NCLEX-RN Exam: Practice Questions With Nurse Brennan (Part 1.)

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Below are 10 additional NCLEX practice questions to help supplement your NCLEX review:

NCLEX Practice Questions:

Question #1: A client with a history of type 1 diabetes presents to the clinic with complaints of blurred vision and increased thirst. The healthcare provider orders a hemoglobin A1c test. Which of the following statements accurately reflects the purpose of this test?

A. The test measures the amount of glucose in the client's blood at the time of the test

B. The test measures the client's blood sugar levels over the past 24 hours

C. The test measures the client's blood sugar levels over the past 2-3 months

D. The test measures the client's blood sugar levels over the past year

Question #2: A client with hypertension is prescribed hydrochlorothiazide. The nurse should instruct the client to report which of the following symptoms immediately to the healthcare provider?

A. Nausea and vomiting

B. Muscle cramps

C. Tinnitus

D. Dry mouth

Question #3: A nurse is caring for a client with hypertension who is prescribed enalapril. Which of the following statements made by the client indicates the need for further teaching?

A. "I should check my blood pressure at home regularly"

B. "I should avoid taking any over-the-counter medications"

C. "I should report any cough or difficulty breathing"

D. "I should take the medication with food"

Question #4: A nurse is caring for a client with pneumonia who is experiencing dyspnea and respiratory distress. Which of the following interventions should the nurse prioritize?

A. Administering oxygen via nasal cannula

B. Administering an albuterol nebulizer treatment

C. Placing the client in a high-Fowler's position

D. Administering an intravenous diuretic

Question #5: A nurse is caring for a client who has been prescribed warfarin for deep vein thrombosis. Which of the following laboratory values should the nurse monitor to determine the effectiveness of the medication?

A. Prothrombin time (PT)

B. Partial thromboplastin time (PTT)

C. International normalized ratio (INR)

D. Platelet count

Question #6: A client is receiving a continuous heparin infusion for the treatment of deep vein thrombosis. The nurse notes that the client has a decreased level of consciousness and slurred speech. What is the nurse's first action?

A. Stop the heparin infusion immediately

B. Administer vitamin K to reverse the heparin

C. Assess the client's vital signs and blood glucose level

D. Notify the healthcare provider

Question #7: A nurse is caring for a client with a diagnosis of acute renal failure. Which of the following laboratory values is the nurse most likely to assess in this client?

A. Serum albumin

B. Serum creatinine

C. Serum potassium

D. Serum sodium

Question #8: Which of the following is a common sign of right-sided heart failure?

A. Dyspnea

B. Orthopnea

C. Peripheral edema

D. Productive cough

Question #9: Which of the following laboratory values is an indicator of liver function?

A. Platelet count

B. BUN (blood urea nitrogen) level

C. AST (aspartate transaminase) level

D. Potassium level

Question #10: Which of the following is a symptom of major depressive disorder?

A. Hyperactivity

B. Increased appetite

C. Insomnia

D. Grandiosity

NCLEX Practice Answers and Rationale:

Answer #1: C. The test measures the client's blood sugar levels over the past 2-3 months

Rationale: The hemoglobin A1c test is used to assess a client's blood sugar levels over the past 2-3 months, which is the lifespan of red blood cells. The test measures the percentage of glycated hemoglobin in the blood, which reflects the average blood sugar level over that time period. This test is useful in diagnosing and monitoring diabetes because it provides a more comprehensive picture of blood sugar control than a single blood glucose measurement. Options A, B, and D are incorrect because they do not accurately reflect the purpose of the test.

Answer #2: C. Tinnitus

Rationale: Hydrochlorothiazide is a diuretic that can cause ototoxicity, which is damage to the inner ear resulting in hearing loss or tinnitus (ringing in the ears). It is important for the nurse to educate the client about this potential side effect and instruct the client to report any symptoms of tinnitus immediately to the healthcare provider to prevent further hearing loss. Nausea and vomiting, muscle cramps, and dry mouth are also possible side effects of hydrochlorothiazide, but they are not as urgent as tinnitus and can be addressed with additional interventions.

Answer #3: D. "I should take the medication with food"

Rationale: Enalapril is an angiotensin-converting enzyme (ACE) inhibitor that is used to treat hypertension. Clients should take the medication on an empty stomach one hour before or two hours after a meal. Taking the medication with food may decrease the absorption of the drug, reducing its effectiveness. The other statements made by the client indicate a good understanding of the medication's use and potential side effects.

Answer #4: A. Administering oxygen via nasal cannula

Rationale: In a client with respiratory distress, the nurse should prioritize administering oxygen to maintain adequate oxygen saturation levels. Nasal cannula is a simple and effective way to deliver supplemental oxygen. While the other interventions may be appropriate for treating pneumonia and respiratory distress, they are not the priority in this scenario.

Answer #5: C. International normalized ratio (INR)

Rationale: Warfarin is an anticoagulant medication that is used to treat and prevent blood clots. The effectiveness of warfarin therapy is monitored using the INR, which measures how long it takes for blood to clot. The target INR for a client on warfarin therapy is typically between 2.0 and 3.0. While the other laboratory values are important for evaluating coagulation and platelet function, they are not used specifically to monitor warfarin therapy.

Answer #6: C. Assess the client's vital signs and blood glucose level

Rationale: The client is experiencing neurological symptoms that could be indicative of intracranial hemorrhage, a serious complication of heparin therapy. However, before taking any action that could affect the heparin therapy, the nurse must first assess the client's vital signs and blood glucose level to rule out other potential causes of the symptoms. Abnormal vital signs or hypoglycemia could be contributing to the client's condition and would require immediate intervention. Once these assessments have been completed, the nurse should notify the healthcare provider and/or stop the heparin infusion as appropriate. Administering vitamin K to reverse the heparin is not indicated in this situation.

Answer #7: B. Serum creatinine

Rationale: Acute renal failure is a condition in which the kidneys suddenly become unable to filter waste products from the blood. As a result, creatinine, a waste product of muscle metabolism, accumulates in the blood. Elevated serum creatinine levels are a hallmark of acute renal failure and a critical laboratory value to assess for this condition. While serum albumin levels may be affected by acute renal failure, they are not as specific to this condition as serum creatinine. Similarly, while serum potassium and sodium levels may be affected by acute renal failure, they are not the most specific laboratory values to assess for this condition.

Answer #8: C. Peripheral edema

Rationale: Right-sided heart failure is caused by the inability of the right ventricle to pump blood effectively. This leads to fluid buildup in the peripheral tissues, which manifests as peripheral edema. Dyspnea and orthopnea are common signs of left-sided heart failure, while a productive cough is not specific to any type of heart failure.

Answer #9: C. AST (aspartate transaminase) level

Rationale: AST is an enzyme found in the liver and is released into the bloodstream when liver cells are damaged. An elevated AST level indicates liver damage or disease. Platelet count is not a direct indicator of liver function, but may be decreased in individuals with liver disease. BUN (blood urea nitrogen) level is a measure of kidney function. Potassium level is a measure of electrolyte balance and is not directly related to liver function.

Answer #10: C. Insomnia

Rationale: Major depressive disorder is characterized by a persistent feeling of sadness, loss of interest in daily activities, and difficulty sleeping. Insomnia is a common symptom of depression, where the person has trouble falling asleep or staying asleep. Hyperactivity and increased appetite are not typical symptoms of depression, while grandiosity is a symptom of bipolar disorder, not major depressive disorder.