NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022), Exams of Nursing

Download NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) and more Exams Nursing in PDF only on Docsity! NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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 • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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). Fluctuations in heart rate follow the changes in the newborn’s behavioral state – crying, o 4. Question Which individual is at the greatest risk for developing hypertension? o A. 45-year-old African-American attorney NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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, and 1 viable birth (twins). 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? NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: African-Americans develop high blood pressure at younger ages than other groups in the US. Researchers have uncovered that African-Americans respond differently to hypertensive drugs than other groups of people. They are also found out to be more sensitive to salt, which increases the risk of developing hypertension. Option B: The incidence of hypertension in Asian- Americans does not appear to be significantly higher than the general population, according to limited US data. Option C: The racial disparity in hypertension and hypertension- related outcomes has been recognized for decades with African- Americans with greater risks than Caucasians. Option D: Hypertension prevalence rates in Hispanics may vary by gender and country of origin. Hispanic Americans overall have relatively low levels of hypertension, despite elevated levels of diabetes and obesity. Correct Answer: A: 45-year-old African American attorney 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: The reported incidence of myocardial infarction with angina at rest is less than 0.1%, and is mostly influenced by patient-related factors like the extent and severity of underlying cardiovascular- related diseases and technique-related factors. Options C & D: A falling BP and dizziness occur along with hemorrhage of the insertion site which is associated with the first 12 hours after the procedure. Correct Answer: B. Thrombus formation A thrombus formation may prevent blood from flowing normally through the circulatory system, which may become an embolism, and block the flow of blood towards major organs in the body. o B. Control nausea o C. Manage pain o D. Prevent urinary tract infection NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Manage pain • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: IV hydration in the setting of acute renal colic is controversial. Whereas some authorities believe that IV fluids hasten the passage of the stone through the urogenital system, others express concern that additional hydrostatic pressure exacerbates the pain of renal colic. Option B: Because nausea and vomiting frequently accompany acute renal colic, antiemetics often play a role in renal colic therapy. Several antiemetics have a sedating effect that is often helpful. Option D: Overuse of the more effective antibiotic agents leaves only highly resistant bacteria, but failure to adequately treat a UTI complicated by an obstructing calculus can result in potentially life- threatening urosepsis and pyonephrosis. Managing pain is always a priority because it ultimately improves the quality of life. The cornerstone of ureteral colic management is analgesia, which can be achieved most expediently with parenteral narcotics or nonsteroidal anti- inflammatory drugs (NSAIDs). • 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 (75 Questions & Answers Updated 2022) 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: The client with antibiotic-induced diarrhea still needs continuous strict monitoring as the blood sugar levels may become unstable and dehydration is still possible. Option C: Stevens-Johnson syndrome (SJS) is a rare, serious disorder of the skin and mucous membranes. It’s usually a reaction to medication that starts with flu-like symptoms, followed by a painful rash that spreads and blisters. Option D: Cellulitis is often an underestimated complication of HIV disease, but they are responsible for an appreciable morbidity. Correct Answer: 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. The best candidate for discharge is one who has had a chronic condition and is most familiar with their care. This client in option A is most likely stable and could continue medication therapy at home. 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 (75 Questions & Answers Updated 2022) • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: If epiglottitis is seriously considered, no imaging studies are required. In less-clear cases, imaging studies are occasionally helpful in establishing the diagnosis or excluding epiglottitis. Option B: Examining the child’s throat should not be attempted because it may compromise respiratory effort. Option C: There are no indications for the collection of sputum specimens. These findings suggest a medical emergency and may be due to epiglottitis. Any child with an acute onset of an inflammatory response in the mouth and throat should receive immediate care. Option A: Polyphagia or extreme hunger is one of the most common symptoms of diabetes both among adults and children. Option B: Dehydration is not a symptom of type 1 diabetes, but it can be one of the many complications. Option D: Unintentional weight loss would develop gradually in a child with type 1 diabetes. Correct Answer: C. Bedwetting One of the first symptoms of type 1 diabetes in children is bedwetting. Bedwetting in a school-age child is readily detected by the parents. • 14. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: Chlamydial infections are one of the most frequent causes of salpingitis or pelvic inflammatory disease. Chlamydial bacteria could travel up toward the vagina or cervix into the reproductive organs. Option A: Trichomoniasis is a very common sexually transmitted disease, but it rarely predisposes to pelvic inflammatory disease. Options C & D: Staphylococcus and streptococcus may cause PID but it rarely occurs. Correct Answer: B. Chlamydia • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Discomfort at the IV insertion site may indicate inflammation or infection of the site. 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 at noon. Correct Answer: C. The level of the drug is 100 ml at 8 AM and is 80 ml at noon The minimal dose of 10 mL per hour which would be 40 mL given in a four (4) hour period. Only 60 mL should be left at noon. The pump is not functioning when more than expected medicine is left in the container. 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 1.5 grams per day. • 18. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Too much exposure to electrical energy can become a hazard to one’s health. Option C: Mind-body balance refers to yoga. Option D: Low-impact aerobic exercises are easier on the joints but are not part of chiropractic medicine. Correct Answer: B. Spinal column manipulation The theory underlying chiropractic is that interference with the transmission of mental impulses between the brain and body organs produces diseases. Such interference is caused by the misalignment of the vertebrae. Manipulation reduces subluxation. • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: A positive sweat test is one of the indications of cystic fibrosis. Option B: A patient with CF experiences frequent greasy, bulky stools or difficulty with bowel movements as the thick mucus blocks the intestines. 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 lubricant, the secretions plug up tubes, ducts, and passageways, especially in the pancreas and lungs. Respiratory failure is the most dangerous consequence of CF. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) 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. • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: There is no need to keep the client on NPO before the procedure. Option B: Enemas are not recommended for any type of radiograph test. Option C: Furosemide (Lasix) is unnecessary for this examination. Correct Answer: D. No special orders are necessary for this examination There are no special orders for this procedure, however, the client must be instructed of the general rule during radiography tests: remove any clothing, jewelry, or objects that may interfere with the test. o Option D: The symptoms are indicative of an emergency situation so the patient must be brought to the emergency department immediately. 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 Questions & Answers Updated 2022) • 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 Questions & Answers Updated 2022) Option A: When an infant is crying, the fontanels may look like they are bulging. Option C: The client in Option C can wait to be seen within the first hour. Option D: The client in Option D does not have a life- threatening condition but will still require immediate pain relief. Correct Answer: B. A teenager who got a singed beard while camping This client is in the greatest danger with a potential of respiratory distress. Any client with singed facial hair has been exposed to heat or fire in close range that could have caused serious damage to the interior of the lungs. Note that the interior lining of the lungs has no nerve fibers so the client will not be aware of swelling. Option A: The statement in Option A is correct but pertains to the risks associated with a toddler. Option B: Setting limits on a toddler may cause frustration instead of independence. 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 normally an increase in autonomy. The child needs to use motor skills to explore the environment and develop autonomy. • 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 NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: It is also important to check that the feeding solution matches the dietary order to ensure that the client gets proper nutrition. Option C: Aspirating the gastric contents is one of the methods used to determine the last feeding amount in the stomach, but is not the most important action the nurse should do. Option D: Keep it at room temperature so it would not upset the stomach. Correct Answer: A. Verify correct placement of the tube Proper placement of the tube prevents aspiration and entrance of food content into the lungs. The definitive way to ascertain the position of the nasogastric tube is through visualization by an x- ray. Another method is to aspirate stomach contents and check its pH (usually pH 1 to 5). Aspirated stomach content can also be tested for bilirubin to confirm it is placed in the stomach. o Option D: Controlling the child may be harmful to her development as toddlers should be developing their autonomy at this stage. o C. The kidneys o D. The leg bones NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: A. All striated muscles • 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 Questions & Answers Updated 2022) 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 originates in striated (skeletal) muscles and can be found anywhere in the body. Symptoms of rhabdomyosarcoma include if the cancer is in the head or neck area: sudden bulging or swelling of the eyes, conjunctival chemosis, and headache. It can also affect the urinary or reproductive system. Its common site of metastasis is the lung. Option A: Living in harmony with one’s natural environment with the aim of keeping all aspects of a person-mind, body, and spirit- in a state of harmony and balance so that disease never has a chance to develop. Option B: This balance and a healthy lifestyle are the focus of Chinese medicine which empowers the individual to participate in his own health. Correct Answer: D. Restore yin and yang For followers of Chinese medicine, health is maintained through the balance between the forces of yin and yang. Traditional Chinese medicine is a medical system that began being developed in China about 5000 years ago, which makes it the oldest continuous medical system on the planet. • 30. Question During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to: o A. Increase fluids that are high in protein o B. Restrict fluids o C. Force fluids and reassess blood pressure o D. Limit fluids to non-caffeine beverages NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: C. Force fluids and reassess blood pressure Orthostatic hypotension, a decrease in systolic blood pressure of more than 15 mmHg, and an increase in heart rate of more than 15 percent usually accompanied by dizziness indicate volume depletion, inadequate vasoconstrictor mechanisms, and autonomic insufficiency. o Option A: Fluids may not be necessarily protein-rich. o Option B: Restricting fluids could aggravate the client’s dizziness. o Option D: There is no need to restrict the fluid o Option C: In Chinese medicine, the body, and indeed a human being, is not seen as a machine, living in isolation from the world around it. Human beings are seen as part of the whole of things, which includes our environments, nature, and the universe itself. o C. Establish an airway o D. Obtain the crash cart NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: B. Initiate high- quality chest compressions • 33. Question A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications, which of the following should the nurse report immediately to the health care provider? o A. Blood pressure 94/60 mm Hg o B. Heart rate 76 bpm o C. Urine output 50 ml/hour o D. Respiratory rate 16 bpm NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Starting a peripheral IV can come after the C-A-B sequence. Option C: Establishing an airway comes after compressions. Option D: After performing the guidelines by the AHA, the crash cart can be obtained by another nurse responding to the scene. As per new guidelines, the American Heart Association recommends beginning CPR with chest compression (rather than checking for the airway first). Start CPR with 30 chest compressions before checking the airway and giving rescue breaths. Starting with chest compressions first applies to adults, children, and infants needing CPR, but not newborns. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. Correct Answer: A. Blood pressure 94/60 mm Hg Both medications decrease the heart rate. Metoprolol affects blood pressure. Therefore, the heart rate and blood pressure must be within the normal range (HR 60- 100; systolic BP over 100) in order to safely administer both medications. o Option B: A heart rate of 76 is within the normal range. • 34. Question The nurse practicing in a maternity setting recognizes that the postmature fetus is at risk due to: o A. Excessive fetal weight o B. Low blood sugar levels o C. Depletion of subcutaneous fat o D. Progressive placental insufficiency • 35. Question The nurse is caring for a client who had a total hip replacement seven (7) days ago. Which statement NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Progressive placental insufficiency Postmature or post-term pregnancy is a prolonged pregnancy that exceeds the limits of 38 to 42 weeks (normal term pregnancy). Infants of such pregnancy are considered postmature or dysmature if there is evidence that placental insufficiency has occurred and interfered with fetal growth. It occurs in 12% of all pregnancies. The placenta loses its adequacy to function after 42 weeks, after which it acquires calcium deposits which decrease the blood perfusion, supply of oxygen and nutrients to the fetus. o Options A, B, & C: Excessive fetal weight, o Option C: Increase in urine output is the desired effect of diuretics, which is given with digoxin. o Option D: A respiratory rate of 16 is within the normal range. and needs further assessment by the nurse. o Option D: May require a reevaluation of pain and interventions to manage pain though does not need immediate action. • 36. Question A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following assessment cues below may indicate the client is experiencing a negative side effect from the medication? o A. Weight gain of 5 pounds NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o B. Edema of the ankles o C. Gastric irritability o D. Decreased appetite • 37. Question The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing intervention would be most effective in promoting healing? o A. Apply dressing using sterile technique o B. Improve the client’s nutrition status o C. Initiate limb compression therapy NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: D. Decreased appetite Furosemide is a loop diuretic that is used for pulmonary edema, edema in heart failure, nephrotic syndrome, and hypertension. Furosemide causes a loss of potassium unless a supplement or a potassium-rich diet is taken. A decrease in appetite is caused by hypokalemia. Signs and symptoms of hypokalemia include anorexia, fatigue, nausea, decreased GI motility, muscle weakness, dysrhythmias, reduced urine osmolality, altered level of consciousness. o Option A: Weight gain is not a negative side effect of furosemide. o Option B: Edema of the ankles are indications for the administration of furosemide. o Option C: Gastric irritability is not a side effect of furosemide. o D. Begin proteolytic debridement NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: B. Improve the client’s nutrition status Venous stasis occurs when venous blood collects and stagnates in the lower leg due to incompetent venous valves. Eventually, little oxygen and nutrients are supplied to the cells of the lower o D. Performance goals should be higher than what is attainable • 39. Question The nurse is providing information to a client with multiple sclerosis on performing exercises and physical activities. The nurse determines the client needs additional teaching if the client makes which statements? Select all that apply. o A. “I can lift weights and do resistance training.” o B. “I should exercise to the point of exhaustion.” o C. “I can include aerobic exercises in my routine.” o D. “Proper stretching should be done before starting my routine.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: Positive feedback is most useful when given immediately. Option C: Negative statements are never helpful in any given situation. Option D: Every goal should always be attainable. Correct Answer: A. Specific feedback is given as close to the event as possible Feedback is most useful when given immediately. Positive behavior is strengthened through immediate feedback, and it is easier to modify problem behaviors if the standards are clearly understood. o E. “I should exercise continuously without rest.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: Patients with multiple sclerosis should not exercise to the point of fatigue as strenuous physical exercise raises body temperature and may aggravate symptoms. Option E: Continuous exercise with no rest periods is contraindicated for patients with multiple sclerosis Correct answers: B & E. • 40. Question During the evaluation of the quality of home care for a client with Alzheimer’s disease, the priority for the nurse is to reinforce which statement by a family member? o A. “At least two (2) full meals a day are eaten.” o B. “We go to a group discussion every week at our community center.” o C. “We have safety bars installed in the bathroom and have 24-hour alarms on the doors.” o D. “The medication is not a problem to have it taken three (3) times a day.” NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) who wants to exercise. The patient should be advised to take short rest periods, preferably lying down. Again, extreme fatigue may contribute to the exacerbation of symptoms. o Option A: Exercises should include activities that would strengthen weak muscles because diminishing muscle strength is often a primary concern in multiple sclerosis. These activities include lifting weights and resistance exercises. o Option C: Aerobic exercises help promote muscle efficiency, increase flexibility, improves mood, and helps eliminate stress. o Option D: Muscle stretching should be included prior to exercise as this helps minimize muscle spasticity and contractures which is o F. Clofazimine(Lamprene) NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option A: Warfarin (Coumadin). Has a pregnancy category X and associated with central nervous system defects, spontaneous abortion, stillbirth, Correct Answer: A. Warfarin (Coumadin); B. Finasteride (Propecia, Proscar) • 42. Question A nurse is reviewing a patient’s past medical history (PMH). The history indicates the patient has photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select all that apply. o A. Ciprofloxacin (Cipro) o B. Sulfonamide o C. Norfloxacin (Noroxin) o D. Sulfamethoxazole and Trimethoprim (Bactrim) NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) prematurity, hemorrhage, and ocular defects when given anytime during pregnancy and fetal warfarin syndrome when given during the first trimester. o Option B: Finasteride (Propecia, Proscar). Also has a pregnancy category X which has a high risk of causing permanent damage to the fetus. o Option C: Celecoxib (Celebrex). Large doses cause birth defects in rabbits; Pregnancy category C. o Option D: Clonidine (Catapres). Crosses the placenta but no adverse fetal effects have been observed. o Option E: Transdermal nicotine (Habitrol). Nicotine replacement products have been assigned to pregnancy category C (nicotine gum) and category D (transdermal patches, o E. Isotretinoin (Accutane) o F. Nitro-Dur patch NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: A, B, C, D, and E. Photosensitivity is an extreme sensitivity to ultraviolet (UV) rays from the sun and other light sources. A type of photosensitivity called Phototoxic reactions are caused when medications in the • 43. Question A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient’s medication does not cause urine discoloration? o A. Sulfasalazine o B. Levodopa o C. Phenolphthalein o D. Aspirin NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Sulfasalazine may discolor the urine or skin to orange-yellow color. Sulfasalazine is used to treat ulcerative colitis (UC), and to decrease the frequency of UC attacks. Sulfasalazine will not cure ulcerative colitis, but it can reduce the number of attacks you have. Option B: Levodopa may discolor the urine, saliva, or sweat to a dark brown color. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. Correct Answer: D. Aspirin Aspirin is not known to cause discoloration of the urine. Side effects and complications of taking aspirin include stroke caused by a burst blood vessel. The Food and Drug Administration doesn’t recommend aspirin therapy for the prevention of heart attacks in people who haven’t already had a heart attack, stroke or another cardiovascular condition. o Option F: Nitro-Dur patch is used to prevent chest pain or angina. Its side effects are headache, lightheadedness, nausea, and flushing. • 44. Question You are responsible for reviewing the nursing unit’s refrigerator. Which of the following drugs, if found inside the fridge, should be removed? o A. Nadolol (Corgard) o B. Opened (in-use) Humulin N injection o C. Urokinase (Kinlytic) o D. Epoetin alfa IV (Epogen) Correct Answer: A. Corgard Nadolol (Corgard) is stored at room temperature between 59 to 86 ºF (15 and 30 ºC) away from heat, moisture, and light. Do not store in the bathroom and keep the bottle tightly closed. o Option B: Humulin N injection if unopened (not in use) is stored in the fridge and can be used until the expiration date, or stored at room temperature and used within 31 days. If opened (in-use), store the vial in a refrigerator or at room temperature and use within 31 days. Store the injection pen at room temperature (do not refrigerate) and use within 14 days. Keep it in its original container protected from heat and light. Do NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o Option C: Phenolphthalein can discolor the urine to a red color. Phenolphthalein is often used as an indicator in acid-base titrations. For this application, it turns colorless in acidic solutions and pink in basic solutions. not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen. o Option C: Urokinase (Kinlytic) is refrigerated at 2–8°C. Lyophilized Urokinase although stable at room temperature for 3 weeks, should be stored desiccated below -18°C. Upon reconstitution Urokinase should be stored at 4°C between 2-7 days and for future use below -18°C. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) • 46. Question A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take? o A. Immediately see a social worker o B. Start prophylactic AZT treatment o C. Start prophylactic Pentamidine treatment o D. Seek counseling NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Before reporting to a social worker, it is imperative to start a prophylaxis to reduce viral replication. Option C: Pentamidine is an antimicrobial medication given to prevent and treat pneumocystis pneumonia. Option D: It is natural to have strong emotions after an exposure to HIV in the workplace. The healthcare Correct Answer: B. Start prophylactic AZT treatment Azidothymidine (AZT) treatment is the most critical intervention. It is an antiretroviral medication used to prevent and treat HIV/AIDS by reducing the replication of the virus. Post- exposure prophylaxis (PEP) for HIV is a treatment to suppress the virus and prevent infection after exposure. PEP should be taken within 72 hours of possible exposure to HIV, so it is important to seek treatment quickly. immune surveillance by “arming” myeloid effector cells such as basophils and mast cells with IgD antibodies reactive against mucosal antigens, including commensal and pathogenic microbes. o Option C: IgE antibodies cause the body to react against foreign substances such as pollen, spores, animal dander. IgE antibodies are found in the lungs, skin, and mucous membranes. They are involved in allergic • 47. Question A thirty-five-year-old male has been an insulin- dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect? o A. Atherosclerosis o B. Diabetic nephropathy o C. Autonomic neuropathy o D. Somatic neuropathy Correct Answer: C. Autonomic neuropathy Autonomic neuropathy (also known as Diabetic Autonomic Neuropathy) affects the autonomic nerves, which control the bladder, intestinal tract, and genitals, among other organs. Paralysis of the bladder is a common symptom of this type of neuropathy, as manifested by bladder urgency and inability to start urination. o Option A: Atherosclerosis, or hardening of the arteries, is a condition in which plaque builds up inside the arteries. Plaque is made of cholesterol, fatty substances, cellular waste products, calcium, and fibrin (a clotting material in the blood). NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) worker might feel anger, fear, blame, or depression. During the difficult time of prevention treatment and waiting, they may want to seek support. Try an employee- assistance program or local mental health expert. o Option B: Diabetic nephropathy (DN) is typically defined by macro albuminuria— that is, a urinary albumin excretion of more than 300 mg in a 24-hour collection—or macroalbuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate (GFR). Clinically, diabetic nephropathy is characterized by a progressive increase in proteinuria and an increased need to urinate. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) A 24-year-old female is admitted to the ER due to confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect? o A. Diverticulosis o B. Hypercalcemia o C. Hypocalcemia o D. Irritable bowel syndrome • 50. Question Rhogam is most often used to treat mothers that have a infant. NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Diverticulosis is a condition that develops when pouches (diverticula) form in the wall of the large intestine; most people don’t have symptoms. Option C: Hypocalcemia is low calcium levels in the blood; it is asymptomatic in mild forms but can cause paresthesia, tetany, muscle cramps, and carpopedal spasms in severe hypocalcemia. Option D: Irritable bowel syndrome is a widespread condition involving recurrent abdominal pain and diarrhea or constipation, often associated with stress, depression, anxiety, or previous intestinal infection. Correct Answer: B. Hypercalcemia Hypercalcemia can cause polyuria, severe abdominal pain, and confusion. o A. RH positive, RH positive o B. RH positive, RH negative o C. RH negative, RH positive NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o D. RH negative, RH negative Correct Answer: C. RH negative, RH positive Rhogam prevents the production of anti-RH antibodies in the mother that has an Rh-positive fetus. o Option A: RhoGAM is a prescription medicine that is used to prevent Rh immunization, a condition in which an individual with Rh-negative blood develops antibodies after exposure to Rh-positive blood. o Option B: If the father or baby is not conclusively shown to be Rh-negative, RhoGAM should be given to an Rh-negative mother in the following clinical situations to prevent Rh immunization: after delivery of an Rh-positive baby; routine prevention of Rh immunization at 26 to 28 weeks of pregnancy; maternal or fetal bleeding during pregnancy from certain conditions; or an actual or threatened pregnancy loss at any stage. o Option D: It isn’t until second and subsequent pregnancies when antibodies are already built up, that Rh incompatibility can cause problems. Indeed, these antibodies can cross the placenta and attack the baby’s red blood cells. This can cause the baby to develop anemia, and in severe cases, result in miscarriage. • 51. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) increased build up in the body. In addition to its role in protein production, phenylalanine is used to make other important molecules in the body, several of which send signals between different parts of the body. Phenylalanine has been studied as a treatment for several medical conditions, including skin disorders, depression, and pain o Option C: Without treatment, children affected with PKU develop a permanent intellectual disability. Seizures, delayed development, behavioral problems, and psychiatric disorders are also common. Untreated individuals may have a musty or mouse-like odor as a side effect of excess phenylalanine in the body. Children with classic PKU tend to have lighter skin and NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) • 52. Question A patient has taken an overdose of aspirin. Which of the following should a nurse must closely monitor for during acute management of this patient? o A. Onset of pulmonary edema o B. Metabolic alkalosis o C. Respiratory alkalosis o D. Parkinson’s disease type symptoms Correct Answer: A. Onset of pulmonary edema Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development. Early symptoms of aspirin poisoning also include tinnitus, hyperventilation, vomiting, dehydration, and fever. Late signs include drowsiness, bizarre behavior, unsteady walking, and coma. Abnormal breathing caused by aspirin poisoning is usually rapid and deep. Pulmonary edema may be related to an increase in permeability within the capillaries of the lung leading to “protein leakage” and transudation of fluid in both renal and pulmonary tissues. The alteration in renal tubule permeability may lead to a change in colloid osmotic pressure and thus facilitate pulmonary edema (via Medscape). o Option B: Aspirin overdose causes NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) hair than unaffected family members and are also likely to have skin disorders such as eczema. metabolic acidosis, not alkalosis. Metabolic alkalosis is a primary increase in serum bicarbonate (HCO3 -) concentration. o Option C: Respiratory alkalosis is a disturbance in acid and base balance due to alveolar hyperventilation. o Option D: Parkinson’s type symptoms include tremors, bradykinesia, rigid muscles, impaired posture and balance, speech changes, and loss of automatic movements. • 53. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o B. Cough regularly and deeply to clear airway passages. o C. Cough following bronchodilator utilization. o D. Decrease CO2 levels by increased oxygen take output during meals. • 55. Question A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present? NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Deep breathing exercises can help the client’s lungs from becoming more damaged. When one has healthy lungs, breathing is natural and easy. You breathe in and out with the diaphragm doing about 80 percent of the work to fill the lungs with a mixture of oxygen and other gases, and then send the waste gas out. Option B: Coughing may help clear the airway, however, it may not be as effective as taking bronchodilators. Coughing moves mucus out of the large airways. However, moving mucus out of the small airways requires airway clearance techniques (ACTs). This is why coughing should be done with other ACTs. Option D: Changing the level of oxygen at home without asking the healthcare provider is not recommended. Correct Answer: C. Cough following bronchodilator utilization The bronchodilator will allow a more productive cough. o A. Slow pulse rate o B. Weight gain o C. Decreased systolic pressure o D. Irregular WBC lab values NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Correct Answer: B. Weight gain Weight gain due to fluid accumulation is associated with heart failure and congenital heart defects. When the heart does not circulate blood normally, the kidneys receive less blood and filter less fluid out of the circulation into the urine. The extra fluid in the circulation builds up in the lungs, the liver, around the eyes, and sometimes in the legs. o Option A: One of the symptoms of congenital heart defect is a rapid heartbeat. The heart must work harder to pump blood and supply enough for all the body systems. o Option C: There is an increase in the systolic blood pressure to compensate for the decrease of sufficient oxygen. o Option D: Irregular WBC is not a symptom of a congenital heart defect. An elevated WBC count is directly associated with an increased incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African- American and White men and women. An elevated total white blood cell (WBC) count is a risk factor for atherosclerotic vascular disease. • 56. Question A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome? NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) • 58. Question A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?” o A. Green vegetables and liver o B. Yellow vegetables and red meat o C. Carrots o D. Milk NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option B: Yellow vegetables are great sources of vitamins, such as vitamins A, B6, C, folate, magnesium, fiber, riboflavin, phosphorus, and potassium. Red meat is rich in protein, saturated fat, iron, zinc, and vitamin B. Option C: Carrots are a rich source of vitamin A from beta carotene, K1 (phylloquinone), and vitamin B6. Option D: Milk is a rich source of calcium. Milk is an excellent source of many vitamins and minerals, including vitamin B12, calcium, riboflavin, and phosphorus. It’s often fortified with other vitamins, especially vitamin D. Correct Answer: A. Green vegetables and liver Green vegetables and liver are a great source of folic acid. o Option B: Although current guidelines do not include renal dysfunction as a contraindication to tPA therapy, some clinicians hesitate to administer tPA because of a tendency of bleeding in these patients. o Option C: Having a food diary is not related to the use of medication. Thrombolytic therapy is indicated in patients with evidence of ST- segment elevation MI (STEMI) or presumably new left bundle-branch block (LBBB) presenting within 12 hours of the onset of symptoms if there are no contraindications to fibrinolysis. • 59. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans? o A. S. pneumoniae o B. H. influenzae o C. N. meningitidis o D. Cl. difficile • 60. Question NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Pneumococcal meningitis is caused by Streptococcus pneumoniae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae, which must avoid mucosal entrapment and evade the host immune system after local activation. Option B: H influenzae meningitis is caused by Haemophilus influenzae type B bacteria. It is the leading cause of bacterial meningitis in children under age 5. Haemophilus species are small oxidase-positive pleomorphic gram-negative aerobic or facultative anaerobic coccobacilli. Humans are the only known host for Haemophilus influenza. Option C: Bacteria called Neisseria meningitidis cause meningococcal disease. About 1 in 10 people have these bacteria in the back of their nose and throat without being ill. Correct Answer: D. Cl. difficile Cl. difficile has not been linked to meningitis. Clostridium difficile (C. diff ) is a germ (bacteria) that causes life-threatening diarrhea. It is usually a side-effect of taking antibiotics. detection, analysis, and isolation of aging RBC and thus detailed studies of their properties. • 61. Question A 65-year-old man has been admitted to the hospital for spinal stenosis surgery. When should the discharge training and planning begin for this patient? o A. Following surgery o B. Upon admission o C. Within 48 hours of discharge NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) o D. Preoperative discussion • 62. Question A 5-year-old child and has been recently admitted to the hospital. According to Erik Erikson’s psychosocial development stages, the child is in which stage? o A. Trust vs. mistrust o B. Initiative vs. guilt o C. Autonomy vs. shame and doubt o D. Intimacy vs. isolation NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Preoperative instructions are important for discharge planning, so it must start not only after the surgery. Option C: Creating a discharge plan within 48 hours of discharge could cause the plan to be incomplete, as it would lack the preparations made before the surgery. Option D: Including the preoperative discussion in the discharge plan is correct, but this should also extend towards the admission and the data taken upon admission for comprehensive planning of the client’s discharge. Correct Answer: B. Upon admission Discharge education begins upon admission. Ideally, it involves the client and the family, as well as the hospital staff. Effective discharge planning can decrease the chances of the client being readmitted to the hospital, and also can help in recovery, ensure medications are prescribed and given correctly, and adequately prepare folks to take over the client’s care. Correct Answer: B. Initiative vs. guilt It is as children enter the preschool years (3-6 years old) that they begin the third stage of psychosocial development centered • 63. Question A toddler is 26 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in? o A. Trust vs. mistrust o B. Initiative vs. guilt o C. Autonomy vs. shame and doubt o D. Intimacy vs. isolation NCLEX-RN Exam Pack Set 1 (75 Questions & Answers Updated 2022) Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at birth and continues to approximately 18 months of age. During this stage, children learn whether or not they can trust the people around them. Option C: Autonomy vs Shame and doubt is the second stage of Erik Erikson’s stages of psychosocial development. This stage occurs between the ages of 18 months to 3 years. According to Erikson, children at this stage are focused on developing a greater sense of control. Option D: Intimacy vs Isolation takes place during young adulthood between the ages of approximately 19 and 40. The major conflict at this stage of life centers on forming intimate, loving relationships with other people. on initiative versus guilt. It is important for the kids of this age to learn that they can exert power over themselves and the world. Correct Answer: C. Autonomy vs. shame and doubt Autonomy vs Shame and doubt is the second stage of Erik Erikson’s stages of psychosocial development. This stage occurs between the ages of 18 months to 3 years. According to Erikson, children at this stage are focused on developing a greater sense of control. o Option A: Trust vs Mistrust is the first stage of the psychosocial theory. This stage begins at