NCLEX-PN
NCLEX PN Exam Practice Test Questions
Extract:
Medication monitoring therapeutic ranges
Phenytoin
10-20 mcg/mL
(40-79 mcmol/L)
Digoxin
0.8-2 ng/mL
(1.02-2.56 nmol/L)
INR (prosthetic valve)
3-4
Lithium
0.8-1.2mEq/L
(0.8-1.2 mmol/L)
Question 1 of 5
Which of the following laboratory values requires immediate follow-up?
Correct Answer: A
Rationale: Phenytoin levels of 8 mcg/mL are subtherapeutic (therapeutic range: 10-20 mcg/mL), especially with enteral feedings that reduce absorption, requiring immediate adjustment.
Extract:
Laboratory reference ranges
Platelets
150,000–400,000/mm3
(150–400 × 109/L)
Question 2 of 5
A client is being discharged with a prescription for apixaban after being treated for a pulmonary embolus. Which clinical data is most concerning to the nurse?
Correct Answer: C
Rationale: Indomethacin, an NSAID, increases bleeding risk when combined with apixaban, an anticoagulant, making it concerning. The other data are not significant.
Extract:
1700
Found client lying on floor next to bed. Client states, "I fell out of bed while reaching for my eyeglasses and hit my head on the bedside table." Client is alert and oriented to time, place, person, and situation. Denies pain, dizziness, or nausea. No visible injuries. Assisted back to bed. Neurological vital signs within normal limits (see assessment flow sheet). Client instructed to use call bell for assistance. Will continue to monitor. __________RN
1710: Health care provider (HCP) notified of fall. Prescribed CT of head STAT. ___________RN
1740: No change in neurologic status. Client to CT via gurney. Report filed per policy. __________RN
1810: Client returned from CT. No change in neurologic status. Reinforced use of call bell, and client demonstrated understanding. Will continue to monitor. __________RN
Question 3 of 5
The nurse finds a client on the floor in the client's room. Based on the documentation shown in the exhibit, the nurse made an incorrect entry in the client's medical record at what time?
Correct Answer: C
Rationale: Without specific exhibit details, 1740 is assumed incorrect based on context, possibly due to a documentation error related to the fall. Rationale is limited without exhibit.
Extract:
Question 4 of 5
An elderly client with depression, diabetes mellitus, and heart failure has received a new digoxin prescription for daily use. Which client assessment indicates that the nurse should follow up on serum digoxin levels frequently?
Correct Answer: D
Rationale: Elevated serum creatinine (2.3 mg/dL) indicates renal impairment, which can lead to digoxin accumulation, necessitating frequent monitoring.
Question 5 of 5
A 38-year-old client who has mitral stenosis is hospitalized for a valve replacement. Which condition is the client most likely to report having had earlier in life?
Correct Answer: C
Rationale: Mitral stenosis is commonly a sequel of rheumatic fever, which damages heart valves. Meningitis, syphilis, and rubella are not typically associated with mitral valve pathology.