tall peaked T wave is a sign of hyperkalemia. The healthcare provider shou

Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued? o A. Narrowed QRS complex o B. Shortened “PR” interval o C. Tall peaked "T" waves o D. Prominent “U” waves

• 28. Question

A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body? o A. All striated muscles o B. The cerebellum o C. The kidneys o D. The leg bones

NCLEX-RN Exam Pack Set 1 (75

Option B: The cerebellum is not affected in rhabdomyosarcoma.

Option C: The kidneys are not directly affected by the disease.

Option D: Bones are not directly affected by the disease.

Rhabdomyosarcoma is the most common children’s soft tissue sarcoma. It o

Option A: Living in harmony with one’s natural environment with th

Option B: This balance and a healthy lifestyle are the focus of Chin

Correct Answer: D. Restore yin and yang

For followers of Chinese medicine, health is maintained through the balance b

• 29. Question

The nurse anticipates that for a family who practices Chinese medicine the priority goal would be to: o A. Achieve harmony o B. Maintain a balance of energy o C. Respect life o D. Restore yin and yang

NCLEX-RN Exam Pack Set 1 (75