10 Tricky Practice NCLEX Questions and Answers | Weekly Practice #1 for Nursing Students & Graduates

Are you stressing out about passing the NCLEX? Then you’ve come to the right place, because this episode is for you!

I know what it’s like to be super anxious about the NCLEX; I myself had to take it three times because I could pass. 

Studying for such a big exam was daunting, until I learned how to study better! And one of the ways I did that was to practice the trickiest, most difficult NCLEX questions and answers I could find.

And this is exactly what you and I will be doing in this week’s episode of NCLEX Ready.

Want to pass the NCLEX on your first try?

Then tune in now!

Question #1:

A nurse is providing care for a patient with a suspected pulmonary embolism. Which of the following symptoms would the nurse expect to find in a patient with a suspected pulmonary embolism?

1. Hives
2. Tachypnea
3. Hypotension
4. Bradycardia

Answer: Tachypnea.

Rationale: Tachypnea, which is when the breathing is abnormally rapid and shallow, is an expected finding in a patient that presents with pulmonary embolism. Tachypnea occurs as a result of impaired gas exchange. Know that pulmonary embolism occurs when there is a sudden blockage in the pulmonary arteries. Knowing what pulmonary embolism is will help you realize that this will cause difficulty breathing. This will help you see the answer tachypnea jump at you in comparison to the other answers, which are not related to pulmonary embolism.

Question #2

A nurse is providing care for a patient who is receiving blood transfusions. The patient states that he is itching and suddenly feels chills. Which of the following actions should the nurse take next?

1. Stop the transfusion immediately
2. Slow down the transfusion rate
3. Call the provider
4. Increase the transfusion rate

Answer: Stop the transfusion immediately.

Rationale: The nurse should not jump to calling the provider. The question is asking what should the nurse do NEXT. The first step is to stop the transfusion immediately. This already automatically removes slowing down or increasing the transfusion rate. Calling the provider would be the next step.

Question #3:

A nurse is providing care for a patient diagnosed with congestive heart failure (CHF). The patient’s weight must be monitored on a daily basis. Which of the following weight gain should be reported to the provider?

1. 1 lb
2. 2 lbs
3. 3 lbs
4. 4 lbs

Answer: 3 lbs.

Rationale: The nurse should report a weight gain of 3 lbs or more within 24-hours to the provider. A gain of 1 or 2 lbs can be daily weight fluctuation, but if the patient gains 3 lbs, it may be due to fluid retention that can indicate worsening heart failure. 4 lbs weight gain should definitely be reported, but the nurse should report 3 lbs weight gain before getting to 4 lbs.

Question #4:

The nurse is providing patient education for hypertension management. Which of the following indicates that the patient has an understanding of hypertension management?

1. “If my blood pressure is within normal limits, I can stop taking my blood pressure medication.”
2. “Gaining weight will help me manage my blood pressure.”
3. “I should increase my sodium intake.”
4. “I should take my blood pressure vitals before I take my blood pressure medication.”

Answer: “I should take my blood pressure vitals before I take my blood pressure medication.”

Rationale: If the blood pressure is too low, then the patient may end up having hypotension, so the patient should take their blood pressure prior to taking their medication. The blood pressure is within normal limits due to the blood pressure medication. Stopping the blood pressure medication can cause it to go back up. Weight loss plays a factor in improving blood pressure. Gaining weight would not help the patient manage their blood pressure. Increasing sodium intake can increase the blood pressure so the nurse should not encourage an increase in sodium intake.

Question#5:

A nurse is providing care for a 35-years old female patient who is diagnosed with chronic kidney disease. Which of the following dietary recommendations is appropriate for this patient?

1. Low potassium intake
2. High potassium intake
3. Low protein intake
4. High sodium intake

Answer: Low potassium intake.

Rationale: A patient with chronic kidney disease will have decreased kidney function, which means that potassium and sodium cannot be excreted efficiently. Answers 2 and 3 should be eliminated based on this logic. Patients with chronic kidney disease are encouraged to increase their protein intake so we can eliminate low protein intake. The nurse should encourage the patient with chronic kidney disease to have low potassium intake.

Question #6:

A 41-years old male patient presents to the Emergency Department and has type 1 diabetes mellitus. The nurse is providing care for the patient and knows which of the following is an early sign of diabetic ketoacidosis (DKA)?

1. Bradycardia
2. Bradypnea
3. Polyuria
4. Hypoglycemia

Answer: Polyuria.

Rationale: An early sign of diabetic ketoacidosis is polyuria, which is excessive urination. Hyperglycemia is seen in diabetic ketoacidosis, not hypoglycemia. However, while treating DKA, hypoglycemia can occur. Patients experiencing DKA are more likely to experience tachypnea, not bradypnea. Bradycardia is not usually seen in patients experiencing DKA.

Question #7:

A nurse is preparing a patient for a colonoscopy by providing patient education. The patient has demonstrated understanding when he states which of the following statements?

1. “I should eat a low-fiber diet starting a week prior to the procedure.”
2. “I can only have clear liquids 24-hours prior to my colonoscopy procedure.”
3. “I should avoid drinking water 24-hours prior to my procedure.”
4. “I can eat light meals, but must not eat anything after midnight.”

Answer: “I can only have clear liquids 24-hours prior to my colonoscopy procedure.”

Rationale: The tricky part about this is that a lot of procedures require the patient to not eat anything after midnight. However, with a colonoscopy, the patient should consume only clear liquids 24-hours prior to the colonoscopy procedure and cannot eat anything during this timeframe. Eating a low-fiber diet doesn’t ensure that the patient will avoid eating anything for 24-hours prior to the procedure. The patient should not avoid drinking water at this time.

Question #8:

A nurse is assigned to a patient who just had an appendectomy two hours ago. Which of the following findings can indicate a postoperative appendectomy complication?

1. Redness around the incision
2. Hypertension
3. Pain at the incision site
4. Purulent drainage at the incision

Answer: Purulent drainage at the incision.

Rationale: The nurse should look for signs and symptoms of infection after an appendectomy. Purulent drainage at the incision can indicate an infection and should be reported to the provider. Pain and redness around the incision are expected findings and do not necessarily indicate an infection or complication. Hypertension is not a related finding that the nurse should associate with a potential postoperative infection.

Question #9:

Nurse Patrick is providing care for a patient and noted that the patient may be experiencing compartment syndrome following a fracture. Which of the following is a sign of compartment syndrome?

1. Paresthesias
2. Polydipsia
3. Hypotension
4. Bradypnea

Answer: Paresthesias.

Rationale: Compartment syndrome is a serious condition that occurs when there is a buildup of excessive pressure inside a muscle. This usually happens after an injury, such as a fracture. A decrease in blood flow can occur due to this pressure, which stops oxygen from reaching the appropriate nerve and muscle cells. This is a medical emergency. Know the 5 P’s of compartment syndrome, which are Pain, Pallor, Paresthesia, Pulselessness, and Paralysis.

Question #10:

A nurse is providing care for a patient who is taking warfarin for atrial fibrillation. Which of the following laboratory values should be monitored to assess the therapeutic effect of warfarin?

1. International Normalized Ratio (INR)
2. Platelet count
3. Creatinine levels
4. Potassium levels

Answer: International Normalized Ratio (INR).

Rationale: Warfarin is prescribed to prevent blood clots. Warfarin is an anticoagulant and is monitored by International Normalized Ratio (INR). Atrial fibrillation is an irregular and rapid heart rhythm. Atrial fibrillation can lead to blood clots in the heart so warfarin can be prescribed for someone with a history of atrial fibrillation. The therapeutic range of INR is between 2 and 3, but of course, this can vary in different hospitals. The nurse would not monitor the therapeutic effects of warfarin with platelet count, creatinine levels, or potassium levels.