Comprehensive NCLEX Readiness Practice Exam a

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Sample questions from Comprehensive NCLEX Readiness Practice Exam a

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

1. 1.A 68-year-old client is admitted to the medical-surgical unit with pneumonia. The client is suddenly confused, has a respiratory rate of 32/min, oxygen saturation of 86% on room air, and blood pressure of 92/58 mm Hg. Which action should the nurse take first?

   • A.Apply oxygen and assess the client's response
   • B.Obtain a sputum culture before treatment
   • C.Notify the provider of the confusion
   • D.Ask the family about the client's usual mental status

   Rationale: Hypoxemia with tachypnea and hypotension signals immediate physiologic instability, so oxygen and reassessment take priority. A sputum culture is useful but should not delay stabilization. Notifying the provider and obtaining baseline information are appropriate after addressing the airway and breathing threat. The exam takeaway is to stabilize an unstable client before pursuing diagnostic or historical details.

2. 2.A 74-year-old client with heart failure is admitted to a medical unit. The client has crackles, 2+ leg edema, oxygen saturation of 93% on room air, and a prescription for IV furosemide. Which finding requires the nurse to clarify the prescription before administration?

   • A.Blood pressure of 88/54 mm Hg
   • B.Potassium level of 4.0 mEq/L
   • C.Urine output of 45 mL/hr
   • D.Respiratory rate of 22/min

   Rationale: The client's blood pressure is low, and furosemide can further reduce circulating volume and worsen hypotension. A potassium of 4.0 mEq/L and urine output of 45 mL/hr do not independently contraindicate the dose. A respiratory rate of 22/min supports close assessment but is not the most immediate reason to hold the medication. The exam takeaway is to evaluate hemodynamic stability before administering a diuretic.

3. 3.A 42-year-old client with diabetes is 6 hours postoperative after abdominal surgery. The client is awake, has a respiratory rate of 18/min, and reports incisional pain of 7/10. A prescription for IV morphine is available. Which action should the nurse take before giving the medication?

   • A.Assess the client's sedation level and respiratory status
   • B.Ask the client to rate the pain again in 30 minutes
   • C.Withhold the medication because the client has diabetes
   • D.Administer the medication and reassess at the end of the shift

   Rationale: Opioids can suppress respirations and level of consciousness, so the nurse should assess these before administration. Diabetes is not, by itself, a reason to withhold prescribed morphine. Delaying treatment to repeat a clearly reported pain score is unnecessary, and reassessment should occur soon after administration rather than at shift's end. The exam takeaway is to assess opioid-related safety risks before giving the dose.

4. 4.A 31-year-old client in the emergency department has fever, flank pain, vomiting, and a blood pressure of 84/48 mm Hg. The client is suspected of having sepsis. Which prescription should the nurse implement first?

   • A.Begin the prescribed isotonic IV fluid bolus
   • B.Collect a urine specimen for culture
   • C.Administer the prescribed acetaminophen
   • D.Arrange transport for renal imaging

   Answer and rationale are in the full material.

5. 5.A 55-year-old client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by nasal cannula. The client is drowsy but arousable, with a respiratory rate of 10/min and oxygen saturation of 91%. Which action is most appropriate?

   • A.Assess respiratory effort and notify the provider of the change
   • B.Increase oxygen to 6 L/min to achieve an oxygen saturation of 100%
   • C.Remove the oxygen immediately
   • D.Encourage the client to sleep and recheck in 2 hours

   Answer and rationale are in the full material.