NCLEX Q and A with Rationales – COMPREHENSIVE


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  • Published: 2015
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NCLEX Q and A with Rationales – COMPREHENSIVE


There is no bed available in the med-surg floor,

but there’s bed available at the pediatric unit,

which patient are you going to transfer?

1. Post op breast CA patient

2. COPD client

3. Fracture of femur

4. TURP post op

3. Fracture of femur.

Rationales for answer:

1. Post op breast CA patient – chemo

involved, being around kids, complicated cre

2. COPD client – high risk for infection

4. TURP patient – CBI required,


Question #2

A patient is having ongoing hemodialysis. Which

medication is contraindicated?

1. Amphojel

2. Maalox

3. Milk of Magnesia

4. Magnesium Hydroxide

1. Amphojel.

Amphogel contains phosphorous which is

contraindicated with kidney failure.

Magnesium is also, but less so than

phosphorous. This is a very icky question.

Question #3

Your patient has an allergy to pollen. Which of the

following advice should you give?

1. Do your gardening in the morning

2. Do your gardening late in the afternoon

3. Take a walk on the beach instead of hiking in

the woods

4. Focus your attention on dried flowers instead

4. Focus attention on dried flowers instead

All other choices contain possible exposure

to allergens and pollen

Question #4

A patient is on peritoneal dialysis. Which of the

following would cause you alarm 1 hour after


1. Frank, bloody drainage

2. Light brown drainage

3. No drainage

4. Clear, yellow drainage

1. Frank, bloody drainage. Any time you

have bloody return from CAPD, you have a

danger signal.

Question #5

Which of the following signs would indicate that

a patient with esophageal varices is deteriorating?

1. Pt complains of frequent swallowing

2. Pt’s skin is cool and clammy

3. An increase in body temperature

4. The pt has abdominal distension

4. Pt has abdominal distension.

Esophageal varices develop in esophagus,

primarily in rectum and abdomen.

1. Frequent swallowing is with


2. Cool & clammy is cardiac

3. Increased body temp could signify


Question #6

A pt has an aortic abdominal aneurysm. He is

complaining of a constant back ache. What would

you do?

1. Give pt a pillow to put between his legs and

tell him to lay on his side.

2. Give pt analgesic

3. Call MD immediately

4. Teach breathing exercises for pain

3. Call MD immediately. Back pain is an

indication of bleed. AAA may have ruptured.

None of the other options are valid

Question #7

Your patient has Meniere’s disease. Which of the

following would you teach?

1. Pt should eat high fiber diet

2. Pt should eat low protein, high carbs diet

3. Pt will not have to worry about tinnitus

4. Pt needs to have hearing tested

4. Pt needs to have hearing tested.

Unilateral sensorineural hearing loss may be

present S&SX of Meniere’s disease include

tinnitus, nausea, vomiting and vertigo. All

diets should be high in calories but low in

carbs and fiber.



Question #8

Your patient is scheduled for a liver biopsy.

Which of the following would be most important?

A. PT results

B. NPO 2 hours before

C. Bedrest 6 hours after procedure

D. Low residue diet 24 hours before

A. PT results.

Bleeding is a major complication of liver

biopsy. Knowing PT may indicate whether

test is performed or not.

Question #9

Which of the following would be the correct

position for a patient who is walking with a cane?

A. The patient should lean forward at the cane

B. The hand piece should allow for 30 degrees

of flexion at the elbow

C. The patient should put all of his weight on

the cane

D. The cane should be perfectly straight.


B. Should allow 30 degrees of flexion at


If cane is too straight, the client won’t be

able to support all his weight and may injure

his back. The cane should extend from the

greater trochanter to the floor with a 20-30

degree flexion at elbow.

Question #10

Which of the following foods are highest in

Vitamin K?

A. Eggs

B. Green leafy vegetables

C. Fish

D. Cheese


B. Green leafy vegetables. Eggs are high

in iron, fish is good source of protein and

oleic acid, cheese is good source of calcium

and tyramine.

Question #11

•You have a patient with Glaucoma and who had a

trabaeculotomy. You tell if post discharge teaching

was effective if he states which of the following?

–A. My eyesight will improve when I take my eye

drops for 6 months

–B. I should take my eye drops continually

–C. I should rub my eyes vigorously after


–D. I should use my eye drops only if I have


B. Eye drops should not be stopped

•A. Implies that pt can stop drops after 6

months •C. Never rub eyes vigorously after

administration •D. Implies only use drops if

have symptoms

Question #12

•When teaching a patient about crutch walking,

which of the following gets first priority?

•A. Advance both crutches simultaneously

•B. Advance unaffectedleg first

•C. Place weight on arms and hands when using


•D. Advance affected leg first

•C. Place weight on arms & hands when

using crutch

•A. This is also correct, but is not 1st


•B. Always advance crutches first

•D. If advance affected leg first, will be

placing weight on that leg. Not a principle of

crutch walking.

Question #13

•You are caring for a burn patient with a serum

potassium of 4. Which of the following medications

would you question?

•A. Morphine

•B. Demerol

•C. Potassium

•D. Tylenol

•C. Potassium. Serum K is 4 which is WNL.

Also, with burn patients, you will see an

increase in K due to crushing injury. •All

other choices are OK because they are

analgesics though Tylenol may seem to be

too little.

NCLEX Q and A with Rationales – COMPREHENSIVE