NCLEX PN Practice Tests

NCLEX PN Practice Tests Related

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Exhibit 1
Medication administration record

Allergies: No known drug allergies

Medication Time
Insulin NPH: 75 units subcutaneously, twice daily 0800, 2000
Insulin lispro: sliding scale dosing, before meals and at bedtime 0800, 1130, 1730, 2100

Exhibit 2
Laboratory results and reference ranges

Sodium
136-145 mEq/L
(136-145 mmol/L) 141 mEq/L
(141 mmol/L)
Potassium
3.5-5.0 mEq/L
(3.5-5.0 mmol/L) 3.0 mEq/L
(3.0 mmol/L)
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L) 328 mg/dL
(18.2 mmol/L)




The nurse is preparing to administer medications scheduled for 0800 to a client with type 1 diabetes mellitus. After reviewing the client's morning laboratory test results, which of the following actions would be a priority for the nurse to take?

  • A. Administer insulin lispro per protocol and insulin NPH
  • B. Contact the client's health care provider
  • C. Obtain a urine specimen to check for ketones
  • D. Recheck the client's capillary blood glucose level
Correct Answer: B

Rationale: Abnormal lab results (e.g., severe hypo/hyperglycemia) require provider notification to adjust treatment. Administering insulin, checking ketones, or rechecking glucose are secondary without specific lab values.

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An adult is receiving cancer chemotherapy. Metoclopramide (Reglan) is also prescribed. The client asks why she is getting Reglan. How should the nurse respond?

  • A. Reglan helps to prevent bleeding that may occur as a side effect of your other medications.'
  • B. Reglan helps to prevent any nausea and vomiting that may occur as a side effect of your other medications.'
  • C. Reglan increases the effectiveness of the cancer chemotherapeutic agents.'
  • D. Reglan helps to control pain associated with your disease.'
Correct Answer: B

Rationale: Metoclopramide is an antiemetic, prescribed to prevent nausea and vomiting, common chemotherapy side effects, improving patient comfort.

The nurse is reviewing new medication prescriptions for a client who has a suspected brain tumor. The client is scheduled for a CT scan of the head with IV iodinated contrast in 24 hours. The nurse should clarify the prescription for

  • A. gabapentin
  • B. amlodipine
  • C. metformin
  • D. phenytoin
Correct Answer: C

Rationale: Metformin should be held before and after iodinated contrast due to the risk of lactic acidosis if contrast-induced kidney injury occurs. Gabapentin, amlodipine, and phenytoin are safe with contrast.

After receiving shift report, the nurse is assessing a client started on trimethoprim-sulfamethoxazole 2 days ago for treatment of a urinary tract infection. The client reports itching, and the nurse notices a diffuse maculopapular rash on the client's face. What should the nurse do first?

  • A. Administer diphenhydramine
  • B. Administer injectable epinephrine
  • C. Examine the client's trunk and limbs
  • D. Reassess the client's allergy history
Correct Answer: C

Rationale: Examining the trunk and limbs determines the rash’s extent, guiding whether it’s a mild reaction or a severe one (e.g., Stevens-Johnson syndrome). Diphenhydramine, epinephrine, or allergy reassessment are secondary until the rash is fully assessed.

Which of these clients would be most appropriate to assign to a practical nurse (PN)?

  • A. A trauma victim with quadriplegia and a client 1 day post-op radical neck dissection
  • B. A client with newly diagnosed type 2 diabetes mellitus and a client with a history of AIDS admitted for pneumonia
  • C. A client with hemiplegia is fed by a nasogastric tube and client with a left leg amputation in rehabilitation
  • D. A client with a history of schizophrenia in alcohol withdrawal and a client with chronic renal failure
Correct Answer: C

Rationale: This client requires supportive care and interventions within the scope of practice of a PN. This client is stable with little risk of complications or instability.

An adult asks the nurse what could be causing him to have a black tongue and black stools. The following items are in the client's history. Which is most likely to be causing his symptoms?

  • A. He is taking bismuth subsalicylate (Pepto-Bismol) for loose stools.
  • B. He has been eating a lot of beets and broccoli recently.
  • C. He has been taking iron tablets for anemia.
  • D. He eats a lot of red meat.
Correct Answer: A

Rationale: Bismuth subsalicylate commonly causes black tongue and stools, a harmless side effect, unlike the other options.

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