[UPDATED 2024] Free NCLEX NCLEX-RN Exam Questions Self-Assess Preparation

NCLEX-RN Free Sample Questions to Practice One Year Update

NCLEX-RN exam is computerized and adaptive, meaning that the difficulty level of the exam adjusts based on a nurse's performance. NCLEX-RN exam is designed to be challenging, and many nurses find it to be a stressful experience. However, the NCLEX-RN is an essential step for nurses who wish to enter the workforce and begin practicing as registered nurses. With proper preparation and study, nurses can feel confident and well-prepared to pass the exam and begin their careers in nursing.

NCLEX-RN (National Council Licensure Examination for Registered Nurses) is a standardized exam that all nursing graduates must pass in order to obtain a license to practice nursing in the United States. NCLEX-RN exam is developed and administered by the National Council of State Boards of Nursing (NCSBN). The NCLEX-RN exam measures the knowledge, skills, and abilities essential for safe and effective nursing practice.

 

NEW QUESTION # 463
Because a client is taking an MAO inhibitor, it is necessary to discuss the need for adherence to a low-tyramine diet. Which of the following are foods that she should avoid?

• A. Broiled fresh fish and fowl
• B. Fresh vegetables
• C. Pickled, aged, smoked, and fermented foods
• D. Fresh fruit such as apples and oranges

Answer: C

Explanation:
(A) These foods may produce elevation in blood pressure when consumed during MAO inhibition therapy. (B) These foods have not been pickled, fermented, smoked, or aged. They contain very little, if any, tyramine or tryptophan. (C) As long as the meat has not been aged or smoked, it is within the dietary regimen. (D) Fresh fruits can be consumed as desired. However, the consumption of bananas is limited.

NEW QUESTION # 464
Which of the following would have the physiological effect of decreasing intracranial pressure (ICP)?

• A. Increased core body temperature
• B. Administration of hypo-osmolar fluids
• C. Decreased PaCO2
• D. Decreased serum osmolality

Answer: C

Explanation:
Explanation
(A) An increase in core body temperature increases metabolism and results in an increase in ICP. (B) Decreased serum osmolality indicates a fluid overload and may result in an increase in ICP. (C) Hypo-osmolar fluids are generally voided in the neurologically compromised. Using IV fluids such as D5W results in the dextrose being metabolized, releasing free water that is absorbed by the brain cells, leading to cerebral edema.
(D) Hypercapnia and hypoventilation, which cause retention of CO2 and lead to respiratory acidosis, both increase ICP. CO2 is the most potent vasodilator known.

NEW QUESTION # 465
The nurse is trying to help a mother understand what is happening with her son who has recently been diagnosed with paranoid schizophrenia. At present, he is experiencing hallucinations and delusions of persecution and suffers from poor hygiene. The nurse can best help her understand her son's condition by which of the following statements?

• A. "Has anyone in your family ever had schizophrenia?"
• B. "If your son has a twin, he probably will eventually develop schizophrenia, too."
• C. "Some of his symptoms may be a result of his lack of a strong mother-child bonding relationship."
• D. "Sometimes these symptoms are caused by an overstimulation of a chemical called dopamine in the brain."

Answer: D

Explanation:
Explanation
(A) The most plausible theory to date is that dopamine causes an overstimulation in the brain, which results in the psychotic symptoms. (B) This statement will only create anxiety in the mother, and the genetic theory is only one of the etiological factors. (C) This statement will cause the mother much alarm, and nothing was mentioned about any other child. (D) The motherchild relationship is one of the previous theories examined, but it is not one to be emphasized, thereby causing a lot of anxiety for the mother.

NEW QUESTION # 466
An obstructing stone in the renal pelvis or upper ureter causes:

• A. Radiating pain into the urethra with labia pain experienced in females or testicular pain in males
• B. Dull, aching, back pain
• C. Severe flank and abdominal pain with nausea, vomiting, diaphoresis, and pallor
• D. Urinary frequency and dysuria

Answer: C

Explanation:
(A) Radiating pain in the urethra in both sexes, extending into the labia in females and into the testicle or penis in the male, indicates a stone in the middle or lower segment of the ureter. (B) Urinary frequency and dysuria are caused by a stone in the terminal segment of the ureter withinthe bladder wall. (C) An obstructing stone in the renal pelvis or upper ureter causes severe flank and abdominal pain with nausea, vomiting, diaphoresis, and pallor. (D) Dull and aching pain may indicate early stages of hydronephrosis. Also, a stone in the renal
pelvis or upper ureter causes severe flank and abdominal pain.

NEW QUESTION # 467
A 70-year-old homeless woman is admitted with pneumonia. She is weak, emaciated, and febrile. The physician orders enteral feedings intermittently by nasogastric tube. When inserting the nasogastric tube, once the tube passes through the oropharynx, the nurse will instruct the client to:

• A. Swallow as tube passes
• B. Cough as tube passes
• C. Tilt her head backwards
• D. Hold breath as tube passes

Answer: A

Explanation:
Explanation
(A) Head should be tilted slightly forward to facilitate insertion. (B) Swallowing assists with insertion of tube and closes off airway. (C) Client should be swallowing as tube passes; holding the breath facilitates nothing.
(D) Coughing may expel tube.

NEW QUESTION # 468
A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimer's disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:

• A. Reality testing
• B. Confronting confabulations
• C. Providing a highly stimulating environment
• D. Allowing the client to perform activities of daily living as much as possible unassisted

Answer: D

Explanation:
Section: Questions Set D
Explanation:
(A) This answer is correct. The more the client is able to control her daily routine, the less anxiety she will experience. (B) This answer is incorrect. Confrontation tends to increase anxiety. (C) This answer is incorrect.
Reality testing is an assessment tool. It does not decrease anxiety. (D) This answer is incorrect. A highly stimulating environment increases distractibility and anxiety.

NEW QUESTION # 469
When a client with pancreatitis is discharged, the nurse needs to teach him how to prevent another occurrence of acute pancreatitis. Which of the following statements would indicate he has an understanding of his disease?

• A. "I will report any changes in bowel movements to my doctor."
• B. "I will look into attending Alcoholics Anonymous meetings."
• C. "I will not eat any raw or uncooked vegetables."
• D. "I will limit my alcohol to one cocktail per day."

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) Raw or uncooked vegetables are all right to eat postdischarge. (B) This client must avoid any alcohol intake. (C) The client displays awareness of the need to avoid alcohol. (D) This action would be pertinent only if fatty stools associated with chronic hepatitis were the problem.

NEW QUESTION # 470
Degenerative disorders are attributed to many factors. As a nurse assigned to a convalescent home, one must often educate families about how such conditions occur. Which of the following statements might the nurse need to explore when a daughter tries to explain to her mother what caused her degenerative disorder?

• A. "Some folks believe that aging causes this, Mother."
• B. "I know some people who are having this problem and they were exposed to chemicals at work, Mother."
• C. "It can be caused by lots of things, toxic agents and even alcohol, Mother."
• D. "Perhaps, it's the way your parents used those double-bind messages, Mother."

Answer: D

Explanation:
Section: Questions Set F
Explanation:
(A) Aging is a factor in the cause of degenerative disorders. (B) Double-bind messages may be found in the histories of families of individuals who develop schizophrenia, but they are not related to degenerative disorders. (C) Chemicals (toxic agents) in work environments are predisposing factors to degenerative disorders. (D) Alcohol causes some degenerative disorders, such as Wernicke's syndrome.

NEW QUESTION # 471
Assessment of the client with pericarditis may reveal which of the following?

• A. Narrowed pulse pressure and shortness of breath
• B. Ventricular gallop and substernal chest pain
• C. Pericardial tamponade and widened pulse pressure
• D. Pericardial friction rub and pain on deep inspiration

Answer: D

Explanation:
(A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs.

NEW QUESTION # 472
A female client has been treated since childhood for mitral valve prolapse. The antibiotic of choice for her during pregnancy would be:

• A. Tetracycline
• B. Sulfa
• C. Hydralazine
• D. Erythromycin

Answer: D

Explanation:
(A) Sulfa is a teratogen and will cause kernicterus. (B) Tetracycline is a teratogen and will effect tooth development. (C) Hydralazine is not an antibiotic but a calcium channel blocker. (D) Erythromycin is safe during pregnancy and can be used when the client is allergic to penicillin.

NEW QUESTION # 473
A 68-year-old man was recently diagnosed with endstage renal disease. He has not yet begun dialysis but is experiencing severe anemia with associated symptoms of dyspnea on exertion and chest pain. Which statement best describes the management of anemia in renal failure?

• A. Transfusion is often begun as early as possible to prevent complications of anemia such as dyspnea and angina.
• B. The renal secretion of erythropoiesis is decreased. The bone marrow requires erythropoietin to mature red blood cells.
• C. Anemia in renal failure is frequently caused by low serum iron and ferritin and corrected by oral iron and ferritin replacement therapy.
• D. Hematocrit levels usually remain slightly below normalin clients with renal failure.

Answer: B

Explanation:
Explanation/Reference:
Explanation:
(A) Clients in renal failure typically have very low hematocrits, often in the range of 16-22%. (B) Transfusion is avoided unless the client exhibits acute symptoms such as dyspnea, chest pain, tachycardia, and extreme fatigue. When the client is given a transfusion, the bone marrow adjusts by producing less red blood cells. (C) Anemia in renal failure is caused primarily by decreased erythropoietin.
Low serum iron and ferritin may aggravate the anemia and require treatment. (D) Decreased secretion of erythropoietin by the kidney is the primary cause of anemia. The bone marrow requires this hormone to mature red blood cells. Treatment is with replacement therapy.

NEW QUESTION # 474
A successful executive left her job and became a housewife after her marriage to a plastic surgeon. She started doing volunteer work for a charity organization. She developed pain in her legs that advanced to the point of paralysis. Her physicians can find no organic basis for the paralysis. The client's behavior can be described as:

• A. Conversion reaction
• B. Agoraphobia
• C. Housework phobia
• D. Malingering

Answer: A

Explanation:
Explanation/Reference:
Explanation:
(A) A typical phobia does not result in physical symptoms (i.e., paralysis). (B) Malingering is pretending to be ill. This person has a true paralysis. (C) A conversion reaction is a physical expression of an emotional conflict. It has no organic basis. (D) Agoraphobia is fear of public places.

NEW QUESTION # 475
The postpartum nurse should include which of the following instructions to breast-feeding mothers?

• A. Daily caloric intake should be increased by 500 cal.
• B. Breast milk is totally digestible by the baby because it contains lactose.
• C. Limit feeding times for several days to avoid nipple soreness.
• D. Wash the nipples with soap and water before and after each feeding.

Answer: A

Explanation:
Section: Questions Set E
Explanation:
(A) Limiting initial feeding times will only delay nipple soreness as well as the establishment of the letdown reflex, thus encouraging engorgement from clogged ducts and ductules. (B) Soap should be avoided because it may be excessively drying, predisposing nipples to cracking. (C) For optimal milk production, an additional
500 kcal over maintenance levels are needed daily. (D) Lipase, not lactose, emulsifies the fat in breast milk, making it almost totally digestible by infants.

NEW QUESTION # 476
When assessing a female child for Turner's syndrome, the nurse observes for which of the following symptoms?

• A. Gynecomastia
• B. Secondary sex characteristics
• C. Amenorrhea
• D. Tall stature

Answer: C

Explanation:
Explanation/Reference:
Explanation:
(A) This syndrome is caused by absence of one of the X chromosomes. These children are short in stature. (B) Amenorrhea is a symptom of Turner's syndrome, which appears at puberty. (C) Sexual infantilism is characteristic of this syndrome. (D) Gynecomastia is a symptom in Klinefelter's syndrome.

NEW QUESTION # 477
Following a gastric resection, which of the following actions would the nurse reinforce with the client in order to alleviate the distress from dumping syndrome?

• A. Eating three large meals a day
• B. Taking a long walk after meals
• C. Drinking small amounts of liquids with meals
• D. Eating a low-carbohydrate diet

Answer: D

Explanation:
(A) Six small meals are recommended. (B) Liquids after meals increase the time food empties from the stomach. (C) Lying down after meals is recommended to prevent gravity from producing dumping. (D) A low-carbohydrate diet will prevent a hypertonic bolus, which causes dumping.

NEW QUESTION # 478
A 1-year-old child is to receive an IM injection ordered by his pediatrician. He has fallen asleep in his mother's arms when the nurse approaches. Which approach is most appropriate at this time?

• A. Awaken the child first and give the injection in the dorsogluteal site.
• B. Ask the mother to place the child on the examination table and leave the room, and then give the injection in an appropriate site.
• C. Awaken the child first and give the injection in the ventrogluteal site.
• D. Give the injection in the vastus lateralis site before the child awakens.

Answer: C

Explanation:
Explanation/Reference:
Explanation:
(A) If awakened first, the child will know that nothing painful will be done without the child being alerted. (B) The ventrogluteal site is a safe site for children because it is a large muscle free of major nerves and blood vessels. (C) The dorsogluteal site is not recommended in children who have not been walking for at least 1 year because the muscle is not fully developed. (D) The parent will be able to offer support and comfort during and after the injection.

NEW QUESTION # 479
A 25-year-old outpatient presents with a diagnosis of compulsive personality disorder. His coworkers become annoyed with his rigid, perfectionistic manner and preoccupation with trivial details and schedules. A nursing intervention appropriate for this client would include:

• A. Encouraging the client to set a time schedule and deadlines for himself
• B. Contracting with him for the amount of time he will spend on the compulsive behaviors
• C. Avoiding discussion of his annoying behavior
• D. Encouraging him to engage in recreational activities

Answer: B

Explanation:
Explanation
(A) This answer is incorrect. The client will work hard at the activity instead of enjoying it. (B) This answer is incorrect. The nurse should allow the client to discuss these thoughts, within limits, not to avoid discussing them. (C) This answer is incorrect. The compulsive client tends to control time to excess. It should not be encouraged. (D) This answer is correct. A contract with the client regarding the amount of time that will be spent discussing the compulsive activities is appropriate. Time allotted should be gradually decreased.

NEW QUESTION # 480
After the RN is finished the initial assessment of a newborn baby and after the initial bonding between the newborn and the mother has taken place in the delivery room, the RN will bring the newborn to the well-baby nursery. Before the newborn is taken from the delivery room and brought to the well-baby nursery, the RN makes sure that which of the following interventions was completed?

• A. The nurse counts the instruments and sponges with the scrub nurse.
• B. The physician verifies the exact time of birth.
• C. The nurse instills prophylactic ointment in the conjunctival sacs of the newborn's eyes.
• D. The nurse makes sure the mother and her newborn have been tagged with identical bands.

Answer: D

Explanation:
Explanation
(A) The delivery room personnel are responsible for verifying time of birth. (B) The scrub and circulating nurses count sponges and instruments. (C) This intervention is done in the nursery. (D) Tagging the mother and infant with identical bands is of utmost importance. The mother wears one band, and the newborn wears two. Identical numbers on the three bands provide identification for the newborn and the birth mother. Every time the newborn is brought to the mother after delivery, those bands are checked to be sure that the numbers are identical.

NEW QUESTION # 481
The most frequent cause of early postpartum hemorrhage is:

• A. Uterine atony
• B. Coagulation disorders
• C. Retained placental fragments
• D. Hematoma

Answer: A

Explanation:
(A) Hematomas, which are the result of damage to a vessel wall without laceration of the
tissue, are a cause, though not the most frequent cause. (B) Coagulation disorders are among the causes of postpartal hemorrhage, but they are less common. (C) The most frequent causes of hemorrhage in the postpartal period are related to an interference with involution of the uterus. Uterine atony is the most frequent cause, occurring in the first 24 hours after delivery. (D) Retained placental fragments are also a cause, although these bleeds usually occur 7-14 days after delivery.

NEW QUESTION # 482
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