NCLEX PN ACTUAL EXAM 2024 QUESTIONS
AND ANSWERS WITH RATIONALE.
Question 1:
A client with diabetes is admitted to the hospital with hyperglycemia. The nurse is aware that which of the following insulin types has the quickest onset of action?
A) Regular insulin
B) NPH insulin
C) Lispro insulin
D) Glargine insulin
Answer 1:
C) Lispro insulin
Rationale:
Lispro insulin has a rapid onset of action, typically within 15 minutes of administration. This makes it an appropriate choice for controlling postprandial hyperglycemia. Regular insulin has a slower onset, NPH insulin is intermediate-
acting, and Glargine insulin has a slow and steady release with no pronounced peak.
Question 2:
A client with chronic kidney disease is prescribed a phosphate binder. Which medication is commonly used to reduce serum phosphate levels in patients with renal impairment?
A) Furosemide
B) Calcium carbonate
C) Aluminum hydroxide
D) Metolazone Answer 2:
C) Aluminum hydroxide
Rationale:
Aluminum hydroxide is a phosphate binder commonly used in patients with renal impairment. It works by binding to dietary phosphate in the GI tract, preventing its absorption. Furosemide is a loop diuretic, calcium carbonate is not typically used for phosphate binding, and metolazone is a thiazide diuretic.
Question 3:
A postoperative client receiving patient-controlled analgesia (PCA) reports feeling lightheaded and dizzy. The nurse's initial action should be to:
A) Administer an antiemetic
B) Assess the respiratory rate
C) Increase the PCA dose
D) Check the blood pressure
Answer 3:
Question 4:
A client with heart failure is prescribed digoxin. The nurse should monitor for which early sign of digoxin toxicity?
A) Nausea and vomiting
B) Hyperkalemia
C) Hypotension
D) Visual disturbances Answer 4:
D) Visual disturbances
Rationale:
Visual disturbances, such as yellow-green halos around lights, are early signs of digoxin toxicity. Nausea and vomiting, hyperkalemia, and hypotension are not specific to digoxin toxicity.
Question 5:
A client with chronic obstructive pulmonary disease (COPD) is prescribed albuterol inhaler. The nurse instructs the client to use the albuterol inhaler before using other inhaled medications. What is the rationale for this instruction?
A) Albuterol enhances the effects of other inhaled medications.
B) Albuterol decreases the risk of bronchoconstriction.
C) Albuterol opens the airways and facilitates better absorption of other medications.
D) Albuterol reduces the risk of systemic side effects.
Answer 5:
C) Albuterol opens the airways and facilitates better absorption of other medications.
Rationale:
Albuterol is a bronchodilator that opens the airways, allowing better penetration and
absorption of other inhaled medications. Using albuterol first can enhance the effectiveness of subsequent medications.
Question 6:
A client with a history of deep vein thrombosis (DVT) is receiving enoxaparin (Lovenox). The nurse should monitor the client for which adverse effect? A) Hyperglycemia
B) Hypertension
C) Thrombocytopenia
D) Hyponatremia
Answer 6:
C) Thrombocytopenia
Rationale:
Thrombocytopenia (a decrease in platelet count) is a potential adverse effect of enoxaparin. Monitoring platelet levels is essential during therapy. Hyperglycemia, hypertension, and hyponatremia are not typically associated with enoxaparin use.
Question 7:
A client with type 2 diabetes is prescribed metformin. The nurse instructs the client to monitor for which common side effect of metformin therapy?
A) Hypertension
B) Weight gain
C) Hypoglycemia
D) Gastrointestinal upset
Answer 7:
D) Gastrointestinal upset
Rationale:
Gastrointestinal upset, including nausea, vomiting, and diarrhea, is a common side effect of metformin. Metformin does not cause hypoglycemia, hypertension, or weight gain.
Question 8:
AND ANSWERS WITH RATIONALE.
Question 1:
A client with diabetes is admitted to the hospital with hyperglycemia. The nurse is aware that which of the following insulin types has the quickest onset of action?
A) Regular insulin
B) NPH insulin
C) Lispro insulin
D) Glargine insulin
Answer 1:
C) Lispro insulin
Rationale:
Lispro insulin has a rapid onset of action, typically within 15 minutes of administration. This makes it an appropriate choice for controlling postprandial hyperglycemia. Regular insulin has a slower onset, NPH insulin is intermediate-
acting, and Glargine insulin has a slow and steady release with no pronounced peak.
Question 2:
A client with chronic kidney disease is prescribed a phosphate binder. Which medication is commonly used to reduce serum phosphate levels in patients with renal impairment?
A) Furosemide
B) Calcium carbonate
C) Aluminum hydroxide
D) Metolazone Answer 2:
C) Aluminum hydroxide
Rationale:
Aluminum hydroxide is a phosphate binder commonly used in patients with renal impairment. It works by binding to dietary phosphate in the GI tract, preventing its absorption. Furosemide is a loop diuretic, calcium carbonate is not typically used for phosphate binding, and metolazone is a thiazide diuretic.
Question 3:
A postoperative client receiving patient-controlled analgesia (PCA) reports feeling lightheaded and dizzy. The nurse's initial action should be to:
A) Administer an antiemetic
B) Assess the respiratory rate
C) Increase the PCA dose
D) Check the blood pressure
Answer 3:
Question 4:
A client with heart failure is prescribed digoxin. The nurse should monitor for which early sign of digoxin toxicity?
A) Nausea and vomiting
B) Hyperkalemia
C) Hypotension
D) Visual disturbances Answer 4:
D) Visual disturbances
Rationale:
Visual disturbances, such as yellow-green halos around lights, are early signs of digoxin toxicity. Nausea and vomiting, hyperkalemia, and hypotension are not specific to digoxin toxicity.
Question 5:
A client with chronic obstructive pulmonary disease (COPD) is prescribed albuterol inhaler. The nurse instructs the client to use the albuterol inhaler before using other inhaled medications. What is the rationale for this instruction?
A) Albuterol enhances the effects of other inhaled medications.
B) Albuterol decreases the risk of bronchoconstriction.
C) Albuterol opens the airways and facilitates better absorption of other medications.
D) Albuterol reduces the risk of systemic side effects.
Answer 5:
C) Albuterol opens the airways and facilitates better absorption of other medications.
Rationale:
Albuterol is a bronchodilator that opens the airways, allowing better penetration and
absorption of other inhaled medications. Using albuterol first can enhance the effectiveness of subsequent medications.
Question 6:
A client with a history of deep vein thrombosis (DVT) is receiving enoxaparin (Lovenox). The nurse should monitor the client for which adverse effect? A) Hyperglycemia
B) Hypertension
C) Thrombocytopenia
D) Hyponatremia
Answer 6:
C) Thrombocytopenia
Rationale:
Thrombocytopenia (a decrease in platelet count) is a potential adverse effect of enoxaparin. Monitoring platelet levels is essential during therapy. Hyperglycemia, hypertension, and hyponatremia are not typically associated with enoxaparin use.
Question 7:
A client with type 2 diabetes is prescribed metformin. The nurse instructs the client to monitor for which common side effect of metformin therapy?
A) Hypertension
B) Weight gain
C) Hypoglycemia
D) Gastrointestinal upset
Answer 7:
D) Gastrointestinal upset
Rationale:
Gastrointestinal upset, including nausea, vomiting, and diarrhea, is a common side effect of metformin. Metformin does not cause hypoglycemia, hypertension, or weight gain.
Question 8:
