NCLEX NGN RN / NGN NCLEX ACTUAL
EXAM MAY 2023 EXAM| 300 QUESTIONS
AND VERIFIED ANSWERS| 100%
CORRECT
QUESTION
The client with schizophrenia says to the nurse, ” I was walking down the street and really
enjoyed the weather, but carrots are probably my favorite vegetable. did the ocean always look
blue?” the nurse recognizes the statement as an example of which of the following?
1 associative looseness
2 concrete thinking
3 tangentiality
4 word salad
Answer:
1
QUESTION
The nurse is caring for a client with severe anorexia nervosa. which of the following findings are
consistent with this diagnosis? select all that apply
1 BMI of 16kg/m2
2 Fine downy hair on the face and back
3 has not menstruated in 3 months
4 potassium of 3.1 mEq/L
5 refuses to engage in exercise
6 unable to tolerate Heat
Answer:
ANS 1234
Anorexia nervosa is an eating disorder common among adolescents and young adults ages 18 to
- subtypes of the disorder include the restricting type in which there are no bulimic features
and the binging purging type in which restriction is still primary cause of weight loss but bulimic
features such as self-induced vomiting are present. clinical manifestations of anorexia nervosa
include:
fear of weight gain: clients May engage in extensive dieting, intense exercise, and or purging
behaviors (eg self-induced vomiting, misuse of laxatives or diuretics) resulting in excessive
weight loss (BMI <18.5 kg/m3) option 1
Lanugo: find terminal hair can be seen extreme c cases (option 2)
Amenorrhea: clients may stop menstruating due to decreased body fat and the resulting low
estrogen levels (option3)
fluid and electrolyte imbalance: malnutrition, dehydration, and excessive vomiting can cause
hypokalemia and metabolic alkalosis leading to complications such as cardiac dysrhythmias
(option 4)
decrease metabolic rate: severe weight loss results in hypertension bradycardia decreased body
temperature and cold intolerance
manifestations of anorexia nervosa will resolve after the weight loss is corrected although the
recovery process will take several months
Option 5 clients with anorexia nervosa often engage in lengthy invigorous exercise to lose
weight
Option 6 anorexia nervosa manifests as cold not heat intolerance due to the clients decrease
metabolic rate
QUESTION
The mental health nurse is planning care for a client nearly admitted with dissociative identity
disorder. Which interventions will the nurse include? Select all that apply
1 develop a trusting relationship with each of the alternate identities
2 encourage the client to journal about feelings and dissociation triggers
3 explain to the client in detail the events of missing memories and lost time
4 listen for expressions of self harm from the alternate identities
5 teach grounding taking such as deep breathing to hinder dissociation
Answer:
ANS 1245
Dissociative identity disorder is a condition in which two or more identities alternately control
the client’s behavior. The alternate identities likely develop as a response to abuse or traumatic
events and serve to protect the client from stressful memories. the client may not be able to be
aware of the alternate identities and may be confused by lost time and gaps in memory.
switching between identities occurs as a reaction to stress and individual triggers. The goal of
treatment is to integrate the identities into one personality while maintaining safety.
the client should Journal about feelings and dissociation triggers and use a groundbreaking
technique (eg deep breathing, rubbing stone, counting coins) to counter dissociative episodes
(options 2 and 5). Identities may be volatile and should be monitored for indications of harm to
solve for others (option 4). the nurse should attempt to form trusting, therapeutic relationships
with each identity to explore feelings and facilitate identity integration (option 1)
Option 3 this is Association and memory gaps are protective mechanisms. forcing the client to
hear or attempt to recall memories may result in distress and regress. allow clients to recall
memories at their own pace.
QUESTION
The nurse provides teaching to an adolescent client prescribed extended release methylphenidate
for attention deficit hyperactivity disorder. Which client statement indicates the teaching has
been effective?
1 if I miss a dose I should take an extra dose at the next meal
2 I mean initially gain some weight when starting this medication
3 I should drink caffeine containing beverages if I get tired while studying
4 I will take this medication in the morning before school
Answer:
4
ANS D
Attention deficit hyperactivity disorder causes problems with executive function which can
affect all aspects of life including school performance, social relationships and Career Success.
Methylphenidate Is a central nervous system stimulant used to treat ADHD and narcolepsy. It
improves focus and attention by increasing levels of certain neurotransmitters (e.g. dopamine,
norepinephrine) in the brain. adverse effects include irritability, decreased appetite, hypertension,
tachycardia, sleep disturbances and jitteriness.
extended release Methylphenidate Should be taken in the morning to minimize the risk of sleep
disturbances. some dosage forms are taken 30 to 45 minutes before meals because food can
affect absorption While others are taken with food. client should follow the prescription
instructions for their specific medication and may also consult with the pharmacist (option 4)
Option 1 Methylphenidate is a controlled substance with the potential for tolerance psychological
dependence and psychosis if taken it excess (Eg taking extra after a missed dose). client should
not take extra doses unless instructed by a healthcare provider
Option 2 Methylphenidate can cause appetite suppression and weight loss not weight gain
growth patterns and nutritional status should be closely monitored
Option 3 caffeine containing beverages should be avoided while taking this medication because
caffeine is also a CNS stimulant and may increase the incidence of adverse effects (eg
hypertension, irritability, tachycardia, insomnia).
QUESTION
A behavioral health clinic nurse assesses 23 year old client who started taking paroxetine 3
weeks ago. which statement made by the client is most important for the nurse to investigate?
1 I don’t have much of an appetite since starting this medication
2 I have a lot more energy, but I’m feeling just as depressed
3 I have been feeling dizzy when I walk around at home
4 I have experienced frequent headaches lately
Answer:
ANS 2 selective serotonin reuptake inhibitors (SSRIs) (eg fluoxetine, paroxetine, sertraline,
citalopram) Are used to treat a number of psychiatric conditions (eg major depressive disorder,
generalized anxiety disorder). clients usually see therapeutic effects in 1 to 4 weeks. SSRIs may
increase the risk of suicide especially in young children during initial therapy or after a dosage
increase. a client who reports increased energy without a change and depressive feelings needs to
be assessed and monitored for suicidal ideation or actions as a client may now have the energy to
execute the suicide plan (option 2)
common expected side effects of SSRIs include:
loss of appetite, weight loss or weight gain (option 1)
gastrointestinal disturbances (nausea, vomiting, diarrhea)
headaches dizziness drowsiness insomnia (options 3 and 4)
sexual dysfunction
side effects should gradually diminish over 3 months although some may persist. if symptoms
are intolerable or a particular SSRI is ineffective the client may be switched to a different
antidepressant.
QUESTION
The client is brought to the emergency department in handcuffs by the police. Witnesses said that
the client became violent and confused after consuming large amounts of alcohol at a party. The
client is placed in four point restraints, and ziprasidone hydrochloride is administered. The client
is sleeping 30 minutes later. What is a priority action for the nurse at this time?
check for history of bipolar disease
determine if restraints can now be removed
monitor for wide and QT intervals in hypotension
obtain blood for the current blood alcohol level
Answer:
monitor for wide and QT intervals in hypotension
ANS C
Ziprasidone hydrochloride (Geodon) is a atypical antipsychotic drug that is used for acute
bipolar Mania, acute psychosis, and agitation. its uses carry a risk for Cutie prolongation leading
to torsade de pointes. a baseline electrocardiogram and potassium usually checked. at a minimum
the client should be placed on a cardiac monitor. client should also be monitored for hypotension
and seizures, especially if the previous medical history is not known or obtainable. the risk for
adverse effects is increased with the interaction of alcohol.
Option 1 although knowing psychiatric history role assistant determining the cause of this
episode, this knowledge is not essential when caring for this client’s current needs. any physical
reasons for the behavior should be ruled out before focusing on psychiatric history. risk for
suicide also needs to be assessed after the client is alert and sober.
Option 2 this should be reassessed after the drug is wearing off not before the medication is
peaking. the client could only wake up and become violent again. Also it is priority to perform
restrain monitoring per protocol including checks and circulation hydration elimination needs.
the client’s physiological response is priority.
Option 4 it would be beneficial to know the current alcohol level in order to estimate the client’s
level of intoxication and when the client will be sober. the body normally clears alcohol at a rate
NCLEX-RN EXAM (LATEST 2023/ 2024)
|400+ QUESTIONS AND VERIFIED
ANSWERS| 100% CORRECT
QUESTION:
Direct pressure to a deep laceration on the client’s lower leg has failed to stop the bleeding. The
nurse’s next action should be able to:
A. place tourniquet proximal to lac
B. elevate leg above level of heart
C. cover laceration and apply ice
D. apply pressure to femoral artery
Answer:
B – A and D only done if other measures ineffective
QUESTION:
A pediatric client is admitted after ingesting a bottle vitamins with iron. Emergency care would
include Tx with:
A. acetylcysteine
B. Deferoxamine
C. calcium disodium acetate
D. british anti-lewisite
Answer:
B
QUESTION:
The nurse is preparing to administer Lactated Ringer’s to a client with hypovolemic shock.
Which intervention is important in helping to stabilize the client’s condition?
A. warming IV fluid
B. determining whether client can take oral fluids
C. checking for strength of pedal pulses
D. obtaining specific gravity of urine
Answer:
A – warming helps prevent further stress on vascular system
QUESTION:
The emergency room staff is practicing for its annual disaster drill. According to disaster triage,
which of the following 4 clients would be cared for last?
A. client with pneumothorax
B. client with 70% TBSA full thickness burns
C. client with fractures of tibia and fibula
D. client with smoke inhalation injuries
Answer:
B
QUESTION:
An unresponsive client is admitted to the ER with a hx of DM. The client’s skin is cold and
clammy, and her BP reading is 82/56. The first step in emergency Tx of client’s symptoms would
be:
A. check blood sugar
B. administer IV dextrose
C. intubation and ventilator support
D. administer regular insulin
Answer:
A
QUESTION:
A client with a history of severe depression has been brought to the ER with an overdose of
barbiturates. The nurse should pay careful attention to the client’s:
A. urinary output
B. respirations
C. temp
D. verbal responsiveness
Answer:
B
QUESTION:
A client is to receive antivenin following a snake bite. Before administering the antivenin, the
nurse should give priority to:
A. administering local anesthetic
B. checking for allergic response
C. administering anxiolytic
D. withholding fluids for 6-8 hrs
Answer:
B – perform skin or eye test before administering
QUESTION:
The nurse is caring for a client following a radiation accident. The client is determined to have
incorporation. The nurse knows that the client will:
A. not need any medical Tx for radiation exposure
B. have damage to bones, kidneys, liver, thyroid
C. experience only erythema and desquamation
D. Not be radioactive because the radiation passes through the body
Answer:
B
QUESTION:
The emergency staff has undergone intensive training in the care of clients with suspected
anthrax. The staff understands that the suggested drug for treating anthrax is:
A. Ancef (cefazolin sodium)
B. Cipro (ciprofloxacin)
C. Kantrex (kanamycin)
D. Garamycin (gentamicin)
Answer:
B
QUESTION:
The nurse is making assessment for the day. Which client should be assigned to the pregnant
nurse?
A. the client receiving radium linear accelerator radiation therapy for cancer
B. the client with a radium implant for vaginal cancer
C. the client who has just been administered radioactive isotopes for cancer
D. The client who returned from placement of iridium seeds for prostate cancer
Answer:
A – client is not radioactive
QUESTION:
The nurse is planning room assignments for the day. Which client should be assigned to the only
private room?
A. client with Cushing’s disease
B. client with diabetes
C. client with acromegaly
D. client with myxedema
Answer:
A – client with Cushing’s disease has adrenocortical hyper secretion thus causing them to be
immunosuppressed
QUESTION:
The charge nurse witnesses the nursing assistant being abusive to a client in the nursing home
facility. The nursing assistant can be charge with which of the following?
A. negligence
B. tort
C. assault
D. malpractice
Answer:
C
QUESTION:
Which assignment is outside the realm of nursing practice for the LPN?
RN NCLEX 2023/ 2024 EXAM|
QUESTIONS AND VERIFIED ANSWERS|
GRADE A
QUESTION:
A client calls the emergency department and tells the nurse that he came directly into contact
with poison ivy shrubs. The client tells the nurse that he cannot see anything on the skin and asks
the nurse what to do. The nurse should make which response?
A. “Come to the emergency department.”
B. “Apply calamine lotion immediately to the exposed skin areas.” C. “Take a shower
immediately, lathering and rinsing several times.” D. “It is not necessary to do anything if you
cannot see anything on your skin.”
Answer:
C
Rationale:
When an individual comes in contact with a poison ivy plant, the sap from the plant forms an
invisible film on the human skin. The client should be instructed to cleanse the area by
showering immediately and to lather the skin several times and rinse each time in running water.
Removing the poison ivy sap will decrease the likelihood of irritation. Calamine lotion may be
one product recommended for use if dermatitis develops. The client does not need to be seen in
the emergency department at this time.
QUESTION:
A client is being admitted to the hospital for treatment of acute cellulitis of the lower left leg.
During the admission assessment, the nurse expects to note which finding?
A. An inflammation of the epidermis only
B. A skin infection of the dermis and underlying hypodermis
C. An acute superficial infection of the dermis and lymphatics
D. An epidermal and lymphatic infection caused by Staphylococcus
Answer:
B
Rationale:
Cellulitis is an infection of the dermis and underlying hypodermis that results in a deep red
erythema without sharp borders and spreads widely throughout tissue spaces. The skin is
erythematous, edematous, tender, and sometimes nodular. Erysipelas is an acute, superficial,
rapidly spreading inflammation of the dermis and lymphatics. The infection is not superficial and
extends deeper than the epidermis.
QUESTION:
The clinic nurse assesses the skin of a client with psoriasis after the client has used a new topical
treatment for 2 months. The nurse identifies which characteristics as improvement in the
manifestations of psoriasis? Select all that apply.
A. Presence of striae
B. Palpable radial pulses
C. Absence of any ecchymosis on the extremities
D. Thinner and decrease in number of reddish papules
E. Scarce amount of silvery-white scaly patches on the arms
Answer:
D, E
Rationale:
Psoriasis skin lesions include thick reddened papules or plaques covered by silvery-white
patches. A decrease in the severity of these skin lesions is noted as an improvement. The
presence of striae (stretch marks), palpable pulses, or lack of ecchymosis is not related to
psoriasis.
QUESTION:
The clinic nurse notes that the primary health care provider has documented a diagnosis of
herpes zoster (shingles) in the client’s chart. Based on an understanding of the cause of this
disorder, the nurse determines that this definitive diagnosis was made by which diagnostic test?
A. Positive patch test
B. Positive culture results
C. Abnormal biopsy results
D. Wood’s light examination indicative of infection
Answer:
B
Rationale:
With the classic presentation of herpes zoster, the clinical examination is diagnostic. However, a
viral culture of the lesion provides the definitive diagnosis. Herpes zoster (shingles) is caused by
a reactivation of the varicella zoster virus, the virus that causes chickenpox. A patch test is a skin
test that involves the administration of an allergen to the surface of the skin to identify specific
allergies. A biopsy would provide a cytological examination of tissue. In a Wood’s light
examination, the skin is viewed under ultraviolet light to identify superficial infections of the
skin.
QUESTION:
A client returns to the clinic for follow-up treatment after a skin biopsy of a suspicious lesion
performed 1 week ago. The biopsy report indicates that the lesion is a melanoma. The nurse
understands that melanoma has which characteristics? Select all that apply.
A. Lesion is painful to touch.
B. Lesion is highly metastatic.
C. Lesion is a nevus that has changes in color.
D. Skin under the lesion is reddened and warm to touch.
E. Lesion occurs in body areas exposed to outdoor sunlight.
Answer:
B, C
Rationale:
Melanomas are pigmented malignant lesions originating in the melanin-producing cells of the
epidermis. Melanomas cause changes in a nevus (mole), including color and borders. This skin
cancer is highly metastatic, and a person’s survival depends on early diagnosis and treatment.
Melanomas are not painful or accompanied by sign of inflammation. Although sun exposure
increases the risk of melanoma, lesions may occur any place on the body, especially where
birthmarks or new moles are apparent.
QUESTION:
When assessing a lesion diagnosed as basal cell carcinoma, the nurse most likely expects to note
which findings? Select all that apply.
A. An irregularly shaped lesion
B. A small papule with a dry, rough scale
C. A firm, nodular lesion topped with crust
D. A pearly papule with a central crater and a waxy border
E. Location in the bald spot atop the head that is exposed to outdoor sunlight
Answer:
D, E
Rationale:
Basal cell carcinoma appears as a pearly papule with a central crater and rolled waxy border.
Exposure to ultraviolet sunlight is a major risk factor. A melanoma is an irregularly shaped
pigmented papule or plaque with a red-, white-, or blue-toned color. Actinic keratosis, a
premalignant lesion, appears as a small macule or papule with a dry, rough, adherent yellow or
brown scale. Squamous cell carcinoma is a firm, nodular lesion topped with a crust or a central
area of ulceration.
QUESTION:
A client arriving at the emergency department has experienced frostbite to the right hand. Which
finding would the nurse note on assessment of the client’s hand?
A. A pink, edematous hand
B. Fiery red skin with edema in the nailbeds
C. Black fingertips surrounded by an erythematous rash
D. A white color to the skin, which is insensitive to touch
Answer:
D
Rationale:
Assessment findings in frostbite include a white or blue color; the skin will be hard, cold, and
insensitive to touch. As thawing occurs, flushing of the skin, the development of blisters or
blebs, or tissue edema appears. Options 1, 2, and 3 are incorrect.
QUESTION:
The staff nurse reviews the nursing documentation in a client’s chart and notes that the wound
care nurse has documented that the client has a stage II pressure injury in the sacral area. Which
finding would the nurse expect to note on assessment of the client’s sacral area?
A. Intact skin
B. Full-thickness skin loss
C. Exposed bone, tendon, or muscle
D. Partial-thickness skin loss of the dermis
Answer: