Fundamentals of Nursing: NCLEX Practice Questions

Fundamentals of Nursing: NCLEX Practice Questions

We prepared a quiz of practice test questions on the fundamentals of nursing, similar to the ones you’ll find in the NCLEX exam. This test bank of 25 multiple choice questions will challenge your knowledge of nursing fundamentals in several categories, including Physiological Adaptation, Pharmacology, Basic Care & Comfort and Safety & Infections.

1. Question

The nurse is attending to a client who was diagnosed with heart failure. During the examination, the nurse observes that the client is dyspneic with crackles upon auscultation. Which symptoms would manifest for a client with excess fluid volume?

• A. Decreased central venous pressure
• B. Flat neck and hand veins
• C. Hypertension
• D. Weight loss

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Correct:

C. Hypertension is a sign of fluid volume excess or fluid overload. The increase in fluid volume causes an increase in blood pressure in the vessels.

Incorrect:

A., B., D. Decreased central venous pressure, flat neck and hand veins, and weight loss are all signs of fluid volume deficit.

2. Question

During the client’s medical records review, what condition can put the client at risk for developing hypokalemia?

• A. Has a history of Addison’s disease
• B. Nasogastric suction
• C. Burn
• D. Uric acid level of 10.2 mg/dL (59.48 µmol/L)

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Correct:

B. The client is at risk for hypokalemia due to losing potassium-rich gastrointestinal fluids during nasogastric suction.

Incorrect:

A., C., D. Clients with tissue damage (such as from severe burns), hyperuricemia, and Addison’s disease are at risk for developing hyperkalemia. The normal uric acid level ranges from 2.7 to 8.5 mg/dL (160 to 501 µmol/L).

3. Question

The nurse analyzes the electrolyte test results for a client and notes that the potassium level is 2.2 mEq/L (2.2 mmol/L). Based on the laboratory result, which ECG pattern is not expected?

• A. Absent P waves
• B. Depressed ST segment
• C. Inverted T waves
• D. Presence of U waves

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Correct:

A. A serum potassium level of 3.5 – 5.0 mEq/L (3.5-5.0 mmol/L) is considered normal. Hypokalemia is a serum potassium level below 3.5 mEq/L (3.5 mmol/L). Absent P waves are not a sign of hypokalemia. However, it can be seen in a patient with ventricular rhythms, junctional rhythms, or atrial fibrillation.

Incorrect:

B., C., D. Shallow, flat, or inverted T waves, ST segment depression, and the presence of U waves are electrocardiographic alterations in hypokalemia.

4. Question

An intravenous dose of potassium chloride is prescribed for a client with hypokalemia. Which action of the nurse indicates a need for further teaching in the preparation and administration of potassium?

• A. Administer potassium through IV bolus.
• B. Check if the label of the bag indicates the volume of the potassium in the solution.
• C. Infuse potassium through an intravenous (IV) infusion pump.
• D. Monitor urine output during infusion.

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Correct:

A. Never administer potassium chloride through bolus (IV push). Cardiac arrest may occur when potassium chloride is injected intravenously as a bolus. The nurse needs to ensure that the potassium is diluted in the correct fluid or diluent.

Incorrect:

B. The amount of potassium chloride in the IV bag is always noted on the label.
C. Potassium chloride must always be diluted with IV fluid and infused using an infusion pump before being delivered intravenously.
D. During administration, the nurse closely monitors the urinary output and reports to the healthcare provider if it decreases below 30 mL/hr.

5. Question

A client with hypoparathyroidism is suspected of having hypocalcemia. Upon assessment, the nurse notes which clinical symptom would indicate hypocalcemia.

• A. Diminished deep tendon reflexes
• B. Hypoactive bowel sounds
• C. Negative Trousseau’s sign
• D. Twitching

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Correct:

D. Low parathyroid levels in hypoparathyroidism cause hypocalcemia by disrupting the calcium balance.The normal serum calcium is 9 to 10.5 mg/dL (2.25 to 2.75 mmol/L). It is known as hypocalcemia when the serum calcium level is less than 9 mg/dL (2.25 mmol/L). Twitching is a sign of neuromuscular excitability in hypocalcemia.

Incorrect:

A., B., and C. Hyperactive deep tendon reflexes,and a positive Trousseau’s or Chvostek’s sign indicate hypocalcemia. Increased neuromuscular excitability, muscle cramps, twitching, tetany, seizures, irritability, and anxiety are symptoms of hypocalcemia.

6. Question

A client diagnosed with Crohn’s disease has a calcium level of 7 mg/dL (1.75 mmol/L). Which ECG patterns would the nurse monitor?

• A. Peaked T wave
• B. Prolonged QT interval
• C. Prominent U wave
• D. Widened T wave

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Correct:

B. A Crohn’s disease patient is susceptible to hypocalcemia.The normal serum calcium is 9–10.5 mg/dL (2.25–2.75 mmol/L). Hypocalcemia manifests by a blood calcium level of less than 9 mg/dL (2.25 mmol/L). A prolonged QT interval and a prolonged ST segment are electrocardiographic alterations in clients with hypocalcemia.

Incorrect:

A. Myocardial infarction results in peaked T waves.
C. Hypokalemia results in ST depression and prominent U waves.
D. Hypercalcemia causes a narrowed ST segment and a widened T wave.

7. Question

A client diagnosed with Cushing’s disease has a potassium level of 2.3 mEq/L (2.3 mmol/L). Based on the result, which pattern would the nurse be monitoring for on the cardiac monitor?

• A. Prolonged ST segment
• B. Prominent U wave
• C. ST elevation
• D. Tall peaked T waves

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Correct:

B. A potassium level of 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L) is considered normal. Hypokalemia is indicated by a blood potassium level of less than 3.5 mEq/L (3.5.0 mmol/L). In Cushing’s syndrome, the increase in cortisol causes hypokalemia.

Incorrect:

A. Hypocalcemia causes the prolonged ST segment.
C. In hypokalemia, there is ST depression and NOT elevation.
D. Hyperkalemia causes tall peaked T waves, enlarged QRS complexes, longer PR intervals, and flat P waves.

8. Question

Which client will most likely experience a serum sodium concentration of 127 mEq/L (127 mmol/L)?

• A. A client who has Cushing’s syndrome
• B. A client who has hyperaldosteronism
• C. A client who is taking thiazide diuretics
• D. A client who uses corticosteroids

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Correct:

C. A serum sodium level of 135 to 145 mEq/L (or 135 to 145 mmol/L) is considered normal. Hyponatremia is indicated by a serum sodium level of 127 mEq/L (127 mmol/L). The client who is taking diuretics may experience hyponatremia.

Incorrect:

A., B., and D. Risk factors for hypernatremia include using corticosteroids, having hyperaldosteronism, or having Cushing’s syndrome.

9. Question

The client was diagnosed with heart failure and is currently taking high doses of diuretics. During the assessment, the nurse noted generalized weakness, flat neck veins, and diminished deep tendon reflexes. Which of the following symptoms would indicate that the client has hyponatremia?

• A. Decreased urinary output
• B. Hyperactive bowel sounds
• C. Increased urine specific gravity
• D. Tremors

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Correct:

B. A serum sodium level of 135 to 145 mEq/L (or 135 to 145 mmol/L) is considered normal. A serum sodium level of less than 135 mEq/L (135 mmol/L) indicates hyponatremia. Hyperactive bowel movements indicate hyponatremia.

Incorrect:

A., C., and D. Hypernatremia symptoms include decreased urine output, increased urine specific gravity, and tremors.

10. Question

After the nurse reviewed the client’s lab results, the client’s serum phosphorus (phosphate) level was found to be at 1.8 mg/dL (0.58 mmol/L) level. What condition is most likely to cause the serum phosphorus level?

• A. Hypoparathyroidism
• B. Kidney failure
• C. Malnutrition
• D. Tumor lysis syndrome

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Correct:

C. The normal serum phosphorus (phosphate) level is 3.0 to 4.5 mg/dL (0.97 to 1.45 mmol/L). There is hypophosphatemia in the client. Malnutrition and using antacids with aluminum hydroxide or magnesium base are contributing factors.