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NCLEX-PN : National Council Licensure Examination (NGN SATA Included) 2025

NCLEX NCLEX-PN Questions & Answers

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National Council Licensure Examination(NCLEX-PN) 2025 NGN and SATA Questions included.


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Question: 13


Which of the following is not considered one of the five rights of medication administration?

  1. client

  2. drug

  3. dose

  4. routine


Answer: D


Explanation:

tion: 14


giving an intramuscular injection to an infant. Which of the following sites is preferred?

entrogluteal region ltoid

astus lateralis orsogluteal region


er: C


anation:

lateralis is the ideal choice for infants.

tion: 15


choosing a needle gauge for an intramuscular injection in a 12 year old boy. Which of the following ga you choose?

gauge gauge gauge gauge


er: C


anation:

uge is recommended for school age children, toddlers, and adolescents while 23-25 gauge is recommen fants.

tion: 16

Dose, client, drug, route and time are considered the five rights of medication.

Ques


When

  1. V

  2. De

  3. V

  4. D


Answ


Expl Vastus Ques


When uges

would

  1. 27

  2. 25

  3. 22

  4. 20


Answ


Expl

22 ga ded

for in

Ques


Which of the following is not considered one of the main mechanisms of Type II Diabetes treatment?

  1. Medications

  2. Nutrition

  3. Increased activity

  4. Continuous Insulin


Answer: D


Explanation:

Insulin is not required in continuous treatment for every Type II diabetic.

Question: 17

A nurse is caring for a retired MD. The MD asks the question, "What type of cells create exocrine secretions?" The correct answer is:

  1. alpha cells

  2. beta cells

  3. acinar cells

  4. plasma cells


Answer: C


Explanation:

Acinar cells create exocrine secretions.

Question: 18


se is caring for a patient who has experienced burns to the right lower extremity. According to the Rule

which of the following percents most accurately describes the severity of the injury?

%

%

%


er: C


anation:

ower extremity is scored as 18% according to the Rule of Nines.

tion: 19


ient has experienced a severe third degree burn to the trunk in the last 36 hours. Which phase of burn gement is the patient in?

ock phase mergent phase ealing phase

ound proliferation phase


er: A


anation:

hock phase is considered the first 24-48 hours in wound management.

tion: 20


ient has fallen off a bicycle and fractured the head of the proximal fibula. A cast was placed on the patie

A nur of

Nines

  1. 36

  2. 27

  3. 18

  4. 9%


Answ


Expl Each l Ques


A pat mana

  1. Sh

  2. E

  3. H

  4. W


Answ


Expl The s Ques


A pat nt’s

lower extremity. Which of the following is the most probable result of the fall?

  1. Peroneal nerve injury

  2. Tibial nerve injury

  3. Sciatic nerve injury

  4. Femoral nerve injury


Answer: A


Explanation:

The head of the proximal fibula is in close proximity to the peroneal nerve.

Question: 21


A nurse has been ordered to set-up Buck’s traction on a patient’s lower extremity due to a femur fracture. Which

of the following applies to Buck’s traction?

  1. A weight greater than 10 lbs. should be used.

  2. The line of pull is upward at an angle.

  3. The line of pull is straight

  4. A weight greater than 20 lbs. should be used.


Answer: C


Explanation:

A straight line of pull is indicated with Buck’s traction.

Question: 22



onation pination bduction dduction


er: B


anation:

ation- "Holding a bowl of soup in your hand."

tion: 23


se is caring for a retired MD. The MD asks the question, "What type of cells secrete insulin?" The corre answer is:

pha cells ta cells D4 cells lper cells


er: B


anation:

ells secrete insulin.

tion: 24


se is reviewing a patient’s current Lithium levels. Which of the following values is outside the therapeut


mEq/L

Which of the following motions is identified with the corresponding action? (Action- Turning palm of hand over to face in the anterior direction, dorsum of the hand is pointed downward toward the floor.)

  1. Pr

  2. Su

  3. A

  4. A


Answ


Expl Supin Ques


A nur ct


  1. al

  2. be

  3. C

  4. he


Answ


Expl Beta c Ques


A nur ic

range?

  1. 1.0

  2. 1.1 mEq/L

  3. 1.2 mEq/L

  4. 1.3 mEq/L


Answer: D


Explanation:

1.0-1.2 mEq/L is considered standard therapeutic range for patient care.

Question: 25


A client is going to have an endoscopy performed. Which of the following is not a probable reason for an endoscopy procedure?

Question: 1657


Nurse's Note:

0900: 70-year-old male client with a history of hypertension and diabetes presents to the emergency department with severe chest pain radiating to the left arm. The client reports associated shortness of breath and diaphoresis.


98.6°F (37°C)


80/110

94% on room air


urse suspects the client may be experiencing a myocardial infarction. Which finding supports ion? (Select all that apply.)


phoresis.

est pain radiating to the left arm. vated heart rate.

reased blood pressure. ygen saturation of 94%. tory of diabetes.


er: A, B, C, D


nation: Diaphoresis, chest pain radiating to the left arm, elevated heart rate, and increased blo re are all classic signs of myocardial infarction, indicating the need for immediate interventi


ion: 1658

Vital Signs: Temp:

P: 115

RR: 22

BP: 1

O2: sat


The n this

suspic


  1. Dia

  2. Ch

  3. Ele

  4. Inc

  5. Ox

  6. His Answ

Expla od

pressu on.


Quest


Client History:

70-year-old male client with a history of heart failure presents with increased shortness of breath and a productive cough. The client reports feeling more fatigued than usual.


Vital Signs: BP: 130/80 HR: 98

Temp: 99°F (37.2°C) RR: 30

SpO2: 89% on 2L O2/NC

Identify the priority nursing interventions for this client. (Select All That Apply)


  1. Administer diuretics as prescribed

  2. Assess lung sounds frequently

  3. Educate the client on daily weight monitoring

  4. Initiate oxygen therapy

  5. Monitor for signs of fluid overload Answer: A, B, D, E

nation: Administering diuretics helps relieve fluid overload. Assessing lung sounds frequentl to evaluate respiratory status. Initiating oxygen therapy addresses hypoxia, and monitoring f fluid overload ensures timely intervention.


ion: 1659


nt with heart failure is prescribed furosemide. What laboratory value should the nurse monit y? (Select All That Apply)


assium levels dium levels

N and creatinine cium levels


er: A, B, C


nation: Furosemide can cause electrolyte imbalances, particularly hypokalemia and hyponatre ay affect renal function, necessitating monitoring of BUN and creatinine levels.


ion: 1660

Expla y is

critical for

signs o


Quest


A clie or

closel


  1. Pot

  2. So

  3. BU

  4. Cal Answ

Expla mia,

and m


Quest


Nurse's Note:

1500: 82-year-old female client with a history of dementia presents with increased agitation and refusal to eat. The family reports a sudden change in her behavior.


Vital Signs:

Temp: 98.5°F (36.9°C) P: 80

RR: 16 BP: 120/80

O2: sat 95% on room air

Which 4 findings from the nurse's notes are most important to address immediately?


  1. Increased agitation.

  2. Refusal to eat.

  3. Sudden change in behavior.

  4. Normal vital signs.

  5. History of dementia.


    nation: Increased agitation and refusal to eat are concerning as they may indicate underlying medical issues or acute changes in the client’s condition. A sudden change in behavior necessitates

    evaluation to identify possible causes.


    ion: 1661


    Note:

    9-year-old male client with a history of asthma presents with severe wheezing and shortnes after exposure to allergens. The client reports increased use of his rescue inhaler.


    igns:

    98.4°F (36.9°C)


    25/80

    87% on 3L O2 via nasal cannula

    4 findings from the nurse's notes are most critical to address immediately? vere wheezing.

    ortness of breath.

    reased use of rescue inhaler.

    Family concerns. Answer: A, B, C, F Expla

further


Quest


Nurse's

1600: 4 s of

breath


Vital S Temp: P: 100

RR: 28

BP: 1

O2: sat Which

  1. Se

  2. Sh

  3. Inc

  4. Oxygen saturation of 87%.

  5. Normal blood pressure.

  6. Elevated pulse rate. Answer: A, B, D, C

Explanation: Severe wheezing and shortness of breath indicate an acute asthma exacerbation requiring immediate treatment. An oxygen saturation of 87% suggests hypoxia, necessitating urgent intervention.

Question: 1662


Nurse's Note:

2600: 65-year-old male client with a history of chronic heart failure presents with increased edema and shortness of breath. The client reports a rapid weight gain of 5 pounds over the past week.


Vital Signs:

Temp: 98.7°F (37.1°C) P: 90

35/85

90% on 3L O2 via nasal cannula

findings from the nurse's notes require immediate attention? (Select all that apply.) reased edema.

ortness of breath. pid weight gain.

ygen saturation of 90%. vated blood pressure. tory of heart failure.


er: A, B, D, C


nation: Increased edema and shortness of breath are indicative of fluid overload that requires ention. An oxygen saturation of 90% suggests hypoxia that needs to be addressed immediatel


ion: 1663


nurse is preparing to administer a blood transfusion. Which of the following assessments should med before starting the transfusion? (Select All That Apply)


eck the patient's vital signs

RR: 24

BP: 1

O2: sat Which

  1. Inc

  2. Sh

  3. Ra

  4. Ox

  5. Ele

  6. His Answ

Expla urgent

interv y.


Quest


A be

perfor


  1. Ch

  2. Confirm the blood type and Rh factor with another nurse

  3. Assess for any history of allergic reactions to blood products

  4. Obtain a signed consent form Answer: A, B, C, D

Explanation: It is essential to check vital signs to establish a baseline, confirm blood type for compatibility, assess for allergic history to prevent reactions, and ensure that informed consent is obtained before any transfusion.

Question: 1664


Client History:

65-year-old female client with a history of hypertension presents with severe headache and visual disturbances. The client reports a sudden onset of symptoms and has a family history of stroke.


Nurse's Note:

mine the priority nursing actions for this client. (Select All That Apply) minister antihypertensive medication

iate a stroke protocol

nitor neurological status frequently pare for a CT scan

vide education on stroke prevention er: B, C, D

nation: Initiating a stroke protocol is crucial for rapid assessment and intervention. Monitorin ogical status helps detect changes in condition. Preparing for a CT scan is essential to rule o rhagic stroke.


ion: 1665


nurse is assessing a client with pneumonia. Which of the following findings would indicate the need mediate intervention? (Select All That Apply)


spiratory rate of 28 breaths per minute ygen saturation of 90%

ductive cough with green sputum

Vital signs reveal elevated blood pressure, and the client is diaphoretic. Neurological assessment shows weakness on the right side.


Deter


  1. Ad

  2. Init

  3. Mo

  4. Pre

  5. Pro Answ

Expla g

neurol ut

hemor


Quest


A

for im


  1. Re

  2. Ox

  3. Pro

  4. Chest pain with inspiration Answer: A, B, D

Explanation: Increased respiratory rate, low oxygen saturation, and chest pain during inspiration indicate potential respiratory distress and warrant immediate intervention.


Question: 1666

Nurse's Note:

1500: 65-year-old male client with a history of coronary artery disease presents with chest pain described as "pressure" and shortness of breath. The client is on aspirin and a beta-blocker.


Vital Signs:

Temp: 98.6°F (37°C) P: 112

RR: 24

BP: 160/100

indings from the nurse's notes require immediate intervention? (Select all that apply.) est pain described as "pressure."

ortness of breath.

vated heart rate. vated blood pressure.

tory of coronary artery disease. ygen saturation of 94%.


er: A, B, D, C


nation: Chest pain and shortness of breath in the context of coronary artery disease are critica quire urgent assessment. Elevated heart rate and blood pressure may indicate increased myoc

demand, necessitating immediate intervention.


ion: 1667


istory:

-old client diagnosed with type 1 diabetes presents with severe abdominal pain, nausea, an ng. The client has been experiencing increased thirst and urination. Laboratory results reveal lucose level of 450 mg/dL and metabolic acidosis.

O2: sat 94% on room air What f

  1. Ch

  2. Sh

  3. Ele

  4. Ele

  5. His

  6. Ox


Answ


Expla l signs

that re ardial

oxygen


Quest


Client H

45-year d

vomiti a

blood g


Nurse's Note:

The client appears lethargic and dehydrated. The respiratory rate is rapid, and breath has a fruity odor. The renal function tests indicate elevated creatinine levels.


Determine the priority nursing diagnosis for this client. (Select All That Apply)


  1. Risk for fluid volume deficit

  2. Ineffective airway clearance

  3. Impaired glucose metabolism

  4. Risk for impaired skin integrity

  5. Acute pain related to abdominal distention Answer: A, C

Explanation: The client presents with hyperglycemia and signs of diabetic ketoacidosis (DKA), indicating impaired glucose metabolism. Risk for fluid volume deficit is significant due to dehydration from osmotic diuresis. Addressing these issues is critical for the client’s stabilization.



istory:

-old female client with a history of chronic kidney disease presents with fatigue, pruritus, a ion. The family reports increased forgetfulness.


igns: 20/70


98.9°F (37.2°C)


96% on room air

Identify the priority nursing interventions for this client. (Select All That Apply) minister phosphate binders as prescribed

ucate the client on fluid restrictions

nitor laboratory values for renal function sess skin integrity regularly

plement a low-protein diet er: A, C, E

nation: Administering phosphate binders helps manage hyperphosphatemia. Monitoring labor is essential for tracking renal function, and implementing a low-protein diet is critical to red rkload on the kidneys.

Question: 1668


Client H

67-year nd

confus


Vital S BP: 1

HR: 85

Temp: RR: 20 SpO2:


  1. Ad

  2. Ed

  3. Mo

  4. As

  5. Im


Answ


Expla atory

values uce

the wo


Question: 1669


A nurse is reviewing a client’s lab results. Which result would indicate a need for further investigation in a patient undergoing treatment for cancer?


  1. Elevated white blood cell count

  2. Low hemoglobin level

  3. Elevated liver enzymes

  4. Normal platelet count Answer: C

Explanation: Elevated liver enzymes could indicate liver metastasis or toxicity from chemotherapy, requiring further investigation.


Quest


Client H

ion: 1670


istory:

-old female client with a history of heart failure presents with sudden onset of shortness of est pain. The family reports increased fatigue over the past week.


Note:

ient appears anxious, and lung auscultation reveals bilateral crackles. Vital signs indicate ardia and hypotension.


igns: 0/60

10

98.6°F (37°C)


92% on 3L O2/NC

Identify the priority nursing interventions for this client. (Select All That Apply) minister diuretics as prescribed

pare for possible intubation ess for signs of fluid overload nitor vital signs frequently

ucate the family on heart failure management

79-year breath

and ch


Nurse's The cl tachyc


Vital S BP: 9

HR: 1

Temp: RR: 30 SpO2:


  1. Ad

  2. Pre

  3. Ass

  4. Mo

  5. Ed


Answer: A, B, C, D


Explanation: Administering diuretics helps relieve fluid overload. Preparing for intubation may be necessary if the respiratory distress worsens. Assessing for signs of fluid overload is critical, and monitoring vital signs frequently ensures timely interventions.


Question: 1671

A patient has been diagnosed with chronic obstructive pulmonary disease (COPD) and is experiencing an exacerbation. What is the most critical nursing intervention?


  1. Encourage deep breathing exercises

  2. Administer bronchodilators as ordered

  3. Provide supplemental oxygen

  4. Monitor respiratory rate Answer: B

an exacerbation.


ion: 1672


Note:

A 50-year-old client with a history of liver cirrhosis is admitted with gastrointestinal bleed ient reports vomiting bright red blood and has dark, tarry stools.


igns:

7°F (36.1°C), HR 130, BP 85/50, RR 24.


esults:

.0 g/dL, Hct 25%, Platelets 90,000/mm3, INR 2.5.

Identify the critical factors for the nurse to consider in this case. (Select all that apply.) ght red blood in vomit

k, tarry stools

hemoglobin and hematocrit levels vated INR

tory of liver cirrhosis


er: A, B, C, D, E

Explanation: Administering bronchodilators is critical for relieving bronchospasm and improving airflow during


Quest


Nurse's

Report: ing.

The cl


Vital S Temp 9


Lab R Hgb 8


  1. Bri

  2. Dar

  3. Low

  4. Ele

  5. His Answ

Explanation: Each option presents vital information regarding the severity of the client's condition, indicating significant hemorrhage and potential liver dysfunction requiring immediate nursing action.


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