NCLEX RN· Full Length · NCLEX RN Practice Exam
Full Question & Rationale Repository
Showing all 10 practice questions with expert explanatory rationales.
The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:
Expert Explanatory Rationale
Correct Answer: Tire easily
A ventricular septal defect causes increased pulmonary blood flow, leading to easy tiring due to cardiac workload.
The nurse is preparing a client for cervical uterine radiation implant insertion. Which will be included in the teaching plan?
Expert Explanatory Rationale
Correct Answer: A Foley catheter is usually inserted.
A Foley catheter is inserted during cervical radiation implants to keep the bladder empty, reducing radiation exposure to nearby organs. The other options are incorrect or irrelevant.
The nurse has rounded on all the assigned clients. While rounding, several health care providers have written orders on the nurse's clients. Which order would be the priority for the nurse to address?
Expert Explanatory Rationale
Correct Answer: furosemide (Lasix) 80 mg IV push STAT for a client with fluid overload
STAT orders for furosemide address acute fluid overload, a potentially life-threatening condition, making it the priority over insulin, dressing changes, or discharge.
The nurse is reflecting on the client-nurse relationship. Which statement is correct regarding the orientation (introductory) phase of the relationship?
Expert Explanatory Rationale
Correct Answer: identifying the client's strengths and limitations
The orientation phase focuses on establishing trust and identifying the client’s strengths and limitations to guide care.
The nurse is caring for a client with leukemia who has received the drug (daunorubicin) Cerubidine. Which of the following common side effects would cause the most concern?
Expert Explanatory Rationale
Correct Answer: Cardiotoxicity
Daunorubicin is known for cardiotoxicity, which can lead to heart failure and is life-threatening, making it the most concerning side effect. Nausea, vomiting, and alopecia are common but less severe.
A 28-year-old woman pregnant with twins comes in for her prenatal appointment. She tells the nurse that she has two children at home (ages 4 years and 16 months), and she had one abortion 6 years ago when she was 8 weeks along in the pregnancy. The nurse charts
Expert Explanatory Rationale
Correct Answer: gravida 5, para 2.
Gravida counts all pregnancies (2 children, 1 abortion, current twin pregnancy = 5). Para counts deliveries after 20 weeks (2 children = 2). Twins count as one delivery.
The physician orders an MRI of the spine with infusion for an adult female. Which of the following findings in the client's history should the nurse report to the physician?
Expert Explanatory Rationale
Correct Answer: allergy to shellfish
A client has a diagnosis of discoid lupus erythematosus (DLE). The nurse recognizes that discoid lupus differs from systemic lupus erythematosus because it:
Expert Explanatory Rationale
Correct Answer: Is confined to changes in the skin
Discoid lupus erythematosus primarily affects the skin, causing chronic rashes, unlike systemic lupus, which can involve multiple organs.
A client with a right lobectomy is being transported from the intensive care unit to a medical unit. The nurse understands that the client's chest drainage system:
Expert Explanatory Rationale
Correct Answer: Can be disconnected from suction, but the chest tube should remain unclamped
The chest tube should remain unclamped and disconnected from suction during transport to prevent tension pneumothorax, with the system kept below chest level.
A client prescribed furosemide (Lasix) should choose which meal for lunch?
Expert Explanatory Rationale
Correct Answer: baked salmon, spinach salad, banana
Furosemide causes potassium loss. A meal with potassium-rich foods (e.g., spinach, banana) helps maintain electrolyte balance.
Start Your NCLEX RN Preparation Journey Today
Access over 300,000 verified practice questions, comprehensive subject diagnostic exams, and timed clinical simulations engineered for success.