Font size
WorksheetsNCLEX Trivia
Total questions: 45
Worksheet time: 24mins
Mr. Lopez, 68, is postoperative day 2 after a right total hip arthroplasty. He suddenly develops pleuritic chest pain and dyspnea while ambulating with PT.He is tachycardic (HR 124), mildly hypotensive (BP 98/62), RR 30, SpO₂ 86%on room air, and anxious. Lungs are clear; he has new right-calf tenderness and swelling. ECG shows sinus tachycardia. What is the nurse’s first priority?
Call rapid response and prepare for intubation
Apply high-flow oxygen and raise HOB
Start a large-bore IV and give a fluid bolus
Draw D-dimer and troponin levels
Which diagnostic is most urgent to confirm PE?
D-dimer
CT pulmonary angiography
V/Q scan
Point-of-care ultrasound of the leg
Which initial orders do you anticipate? (Select all that apply)
IV unfractionated heparin infusion
Thrombolysis with alteplase
Arterial blood gas
Lower-extremity duplex ultrasound
Immediate warfarin loading
Which finding is a major contraindication to thrombolysis?
Age >65
Post-op day 2 after major surgery
Prophylactic heparin today
SpO₂ <88%
Which change signals worsening obstructive shock?
Anxiety subsides
BP drops to 78/48 with cool mottled skin
RR falls to 20 with new wheeze
Calf tenderness improves
Why is IV unfractionated heparin (UFH) often preferred initially?
It is more effective than LMWH
It has no bleeding risk
It can be rapidly titrated and reversed
It cures PE faster than DOACs
Mr. C., 52, presents 12 hours after his last drink with tremors, diaphoresis, nausea, anxiety, and insomnia. Vitals: BP 168/98, HR 122, RR 24, T 99.9°F. He reports drinking a fifth of liquor daily. Oriented ×2, distractible, restless. Labs pending. Which medication should be administered before IV dextrose?
Lorazepam
Thiamine
Haloperidol
Clonidine
Which tool best standardizes withdrawal severity?
PHQ-9
COWS
CIWA
GAD-7
Which nursing interventions are most appropriate now? (Select all that apply)
Seizure precautions
Quiet, low-stimulation room
PRN haloperidol as first-line
Replace Mg and K
Dextrose before thiamine
Which change most strongly suggests progression to Delirium Tremors (DTs)?
Increased tremor
Visual hallucinations + disorientation + 103°F
Sleepiness and improving vitals
Mild anxiety, BP 140/88
Which lab abnormalities are most typical?
Hypomagnesemia
Hypernatremia
Hypokalemia
Elevated GGT/AST
Hypercalcemia
Lena, 10, presents lethargic with new-onset polyuria, polydipsia,abdominal pain, and vomiting. Vitals: HR 138, RR 30 Kussmaul, BP 102/60.Labs: glucose 520, pH 7.10, HCO₃ 8, K⁺ 4.8, Na⁺ 132. Positive ketones, caprefill 3–4 sec, mucous membranes dry. What is the first intervention?
IV regular insulin bolus
10–20 mL/kg isotonic saline bolus
0.45% saline maintenance fluids
Bicarbonate infusion
When is insulin infusion typically started?
Immediately on arrival
After initial fluid resuscitation with continuous IV infusion
Only after pH normalizes
Subcutaneously every hour
Which potassium plan is most appropriate initially?
Hold K⁺ until serum K⁺ <3.0
Add K⁺ to IV fluids once urine output is established and K⁺ ≤5.5
Give IV push KCl for quick replacement
Avoid K⁺ because initial K⁺ is normal-high
Which change most strongly suggests cerebral edema?
Gradual fall in glucose from 520 to 320 in 2 hours
Sudden headache, decreased LOC, bradycardia with rising BP
Increased urine output after fluids
Mild nausea with improving vitals
A nurse is providing discharge instruction to the guardian of an adolescent who has bipolar disorder. Which of the following manifestations should the nurse identify as an indication of acute mania? (select all that apply.)
Completes school projects
Naps during the daytime
Eats large amounts of food
Spends excessive amounts of money
Speaks crassly using a loud voice
A nurse is evaluating a 20 months old baby who received a hepatitis A vaccine 3 days ago. The patient reports that the child has exhibited a loss of appetite following the vaccine. Which of the following actions should the nurse take?
Tell the parent that this reaction should only last for a couple of days
Notify the provider immediately
Prepare an antidote to administer to the child
Request that the provider order a serum titer level
A nurse administers betamethasone to a client who is at 33weeks gestation to stimulate fetal lung maturity. When planning care for the newborn, which of the following conditions should the nurse identify as an adverse effect of this conditions?
Hyperthermia
Decreased blood glucose
Rapid pulse rate
Irritability
A nurse is reviewing the labs findings of a 24 hr old newborn.Which of the following findings should the nurse report to the provider?
Hemoglobin 12g/dl
Platelet count of 200,000/mm^3
Total bilirubin 4mg/dl
Glucose 50mg/dl
Ms. A., 31, G3P1 at 34 + 2 weeks, arrives with painless bright-red vaginal bleeding that began after intercourse. She denies contractions, has normal fetal movement, and is hemodynamically stable. Prenatal ultrasound at 28weeks showed a complete placenta previa. Vitals: BP 112/68, HR 96, afebrile.FHR baseline 145 with moderate variability. She is Rh-negative. What is the first nursing action?
Perform a digital cervical exam to assess dilation
Place the patient on continuous fetal monitoring and establish an IV
Encourage ambulation to assess bleeding pattern
Perform a bedside speculum exam with bimanual palpation
Which action is contraindicated in placenta previa?
Type and crossmatch
Administration of antenatal corticosteroids if delivery likely
Digital vaginal examination
Pelvic rest
Which orders do you anticipate now? Select all that apply.
Pelvic rest and abstain from intercourse
Rho(D) immune globulin administration
Tocolysis to stop all bleeding
Scheduled cesarean at 36–37 weeks if stable,
Prepare for emergent cesarean if bleeding becomes heavy or FHR non-reassuring
Which statement shows correct understanding?
“If the bleeding stops, I can resume intercourse.”
“I should report any bleeding immediately and avoid vaginal insertion of anything.”
“A vaginal delivery is still likely if the bleeding is light.”
“I can have cervical checks to see if I’m dilating.”
Which fetal status would most prompt urgent delivery?
Moderate variability with occasional accelerations
Recurrent late decelerations with minimal variability
Baseline 140 with rare variables
One isolated early deceleration
Why is two IV access recommended even if vitals are stable?
To give antibiotics quickly
For potential rapid transfusion and utero tonic infusion if status changes
To allow frequent blood draws only
It is routine but not clinically necessary
A nurse is preparing to administer anIV infusion of oxytocin for labor induction to a client who is 41 weeks of gestation. Which of the following actions should the nurse plan to take?
Administer oxytocin with manual IV tubing
Monitor the fetal heart rate every 15 min initially
Begin the infusion at 10 milliunits/min
Titrate the dosage until the client has 1 contraction every minute
A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. A severe allergy to which of the following medications is contraindicated to ceftriaxone?
Gentamicin
Clindamycin
Piperacillin
Sulfamethoxazole-trimethoprim
A nurse is planning care for a client who has a deep partial-thickness and full-thickness thermal burns over 40% of his total body surface and is in the acute phase of burn injury. Which of the following interventions should the nurse include in the plan?
Initiate range of motion exercises
Use clean technique to provide wound care
Place the client on a low protein diet
Maintain the client on bed rest
A nurse is reviewing the laboratory findings of a client who has chronic kidney disease. The client reports significant persistent nausea and muscle weakness. Which of the findings should the nurse expect?
Hypernatremia
Hypomagnesemia
Hypercalcemia
Hyperkalemia
A nurse is providing teaching to a client who has cancer and is undergoing external radiation treatment. Which of the following statements by the client indicates an understanding of the teaching?
“ I should use petroleum-based lotions on the areas being radiated. “
“I will dry the areas being radiated by rubbing in a circular pattern.”
“I should use my hand, instead of a washcloth, to wash the area being radiated.”
” I will apply sunscreen to the areas being radiated when I spend time in the sun.”
A nurse is teaching self-administration of NPH insulin to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include?
Alternate injecting doses between the abdomen and the thigh
Rotate injection sites within the same area
Shake the vial before withdrawing the dosage
Discard the vial in the insulin is cloudy
A nurse is caring for a client who has a new diagnosis of breast cancer. The client becomes quiet and withdrawn and says to the nurse. “what do you think people will say about me when I’m gone?” which of the the following responses should the nurse make?
“What are you worried they will say about you?”
”The thought of having breast cancer may seem hopeless.”
” Maintaining a positive attitude can influence your recovery.
“You will be remembered as a kind person.”
A nurse is planning postoperative education for a client who will undergo a radical neck dissection for cancer of the larynx. The nurse should include which of the following topics? (select all that apply.)
NPO status
Alternative methods of communication
Endotracheal intubation
Changes in body image
Swallowing exercises
A nurse is caring for a client at 35 weeks gestation who has severe pre-eclampsia. Which of the following assessments provides the most accurate information regarding the clients’ fluid and electrolytes status?
Blood pressure
Intake and output
Daily weight
Severity of edema
A nurse is preparing to perform a routine heel puncture on a newborn. Which of the following actions should the nurse take?
Administer tolmetin prior to the procedure
Apply an eutectic mixture of local anesthetics (EMLA) cream to the newborn’s heel after the procedure
Prepare concentrated sucrose for oral administration
Place the newborn in an extended position
A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications?
Naproxen
Pegloticase
Probenecid
Allopurinol
A nurse receives a report for a client who is in labor and is experiencing contractions that are 4 min apart. Which of the following patterns should the nurse expect on the fetal monitor tracing?
Contractions that last for 60 sec each with a 4 min rest between contractions
Contractions that last for 60 sec each with a 3 min rest between contractions
A contraction that lasts for 4 min followed by a period of relaxation
Contractions that last for 45 sec each with a 3 min rest between contractions
A nurse is providing teaching to a client who has obsessive-compulsive disorder and performs hand hygiene to decrease anxiety. Which of the following actions by the nurse implements modeling as a behavioral intervention strategy?
Setting a time between episodes of hand hygiene
Demonstrating performance of hand hygiene at scheduled times
Telling the client to shout “stop” each time an urge to perform hand hygiene arises
Instructing the client to practice muscle relaxation when experiencing the urge to perform hand hygiene
A nurse is assessing a client who has cholecystitis. Which of the following findings should the nurse expect?
Blumberg’s sign
Ascites
Gastrointestinal bleeding
Kehr’s sign
A nurse is planning care for a client following of a chest tube 1 hr ago. Which of the following actions should the nurse include in the plan of care?
Clamp the chest tube of there is a continuous bubbling in the water seal chamber
Keep the chest tube drainage system at the level of the right atrium
Tape all connection between the chest tube and drainage system
Empty the collection chamber and record the amount of drainage every 8 hr
A nurse in a provider’s office is reviewing the medical history of a client who asks about the use of varenicline for smoking cessation. Which of the following items in the client’s medical history indicates a precaution for the use of varenicline?
The client has type I diabetes mellitus
The client has a history of depression
The client has rheumatoid arthritis
The client has a history of GERD
A nurse in the emergency room has assessed a client’s airway, breathing and circulation (Abc) following a head injury from a fall at work. Which of the following actions is the priority for the nurse to perform next?
Question the client’s coworkers about the mechanism of injury
Check the client’s pupils for equality and reaction to light
Measure the client’s alertness using the Glasgow Coma Scale
Immobilize the client’s cervical spine
A charge nurse receives notification of the admission of a client who is coughing frequently and whose sputum is pink, frothy, and copious. The client has a history of night sweats, anorexia, and weight loss. Which of the following actions should the nurse take? (select all that apply?)
Assign the client to a private room with negative-pressure airflow
Add a contact precautions to the client’s plan of care
Wear an N95 respirator when entering the client’s room
Ensure the client’s environment provides 4 exchanges of fresh air per minute
Institute protective environment precautions as soon as the client arrives on the unit
A nurse is teaching a client who is postmenopausal and has a prescription for alendronate. Which of the following statements should the nurse include in the teaching?
“you can lie down 15 min after taking this medication.”
“Take this medication on an empty stomach.”
“Crush this medication to improve absorption.”
“Avoid taking antacids or supplements that contain calcium while taking this medication.”
A nurse is reviewing the medical record of a client who has a prescription for a combination oral contraceptive. The nurse should identify that which of the following findings is a contraindication to receiving this medication?
High cholesterol levels
Liver disease
Family history of ovarian cancer
Client report of hypermenorrhea
