New versionHESI Exit simulations are here — Predictor, CAT, RAT, quizzes and lessons. Subscribers get full, unlimited access to every latest material.

See plans · from $19
Naxlex RN Hub

NCLEX-RN original latest material

150 questions · Original · Latest version

Question 1

A nurse is caring for a client with neutropenia after chemotherapy. Which action should the nurse take to reduce the risk for infection?

  1. A. Place fresh flowers from family members at the bedside to improve morale
  2. B. Assign the client to a private room and perform meticulous hand hygiene
  3. C. Obtain a rectal temperature every 4 hours
  4. D. Use a disposable mask only when the client leaves the room

ANS: Answer: B

Correct: A client with neutropenia is at high risk for infection. A private room and meticulous hand hygiene reduce exposure to pathogens and are priority protective measures. Incorrect: Fresh flowers can harbor microorganisms and should be avoided for a neutropenic client. Rectal temperatures can traumatize mucosa and introduce infection; oral or axillary temperatures are preferred depending on facility policy. A disposable mask only when the client leaves the room is insufficient; protective precautions depend on exposure risk and facility protocol, and hand hygiene is more critical than a mask alone. Clinical judgment step: Take action. Test plan category: Safety and Infection Control.

Question 2

A nurse is teaching a 16-year-old client who is starting combined oral contraceptives. Which statements by the client indicate correct understanding? Select all that apply.

  1. A. "I should take one pill at the same time every day."
  2. B. "If I miss one pill, I should take it as soon as I remember."
  3. C. "This method protects me from HIV and other STIs."
  4. D. "I should report severe chest pain or leg swelling right away."
  5. E. "I may need backup contraception when I start the pills."
  6. F. "I can stop using condoms because the pill is effective immediately."

ANS: Answer: A, B, D, E

Correct: Taking the pill at the same time every day improves contraceptive effectiveness. If one pill is missed, taking it as soon as remembered is appropriate for many combined pill regimens. Severe chest pain or leg swelling can indicate a thromboembolic complication and requires immediate follow-up. Backup contraception may be needed when starting the pills, depending on when in the cycle therapy begins and the specific product instructions. Incorrect: Oral contraceptives do not protect against HIV or other STIs; condoms are still needed for STI prevention. The pill does not always provide immediate contraception; backup protection may be required during initiation. Stopping condom use because the pill is effective immediately is incorrect and unsafe. Clinical judgment step: Evaluate outcomes. Test plan category: Health Promotion and Maintenance.

Question 3

A client with type 2 diabetes mellitus is prescribed regular insulin 8 units subcutaneously now. Which action should the nurse take first?

  1. A. Verify the blood glucose result before administering the insulin
  2. B. Massage the injection site after giving the insulin
  3. C. Mix the insulin with NPH insulin in the same syringe
  4. D. Teach the client to avoid all carbohydrates for the rest of the day

ANS: Answer: A

Correct: Regular insulin is a hypoglycemic medication, so the nurse must verify the current blood glucose before administration to ensure it is safe to give and to determine whether the insulin dose matches the glucose level and meal status. Incorrect: Massaging the site can alter absorption and is not the first action. Mixing insulin may be appropriate for some orders, but only after verifying the blood glucose and the specific prescription. Telling the client to avoid all carbohydrates is not appropriate; insulin therapy is coordinated with meals and carbohydrate intake, not complete carbohydrate elimination. Clinical judgment step: Recognize cues. Test plan category: Pharmacological and Parenteral Therapies.

Question 4

A 68-year-old client is 4 hours postoperative after a total hip arthroplasty. Nurse's Notes 14:00 Client reports severe pain in the operative hip despite receiving prescribed pain medication 30 minutes ago. The operative leg is shortened and externally rotated. Pedal pulse on the affected side is weaker than the opposite side. The client is pale and anxious. Vital Signs 14:00 Temperature 37.0 C (98.6 F), heart rate 118/min, respiratory rate 22/min, blood pressure 96/60 mm Hg, SpO2 95% on room air Laboratory Results 14:15 Hemoglobin 9.1 g/dL (12-16 g/dL), hematocrit 27% (36%-46%), potassium 4.0 mEq/L (3.5-5.0 mEq/L) Which finding requires immediate follow-up? Click to highlight the findings that require follow-up.

  1. A. severe pain in the operative hip despite receiving prescribed pain medication 30 minutes ago
  2. B. the operative leg is shortened and externally rotated
  3. C. pedal pulse on the affected side is weaker than the opposite side
  4. D. the client is pale and anxious
  5. E. temperature 37.0 C (98.6 F)
  6. F. heart rate 118/min
  7. G. blood pressure 96/60 mm Hg
  8. H. hemoglobin 9.1 g/dL (12-16 g/dL)
  9. I. hematocrit 27% (36%-46%)
  10. J. potassium 4.0 mEq/L (3.5-5.0 mEq/L)

Question 5

A nurse on a medical-surgical unit is receiving the shift report below. Nurse's Notes 0730: Four clients assigned for admission and transfer. Client A: 58-year-old with new onset atrial fibrillation, HR 132/min, BP 104/68 mm Hg, reports palpitations. Client B: 71-year-old with COPD, requesting discharge teaching about home oxygen today. Client C: 84-year-old 2 days post-op hip arthroplasty, pain 3/10 after oral analgesic, needs assistance to chair. Client D: 46-year-old with type 1 diabetes, blood glucose 268 mg/dL, ketones negative, alert and eating breakfast. Which task should the nurse complete first?

  1. A. Assess Client A for decreased cardiac output and notify the provider of the change in rhythm.
  2. B. Provide discharge teaching to Client B about no smoking and oxygen safety.
  3. C. Assist Client C to the chair using proper body mechanics and fall precautions.
  4. D. Administer prescribed rapid-acting insulin to Client D with breakfast.

Study the full original latest version

Add to My MaterialsSee Pro plans