NCLEX-RN Question Pack

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Sample questions from NCLEX-RN Question Pack

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

1. 1.A 72-year-old client is admitted to a medical-surgical unit with fever, productive cough, and pneumonia. The client is newly confused, has a respiratory rate of 30/min, oxygen saturation of 86% on room air, and blood pressure of 88/54 mm Hg. Which action should the nurse take first?

   • A.Apply oxygen and activate the rapid response system
   • B.Obtain a sputum specimen before starting treatment
   • C.Administer the prescribed antipyretic
   • D.Call the client's family to obtain baseline mental status

   Rationale: Hypoxemia, hypotension, tachypnea, and acute confusion indicate possible respiratory failure and sepsis, so immediate oxygen support and escalation are priorities. A sputum specimen and antipyretic may be appropriate later but do not stabilize the client. Baseline information is useful, but contacting family must not delay urgent care; the takeaway is to address airway, breathing, and circulation first.

2. 2.A 6-year-old client with asthma is in the emergency department with audible wheezing, retractions, and oxygen saturation of 91% on room air. The prescription is for nebulized albuterol. Which action is most appropriate?

   • A.Administer the albuterol and reassess respiratory status
   • B.Give an oral sedative to reduce anxiety
   • C.Encourage the child to lie flat and rest
   • D.Delay treatment until a peak flow measurement is obtained

   Rationale: Albuterol is a rapid-acting bronchodilator and should be administered promptly for acute bronchospasm. Sedation can depress respirations, and lying flat may worsen breathing effort. A peak flow can help assess severity but should not delay treatment in a symptomatic child; reassessment after bronchodilator therapy is essential.

3. 3.A 24-year-old client at 32 weeks of pregnancy arrives at the clinic reporting a severe headache and blurred vision. Blood pressure is 168/112 mm Hg, and urine dipstick shows 3+ protein. Which action should the nurse take first?

   • A.Place the client in a quiet environment and notify the obstetric provider immediately
   • B.Encourage oral fluids and recheck blood pressure in 1 hour
   • C.Ask the client to walk for 10 minutes to reduce anxiety
   • D.Schedule a routine prenatal appointment for the next day

   Rationale: Severe-range hypertension with headache, visual changes, and proteinuria suggests preeclampsia with severe features and requires urgent evaluation to prevent maternal and fetal complications. Fluids and delayed reassessment do not address the immediate risk, and walking is unsafe. A routine appointment is inappropriate; prompt escalation and preparation for prescribed treatment are indicated.

4. 4.A 68-year-old client with type 1 diabetes is found diaphoretic and confused in a rehabilitation facility. Capillary glucose is 42 mg/dL; the client is awake and can swallow. Which action should the nurse take?

   • A.Give 15 g of rapid-acting oral carbohydrate and recheck glucose in 15 minutes
   • B.Administer the scheduled rapid-acting insulin
   • C.Give a high-protein snack and recheck glucose in 1 hour
   • D.Keep the client NPO and wait for the provider

   Answer and rationale are in the full material.

5. 5.A 54-year-old client is 2 hours postoperative after abdominal surgery. The client is restless, has a heart rate of 124/min, blood pressure of 86/50 mm Hg, and a saturated abdominal dressing. What should the nurse do first?

   • A.Reinforce the dressing, assess for bleeding, and activate the rapid response system
   • B.Remove the dressing and leave the incision open to air
   • C.Administer the prescribed opioid for restlessness
   • D.Document the drainage and reassess in 30 minutes

   Answer and rationale are in the full material.