Another set of 50-item practice exam for the NCLEX-PN. These questions will help you sharpen your critical thinking skills.
Topics or concepts included in this exam are:
- Various questions
- Read each question carefully and choose the best answer.
- You are given one minute per question. Spend your time wisely!
- Answers and rationales (if any) are given below. Be sure to read them.
- If you need more clarifications, please direct them to the comments section.
In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz. You are given 1 minute per question.
NCLEX-PN Review Quiz 2 (50 Questions)
Practice Mode: This is an interactive version of the Text Mode. All questions are given in a single page and correct answers, rationales or explanations (if any) are immediately shown after you have selected an answer. No time limit for this exam.
NCLEX-PN Review Quiz 2 (50 Questions)
In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.
2. Which diet is associated with an increased risk of colorectal cancer?
A. Low protein, complex carbohydrates
B. High protein, simple carbohydrates
C. High fat, refined carbohydrates
D. Low carbohydrates, complex proteins
3. The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid:
A. Holding the infant
B. Offering a pacifier
C. Providing a mobile
D. Offering sterile water
4. The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by:
5. The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron?
C. Dried fruits
6. The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to:
7. The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client?
A. Low calorie, low carbohydrate
B. High calorie, low fat
C. High protein, high fat
D. Low protein, high carbohydrate
8. A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
A. Uses an electric blanket at night
B. Dresses in extra layers of clothing
C. Applies a heating pad to her feet
D. Takes a hot bath morning and evening
9. A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer?
A. A family history of laryngeal cancer
B. Chronic inhalation of noxious fumes
C. Frequent straining of the vocal cords
D. A history of alcohol and tobacco use
10. The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia?
A. Difficulty in breathing after exertion
B. Numbness and tingling in the extremities
C. A faster-than-usual heart rate
D. Feelings of lightheadedness
11. The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to:
A. Speak using words that rhyme
B. Repeat words or phrases used by others
C. Include irrelevant details in conversation
D. Make up new words with new meanings
12. Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis?
A. Brushing the teeth
B. Drinking a glass of juice
C. Drinking a cup of coffee
D. Brushing the hair
13. A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh:
A. 14 pounds
B. 18 pounds
C. 25 pounds
D. 30 pounds
14. A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms?
A. Tossed salad with oil and vinegar dressing
B. Baked potato with sour cream and chives
C. Cream of tomato soup and crackers
D. Mixed fruit and yogurt
A. Increased urinary output
B. Stabilized weight
C. Improved appetite
D. Increased pedal edema
16. Which play activity is best suited to the gross motor skills of the toddler?
A. Coloring book and crayons
C. Building cubes
D. Swing set
17. The physician has ordered Basaljel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include:
18. A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is:
A. Loss of sensation in the lower extremities
B. Back pain that lessens when standing
C. Decreased urinary output
D. Pulsations in the periumbilical area
19. A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has:
A. Low blood pressure
B. Slow, regular pulse
C. Warm, flushed skin
D. Increased urination
20. An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
A. Hourly urinary output of 40–50cc
B. Bright red urine with many clots
C. Dark red urine with few clots
D. Requests for pain med q 4 hrs.
A. Irregular movements of the extremities and facial grimacing
B. Painless swelling over the extensor surfaces of the joints
C. Faint areas of red demarcation over the back and abdomen
D. Swelling, inflammation, and effusion of the joints
22. A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to:
A. Prevent insensible water loss
B. Provide a moist environment with oxygen at 30%
C. Prevent dehydration and reduce fever
D. Liquefy secretions and relieve laryngeal spasm
23. A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal:
A. Slow pulse rate, weight loss, diarrhea, and cardiac failure
B. Weight gain, lethargy, slowed speech, and decreased respiratory rate
C. Rapid pulse, constipation, and bulging eyes
D. Decreased body temperature, weight loss, and increased respirations
24. Which statement describes the contagious stage of varicella?
A. The contagious stage is 1 day before the onset of the rash until the appearance of vesicles.
B. The contagious stage lasts during the vesicular and crusting stages of the lesions.
C. The contagious stage is from the onset of the rash until the rash disappears.
D. The contagious stage is 1 day before the onset of the rash until all the lesions are crusted.
25. A client admitted to the psychiatric unit claims to be the Son of God and insists that he will not be kept away from his followers. The most likely explanation for the client’s delusion is:
A. A religious experience
B. A stressful event
C. Low self-esteem
D. Overwhelming anxiety
26. A client has returned to his room following an esophagoscopy. Before offering fluids, the nurse should give priority to assessing the client’s:
A. Level of consciousness
B. Gag reflex
C. Urinary output
D. Movement of extremities
A. Over-the-counter eyedrops can be used to treat redness and irritation.
B. The eye shield should be worn at night.
C. It will be necessary to wear special cataract glasses.
D. A prescription for medication to control post-operative pain will be needed.
28. An 8-year-old is admitted with drooling, muffled phonation, and a temperature of 102°F. The nurse should immediately notify the doctor because the child’s symptoms are suggestive of:
29. Phototherapy is ordered for a newborn with physiologic jaundice. The nurse caring for the infant should:
A. Offer the baby sterile water between feedings of formula
B. Apply an emollient to the baby’s skin to prevent drying
C. Wear a gown, gloves, and a mask while caring for the infant
D. Place the baby on enteric isolation
30. A teen hospitalized with anorexia nervosa is now permitted to leave her room and eat in the dining room. Which of the following nursing interventions should be included in the client’s plan of care?
A. Weighing the client after she eats
B. Having a staff member remain with her for 1 hour after she eats
C. Placing high-protein foods in the center of the client’s plate
D. Providing the client with child-size utensils
31. According to Erikson’s stage of growth and development, the developmental task associated with middle childhood is:
32. The nurse should observe for side effects associated with the use of bronchodilators. A common side effect of bronchodilators is:
33. The 5-minute Apgar of a baby delivered by C-section is recorded as 9. The most likely reason for this score is:
A. The mottled appearance of the trunk
B. The presence of conjunctival hemorrhages
C.Cyanosis of the hands and feet
D. Respiratory rate of 20–28 per minute
34. A 5-month-old infant is admitted to the ER with a temperature of 106°F and irritability. The mother states that the child has been listless for the past several hours and that he had a seizure on the way to the hospital. A lumbar puncture confirms a diagnosis of bacterial meningitis. The nurse should assess the infant for:
A. Periorbital edema
B. Tenseness of the anterior fontanel
C. Positive Babinski reflex
D. Negative scarf sign
35. A client with a bowel resection and anastomosis returns to his room with an NG tube attached to intermittent suction. Which of the following observations indicates that the nasogastric suction is working properly?
A. The client’s abdomen is soft.
B. The client is able to swallow.
C. The client has active bowel sounds.
D. The client’s abdominal dressing is dry and intact.
B. Slow pulse
D. Flushed skin
37. Which of the following symptoms is associated with exacerbation of multiple sclerosis?
38. Which of the following conditions is most likely related to the development of renal calculi?
C. Fractured femur
D. Disc disease
39. A client with AIDS is admitted for treatment of wasting syndrome. Which of the following dietary modifications can be used to compensate for the limited absorptive capability of the intestinal tract?
A. Thoroughly cooking all foods
B. Offering yogurt and buttermilk between meals
C. Forcing fluids
D. Providing small, frequent meals
A. Decrease the secretion of pancreatic enzymes
B. Enhance the effectiveness of methotrexate
C. Promote peristalsis
D. Prevent a common side effect of prednisone
41. Which of the following meal choices is suitable for a 6-month-old infant?
A. Egg white, formula, and orange juice
B. Apple juice, carrots, whole milk
C. Rice cereal, apple juice, formula
D. Melba toast, egg yolk, whole milk
42. The LPN is preparing to administer an injection of vitamin K to the newborn. The nurse should administer the injection in the:
A. Rectus femoris muscle
B. Vastus lateralis muscle
C. Deltoid muscle
D. Dorsogluteal muscle
43. The physician has prescribed Cytoxan (cyclophosphamide) for a client with nephrotic syndrome. The nurse should:
A. Encourage the client to drink extra fluids
B. Request a low-protein diet for the client
C. Bathe the client using only mild soap and water
D. Provide additional warmth for swollen, inflamed joints
44. The nurse is caring for a client with detoxification from alcohol. Which medication is used in the treatment of alcohol withdrawal?
A. Antabuse (disulfiram)
B. Romazicon (flumazenil)
C. Dolophine (methadone)
D. Ativan (lorazepam)
45. A client with insulin-dependent diabetes takes 20 units of NPH insulin at 7 a.m. The nurse should observe the client for signs of hypoglycemia at:
A. 8 a.m.
B. 10 a.m.
C. 3 p.m.
D. 5 a.m.
46. The licensed practical nurse is assisting the charge nurse in planning care for a client with a detached retina. Which of the following nursing diagnoses should receive priority?
A. Alteration in comfort
B. Alteration in mobility
C. Alteration in skin integrity
D. Alteration in O2 perfusion
47. The primary purpose for using a CPM machine for the client with a total knee repair is to help:
A. Prevent contractures
B. Promote flexion of the artificial joint
C. Decrease the pain associated with early ambulation
D. Alleviate lactic acid production in the leg muscles
48. Which of the following statements reflects Kohlberg’s theory of the moral development of the preschool-age child?
A. Obeying adults is seen as correct behavior.
B. Showing respect for parents is seen as important.
C.Pleasing others is viewed as good behavior.
D. Behavior is determined by consequences.
A. Determine whether the ear infection has affected her hearing
B. Make sure that she has taken all the antibiotic
C. Document that the infection has completely cleared
D. Obtain a new prescription in case the infection recurs
50. A factory worker is brought to the nurse’s office after a metal fragment enters his right eye. The nurse should:
A. Cover the right eye with a sterile 4×4
B. Attempt to remove the metal with a cotton-tipped applicator
C. Flush the eye for 10 minutes with running water
D. Cover both eyes and transport the client to the ER
Answers and Rationale
1. Answer A is correct. The major complication of SLE is lupus nephritis, which results in end-stage renal disease. SLE affects the musculoskeletal, integumentary, renal, nervous, and cardiovascular systems, but the major complication is renal involvement; therefore, answers B and D are incorrect. Answer C is incorrect because the SLE produces a “butterfly” rash, not desquamation.
2. Answer C is correct. A diet that is high in fat and refined carbohydrates increases the risk of colorectal cancer. High fat content results in an increase in fecal bile acids, which facilitate carcinogenic changes. Refined carbohydrates increase the transit time of food through the gastrointestinal tract and increase the exposure time of the intestinal mucosa to cancer-causing substances. Answers A, B, and D do not relate to the question; therefore, they are incorrect.
3. Answer B is correct. The nurse should avoid giving the infant a pacifier or bottle because sucking is not permitted. Holding the infant cradled in the arms, providing a mobile, and offering sterile water using a Breck feeder are permitted; therefore, answers A, C, and D are incorrect.
4. Answer D is correct. The client with esophageal varices can develop spontaneous bleeding from the mechanical irritation caused by taking capsules; therefore, the nurse should request the medication in a suspension. Answer A is incorrect because it does not best meet the client’s needs. Answer B is incorrect because it is not the best means of preventing bleeding. Answer C is incorrect because the medications should not be given with milk or antacids.
5. Answer A is correct. Tomatoes are a poor source of iron, although they are an excellent source of vitamin C, which increases iron absorption. Answers B, C, and D are good sources of iron; therefore, they are incorrect.
6. Answer A is correct. Periodically lying in a prone position without a pillow will help prevent the flexion of the spine that occurs with Parkinson’s disease. Answers B and C flex the spine; therefore, they are incorrect. Answer D is not realistic because of position changes during sleep; therefore, it is incorrect.
7. Answer B is correct. The client recovering from pancreatitis needs a diet that is high in calories and low in fat. Answers A, C, and D are incorrect because they can increase the client’s discomfort.
8. Answer B is correct. Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns, making answers A and C incorrect. Answer D is incorrect because the client with hypothyroidism has dry skin, and a hot bath morning and evening would make her condition worse.
9. Answer D is correct. A history of frequent alcohol and tobacco use is the most significant factor in the development of cancer of the larynx. Answers A, B, and C are also factors in the development of laryngeal cancer, but they are not the most significant; therefore, they are incorrect.
10. Answer B is correct. Numbness and tingling in the extremities is common in the client with pernicious anemia, but not those with other types of anemia. Answers A, C, and D are incorrect because they are symptoms of all types of anemia.
11. Answer B is correct. The client with echolalia repeats words or phrases used by others. Answer A is incorrect because it refers to clang association. Answer C is incorrect because it refers to circumstantiality. Answer D is incorrect because it refers to neologisms.
12. Answer C is correct. Holding a cup of coffee or hot chocolate helps to relieve the pain and stiffness of the hands. Answers A, B, and D do not relieve the symptoms of rheumatoid arthritis; therefore, they are incorrect.
13. Answer A is correct. The infant’s birth weight should double by 6 months of age. Answers B, C, and D are incorrect because they are greater than the expected weight gain by 6 months of age.
14. Answer C is correct. The symptoms of nontropical sprue and celiac are caused by the ingestion of gluten, which is found in wheat, oats, barley, and rye. Creamed soup and crackers contain gluten. Answers A, B, and D do not contain gluten; therefore, they are incorrect.
15. Answer A is correct. Lanoxin slows and strengthens the contraction of the heart. An increase in urinary output shows that the medication is having a desired effect by eliminating excess fluid from the body. Answer B is incorrect because the weight would decrease. Answer C might occur but is not directly related to the question; therefore, it is incorrect. Answer D is incorrect because pedal edema would decrease, not increase.
16. Answer B is correct. The toddler has gross motor skills suited to playing with a ball, which can be kicked forward or thrown overhand. Answers A and C are incorrect because they require fine motor skills. Answer D is incorrect because the toddler lacks gross motor skills for play on the swing set.
17. Answer A is correct. Antacids containing aluminum and calcium tend to cause constipation. Answer A refers to the side effects of anticholinergic medications used to treat ulcers; therefore, it is incorrect. Answer C refers to antacids containing magnesium; therefore, it is incorrect. Answer D refers to dopamine antagonists used to treat ulcers; therefore, it is incorrect.
18. Answer D is correct. The client with an abdominal aortic aneurysm frequently complains of pulsations or “feeling my heart beat” in the abdomen. Answers A and C are incorrect because they occur with rupture of the aneurysm. Answer B is incorrect because back pain is not affected by changes in position.
19. Answer A is correct. The client with acute adrenal crisis has symptoms of hypovolemia and shock; therefore, the blood pressure would be low. Answer B is incorrect because the pulse would be rapid and irregular. Answer C is incorrect because the skin would be cool and pale. Answer D is incorrect because the urinary output would be decreased.
20. Answer B is correct. Bright red bleeding with many clots indicates arterial bleeding that requires surgical intervention. Answer A is within normal limits; therefore, it is incorrect. Answer C indicates venous bleeding, which can be managed by nursing intervention; therefore, it is incorrect. Answer D does not indicate excessive need for pain management that requires the doctor’s attention; therefore, it is incorrect.
21. Answer D is correct. The child with polymigratory arthritis will exhibit swollen, painful joints. Answer B is incorrect because it describes subcutaneous nodules. Answer C is incorrect because it describes erythema marginatum. Answer A is incorrect because it describes Syndeham’s chorea.
22. Answer D is correct. The primary reason for placing a child with croup under a mist tent is to liquefy secretions and relieve laryngeal spasms. Answer A is incorrect because it does not prevent insensible water loss. Answer B is incorrect because the oxygen concentration is too high. Answer C is incorrect because the mist tent does not prevent dehydration or reduce fever.
23. Answer B is correct. Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations. Answers A and D do not describe symptoms associated with myxedema; therefore, they are incorrect. Answer C describes symptoms associated with Graves’s disease; therefore, it is incorrect.
24. Answer D is correct. The contagious stage of varicella begins 24 hours before the onset of the rash and lasts until all the lesions are crusted. Answers A, B, and C are inaccurate regarding the time of contagion; therefore, they are incorrect.
25. Answer C is correct. Delusions of grandeur are associated with low self-esteem. Answer A is incorrect because conversion is expressed as sensory or motor deficits. Answers B and C can cause an increase in the client’s delusions but do not explain their purpose; therefore, they are incorrect.
26. Answer B is correct. The client’s gag reflex is depressed before having an EGD. The nurse should give priority to checking for the return of the gag reflex before offering the client oral fluids. Answer A is incorrect because conscious sedation is used. Answers C and D are not affected by the procedure; therefore, they are incorrect.
27. Answer B is correct. The eye shield should be worn at night or when napping, to prevent accidental trauma to the operative eye. Prescription eyedrops, not over-the-counter eyedrops, are ordered for the client; therefore, Answer A is incorrect. The client might or might not require glasses following cataract surgery; therefore, answer C is incorrect. Answer D is incorrect because cataract surgery is pain free.
28. Answer B is correct. The child’s symptoms are consistent with those of epiglottitis, an infection of the upper airway that can result in total airway obstruction. Symptoms of strep throat, laryngotracheobronchitis, and bronchiolitis are different than those presented by the client; therefore, answers A, C, and D are incorrect.
29. Answer A is correct. Providing additional fluids will help the newborn eliminate excess bilirubin in the stool and urine. Answer B is incorrect because oils and lotions should not be used with phototherapy. Physiologic jaundice is not associated with infection; therefore, answers C and D are incorrect.
30. Answer B is correct. Having a staff member remain with the client for 1 hour after meals will help prevent self-induced vomiting. Answer A is incorrect because the client will weigh more after meals, which can undermine treatment. Answer C is incorrect because the client will need a balanced diet and excess protein might not be well tolerated at first. Answer D is incorrect because it treats the client as a child rather than as an adult.
31. Answer D is correct. According to Erikson’s Psychosocial Developmental Theory, the developmental task of middle childhood is industry versus inferiority. Answer A is incorrect because it is the developmental task of infancy. Answer B is incorrect because it is the developmental task of the school-age child. Answer C is incorrect because it is not one of Erikson’s developmental stages.
32. Answer B is correct. A side effect of bronchodilators is nausea. Answers A and C are not associated with bronchodilators; therefore, they are incorrect. Answer D is incorrect because hypotension is a sign of toxicity, not a side effect.
33. Answer C is correct. Although cyanosis of the hands and feet is common in the newborn, it accounts for an Apgar score of less than 10. Answer B suggests cooling, which is not scored by the Apgar. Answer B is incorrect because conjunctival hemorrhages are not associated with the Apgar. Answer D is incorrect because it is within normal range as measured by the Apgar.
34. Answer B is correct. Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Answer A is incorrect because periorbital edema is not associated with meningitis. Answer C is incorrect because a positive Babinski reflex is normal in the infant. Answer D is incorrect because it relates to the preterm infant, not the infant with meningitis.
35. Answer A is correct. Nasogastric suction decompresses the stomach and leaves the abdomen soft and nondistended. Answer B is incorrect because it does not relate to the effectiveness of the NG suction. Answer C is incorrect because it relates to peristalsis, not the effectiveness of the NG suction. Answer D is incorrect because it relates to wound healing, not the effectiveness of the NG suction.
36. Answer A is correct. Tremulousness is an early sign of hypoglycemia. Answers B, C, and D are incorrect because they are symptoms of hyperglycemia.
37. Answer C is correct. The most common sign associated with exacerbation of multiple sclerosis is double vision. Answers A, B, and D are not associated with a diagnosis of multiple sclerosis; therefore, they are incorrect.
38. Answer A is correct. Gout and renal calculi are the result of increased amounts of uric acid. Answer B is incorrect because it does not contribute to renal calculi. Answers C and D can result from decreased calcium levels. Renal calculi are the result of excess calcium; therefore, answers C and D are incorrect.
39. Answer D is correct. Providing small, frequent meals will improve the client’s appetite and help reduce nausea. Answer A is incorrect because it does not compensate for limited absorption. Foods and beverages containing live cultures are discouraged for the immune-compromised client; therefore, answer B is incorrect. Answer C is incorrect because forcing fluids will not compensate for limited absorption of the intestine.
40. Answer D is correct. A common side effect of prednisone is gastric ulcers. Cimetidine is given to help prevent the development of ulcers. Answers A, B, and C do not relate to the use of cimetidine; therefore, they are incorrect.
41. Answer C is correct. Rice cereal, apple juice, and formula are suitable foods for the 6-month-old infant. Whole milk, orange juice, and eggs are not suitable for the young infant; therefore, they are incorrect.
42. Answer B is correct. The nurse should administer the injection in the vastus lateralis muscle. Answers A and C are not as well developed in the newborn; therefore, they are incorrect. Answer D is incorrect because the dorsogluteal muscle is not used for IM injections until the child is 3 years of age.
43. Answer A is correct. The client taking Cytoxan should increase his fluid intake to prevent hemorrhagic cystitis. Answers B, C, and D do not relate to the question; therefore, they are incorrect.
44. Answer D is correct. Benzodiazepines are ordered for the client in alcohol withdrawal to prevent delirium tremens. Answer A is incorrect because it is a medication used in aversive therapy to maintain sobriety. Answer B is incorrect because it is used for the treatment of benzodiazepine overdose. Answer C is incorrect because it is the treatment for opiate withdrawal.
45. Answer C is correct. The client taking NPH insulin should have a snack midafternoon to prevent hypoglycemia. Answers A and B are incorrect because the times are too early for symptoms of hypoglycemia. Answer D is incorrect because the time is too late and the client would be in severe hypoglycemia.
46. Answer B is correct. The client with a detached retina will have limitations in mobility before and after surgery. Answer A is incorrect because a detached retina produces no pain or discomfort. Answers C and D do not apply to the client with a detached retina; therefore, they are incorrect.
47. Answer B is correct. The primary purpose for the continuous passive-motion machine is to promote flexion of the artificial joint. The device should be placed at the foot of the client’s bed. Answers A, C, and D do not describe the purpose of the CPM machine; therefore, they are incorrect.
48. Answer D is correct. According to Kohlberg, in the preconventional stage of development, the behavior of the preschool child is determined by the consequences of the behavior. Answers A, B, and C describe other stages of moral development; therefore, they are incorrect.
49. Answer C is correct. The client should be assessed following completion of antibiotic therapy to determine whether the infection has cleared. Answer A would be done if there are repeated instances of otitis media; therefore, it is incorrect. Answer B is incorrect because it will not determine whether the child has completed the medication. Answer D is incorrect because the purpose of the recheck is to determine whether the infection is gone.
50. Answer D is correct. The nurse should cover both of the client’s eyes and transport him immediately to the ER or the doctor’s office. Answers A, B, and D are incorrect because they increase the risk of further damage to the eye.