NCLEX Predictor

Free preview · Original latest version

Sample questions from NCLEX Predictor

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, a nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client 2 hours after thyroidectomy who is restless and has audible stridor
   • B.A client 1 day after bowel surgery who rates incisional pain 7 out of 10
   • C.A client with pneumonia whose temperature is 38.2 C (100.8 F) and who requests acetaminophen
   • D.A client with chronic heart failure who has bilateral ankle edema and reports usual exertional dyspnea

   Rationale: Restlessness and stridor after thyroid surgery suggest airway obstruction from edema or a hematoma, an immediate threat to life. Fever, chronic edema, and postoperative pain require attention but are less urgent when the airway is compromised. Apply the airway-first principle and summon emergency assistance while preparing to support ventilation.

2. 2.In a long-term care facility, an RN is assigning care for four residents. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Evaluate whether a PRN analgesic relieved a resident's pain
   • B.Teach a resident how to use a newly prescribed walker
   • C.Assess a resident who reports new shortness of breath
   • D.Obtain routine morning weights for stable residents with heart failure

   Rationale: Obtaining routine weights for stable residents is a predictable task that can be delegated to trained UAP. Assessment, teaching, and evaluation require nursing judgment and remain the RN's responsibility. The RN should communicate parameters for reporting weight changes and review the results.

3. 3.During an inpatient admission, a client with a new colostomy says, "I do not think I can manage this at home." Which nursing actions support effective discharge planning? Select all that apply.

   • A.Include the client and chosen support person in planning, with the client's permission
   • B.Assess the client's ability and willingness to participate in ostomy care
   • C.Ask the client what concerns them most about managing the colostomy
   • D.Document learning needs and communicate them to the interdisciplinary team
   • E.Wait until the day of discharge to request home-care services

   Rationale: Exploring concerns and assessing readiness identify individualized learning and support needs. Involving a support person with permission and communicating needs to the team promote coordinated planning. Waiting until discharge can delay services and teaching, so that action is inappropriate.

4. 4.A provider prescribes a medication dose that is substantially higher than the usual dose listed in the drug reference. The client is stable and the dose is due now. What should the nurse do first?

   • A.Give half the prescribed dose and document the change
   • B.Hold the medication and clarify the prescription with the prescriber
   • C.Ask another nurse to administer the medication
   • D.Administer the dose because the prescription is signed

   Answer and rationale are in the full material.

5. 5.A 76-year-old client admitted with a urinary tract infection has new confusion, temperature 38.7 C (101.7 F), HR 118/min, BP 88/50 mm Hg, and urine output 15 mL/hr. Which action should the nurse take first?

   • A.Administer the prescribed oral antipyretic
   • B.Obtain a clean-catch urine specimen before taking further action
   • C.Notify the rapid response team and initiate the facility's sepsis response
   • D.Reorient the client and dim the lights

   Answer and rationale are in the full material.