NCLEX PN 2025 QUESTIONS BANK WITH

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NCLEX PN 2025 QUESTIONS BANK WITH

500 QUESTIONS AND CORRECT ANSWERS

WITH RATIONALES/ 2025 NCLEX PN EXAM

TEST BANK/ PN NCLEX EXAM PREP (NEW)

• The nurse is reinforcing education to a pregnant client diagnosed with

symptomatic hypothyroidism regarding levothyroxine therapy during pregnancy.Which information is appropriate for the nurse to include?

1.. After symptoms resolve, levothyroxine may be discontinued

• Levothyroxine should be taken in the evening with a prenatal vitamin
• Medication dose will remain the same throughout pregnancy
• Symptoms should begin improving within 4 weeks of starting levothyroxine -

CORRECT ANSWER: 4

Hypothyroidism during pregnancy increases risk for other complications of pregnancy (eg, preeclampsia, placental abruption, preterm labor). Symptoms of hypothyroidism may include fatigue, cold intolerance, constipation, dry skin, and brittle hair/nails. Levothyroxine is the first-line medication for treatment of hypothyroidism during pregnancy. The client may experience some relief of symptoms beginning approximately 3-4 weeks after initiating levothyroxine therapy (Option 4 is correct). Hormone levels are usually rechecked every 4-6 weeks until normal thyroid hormone levels are achieved. It may take up to 8 weeks after initiation to see the full therapeutic effect.

(Option 1 is wrong) Adequate levels of maternal thyroid hormones are important for fetal brain development, particularly during the first trimester. Levothyroxine should not be stopped during pregnancy, even if symptoms resolve.

(Option 2 is wrong) Prenatal vitamins containing iron can affect the absorption of levothyroxine and decrease its effectiveness. The nurse should instruct the client to take levothyroxine in the morning on an empty stomach, at least 4 hours before or after taking a prenatal vitamin. 1 / 4

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(Option 3 is wrong) The client's dose of levothyroxine may need to be increased throughout pregnancy. TSH levels should be monitored closely during pregnancy, because these results may indicate the need for dosing changes of levothyroxine.

• A nurse forgets to administer a client's diuretic and the client experiences an

episode of pulmonary edema. This medication error would be considered negligence if it constituted which of the following?

• The purposeful failure to perform a health care procedure
• The unintentional failure to perform a health care procedure
• The act of substituting a different medication for the one ordered
• Failure to follow a direct order by a physician - Answer 2: Negligence is the

unintentional failure of an individual to perform or not perform an act that a reasonable person would or would not do in the same or similar circumstances.

• Which of the following tasks would not be appropriate for the LPN/LVN to

accept when delegated by the registered nurse (RN)?

• Instructing the LPN/LVN to reinforce teaching of the RN's assigned clients prior

to discharge

• Administering IV push morphine sulfate to the client with post-operative pain
• Removing a dressing from a postoperative client's abdomen
• Collecting and documenting vital signs and reporting changes to the RN - 2.

LPN/LVNs are not allowed to administer IV push medications and should refuse this assignment as it falls outside of their scope of practice.

• An LPN/LVN who has been in practice for 6 months is due for the first

performance evaluation. In preparing for the evaluation, the nurse should look to which standard against which to evaluate personal performance during the first 6 months of employment?

• ANA standards of care 2 / 4

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• The state nurse practice act
• The written job description
• The organization's standard of clinical care - 3. The best way that the nurse can

effectively self-evaluate performance of his or her job is to compare individual performance against the written job description. Job descriptions help identify activities that each staff member may perform

• An individual has a seizure while walking down the street. During the seizure, a

nurse from a physician's office is noticed driving past without stopping to assist.The individual sues the nurse for negligence but fails to win a judgment for which of the following reasons

• The nurse had no duty to the individual.
• The nurse did what most nurses would do in the same circumstance.
• The nurse did not cause the client's injuries.

4.The nurse was off-duty at that time - 1. The nurse must have a relationship with the client that involves providing care

• An LPN/LVN is about to make first rounds after receiving an intershift report at
• p.m. In what order should the LPN/LVN see the following clients? Fill in the

order below

• A 54-year-old client 4 hours post-cardiac catheterization who has mild

discomfort at the access site

• A client newly diagnosed with diabetes mellitus who needs reinforcement of

sick day management guidelines

• A client who arrived 30 minutes ago from the postanesthesia care unit
• A client who is ready for discharge but will not have transportation to home

available until 5 p.m

• A client with pneumonia who has received two doses of IV antibiotics and has

an oxygen saturation of 93% - 3, 5, 1, 4, 2 rationale- Priority setting can be implemented using a variety of models. The client who is postoperative should be seen first because the client is newly arrived on the unit and is at most risk of becoming unstable or experiencing a change in 3 / 4

pg. 4 clinical condition. The client with pneumonia should be seen next because the infection involves the airway, although oxygen saturation levels are higher than the critical value of 90% or less. The client who is 4 hours post-cardiac catheterization should be seen next to evaluate the site and conduct general examination of the affected extremity. The client who will be discharged should be seen next to determine that there are no last minute needs or issues. The client who needs teaching should be seen last because this is not a physiological need.

• The nurse is working in a nursing home that uses the team nursing approach to

client care. The nurse is orienting a new CNA who asks if she will be assigned her

own clients to care for. The nurse would respond:

• "Yes, every day you come in you'll have a client list that will be your sole

responsibility once you've completed orientation."

• "Yes."
• "No, you'll just complete the tasks you are told to complete on whatever client

you are asked to care for."

• "No. In team nursing you will be assigned to a team that will share

responsibilities for a specific group of clients." - 4 - In team nursing, RNs, LPNs/LVNs, and CNAs work together to care for a group of clients, with each care provider working to his or her scope of practice. Working as a team means no client is any nurse's sole reponsibility

• The physician orders a medication in a dose that is considered toxic. The nurse

gives the medication to the client, who later suffers a cardiac arrest and dies.Which of the following consequences can the nurse expect?

• The doctor, not the nurse, can be charged with negligence because the doctor

ordered the dose.

• The nurse and the doctor can dually be charged with negligence.
• Because the nurse actually gave the medication, only the nurse can be charged

with negligence.

• Negligence will not be charged, as this event could happen to any reasonable

person - 2. rationale: Nurses, along with physicians, can be charged with

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