Free NCLEX-RN sample questions

Correct answer: "I will call 911 if my chest pain persists after taking one tablet in five minutes."

This statement indicates correct understanding of the protocol for taking nitroglycerin for chest pain. The client should take one tablet, wait five minutes, and if pain persists, call 911 immediately. They may take up to two more doses five minutes apart while waiting for emergency services. Keeping the medication in sunlight degrades it. Driving to the hospital is unsafe. Waiting for a third tablet before calling 911 delays critical emergency response.

Correct answer: Request a consultation with the hospital's ethics committee or palliative care team.

When there is significant family conflict regarding the goals of care for a client who cannot make their own decisions and has no advance directive, the most appropriate action is to involve an ethics committee or palliative care team. These multidisciplinary teams are trained to facilitate communication, mediate conflict, and help guide decision-making based on the client's best interests and presumed wishes. Simply following one family member's wishes or asking them to leave is inappropriate and does not resolve the ethical dilemma.

Correct answer: An abdominal ultrasound to determine placental location.

Painless, bright red vaginal bleeding in the third trimester is the classic sign of placenta previa. A sterile vaginal exam is absolutely contraindicated as it can cause catastrophic hemorrhage by perforating the placenta. An abdominal ultrasound is the immediate, non-invasive priority to confirm the location of the placenta. An amniocentesis is not indicated for bleeding, and a nonstress test assesses fetal well-being but does not diagnose the cause of bleeding.

Correct answer: A client with stable chronic obstructive pulmonary disease (COPD) requiring routine administration of nebulizer treatments.

The LPN scope of practice includes caring for stable clients with predictable outcomes. Administering routine medications like nebulizer treatments to a client with stable COPD falls within the LPN's scope. The other clients require the comprehensive assessment, planning, and teaching skills of an RN due to their instability (post-op), complex teaching needs (discharge), or need for IV push medications.

Correct answer: Teaching a class on healthy eating and physical activity for school-aged children.

Primary prevention aims to prevent disease before it occurs. Teaching healthy lifestyle habits to children is a classic example of primary prevention for type 2 diabetes. Blood glucose screening is secondary prevention (early detection). Foot care clinics and medication management classes are tertiary prevention (managing existing disease).

Correct answer: False

Nurses are legally and ethically obligated to question any order that appears incorrect, unsafe, or unclear. A nurse who administers a medication based on an unsafe or illegible order is also liable for any harm that results. The nurse's duty is to clarify the order with the prescriber before administration.

Correct answer: "That sounds very frightening. Let's go to the day room where we can sit with others."

The most therapeutic response is to acknowledge the feeling (fear) behind the delusion without reinforcing or challenging the delusion itself. This validates the client's experience while gently redirecting them to a reality-based activity and a safer-feeling environment. Directly challenging the delusion is ineffective and can increase agitation. Asking for more detail reinforces the delusional content. Asking why they believe it can also increase agitation.

Correct answer: Assess the client's breath sounds and check the tubing for kinks.

Lack of tidaling (fluctuation) in the water-seal chamber can indicate either that the lung has re-expanded (a positive sign) or that there is an obstruction in the system (a negative sign). The priority action is to assess for the cause. This includes assessing the client's respiratory status (breath sounds) and checking the tubing for kinks or dependent loops. If breath sounds are diminished and the tubing is kinked, the nurse has identified a problem to correct. If breath sounds are clear and equal, it may indicate lung re-expansion, which can be confirmed with a chest x-ray. The other actions are premature or incorrect.

Correct answers: Reaching over the sterile field to discard a wrapper.; Turning away from the sterile field to speak to the client.; Allowing the sterile field to become wet from a spilled solution.

Reaching over a sterile field violates the principle that a sterile field must not be contaminated by non-sterile objects passing over it.

A sterile field should always be kept in view to ensure it remains sterile. Turning your back to the field is a break in technique.

A wet sterile field allows for capillary action, wicking microorganisms from the non-sterile surface below up to the sterile surface, thus contaminating it.

Correct answer: The infant has had three wet diapers and two transitional stools in the past 24 hours.

The most reliable indicator of adequate intake in a breastfed newborn is output. By day two, the infant should have at least two wet diapers. However, having three wet diapers and the progression from meconium to transitional stools is a stronger indicator of sufficient intake and gastrointestinal function. The duration of feeding is not a reliable indicator, and while soft breasts suggest milk transfer, output is the definitive measure. Two wet diapers and one meconium stool is the minimum expectation for day two, but three wet diapers and two transitional stools is a better indicator of adequate intake.