NCLEX-RN PRACTICE
QUESTIONS WITH RATIONALE
ANSWERS |GRADED
A+WITH RATIONALE ANSWERS
Test Bank
PART 1
(75 Questions) NCLEXRN-01-001
Question Tag: hypertension
Question Category: Physiological Integrity, Reduction of Risk Potential
Which individual is at greatest risk for developing hypertension?
A. 45-year-old African-American attorney
B. 60-year-old Asian-American shop owner
C. 40-year-old Caucasian nurse
D. 55-year-old Hispanic teacher
Correct Answer: A: 45-year-old African American attorney
Option A: African-Americans develop high blood pressure at younger ages than other groups in the US. Researchers have uncovered that African-Americans respond differently to hypertensive drugs than other groups of people. They are also found out to be more sensitive to salt, which increases the risk of developing hypertension. Option B: The incidence of hypertension in Asian-Americans does not appear to be significantly higher than the general population, according to limited US data.
Option C: The racial disparity in hypertension and hypertension-
related outcomes has been recognized for decades with African-
Americans with greater risks than Caucasians.
Option D: Hypertension prevalence rates in Hispanics may vary by gender and country of origin. Hispanic Americans overall have relatively low levels of hypertension, despite elevated levels of diabetes and obesity.
NCLEXRN-01-002
Question Tag: acetaminophen
Question Category: Physiological Integrity, Pharmacological and Parenteral Therapies A 15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first?
A. Gastric lavage B. Administer acetylcysteine (Mucomyst) orally
C. Start an IV Dextrose 5% with 0.33% normal saline to keep the vein open D. Have the patient drink activated charcoal mixed with water
Correct Answer: A. Gastric lavage
Option A: Acetaminophen overdose is extremely toxic to the liver causing hepatotoxicity. Early symptoms of hepatic damage include nausea, vomiting, abdominal pain, and diarrhea. If not treated immediately, hepatic necrosis occurs and may lead to death. Removing as much of the drug as possible is the first step in treatment for acetaminophen overdose, this is best done through gastric lavage. Gastric lavage (irrigation) and aspiration consist of flushing the stomach with fluids and then aspirating the
fluid back out. This procedure is done in life-threatening cases such as acetaminophen toxicity and only if less than one (1) hour has occurred after ingestion. Option B: The oral formulation of acetylcysteine is the drug of choice for the treatment of acetaminophen overdose but should be done after GI decontamination with activated charcoal. Liver damage is minimized by giving acetylcysteine (Mucomyst), the antidote for acetaminophen. Acetylcysteine reduces injury by substituting for depleted glutathione in the reaction that converts
the toxic metabolite of acetaminophen to its nontoxic form. When
given within 8 hours of acetaminophen toxicity, acetylcysteine is effective in preventing severe liver injury. It is administered orally
or intravenously. Option C: Intermittent IV infusion with Dextrose 5% may be considered for late-presenting or chronic ingestion.
Option D: Oral activated charcoal (AC) avidly adsorbs acetaminophen and may be administered if the patient presents within 1 hour after ingesting a potentially toxic dose. Charcoal should not be administered immediately before or with antidotes since it can effectively adsorb it and neutralize the benefits. NCLEXRN-01-003 Question Tag: cardiac catheterization
Question Category: Safe and Effective Care Environment, Management of Care
Which complication of cardiac catheterization should the nurse monitor
for in the initial 24 hours after the procedure?
A. Angina at rest
B. Thrombus formation
C. Dizziness
D. Falling blood pressure
Correct Answer: B. Thrombus formation
A thrombus formation may prevent blood from flowing normally through the circulatory system, which may become an embolism, and block the flow of blood towards major organs in the body. Option A: The reported incidence of myocardial infarction with angina at rest is less than 0.1%, and is mostly influenced by patient-related factors like the extent and severity of underlying cardiovascular-related diseases and technique-
related factors.
Options C & D: A falling BP and dizziness occur along with hemorrhage of the insertion site which is associated with the first 12 hours after the procedure.
NCLEXRN-01-004
Question Tag: renal calculi, flank pain
Question Category: Physiological Integrity, Basic Care and Comfort
A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is: A. Maintain fluid and electrolyte balance
B. Control nausea
C. Manage pain
D. Prevent urinary tract infection
Correct Answer: C. Manage pain
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