NCLEX RN LATEST 2023,2024,2025 (3 NEWEST VERSIONS) TEST BANK
ACTUAL EXAM||2500 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) ||ALREADY
GRADED A+
A 23-year-old woman is admitted to the infusion clinic after a Multiple Sclerosis
Exacerbation. The physician orders methylprednisolone infusions (Solu-Medrol). The RN
would expect which of the following outcomes after administration of this medication?
1. A decrease in muscle spasticity and involuntary movements
2. A slowed progression of Multiple Sclerosis related plaques
3. A decrease in the length of the exacerbation
4. A stabilization of mood and sleep - ANSWER1. A decrease in muscle
spasticity and involuntary movements
Incorrect - While muscle spasticity and involuntary movements can be symptoms of MS,
a corticosteroid infusion is not meant to directly treat these symptoms.
2. A slowed progression of Multiple Sclerosis related plaques
Incorrect - Special drugs like Interferon Beta, Natalizumab, or Glatiramir acetate are
used as first-line treatments to slow the progression of MS. While corticosteroids can be
used in conjunction with these drugs on a long-term basis, they would not be infused.
They would be taken orally.
3. A decrease in the length of the exacerbation
Correct - A methylprednisolone infusion is the first line of treatment during an acute
exacerbation and is used to decrease the length and severity of a relapse.
4. A stabilization of mood and sleep
Incorrect - Some of the frequent side effects of a Methylprednisolone infusion are
anxiety, insomnia, and mood swings.
A 30-year old Caucasian woman who works the night shift has been found to have early
bone loss and has a high risk for osteomalacia and bone degradation. She asks the RN
exactly why she should take Vitamin D supplements. What is the RN's best response?
1. "It's a standard part of the overall nutritional treatment for the prevention of
osteomalacia"
2. "It helps your intestines absorb calcium, which is critical for bone formation."
3. "It stimulates skin cells to produce calcium, which is then released into the
bloodstream to be used for bone formation."
4. "Vitamin D supplements should not be taken by someone of your age." - ANSWER1.
"It's a standard part of the overall nutritional treatment for the prevention of
osteomalacia" Incorrect - While this is true, it doesn't answer the woman's question.
2. "It helps your intestines absorb calcium, which is critical for bone formation."
,Correct - This is the correct mechanism of action for Vitamin D
3. "It stimulates skin cells to produce calcium, which is then released into the
bloodstream to be used for bone formation."
Incorrect- This is not the correct mechanism of action for Vitamin D
4. "Vitamin D supplements should not be taken by someone of your age."
Incorrect - Vitamin D supplements should be taken for clients who are homebound,
institutionalized, or by some other limitations, unable to meet daily requirements. This
woman works the night shift, which may limit her ability to absorb Vitamin D naturally.
A 45-year old woman is prescribed ropinirole (Requip) for Parkinson's Disease. The
client is living at home with her daughter. The RN is most concerned about which side
effect of ropinirole?
1. Slurred speech
2. Sudden dizziness
3. Masklike facial expression
4. Stooped Posture - ANSWER1. Slurred speech
Incorrect - Slurred speech is a common symptom of PD, not a side effect of this drug.
2. Sudden dizziness
Correct - Dizziness and orthostatic hypotension are serious adverse effects of this drug
that can lead to an increased risk of falls. Ropinirole's drug class is a dopamine agonist,
which mimic dopamine in the brain (PD is characterized by a lack of dopamine).
3. Masklike facial expression
Incorrect - Masklike facial expression is a common symptom of PD, not a side effect of
this drug.
4. Stooped Posture
Incorrect - Stooped Posture is a common symptom of PD, not a side effect of this drug.
A 65 year old man is prescribed Flomax (Tamsulosin) for Benign Prostatic Hyperplasia.
The client lives in an upstairs apartment. The RN is most concerned about which side
effect of Flomax?
1. Hypotension
2. Tachycardia
3. Back Pain
4. Difficulty Urinating - ANSWER1. Hypotension
Correct - Hypotension can lead to dizziness and a risk for injury to the client.
2. Tachycardia
,Tachycardia can be a side effect of Flomax, but is not an immediate safety risk, nor is it
a common side effect.
3. Back Pain
Back Pain can be a side effect of Floma, but is not a safety risk
4. Difficulty Urinating
Dysuria is a symptom of Benign Prostatic Hyperplasia, not a side effect of Flomax
A client with Multiple Sclerosis reports a constant, burning, tingling pain in the
shoulders. The RN anticipates that the physician will order which medication for this
type of pain?
1. alprazolam (Xanax)
2. Corticosteroid injection
3. gabapentin (Neurontin)
4. hydrocodone/acetaminophen (Norco) - ANSWER1. alprazolam
(Xanax) Incorrect - alprazolam is used to reduce anxiety
2. Corticosteroid injection
Incorrect - Corticosteroid injections are used to reduce inflammation in a localized area,
often due to joint breakdown. In MS clients it is used to treat acute exacerbations
("flare-ups"), but the symptoms described do not constitute an acute exacerbation.
3. gabapentin (Neurontin)
Correct - Anticonvulsants like gabapentin are often the first line of treatment for nerve
pain
4. hydrocodone/acetaminophen (Norco)
Incorrect - Opioids would not be the appropriate medication to treat nerve pain.
A female client is prescribed metformin for glucose control. The client is on NPO
status pending a diagnostic test. The RN is most concerned about which side effect of
metformin?
1. Diarrhea and Vomiting
2. Dizziness and Drowsiness
3. Metallic taste
4. Hypoglycemia - ANSWER1. Diarrhea and Vomiting
Incorrect - While these may occur, the client is at higher risk for another adverse effect.
2. Dizziness and Drowsiness
Incorrect - While these may occur, the client is at higher risk for another adverse effect.
, 3. Metallic taste
Incorrect - While this may occur, the client is at higher risk for another adverse effect.
4. Hypoglycemia
Correct - The client is at risk because she is on NPO status and continuing to take an
anti-glycemic drug.
A female client with atrial fibrillation has the following lab findings: Hemoglobin of 11
g/dl, a platelet count of 150,000, an INR of 2.5, and potassium of 2.7 mEq/L. Which
result is critical and should be reported to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L - ANSWER1. Hemoglobin 11 g/dl
This is below normal, but a normal female hemoglobin is 12-14. There is a more critical
lab result.
2. Platelet of 150,000
This is also below the normal values, but is not the most critical lab result.
3. INR of 2.5
This is a therapeutic range for a client who is taking an anticoagulant for atrial fibrillation
4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a client with a history of dysrhythmia can be
life-threatening and can lead to cardiac distress.
A man is has been taking lisinopril for CHF. The client is seen in the emergency room
for persistent diarrhea. The RN is concerned about which side effect of lisinopril?
1. Vertigo
2. Hypotension
3. Palpitations
4. Nagging, dry cough - ANSWER1. Vertigo
Incorrect - While this may occur, the client is at higher risk due to another adverse effect.
2. Hypotension
Correct - The client is particularly at risk for hypotension due to possible dehydration
from fluid loss.
3. Palpitations
