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NCLEX RN PAST EXAMS 930 QUESTIONS AND ANSWERS ALL
RATED A+ UPDATE 2025/
A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding would be noted in this condition?
- Limited range of motion in the affected hip
- An apparent lengthened femur on the affected side
- Asymmetric adduction of the affected hip when the infant is placed supine with the knees and hips flexed
- Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table
- Limited range of motion in the affected hip
A 2-year-old child is treated in the emergency department for a burn to the chest and abdomen. The child sustained the burn by grabbing a cup of hot coffee that was left on the kitchen counter. The nurse reinforces safety principles with the parents before discharge. Which statement by the parents indicates an understanding of measures to provide safety in the home?
- "We will be sure not to leave hot liquids unattended."
- "I guess our children need to understand what the word hot means."
- "We will be sure that the children stay in their rooms when we work in the kitchen."
- "We will install a safety gate as soon as we get home so that the children cannot get into the kitchen."
- "We will be sure not to leave hot liquids unattended."
- A pediatrician prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription?
- Obtains a weight
- Takes the temperature
- Takes the blood pressure
- Checks the amount of urine output
- Checks the amount of urine output
A 4-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention would be implemented to alleviate the child's fears?
- Encourage the child's parents to stay with the child.
- Encourage play with other children of the same age.
- Advise the family to visit only during the scheduled visiting hours.
- Provide a private room, allowing the child to bring favorite toys from home.
- Encourage the child's parents to stay with the child.
A 4-year-old child is admitted to the hospital for abdominal pain. The parents report that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse, in collaboration with the RN, determines that which laboratory result confirms the diagnosis?
- Lumbar puncture showing no blast cells
- Bone marrow biopsy showing blast cells
- Platelet count of 350,000 mm
- White blood cell count of 4500 mm
- Bone marrow biopsy showing blast cells
A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm, and a plaster cast is applied. The nurse assists with providing instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction?
- "The cast may feel warm as the cast dries."
- "I can use lotion or powder around the cast edges to relieve itching."
- "A small amount of white shoe polish can touch up a soiled white cast."
- "If the cast becomes wet, a blow-dryer set on the cool setting may be used to dry the cast."
- "I can use lotion or powder around the cast edges to relieve itching."
- The nurse in a newborn nursery is assisting with monitoring a preterm newborn for respiratory distress syndrome. Which assessment findings would alert the nurse to the possibility of this syndrome? Select all that apply.
A 6-year-old child with human immunodeficiency virus (HIV) infection has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse would make which best response to the child?
- "The pain will go away if you lie still and let the medicine work."
- "Try not to think about it. The more you think it hurts, the more it will hurt."
- "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less."
- "Every time it hurts, press on the call button and I will give you something to make the pain go all away."
- "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less."
A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandparent of the child visits and brings a fresh bouquet of flowers picked from the garden and asks the nurse for a vase for the flowers. Which response would the nurse provide to the grandparent?
- "I have a vase in the utility room, and I will get it for you."
- "I will get the vase and wash it well before you put the flowers in it."
- "The flowers from your garden are beautiful, but they cannot be placed in the child's room at this time."
- "When you bring the flowers into the room, place them on the bedside stand as far away from the child as possible."
- "The flowers from your garden are beautiful, but they cannot be placed in the child's room at this time."
- A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level results are available. A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. A subsequent blood glucose level result is available. The LPN would assist the RN to next prepare to administer which medication?
Laboratory Results
Tests and Results Reference Range
Initial: Blood glucose 950 mg/dL 70-99 mg/dL - fasting
Subsequent: Blood glucose 240 mg/dL
- An ampule of 50% dextrose
- NPH insulin subcutaneously
- IV fluids containing dextrose
- Phenytoin for the prevention of seizures
- IV fluids containing dextrose
A 7-year-old child is seen in a clinic, and the pediatrician documents a diagnosis of primary nighttime (nocturnal) enuresis. The nurse would plan to provide which information to the parents?
- Nighttime (nocturnal) enuresis does not respond to treatment.
- Nighttime (nocturnal) enuresis is caused by a psychiatric problem.
- Nighttime (nocturnal) enuresis requires surgical intervention to improve the problem.
- Nighttime (nocturnal) enuresis is usually outgrown without therapeutic intervention.
- Nighttime (nocturnal) enuresis is usually outgrown without therapeutic intervention.
- A client has been started on long-term therapy with rifampin. The nurse would provide which information to the client about the medication?
- Would always be taken with food or antacids
- Would be double-dosed if one dose is forgotten
- Causes orange discoloration of sweat, tears, urine, and feces
- May be discontinued independently if symptoms are gone in 3 months
- Causes orange discoloration of sweat, tears, urine, and feces
- A 55-year-old biologically-born male confides in the nurse that they are concerned about sexual function. What is the nurse's best response?
- "How often do you have sexual relations?"
- "Please share with me more about your concerns."
- "You are still young and have nothing to be concerned about."
- "You should not have a decline in testosterone until you are in your 80s."
- "Please share with me more about your concerns."
- Intravenous infusion of factor VIII
- Which statement reflects a new birthing parent's understanding of the teaching about the prevention of newborn abduction?
- "I will place my baby's crib close to the door."
- "Some health care personnel won't have name badges."
- "It's okay to allow the nurse assistant to carry my newborn to the nursery."
- "I will ask the nurse to attend to my infant if I am napping and my partner is not here."
- "I will ask the nurse to attend to my infant if I am napping and my partner is not here."
A 16-year-old client is admitted to the hospital for acute appendicitis, and an appendectomy is performed. Which nursing intervention is most appropriate to facilitate normal growth and development postoperatively?
- Encourage the client to rest and read.
- Encourage the parents to room in with the client.
- Allow the family to bring in the client's favorite computer games.
- Allow the client to interact with others in their same age-group.
- Allow the client to interact with others in their same age-group. . A child has been diagnosed with acute otitis media of the right ear. Which interventions would the nurse include in the plan of care? Select all that apply.
- Provide a soft diet.
- Position the child on the left side.
- Administer an antihistamine twice daily.
- Irrigate the right ear with normal saline every 8 hours.
- Administer ibuprofen for fever every 4 hours as prescribed and as needed.
- Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.
- Provide a soft diet.
- Administer ibuprofen for fever every 4 hours as prescribed and as needed.
- Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy. . A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The parent becomes concerned because the child is frightened, consistently crying, and trying to climb out of the tent. Which is the most appropriate nursing action?
- Tell the parent that the child must stay in the tent.
- Place a toy in the tent to make the child feel more comfortable.
- Call the pediatrician and obtain a prescription for a mild sedative.
- Let the parent hold the child and direct the cool mist over the child's face.
- Let the parent hold the child and direct the cool mist over the child's face. . A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?
Laboratory Results
Tests and Results Reference Range
Hematocrit 33% 37%-52%
Platelets 400,000/mm3 150,000-400,000/mm
BUN 15 mg/dL 10-20 mg/dL
Creatinine 1.0 mg/dL 0.5-1.2 mg/dL
- Hematocrit result
- Platelet count
- BUN level
- Creatinine level
- Hematocrit result
An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings would the nurse expect to note?
- Sweating and tremors
Allopurinol is prescribed for a client, and the nurse reinforces medication instructions to the client. Which instruction would the nurse provide?
- Drink 3000 mL of fluid a day.
- Take the medication on an empty stomach.
- The effect of the medication will occur immediately.
- Any swelling of the lips is a normal expected response.
- Drink 3000 mL of fluid a day.
Amikacin is prescribed for a client with a bacterial infection. The nurse reinforces the instructions to the client to contact the primary health care provider (PHCP) immediately if which occurs?
- Nausea
- Lethargy
- Hearing loss
- Muscle aches
- Hearing loss
Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse assists with providing discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided?
- "Administer the antibiotics until they are gone."
- "Administer the antibiotics if the child has a fever."
- "Administer the antibiotics until the child feels better."
- "Begin to taper the antibiotics after 3 days of a full course."
- "Administer the antibiotics until they are gone."
As part of chemotherapy education, the nurse explains to a client about the risk for bleeding and provides instructions for self-care during the period of greatest bone marrow suppression (the nadir). The nurse understands that further teaching is needed if the client makes which statement?
- "I should avoid blowing my nose."
- "I may need a platelet transfusion if my platelet count is too low."
- "I'm going to take aspirin for my headache as soon as I get home."
- "I will count the number of pads and tampons I use when menstruating."
- "I'm going to take aspirin for my headache as soon as I get home."
Assessment findings of an infant admitted to the hospital reveal a machinery-like murmur on auscultation of the heart and signs of heart failure. The nurse reviews congenital cardiac anomalies and identifies the infant's condition as which disorder? Refer to figure (the circled area) to determine the condition.
- Aortic stenosis
- Atrial septal defect
- Patent ductus arteriosus
- Ventricular septal defect
- Patent ductus arteriosus
Atropine sulfate, 0.6 mg intramuscularly, is prescribed for a child preoperatively. The nurse has determined that the dose prescribed is safe and prepares to administer how many milliliters to the child?
1.5ml
Betaxolol hydrochloride eye drops have been prescribed for a client with glaucoma. Which nursing action is most appropriate related to monitoring for side and adverse effects of this medication?
- Assessing for edema
- Monitoring temperature
- Monitoring blood pressure
- Assessing blood glucose level
- Monitoring blood pressure
A burn client is receiving treatments of topical mafenide acetate to the site of injury. The nurse monitors the client, knowing that which finding indicates that a systemic effect has occurred?
- Hyperventilation
- Elevated blood pressure
- Local rash at the burn site
- Local pain at the burn site
- Hyperventilation
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied at which times?
- Immediately before swimming
- 5 minutes before exposure to the sun
- Immediately before exposure to the sun
- At least 30 minutes before exposure to the sun
- At least 30 minutes before exposure to the sun
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors the client for side and adverse effects of the medication. Which finding indicates that the client is experiencing an adverse effect?
- Pruritus
- Tachycardia
- Hypertension
- Impaired voluntary movements
- Impaired voluntary movements
Cefuroxime sodium, 1 g in 50 mL normal saline (NS), is to be administered over 30 minutes to a client with an infection. The drop factor is 15 drops (gtt)/1 mL. The nurse prepares to set the flow rate at how many drops per minute? Fill in the blank.
33 drop per minute (gtt/min)
Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy?
- Measure the client's abdominal girth.
- Calculate the client's body mass index.
- Measure the client's current weight and height.
- Ask the client to share current weight and height.
- Measure the client's current weight and height.
A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action would the nurse take?
- Administer an analgesic.
- Release the skin traction.
- Apply ice to the extremity.
- Notify the RN and/or primary health care provider (PHCP).
- Notify the RN and/or primary health care provider (PHCP).
A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted?
- The child has no tears.
- Urine specific gravity is 1.035.
- Capillary refill is less than 2 seconds.
- Urine output is less than 1 mL/kg/hr.
- Capillary refill is less than 2 seconds.
- Sulfonamides
- A previous dose of hepatitis B vaccine or component
- A previous dose of hepatitis B vaccine or component
A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased significantly from the baseline value. The nurse suspects that the child is in shock. Which is the most appropriate nursing action?
- Notify the surgeon.
- Place the child in a supine position.
- Place the child in Trendelenburg's position.
- Increase the flow rate of the intravenous fluids.
- Notify the surgeon.
A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse would take which action?
- Administer an antiemetic.
- Increase the intravenous fluids.
- Place the child in a left lateral position.
- Notify the RN and/or primary health care provider (PHCP).
- Notify the RN and/or primary health care provider (PHCP).
A child with rheumatic fever will be arriving at the nursing unit for admission. On admission assessment, the nurse would ask the parents which question to elicit assessment information specific to the development of rheumatic fever?
- "Has the child complained of back pain?"
- "Has the child complained of headaches?"
- "Has the child had any nausea or vomiting?"
- "Did the child have a sore throat or fever within the last 2 months?"
- "Did the child have a sore throat or fever within the last 2 months?"
A child with type 1 diabetes mellitus is brought to the emergency department by the parents, who state that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?
- Potassium infusion
- NPH insulin infusion
- 5% dextrose infusion
- Normal saline infusion
- Normal saline infusion
A child with β-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication would the nurse anticipate being prescribed?
- Dalteparin
- Meropenem
- Metoprolol
- Deferoxamine
- Deferoxamine
A client admitted to the hospital is diagnosed with a pressure injury on the coccyx and has a wound vac. The wound culture results indicate that methicillin-resistant Staphylococcus aureus is present. The wound dressing and wound vac foam are due to be changed. The nurse would employ which protective precautions to prevent contraction of the infection during care?
- Gloves and a mask
- Contact precautions
- Airborne precautions
- Face shield and gloves
- Contact precautions
A client admitted voluntarily for treatment of an anxiety problem demands to be released from the hospital. Which action would the nurse take initially?
- Contact the RN and/or the client's primary health care provider.
- Photosensitivity
- Tinnitus
A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition?
- Pyelonephritis
- Glomerulonephritis
- Recent trauma to the bladder or abdomen
- Renal cancer in the client's family
- Recent trauma to the bladder or abdomen
A client arrives at the health care clinic and tells the nurse that they were just bitten by a tick and would like to be tested for Lyme disease. The client tells the nurse that the tick was removed and flushed down the toilet. Which actions are most appropriate? Select all that apply.
- Tell the client that testing is not necessary unless arthralgia develops.
- Tell the client to avoid any woody, grassy areas that may contain ticks.
- Reinforce instructions to the client to immediately start to take the antibiotics that are prescribed.
- Inform the client to plan to have a blood test 4 to 6 weeks after the bite to detect the presence of the disease.
- Tell the client that if this happens again, to never remove the tick but to vigorously scrub the area with an antiseptic.
- Tell the client to avoid any woody, grassy areas that may contain ticks.
- Reinforce instructions to the client to immediately start to take the antibiotics that are prescribed.
- Inform the client to plan to have a blood test 4 to 6 weeks after the bite to detect the presence of the disease.
A client arrives in the emergency department following an automobile crash. The client's forehead hit the steering wheel, and a hyphema is diagnosed. The nurse would place the client in which position?
- Flat in bed
- A semi-Fowler's position
- Lateral on the affected side
- Lateral on the unaffected side
- A semi-Fowler's position
A client arrives in the emergency department with a penetrating eye injury from wood chips that occurred while cutting wood. The nurse assesses the eye and notes a piece of wood protruding from the eye. What is the initial nursing action?
- Apply an eye patch.
- Perform visual acuity tests.
- Irrigate the eye with sterile saline.
- Remove the piece of wood using a sterile eye clamp.
- Perform visual acuity tests.
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 pink edematous hand
- Fiery red skin with edema in the nail beds
- Black fingertips surrounded by an erythematous rash
- A white color to the skin, which is insensitive to touch
- A white color to the skin, which is insensitive to touch
A client begins therapy with theophylline. The nurse plans to reinforce instruction to the client to limit the intake of which items while taking this medication?
- Coffee, cola, and chocolate
- Oysters, lobster, and shrimp
- Melons, oranges, and pineapple
- Cottage cheese, cream cheese, and dairy creamers
- Coffee, cola, and chocolate
A client being measured for crutches asks the nurse why the crutches cannot rest up underneath the arm for extra support. The nurse responds, knowing that which would most likely result from this improper crutch measurement?
- A fall and further injury
