NCLEX PN Practice Tests

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Exhibit 1
Vital signs

0800
Temperature 98.4 F (36.8 C)
Blood pressure 110/72 mm Hg
Heart rate 52/min
Respirations 16/min

Exhibit 2
Laboratory results

0800
Hematocrit
Male: 42%–52%
(0.42-0.52)
Female: 37%–47%
(0.37–0.47) 40%
(0.4)
Hemoglobin
Male: 14.0–18.0 g/dL
(140–180 g/L)
Female: 12.0–16.0 g/dL
(120–160 g/L) 14.0 g/dL
(140 g/L)
Platelets
150,000–400,000/mm3
(150–400 × 109/L) 200,000/mm3
(200 × 109/L)
Potassium
3.5-5.0 mEq/L
(3.5-5.0 mmol/L) 4.0 mEq/L
(4.0 mmol/L)


Exhibit 3
Medication administration record

Allergies: No known drug allergies

Medications Time
Aspirin: 81 mg by mouth, daily 0900
Docusate sodium: 100 mg by mouth, daily 0900
Lisinopril: 5 mg by mouth, daily 0900
Metoprolol: 100 mg by mouth, twice daily 0900, 1700
Simvastatin: 20 mg by mouth, daily 2000

A client with ST segment elevation myocardial infarction is due for 0900 medications. Based on the data shown in the exhibit, which medications should the nurse administer? Select all that apply.

  • A. aspirin
  • B. docusate sodium
  • C. lisinopril
  • D. metoprolol
  • E. simvastatin
Correct Answer: A,C,D,E

Rationale: Aspirin (antiplatelet), lisinopril (ACE inhibitor), metoprolol (beta-blocker), and simvastatin (statin) are standard for STEMI to reduce clot formation, blood pressure, and cholesterol. Docusate is unrelated to STEMI management.

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Which of these women in the labor and delivery unit would the nurse check first when the water breaks (ROM) for all of them within a 2 minute period?

  • A. A multigravida with station at +2, contractions at 15 minutes apart with duration of 30 seconds, cervix dilated at 7 cm, and 50% effacement
  • B. A multigravida with station at -1, contractions at 15 minutes apart with duration of 30 seconds, cervix dilated at 3 cm, and 10% effacement
  • C. A primipara with station at 0, contractions at 20 minutes apart with duration of 20 seconds, cervix dilated at 2 cm and 10% effacement
  • D. A primipara with station at 1, contractions at 15 minutes apart with duration of 35 seconds, cervix dilated at 5 cm and 50% effacement
Correct Answer: B

Rationale: A multigravida with station at -1, contractions at 15 minutes apart with duration of 30 seconds, cervix dilated at 3 cm, and 10% effacement. When the station is -1 or -2 and the water breaks, the risk is greater for a prolapsed cord.

A client has sustained second- and third-degree burns over her entire left arm and posterior trunk. Using the Rule of Nines, which percentage of the client's body is burned?

  • A. 9%
  • B. 18%
  • C. 27%
  • D. 36%
Correct Answer: C

Rationale: Per the Rule of Nines, one arm is 9% and the posterior trunk is 18%, totaling 27% body surface area burned.

The nurse is administering a tap water enema when the client begins to complain of abdominal cramping. The nurse should:

  • A. Stop the administration of the enema.
  • B. Lower the height of the enema container.
  • C. Clamp the enema tubing and withdraw it slowly.
  • D. Advance the tubing 1-2 inches.
Correct Answer: B

Rationale: Lowering the enema container slows the flow, reducing cramping. Stopping or withdrawing the tubing is premature, and advancing may worsen discomfort.

Laboratory Reference Ranges
Creatinine
Male: 0.6–1.3 mg/dL
(53–114.9 μmol/L)

Female: 0.5–1.2 mg/dL
(44.2–106.1 μmol/L)

The nurse is planning to assess 4 assigned clients. Which client situation is of greatest concern and warrants immediate assessment?

  • A. Client scheduled for hemodialysis in an hour who has a serum creatinine level of 9.2 mg/dL (813 µmol/L) and refuses to take prescribed medications
  • B. Client taking diphenhydramine for urticaria who reports difficulty urinating and increasing lower abdominal pain
  • C. Client with an infected venous leg ulcer prescribed IV vancomycin who has a dressing saturated with yellow, foul-smelling drainage
  • D. Client with an inguinal hernia who rates abdominal pain as 10 on a 0-10 scale and reports bloating, nausea, and vomiting
Correct Answer: D

Rationale: Severe pain (10/10) with bloating, nausea, and vomiting in an inguinal hernia suggests strangulation, a surgical emergency. High creatinine, urinary retention, and infected ulcers are urgent but less immediately life-threatening.

The nurse is acting as a preceptor for a student nurse in the labor and delivery unit. Which action by the student would require correction by the nurse?

  • A. Removing gloves prior to removing isolation gown
  • B. Using a nail brush to scrub underneath artificial nails
  • C. Using alcohol-based hand sanitizer instead of washing hands when entering and exiting client room
  • D. Washing hands and not wearing gloves when preparing medications in the med room
Correct Answer: B

Rationale: Artificial nails harbor bacteria, and scrubbing underneath is inadequate; they should be avoided in labor and delivery. Other actions align with infection control protocols.

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