NCLEX-RN Free Exam Questions and Answers PDF Updated on May-2025
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NEW QUESTION # 195
A male client is experiencing auditory hallucinations. His nurse enters the room and he tells her that his mother is talking to him, and he will take his medicine after she leaves. The nurse looks around the room and sees that she and the client are the only ones in the room. The nurse's most therapeutic response will be:
- A. "OK, I'll come back later when you're feeling more like taking your medicine."
- B. "I don't see your mother in the room. Let's talk about how you're feeling."
- C. "Why don't you finish talking to her, and I'll wait."
- D. "She may be here, but I can't see her."
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) This response uses the principle of reality orientation by the nurse telling the client that he or she does not see anything, but it does recognize his feelings. (B) This response does not make it clear that the nurse does not see anyone else in the room, and the nurse leaves the client alone to continue hallucinating. (C) This response leaves room for doubt; the nurse is further confusing the client by this statement. (D) This response reinforces the hallucination and implies that the nurse sees his mother, too.
NEW QUESTION # 196
The physician has prescribed metoclopramide (Reglan). When assessing the client, the nurse would expect to find which of the following responses?
- A. Increase in peristalsis
- B. Drowsiness
- C. Increase in gastric secretions
- D. Disorientation
Answer: A
Explanation:
Explanation
(A) Metoclopramide does not stimulate gastric secretions. (B) This response is expected with metoclopramide, in addition to increasing gastric emptying. (C) Disorientation is a symptom of metoclopramide overdose. The drug should be discontinued. (D) Drowsiness is a symptom of metoclopramide overdose and the drug should be discontinued.
NEW QUESTION # 197
A client with a C-3-4 fracture has just arrived in the emergency room. The primary nursing intervention is:
- A. Airway assessment and stabilization
- B. Normalization of intravascular volume
- C. Stabilization of the cervical spine
- D. Confirmation of spinal cord injury
Answer: A
Explanation:
(A) If cervical spine injury is suspected, the airway should be maintained using the jaw thrust method that also protects the cervical spine. (B) Primary intervention is protection of the airway and adequate ventilation. (C, D) All other interventions are secondary to adequate ventilation.
NEW QUESTION # 198
A 7-year-old girl has been diagnosed with juvenile arthritis and has been placed on daily aspirin. Which statement made by the parent indicates a need for further teaching?
- A. "One sign of aspirin toxicity can be ringing in the ears."
- B. "My daughter takes her aspirin with her meals."
- C. "Her gums have been bleeding frequently. Maybe she is brushing too hard."
- D. "I give her aspirin on a regular schedule every day."
Answer: C
Explanation:
(A)
Aspirin should not be given on an empty stomach because it is irritating to the mucosa.
(B)
Bleeding from decreased clotting capacity may be caused by aspirin toxicity. (C) A regular schedule of aspirin administration is important to maintain a satisfactory drug level in the body. (D) Aspirin toxicity may affect cranial nerve VIII, leading to tinnitus (ringing in the ears).
NEW QUESTION # 199
A hyperactive client is experiencing flight of ideas. The most therapeutic activity for him would be:
- A. Working a 1000-piece puzzle
- B. Playing bridge with three other clients
- C. Doing crafts in occupational therapy
- D. Playing basketball in the gym
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) This activity requires motor skills and therefore would be difficult for a hyperactive client. (B) This activity would take too long, and the client would have difficulty concentrating owing to a limited attention span. (C) This client would not be able to concentrate enough to play card games. He would respond to all the stimuli in the area, become distracted, and leave the table. (D) This activity would allow the client to channel his energy in a positive way.
NEW QUESTION # 200
A 24-year-old graduate student recognizes that he has a phobia. He suffers severe anxiety when he is in darkness. It has altered his lifestyle because he is unable to go to a movie theater, concert, and other events that may require absence of light. The client is seeking assistance because he is no longer able to socialize with friends due to his phobia. The psychologist working with him is using desensitization. He has asked the nursing staff to assist the client in muscle relaxation techniques. What result would indicate client education has been successful?
- A. He states that he no longer fears dark places.
- B. He enters a concert, but as the lights dim, he does not experience anxiety.
- C. He takes a part-time job as a photographic assistant. His job necessitates his working in a darkroom.
- D. He enters a movie theater, sits in his chair, and replaces anxiety with relaxation as the theater darkens.
Answer: D
Explanation:
Explanation
(A) This situation provides specific evidence that the client is able to integrate muscle relaxation technique into his lifestyle to alleviate anxiety. (B) The client may not experience anxiety at the concert, but there is no evidence regarding the technique that he used to alleviate anxiety. (C) The client may state he no longer experiences anxiety, but there is no evidence demonstrating this. He may be denying anxiety to discontinue therapy prematurely. (D) Does he experience anxiety in the darkroom? He may have taken this job to force himself to deal with the phobia directly.
NEW QUESTION # 201
The pediatrician has diagnosed tinea capitis in an 8- year-old girl and has placed her on oral griseofulvin.
The nurse should emphasize which of these instructions to the mother and/or child?
- A. May discontinue medication when the child experiences symptomatic relief.
- B. Discontinue drug therapy if food tastes funny.
- C. Observe for headaches, dizziness, and anorexia.
- D. Administer oral griseofulvin on an empty stomach for best results.
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Giving the drug with or after meals may allay gastrointestinal discomfort. Giving the drug with a fatty meal (ice cream or milk) increases absorption rate. (B) Griseofulvin may alter taste sensations and thereby decrease the appetite. Monitoring of food intake is important, and inadequate nutrient intake should be reported to the physician. (C) The child may experience symptomatic relief after 48-96 hours of therapy. It is important to stress continuing the drug therapy to prevent relapse (usually about 6 weeks). (D) The incidence of side effects is low; however, headaches are common. Nausea, vomiting, diarrhea, and anorexia may occur. Dizziness, although uncommon, should be reported to the physician.
NEW QUESTION # 202
A female client is anticipating a visit with her parents over the Thanksgiving holidays. She has recently begun experiencing periods of extreme shortness of breath, which her physician has labeled as panic attacks. Which of the following statements by the nurse would enhance therapeutic communication?
- A. "Tell me about your dislike for your parents."
- B. "Don't worry, everything will be all right on your visit with your parents."
- C. "Perhaps you and I can discover what produces your anxiety."
- D. "Why do you feel this way?"
Answer: C
Explanation:
Section: Questions Set E
Explanation:
(A) Asking the client to provide an explanation for her feelings is often intimidating. (B) This response is probing and may make the client feel used and valued only for the information she can provide. (C) This underrates the client's feelings and belittles her concerns. It may cause the client to stop sharing feelings for fear that they will be ridiculed. (D) The emphasis is on working with the client. It shows that there is hope for change through collaboration.
NEW QUESTION # 203
After 3 weeks of treatment, a severely depressed client suddenly begins to feel better and starts interacting appropriately with other clients and staff. The nurse knows that this client has an increased risk for:
- A. Exacerbation of depressive symptoms
- B. Violence toward others
- C. Psychotic behavior
- D. Suicide
Answer: D
Explanation:
Section: Questions Set A
Explanation:
(A) When the severely depressed client suddenly begins to feel better, it often indicates that the client has made the decision to kill himself or herself and has developed a plan to do so. (B) Improvement in behavior is not indicative of an exacerbation of depressive symptoms. (C) The depressed client has a tendency for self- violence, not violence toward others. (D) Depressive behavior is not always accompanied by psychotic behavior.
NEW QUESTION # 204
A depressed client is seen at the mental health center for follow-up after an attempted suicide 1 week ago. She has taken phenelzine sulfate (Nardil), a monoamine oxidase (MAO) inhibitor, for 7 straight days. She states that she is not feeling any better. The nurse explains that the drug must accumulate to an effective level before symptoms are totally relieved. Symptom relief is expected to occur within:
- A. 2 months
- B. 10 days
- C. 3 months
- D. 2-4 weeks
Answer: D
Explanation:
Explanation
(A) This answer is incorrect. It can take up to 1 month for therapeutic effect of the medication. (B) This answer is correct. Because MAO inhibitors are slow to act, it takes 2-4 weeks before improvement of symptoms is noted. (C) This answer is incorrect. It can take up to 1 month for therapeutic effect of the medication. (D) This answer is incorrect. Therapeutic effects of the medication are noted within 1 month of drug therapy.
NEW QUESTION # 205
Before giving methergine postpartum, the nurse should assess the client for:
- A. Afterpains
- B. Decreased amount of lochial flow
- C. Flushing
- D. Elevated blood pressure
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Methergine is given to contract the uterus and to control postpartal hemorrhage; therefore, lochial flow should decrease. (B) Methergine may elevate the blood pressure. A client with an elevated blood pressure should not receive methergine, but she could be given oxytocin if necessary. (C) Flushing is not a side effect of methergine. (D) Afterpains are increased with methergine usage. The client should be informed that this is a normal response.
NEW QUESTION # 206
Assessment of severe depression in a client reveals feelings of hopelessness, worthlessness; inability to feel pleasure; sleep, psychomotor, and nutritional alterations; delusional thinking; negative view of self; and feelings of abandonment. These clinical features of the client's depression alert the nurse to prioritize problems and care by addressing which of the following problems first:
- A. Rest and activity impairment
- B. Nutritional status
- C. Impaired thinking
- D. Possible harm to self
Answer: D
Explanation:
Explanation
(A) Anorexia and weight loss are problems that need attention in severe depression, but they can be addressed secondary to immediate concerns. (B) Impaired thinking and confusion are problems in severe depression that are addressed with administration of medication, through group and individual psychotherapy, and through activity therapy as motivation and interest increase. (C) Possible harm to self as with suicidal ideation; a suicide plan, means to execute plan; and/or overt gestures or an attempt must be addressed as an immediate concern and safety measures implemented appropriate to the risk of suicide. (D) Rest and activity impairment may take time and further assessment to determine client's sleep pattern and amount of psychomotor retardation with the more immediate concern for safety present.
NEW QUESTION # 207
When assessing a child with diabetes insipidus, the nurse should be aware of the cardinal signs of:
- A. Anemia and vomiting
- B. Hypothermia and azotemia
- C. Polyuria and polydipsia
- D. Irritability relieved by feeding formula
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Anemia and vomiting are not cardinal signs of diabetes insipidus. (B) Polyuria and polydipsia are the cardinal signs of diabetes insipidus. (C) Irritability relieved by feeding water, not formula, is a common sign, but not the cardinal sign, of diabetes insipidus. (D) Hypothermia and azotemia are signs, but not cardinal signs, of diabetes insipidus.
NEW QUESTION # 208
The most commonly known vectors of Lyme disease are:
- A. Mites
- B. Ticks
- C. Mosquitoes
- D. Fleas
Answer: B
Explanation:
Explanation
(A) Mites are not the common vector of Lyme disease. (B) Fleas are not the common vector of Lyme disease.
(C) Ticks are the common vector of Lyme disease. (D) Mosquitoes are not the common vector of Lyme disease.
NEW QUESTION # 209
Which of the following symptoms might the nurse observe in a client with a lithium blood level over 2.0?
- A. Fine hand tremor, headache, mental dullness
- B. Polyuria, polydipsia, edema
- C. Vomiting, impaired consciousness, decreased blood pressure
- D. Gastric irritation, nausea, diarrhea
Answer: C
Explanation:
(A)
These symptoms are acute, common, and usually harmless central nervous system side effects of lithium. (B) These symptoms of lithium toxicity are usually dose related. (C) These symptoms are acute, common, and usually harmless renal side effects of lithium.
(D)
These symptoms are acute, common, and usually harmless gastrointestinal side effects of lithium.
NEW QUESTION # 210
A husband asks if he can visit with his wife on her ECT treatment days and what to expect after the initial treatment. The nurse's best response is:
- A. "There's really no need to stay with her. She's going to sleep for several hours after the treatment."
- B. "Visitors are not allowed. We will telephone you to inform you of her progress."
- C. "Yes, you may visit. She may experience temporary drowsiness, confusion, or memory loss after each treatment."
- D. "You'll have to get permission from the physician to visit. Clients are pretty sick after the first treatment."
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) It is within the nurse's realm of practice to grant visiting privileges according to hospital policy. ECT treatments do not make clients sick. (B) Visitors are allowed and encouraged, particularly family members.
(C) Clients are usually awake within 1 hour posttreatment. Drowsiness wanes as the anesthetic wears off.
(D) A family member is encouraged to stay with the client after return to the unit. The nurse has used an opportunity to do family teaching and allay fears by explaining temporary side effects of the treatment.
NEW QUESTION # 211
A child is to receive atropine 0.15 mg (1/400 g) as part of his preoperative medication. A vial containing atropine 0.4 mg (1/150 g)/mL is on hand. How much atropine should be given?
- A. 0.38 mL
- B. 0.06 mL
- C. 2.7 mL
- D. Information given insufficient to determine the amount of atropine to be administered
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A, C) Information was incorrectly placed in the formula, resulting in an incorrect answer. (B) The answer is correct.
0.4 mg = 1 mL:0.15 mg 5 = mL
0.4 x = 0.15
x = 0.15/0.4
x = 0.375 or 0.38 mL
(D) Sufficient information is provided to determine the amount of atropine to administer. The amount of atropine available and the amount of atropine ordered is required to determine the amount of atropine to be given.
NEW QUESTION # 212
Which of the following medications requires close observation for bronchospasm in the client with chronic obstructive pulmonary disease or asthma?
- A. Propranolol (Inderal)
- B. Verapamil (Isoptin)
- C. Amrinone (Inocor)
- D. Epinephrine (Adrenalin)
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Verapamil has the respiratory side effect of nasal or chest congestion, dyspnea, shortness of breath (SOB), and wheezing. (B) Amrinone has the effect of increased contractility and dilation of the vascular smooth muscle. It has no noted respiratory side effects. (C) Epinephrine has the effect of bronchodilation through β stimulation. (D) Propranolol, esmolol, and labetalol are all β- blocking agents, which can increase airway resistance and cause bronchospasms.
NEW QUESTION # 213
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