NCLEX-RN Exam Practice: Edition 1 with Nurse Brennan
Medliant International Healthcare Staffing is here to support you every step of the way in your journey to successfully immigrate to the USA as a Registered Nurse. I am Nurse Brennan, an international Registered Nurse from Canada who immigrated to the USA in 2019. I have worked as an NCLEX author, instructor, and content writer and I will be creating practice exams similar to this one to help you prepare for the NCLEX-RN Exam itself.
And remember that Medliant will reimburse the cost of your NCLEX-RN exam once you start working in the USA! This is just one of the many benefits of choosing Medliant to sponsor you on a Green Card Visa to help you achieve your American Dream and begin working as a Registered Nurse in the USA!
Practice Questions
1. A 3 month old patient has been prescribed acetaminophen (Tylenol) Q6H at a safe dose calculation of 10mg per kg per dose. The patient weight 17kg. Which of the following would be the correct dose of acetaminophen (Tylenol) for this patient?
a) 100 mg per dose
b) 1.70 mg per dose
c) 107mg per dose
d) 170 mg per dose
2. A patient who is has Type II Diabetes states “I take rapid-acting insulin before my meals.” Which of the following medications is a rapid-acting form of insulin?
a) Lantus
b) Humalog
c) Humulin N
d) Humulin-R
3. A 56 year old male patient was admitted to your pre-operative unit following an accident that resulted in a broken tibia. The nurse enters the patient’s room for their morning assessment and the patient reports multiple complaints. Which of the following complaints, should the nurse prioritize first?
a) “My chest is feeling a little bit tight and I feel a little short of breath”
b) “I am having 5/10 pain to my leg. Can I get a medication to help with this?”
c) “I have never told anyone this before, but I think I might suffer from anxiety”
d) “I recently lost my job. I’d worried this is going to impact how easily I will find employment”
4. A 37 year old patient who successfully gave birth via a caesarian section returns to days prior presents in the Emergency Department with shortness of breath, an enlarged spleen, fatigue, muscle weakness, pale and cool skin, hypotension, tachycardia, and tachypnea. The patient reports voiding normally and is afebrile. The nurse administers a 1000ml IV bolus of normal saline as per the physician’s orders, however the patient remains pale with no improvement in their heart rate or respiratory rate. Which of the following conditions might the nurse suspect is responsible for the listed symptoms?
a) Sepsis
b) Anemia
c) Fatigue
d) Dehydration
5. A nurse is caring for a patient who is order “standard precautions.” Which of the following actions should the nurse take to comply with this order?
a) Proper hand hygiene
b) Clean and disinfect commonly used environmental surfaces in the patients room
c) Use the appropriate personal protective equipment (gloves, masks, eyewear)
d) All of the above
Answers and Rationale
1. A 3 month old patient has been prescribed acetaminophen (Tylenol) Q6H at a safe dose calculation of 10mg per kg per dose. The patient weight 17kg. Which of the following would be the correct dose of acetaminophen (Tylenol) for this patient?
a) 100 mg per dose
b) 1.70 mg per dose
c) 107mg per dose
d) 170 mg per dose
Correct Answer = D. The correct answer is D, 170mg per dose. The safe dose calculation used for this medication is 10mg per kg per dose. If the patient weight 17kg then the dose would be 10mg x 17kg per dose = 170mg per dose
2. A patient who is has Type II Diabetes states “I take rapid-acting insulin before my meals.” Which of the following medications is a rapid-acting form of insulin?
a) Lantus
b) Humalog
c) Humulin N
d) Humulin-R
Correct Answer = B. The correct answer is B, Humalog which is a rapid-acting insulin taken before meals with an onset of 5-15 minutes. The other answers are incorrect as Lantus is a long-acting insulin with an onset of 2-4 hours, Humulin N is an intermediate-acting insulin with an onset of 2-4 hours, and Humulin-R with an onset of 30 minutes.
3. A 56 year old male patient was admitted to your pre-operative unit following an accident that resulted in a broken tibia. The nurse enters the patient’s room for their morning assessment and the patient reports multiple complaints. Which of the following complaints, should the nurse prioritize first?
a) “My chest is feeling a little bit tight and I feel a little short of breath”
b) “I am having 5/10 pain to my leg. Can I get a medication to help with this?”
c) “I have never told anyone this before, but I think I might suffer from anxiety”
d) “I recently lost my job. I’d worried this is going to impact how easily I will find employment”
Correct answer is A. The correct answer is A, the patients complaint of difficulty breathing is the first priority that the nurse should address. When assessing more than one presenting complaint the nurse should remember to use the ABCs (airway, breathing, and circulation with airway being to top priority) and Maslow’s Hierarchy of Needs (physiological needs, safety needs, love and belonging, esteem, and self-actualization with physiological needs as the top priority). The nurse immediately priorities the patients breathing and pain complaints as they are both physiological needs, and proceeds to prioritize the breathing complaint as it is one of the ABCs. The other answers should all be addressed, but are incorrect as they are not the first priority. The patient having pain to their leg would be the second priority to address as this is a physiological need, followed by the patient’s complaint of loss of employment and impact of financial constraint which is a safety need under the Maslow’s Hierarchy of Needs, and lastly, the patients complaint of anxiety which is more closely related to love and belonging as well as esteem.
4. A 37 year old patient who successfully gave birth via a caesarian section returns to days prior presents in the Emergency Department with shortness of breath, an enlarged spleen, fatigue, muscle weakness, pale and cool skin, hypotension, tachycardia, and tachypnea. The patient reports voiding normally and is afebrile. The nurse administers a 1000ml IV bolus of normal saline as per the physician’s orders, however the patient remains pale with no improvement in their heart rate or respiratory rate. Which of the following conditions might the nurse suspect is responsible for the listed symptoms?
a) Sepsis
b) Anemia
c) Fatigue
d) Dehydration
Correct Answer = B. The correct answer is B, Anemia. Risk factors for anemia include pregnancy and gender (female). A patient who has anemia would be expected to present with shortness of breath, an enlarged spleen, fatigue, muscle weakness, pale and cool skin, hypotension, tachycardia, and tachypnea that would not resolve with an IV fluid bolus. The symptoms would be expected to resolve with a blood transfusion and the patient should have their iron levels monitored and supplementation prescribed as needed. The other answers are incorrect as with sepsis you would expect that the patient would have a low urine output, fever, and vital signs to improve with an IV fluid bolus. Fatigue is a symptom of anemia, but not the cause. And with dehydration you would expect that vital signs would improve with an IV fluid bolus.
5. A nurse is caring for a patient who is order “standard precautions.” Which of the following actions should the nurse take to comply with this order?
a) Proper hand hygiene
b) Clean and disinfect commonly used environmental surfaces in the patients room
c) Use the appropriate personal protective equipment (gloves, masks, eyewear)
d) All of the above
Correct Answer = D. The correct answer is D, all of the above. Standard precautions are practices and personal protective equipment (PPE) used for all patient care to mitigate the risk and spread of infection. A nurse caring for a patient ordered to have standard precautions should perform proper hand hygiene, clean and disinfect commonly used environmental surfaces in the patient’s room, and use the appropriate personal protective equipment (gloves, masks, eyewear) needed to prevent the spread of infection.
Frequently Asked Questions Regarding the NCLEX
· Am I eligible to write the NCLEX? Contact your Nursing Regulatory Body (NRB). Typically, when you apply for a nursing license or registration within the state/provincial regulatory body that you were educated in you can seek authorization to write the NCLEX exam. The NRB will grant you Authorization to Take the Test (ATT) with instructions on how to schedule your NCLEX exam.
· Where can I take the NCLEX? USA, Canada, Australia, UK, India, Philippines, Mexico, Puerto Rico, Taiwan, Hong Kong, Guam, Northern Mariana Islands, U.S. Virgin Islands, Brazil, England, Japan, and South Africa.
o The exam can be taken at Pearson Vue Testing Centers.
· How many questions are on the exam? 75-145 (As of October 1, 2020).
· What is the style of the NCLEX? The NCLEX uses the Computerized Adaptive Testing (CAT) format.
· How is the NCLEX graded? The NCLEX is a PASS/FAIL exam using the “logit” model which compares your ability to answer questions and the difficulty of the questions themselves. If you are able to correctly answer moderately difficult questions at least 50% of the time you are likely to pass.
o The exam is completed when there is 95% certainty that your ability was either above or below the passing standard.
· How much time do you have to write the NCLEX? Up to 5 hours.
· How do you apply and register for the NCLEX? You must (1) Apply for a license or registration through your Nursing Regulatory Body (NRB) and (2) Register and pay the testing fee for the NCLEX through Pearson Vue. Once you are granted eligibility from the NRB and acknowledgment of both registration and payment from Pearson Vue is made you are then given Authorization to Take the Test (ATT). Remember that Medliant International Healthcare Staffing will reimburse the cost of your NCLEX-RN exam for successful candidates upon beginning employment in the US!
· If I fail the NCLEX, how often and how many times can I rewrite it? If you fail the NCLEX you can take the test again after 45 days test-free and up to 8 times a year.
· Can I take the NCLEX outside of my local or desired jurisdiction? Yes, once you are eligible to write the NCLEX you can take the exam at any Pearson Vue Testing Location. I recommend choosing a US state and applying for a “license through examination” meaning that if accepted and you pass the NCLEX-RN exam you will then be licensed in that US state. You do not have to take the NCLEX in that state itself as you can take it elsewhere in the world.
· How long will it take to get my NCLEX results? It can take up to 6 weeks to receive your testing results. In the USA you can access your “unofficial results” within 48 hours for a fee of $7.95 USD.
· Can I skip questions and go back to answer them later? No, you can only answer the questions in the order that you receive them with no opportunity to go back and answer them later.
· Do I get a performance report if I fail the exam? Yes.
· Will the names of medications be the generic or brand names in the NCLEX? The NCLEX generally uses only the generic names of medications.
· What languages are the NCLEX exam offered in? English and French (for French-speaking Canadian candidates).
· Are there breaks during the NCLEX exam? Yes, there are two breaks scheduled after 2 hours and after 3 ½ hours of commencement into the exam (please note: breaks do count towards testing time).
· Can I take the NCLEX during the Covid-19 pandemic? Yes. However, you will be required to wear a face mask.
If you are ready to begin your application to become a US Registered Nurse with Medliant International Healthcare Staffing please reach out to us on the Medliant Website, Facebook (Medliant International Healthcare Staffing), or Instagram (@medliant).
You can also email your resume to nursebrennan@medliant.com to start making your American Dream come true!
Nurse Brennan Belliveau
Email: nursebrennan@medliant.com
Medliant International Healthcare Solution
