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NCLEX NCLEX-RN Exam
National Council Licensure Examination - NCLEX-RN (Page 7 )

Updated On: 12-Jan-2026
Page 7 of 345
PDF with 862 Questions

A 35-year-old client is admitted to the hospital with diabetic ketoacidosis. Results of arterial blood gases are pH 7.2, PaO2 90, PaCO2 45, and HCO3 16. The nursing assessment of arterial blood gases indicate the presence of:

  1. Respiratory alkalosis
  2. Respiratory acidosis
  3. Metabolic alkalosis
  4. Metabolic acidosis

Answer(s): D

Explanation:

(A) Respiratory alkalosis is determined by elevated pH and low PaCO2. (B) Respiratory acidosis is determined by low pH and elevated PaCO2. (C) Metabolic alkalosis is determined by elevated pH and HCO3.(D) Metabolic acidosis is determined by low pH and HCO3.



A 45-year-old male client was admitted to a chemical dependency treatment center following legal problems related to alcohol abuse. He states, "I know that alcohol is a problem for some people, but I can stop whenever I want to. I'm never sick or miss work, and no one can complain about me." During the initial assessment, the best response by the nurse would be:

  1. "The fact is you are an alcoholic or you wouldn't be here."
  2. "I understand it took strength to admit yourself to the unit, and I will do my part to help you to stay alcohol- free."
  3. "If you can stop drinking when you want to, why don't you stop?"
  4. "It's good that you can stop drinking when you want to."

Answer(s): B

Explanation:

(A) Direct confrontation initially is nontherapeutic and may result in the client becoming frustrated and wanting to leave. (B) A positive, supportive attitude builds trust, and identifying positive strength raises self-esteem. Offering help allows the client to feel that he is not alone in dealing with problems. (C) Asking the client why or to give an Explanation for his behavior puts him in a position of having to justify his behavior to the nurse. (D) Giving approval or placing a value on feelings or a behavior may limit the client's freedom to behave in a way that may displease another. This response may lead to seeking praise instead of progress.



The physician prescribes a medical regimen of isoniazid, rifampin, and vitamin B6 for a tuberculosis client.
The nurse instructs the client that B6 is given because it:

  1. Increases activity of isoniazid
  2. Increases activity of rifampin
  3. Improves nutritional status
  4. Reduces peripheral neuropathy

Answer(s): D

Explanation:

(A) Vitamin B6does not enhance the activity of isoniazid. (B) Vitamin B6does not enhance the activity of rifampin. (C) A vitamin alone does not improve nutritional status. (D) Isoniazid leads to Vitamin B6deficiency, which is manifested as peripheral neuropathy.



A 17-year-old pregnant client who is gravida 1, para 0, is at 36 weeks' gestation. Based on the nurse's knowledge of the maternal physiological changes in pregnancy, which of these findings would be of concern?

  1. Complaints of dyspnea
  2. Edema of face and hands
  3. Pulse of 65 bpm at 8 weeks, 73 bpm at 36 weeks
  4. Hematocrit 39%

Answer(s): B

Explanation:

(A) Dyspnea is a common complaint during the third trimester owing to the increasing size of the uterus and the resulting pressure against the diaphragm. (B) Edema of the face, hands, or pitting edema after 12 hours of bed rest may be indicative of preeclampsia and would be of great concern to the healthcare provider. (C) An increase in heart rate of 10­15 bpm is a normal physiological change in pregnancy due to the multiple hemodynamic changes. (D) A hematocrit value of 39% is within the normal range. A value <35% would indicate anemia.



A 23-year-old college student seeks medical attention at the college infirmary for complaints of severe fatigue. Her skin is pale, and she reports exertional dyspnea. She is admitted to the hospital with possible aplastic anemia. Laboratory values reflect anemia, and the client is prepared for a bone marrow biopsy. She refuses to sign the biopsy consent and states, "Can't you just get the doctor to give me a transfusion and let me go. This weekend begins spring break, and I have plans to go to Florida." At this time the nurse's greatest concern is that:

  1. The client may contract an infection as a result of being exposed to large crowds at spring break
  2. The client does not grasp the full impact of her illness
  3. The client may require transfusion before leaving for spring break
  4. The causative agent be identified and treatment begun

Answer(s): B

Explanation:

(A) The client could contract an infection, but at this point it is not the most pertinent issue. (B) The client's statement indicates that she does not grasp the full impact of her illness. Further client education must be given, along with allowing her to express her feelings regarding her illness. (C) The client may require a transfusion, but this is a temporary measure because the causative agent has not been identified. Her feelings regarding her illness must be addressed in order for care to continue. (D) A bone marrow is done first to make a definitive diagnosis; then treatment may begin.



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