NCLEX-RN
Free NCLEX RN Practice Test Questions
Extract:
Question 1 of 5
The nurse is auscultating the apical pulse over the PMI (point of maximum impact). Which heart sounds would be audible?
Correct Answer: D
Rationale: S1 (mitral/tricuspid closure) and S2 (aortic/pulmonic closure) are normally audible at the PMI. S3 and S4 are less common and indicate pathology.
Question 2 of 5
A client with adult respiratory distress syndrome has been placed on mechanical ventilation with PEEP. Which finding would indicate to the nurse that the client is experiencing the undesirable effect of an increase in airway and chest pressure?
Correct Answer: C
Rationale: PEEP can increase intrathoracic pressure, reducing venous return and causing hypotension (e.g., BP drop to 90/48), an undesirable effect requiring intervention.
Question 3 of 5
The nurse caring for a client diagnosed with metastatic cancer of the bone is exhibiting mental confusion and a BP of 150/100. Which laboratory value would correlate with the client's symptoms reflecting a common complication with this diagnosis?
Correct Answer: B
Rationale: Bone metastasis often causes hypercalcemia (calcium 13 mg/dL is elevated), leading to confusion and hypertension. The other values are normal or unrelated.
Question 4 of 5
Following surgical repair of a fractured femur, a client's hemoglobin falls to 7.4 and the physician orders one unit of packed red blood cells (250 mL) to be administered over two hours with a drop factor of 10 drops/mL. What flow rate (drops per minute) is needed? Record by rounding to the nearest whole number.
Correct Answer: 21
Rationale:
To calculate the flow rate: (Volume X Drop factor)/ Time in minutes. Volume is 250 mL, drop factor is 10 drops/mL, time is 2 hours = 120 minutes. Thus, (250 X 10)/ 120 = 2,500/ 120 ≈ 20.83, rounded to 21 drops/minute.
Question 5 of 5
The client with hyperemesis gravidarum is at risk for developing:
Correct Answer: B
Rationale: Hyperemesis gravidarum causes vomiting, leading to metabolic acidosis and dehydration from fluid and electrolyte loss.