NCLEX-PN EXAM 2025 EXAM

NCLEX-PN EXAM 2025 EXAM

WITH CORRECT ANSWERS

What position should the practical nurse (PN) place a client in who is receiving an enteral tube feeding?

• Sitting upright
• Laying on the side
• Supine with the head of the bed elevated 30 to 45 degrees.
• Fowler's with the head of the elevated at 45 to 60 degrees. C.

Supine with the head of the bed elevated 30 to 45 degrees.Rationale To prevent the risk of aspiration during an enteral tub feeding, a client should be positioned with the head of the bed elevated 30 to 45 degrees (C), which uses gravitational flow to reduce reflux. Sitting upright (A) places pressure on the abdomen, including the stomach, and contributes to gastric reflux via the esophagus to the trachea. A side lying position (B) does not ensure the client's head of the bed is elevated. (D) places pressure on the stomach, as does (A), and increases the risk for gastric reflux and subsequently aspiration.

A doctor is preparing to remove a chest tube from a client. Before removing

the tube, the nurse should instruct the client to:

• Breathe normally 1 / 4

• Hold breathe and bear down
• Take a deep breath
• Cough on demand B. Hold breathe and

bear down Rationale:

The client should be asked to hold breathe and bear down which prevents changes in pressure until an occlusive dressing is applied.

A client is shifted to the recovery unit after amputation of the left leg.Which of the following is the priority nursing action in the immediate postoperative period?

• Monitor Vital Signs
• Assess the proximal pulse at the amputated part
• Keep a surgical tourniquet t the bedside
• Administer IV fluids C. Keep a surgical tourniquet t

the bedside Rationale:

Hemorrhage is the most concerning primary immediate complication of amputation. Therefore, a surgical tourniquet is kept at the bedside in case of acute bleeding.

The practical nurse knows that human papillomavirus infection (HPV) can lead

to:

• Cervical cancer
• Infertility
• Pelvic inflammatory disease (PID)
• Rectal cancer A.

Cervical cancer Rationale: 2 / 4

HPV can lead to cervical cancer due to changes of the cervix from the genital warts. There is no known connection between HPV and infertility, PID, or rectal cancer.

The nurse is to apply an Ace wrap to the client's right lower leg. Which

action should the nurse take to ensure that the dressing is not too tight:

• Remove it every hour and reapply
• Check the pedal pulses
• Obtain a Doppler study to determine circulation
• Allow the wrap to remain in place for a minimum of 24 hours B.

Check the pedal pulses

Rationale:

To ensure that the Ace wrap is not too tight, the nurse should check the pulse, color, and temperature of the extremity.

A client admitted to the floor 3 days ago after a bowel resection suddenly develops chest pain and shortness of breath. Assessment of the client reveals rales, BP 160/40, and severe tachycardia. The nurse's first action

should be to:

• Apply 02 at 2L/minute via mask
• Begin CPR
• Place the client in high Flower's position
• Administer a prescribed sedative C. Place the client in high

Flower's position Rationale:

The client during the post-operative period with a widening pulse pressure, SOB, and rales may have a pulmonary emboli. To facilitate breathing, he should be placed in high Flowler's position. Oxygen would the be applied. 3 / 4

The nurse is caring for a pt. with a urinary catheter. The nurse should do which of the following to prevent a urinary tract infection? (select all that apply)

• Provide perineal care each day and after each bowel movement
• Change the catheter every day
• Encourage the pt. to drink fluids
• Ask the physician to prescribe prophylactic antibiotics
• Assess the pt. every shift for signs of infection A. Provide perineal

care each day and after each bowel movement

• Encourage the pt. to drink fluids
• Assess the pt. every shift for signs of infection

The nurse is caring for a pt. with Raynaud's phenomenon. The nurse should

emphasize that the pt. can reduce symptoms of this disease by:

• Increase coffee to three cups each day
• Keeping the house at 68 degrees F.
• Wearing gloves when handling frozen foods
• Running cold water over her hands during an episode C. Wearing gloves

when handling frozen foods

Rationale:

Raynaud's phenomenon is characterized by vasospasm caused by extreme changes in temperature. Wearing gloves when handing cold caused by extreme changes in temperature. Wearing gloves when handing cold foods can help prevent the problem. This phenomenon is exacerbated by caffeine so the pt.should not increase caffeine intake. A house temperature of 68 degrees F is

• / 4