Fundamentals NCLEX-RN Practice Exam — Set 2

The nurse is caring for a client with chronic kidney disease who reports fatigue, muscle weakness, and tingling in the fingers. Laboratory results show serum calcium of 6.8 mg/dL (reference 8.5-10.2) and serum phosphorus 6.0 mg/dL (reference 2.5-4.5). Which finding should the nurse expect?

A client receiving TPN through a central line will have the next bag delayed by 3 hours. Which action should the nurse take first?

Fifteen minutes into a transfusion, a client with prior multiple transfusions reports headache and chills. Temp 100.8°F, HR 110, BP 118/72. Which action should the nurse take first?

A new graduate is caring for a client on contact precautions for C. difficile. Which action requires the charge nurse to intervene?

A client receiving a transfusion reports chest pain and dyspnea. Temp 99.2°F, HR 122, BP 88/54, RR 28, SpO2 91% RA. Which condition is most likely?

A client newly prescribed furosemide for heart failure asks what symptoms to report. Which statement indicates a need for further teaching?

The nurse is preparing to insert an NG tube for gastric decompression in an alert client. Which action facilitates safe insertion?

A client received 2 units of PRBCs yesterday and now reports severe lower back pain, nausea, and dark urine. Temp 100.4°F, HR 108, BP 100/62. Which lab finding would the nurse expect?

A continuous enteral feeding has been infusing for 6 hours through a nasogastric tube. Which action should the nurse take?

A client with a new colostomy says, "I don't even want to look at it. This is disgusting." Which response is most appropriate?

A client has a Salem sump NG tube on continuous suction. Gastric output has decreased significantly over 2 hours. Which action should the nurse take first?

An adult client asks how far the enema tube will be inserted. Which response is correct?

Which action by a staff member caring for a client with active pulmonary TB on airborne precautions requires immediate intervention?

A client with a PICC line reports sudden chest pain and dyspnea. RR 32, anxious. Which action should the nurse take first?

A client newly prescribed warfarin for atrial fibrillation asks what foods to avoid. Which food should the nurse instruct the client to eat consistently rather than avoid completely?

A client receives a continuous heparin infusion for DVT. Which lab result indicates therapeutic effect?

A client takes frequent OTC calcium carbonate antacids and reports fatigue and confusion. Calcium 11.5 mg/dL (reference 8.5-10.2). Which additional finding is expected?

A visitor of a client with a sealed cervical radiation implant asks how long they can stay. Which response is correct?

Before removing an indwelling urinary catheter placed 3 days ago, which action should the nurse take?

Before the first feeding through a newly placed gastrostomy tube, which action should the nurse take?

Which client should be assigned to a private room with negative air pressure?

A client on hydrochlorothiazide reports leg cramps and fatigue. Potassium 3.1 mEq/L. Which ECG finding is expected?

Discharge teaching for a new ileostomy: which client statement indicates a need for further teaching?

A client on long-term prednisone for RA sustains a hip fracture. Which complication is the greatest risk?

Postop day 1 abdominal surgery: client reports something "gave way" after coughing; serosanguineous drainage with visible bowel loops. After covering with sterile saline-soaked gauze, which action is next?

DKA client ABG: pH 7.28, PaCO2 32, HCO3 16. Which acid-base imbalance is present?

A client on continuous NG suction has Na 148, Cl 110, K 3.3. Which complication is most likely?

New HF client with 3+ pitting edema and crackles halfway up lung fields. Which dietary instruction is correct?

A scheduled digoxin dose is due. Apical pulse is 52/min. Which action should the nurse take?

A client with dysphagia is on a nectar-thick liquid diet. Which liquids are appropriate to offer? Select all that apply.

After setting up the sterile field for a female urinary catheter insertion, which action does the nurse take next?

Six hours post-hip replacement, a client reports sudden chest pain and dyspnea; SpO2 88% on room air. Which condition should the nurse suspect first?

Teaching a client with CKD a low-phosphorus diet. Which food should be avoided?

Continuous bubbling is noted in the water-seal chamber of a chest drainage system. Which action should the nurse take?

A client with TBI and increased ICP has serum sodium 152 mEq/L. Which intervention should the nurse anticipate?