Question 1 of 35

1. Question
Which of the following clients should the nurse see FIRST?
- A 67 year-old male client admitted with prostatitis who will be discharged tomorrow to a nursing home
- A 67 year-old female client with a pacemaker complaining of dizziness and shortness of breath.
- A 55 year-old male client admitted with heart failure with crackles in both lung bases.
- A 45 year-old female with heart failure and fluid overload who is refusing to take her lasix and her digoxin
Correct

Incorrect
Question 2 of 35

2. Question
The nurse is working in the emergency department. She has 4 clients she needs to assess. Which client should the nurse assess FIRST?
- A client taking aldactone at home and has tall peaked T waves on the monitor.
- A client admitted with right hip fracture and is crying in pain.
- A 5-year-old client with thick vaginal discharge who is quiet and withdrawn.
- A client that comes to the emergency room several times a month and complains of severe headaches.
Correct

Incorrect
Question 3 of 35

3. Question
Let’s go simple. Is this client having EXPECTED or UNEXPECTED/COMPLICATION symptoms?

A client with a history hyperthyroidism who had right hip replacement is complaining of feeling hot, has tachycardia and palpitations, and is very confused.
- Expected
- Unexpected. It's signaling a possible complication
Correct

Incorrect
Question 4 of 35

4. Question
A client who just had a right chest tube due to a pneumothorax has tidaling and small amount of intermittent bubbling in the water seal chamber.
- Expected
- Unexpected
Correct

Incorrect
Question 5 of 35

5. Question
The nurse is working in the emergency department. Which client should the nurse assess FIRST?
- A 50-year-old female client with tracheal deviation.
- A 45-year-old male client with a large bruise to his left abdomen after a motor vehicle accident.
- A 70-year-old client wandering around confused.
- A 5-year-old motor vehicle accident client with an open left femur fracture.
Correct

Incorrect
Question 6 of 35

6. Question
Which of the following clients should the nurse see FIRST?
- A 28-year-old schizophrenic client on thorazine who now reports "feeling very hot."
- A 55-year-old client with bilateral lung pneumonia who has a new order for antibiotics.
- A 45-year-old client on chemotherapy who is experiencing fever, nausea, and vomiting.
- A client who had a parathyroidectomy yesterday and now is using the neck muscles to breathe.
Correct

Incorrect
Question 7 of 35

7. Question
Which of the following clients should the nurse see FIRST?
- A 50-year-old client who just returned from having a bronchoscopy with biopsy.
- A 45-year-old client with pancreatitis who reports abdominal pain
- A 56-year-old client with chronic renal failure admitted yesterday with generalized swelling and low urine output.
- A 45-year-old client with End-Stage Renal disease who has an elevated blood urea nitrogen and creatinine
Correct

Incorrect
Question 8 of 35

8. Question
Which of the following clients should the nurse see FIRST?
- A client wandering in the hallways with MRSA in his left foot diabetic ulcer.
- A client with active tuberculosis wandering in the hallways without a mask.
- A client who reports that his ileostomy bag burst and leaked all over his bed.
- A client in heart failure who refuses to take his morning digoxin and has a heart rate of 110bpm.
Correct

Incorrect
Question 9 of 35

9. Question
Who should the ER nurse assess FIRST?
- A client with a persistent nose bleed who is applying pressure to his own nose as he leans forward.
- A sexually-active client who might be pregnant and has severe right lower quadrant pain.
- A client who had an spontaneous abortion at 19 weeks and now is lethargic and pale.
- A client with COPD with saturations of 91% and respiratory rate of 25 bpm.
Correct

Incorrect
Question 10 of 35

10. Question
Who should the nurse see FIRST?
- A 50-year-old client with Parkinson's Disease who has involuntary movements.
- A 45-year-old client with a pacemaker who is being transported for an MRI
- A 60-year-old client with Raynaud's disease who has tingling of fingers and blanching at the fingertips
- A 67-year-old client with a left hemisphere stroke who needs help to the restroom
Correct

Incorrect
Question 11 of 35

11. Question
Which of the following clients should the nurse see FIRST?
- A sedated client who is mechanically ventilated via a tracheostomy and a family member reports that the tracheostomy ties are untied.
- A client with heart failure on digoxin who reports seeing yellow halos.
- A client with diabetes insipidus who had a urine output of 2000mL in the past 12 hours.
- A client who has a temperature of 102° F and who is tachypneic.
Correct

Incorrect
Question 12 of 35

12. Question
Which of the following clients should the nurse see FIRST?
- A 50-year-old client with liver cirrhosis who had a liver biopsy and now has a BP of 86/59 and a heart rate of 130.
- A 76-year-old female client who had a right hip replacement yesterday and now is requesting pain medication.
- A 56-year-old client admitted with DKA 2 days ago and wants to leave the hospital against medical advice.
- A 60-year-old celebrity client with prostate cancer who is waiting to be discharged.
Correct

Incorrect
Question 13 of 35

13. Question
Which of the following clients should the nurse assess FIRST?
- A 32-year-old client who is having an elective endoscopy this morning and there is no informed consent.
- A 34-year-old female client who had an appendectomy and now is breathing 32 breaths/min and has petechiae to her chest.
- A 65-year-old client with right-sided heart failure with weight gain of 1.7 lbs in one day
- A 60-year-old client with chest pain unrelieved by 2 nitroglycerins 5 minutes apart.
Correct

Incorrect
Question 14 of 35

14. Question
Which of the following clients should the nurse see FIRST?
- A male client who had a left hip replacement and now the UAP reports that while bathing the client, his left foot felt really cold as compared to his right.
- A 67-year-old client with COPD who has a blood gas with a pH of 7.25 and PCO2 78 and is lethargic.
- A 56-year-old heart failure client on Lasix who is complaining of muscle weakness.
- A 68-year-old male client admitted with a pneumothorax who has continuous bubbling in the suction chamber.
Correct

Incorrect
Question 15 of 35

15. Question
Which of the following clients should the nurse see FIRST?
- A client who is high risk for falls and is seen walking in the hallway.
- A client with a post-operative ileus who just pulled out his Nasogastric tube.
- A male client who just had a loose bowel movement in bed and has a stage 3 pressure ulcer to his coccyx.
- A 50-year old client with prostate cancer waiting to be discharge
Correct

Incorrect
Question 16 of 35

16. Question
Which of the following clients should the nurse assess FIRST?
- A client with Coronary Artery Bypass Surgery who is complaning of sternotomy pain when doing coughing and deep breathing exercises.
- A 80-year-old client with a left hip surgery and new-onset confusion.
- A diabetic client complaining of polyuria and polydipsia.
- A client who had abdominal surgery yesterday and is complaining of pain 5 out 10.
Correct

Incorrect
Question 17 of 35

17. Question
Which of the following clients should the nurse assess first?
- A client with a fractured femur who is complaining of shortness of breath and chest pain.
- A client with emphysema who is complaining of shortness of breath with exertion.
- A client with pancreatitis whose abdomen is distended and has a fever of 101.6° F
- A diabetic client with a glucose level of 360 mg/dl who has a heart rate of 110
Correct

Incorrect
Question 18 of 35

18. Question
Which of the following clients should the nurse assess FIRST?
- A client admitted with a duodenal ulcer and now has increasing abdominal distension with increased pain.
- A client admitted with diarrhea who is receiving IV hydration and has a blood pressure of 99/58 and heart rate of 105 bpm
- A client who underwent a cholecystectomy 2 days ago and has a T-tube that is drained only 5ml during the last shift.
- A client who has laparoscopic surgery this morning and now has right shoulder pain.
Correct

Incorrect
Question 19 of 35

19. Question
Which client should the nurse assess FIRST?
- A 60-year-old client with liver cirrhosis who has an elevated bilirubin and is jaundiced.
- A client diagnosed with a brain glioma and is requesting pain medication every 4 hours since admission 3 days ago.
- A client who had a lumbar puncture 3 hours ago and now is complaining of a mild headache.
- A client who had a bowel resection 2 days ago and now has a fever of 101.5° F
Correct

Incorrect
Question 20 of 35

20. Question
Which of the following clients should the nurse assess FIRST?
- A diabetic client with large amount of protein in his urine.
- A client admitted with heart failure that has jugular vein distension at a 45-degree angle.
- A client admitted with hypokalemia (3.4 mg/dl).
- A client who is having gastric bypass in yesterday and is complaining of chills with a blood pressure of 89/55
Correct

Incorrect
Question 21 of 35

21. Question
Which of the following clients should the nurse assess FIRST?
- A client with asthma who has a nonproductive cough, is breathing at 16 breaths per minute, and has an oxygen saturation of 95%.
- A client with Huntington's Disease who is eating and is having an episode of uncontrollable cough.
- A client with a transurethral resection of the prostate (TURP) who has blood-tinged urine and a heart rate of 99
- A client admitted with diabetes mellitus who has a blood sugar of 210 mg/dL and feels thirsty.
Correct

Incorrect
Question 22 of 35

22. Question
Which of the following clients needs follow up?
- A client with rheumatiod arthritis who is taking NSAIDs and now has a creatinine of 2.2 mg/dl.
- A client with liver cirrhosis who has a platelet count of 150,000/per microliter (mcL) of blood.
- A client who had a colostomy yesterday and the stoma is reported red and slightly raised.
- A client who had a carotid endarectomy yesterday and has a Glasgow Coma Scale (GCS) of 15.
Correct

Incorrect
Question 23 of 35

23. Question
Which of the following clients should the nurse help first?
- A client receiving a chemotherapeutic drug and his IV pump is beeping.
- A client whose family needs extensive teaching since the client will be going to hospice.
- A client in heart failure who is due for his scheduled oral furosemide.
- A client admitted with uremic syndrome and has periorbital and facial edema.
Correct

Incorrect
Question 24 of 35

24. Question
Which of the following clients should the trauma nurse assess First?
- A client with a fracture of his right fibula with the bone exposed.
- A client who is complaining of abdominal pain and distension.
- A client with a hematoma to the right side of his neck.
- A client who is confused and hyperemotional about the accident.
Correct

Incorrect
Question 25 of 35

25. Question
Which of the following clients needs follow up by the hemodialysis nurse?
- A client with ESRD who has minimal urine output
- A client with ESRD who has nausea
- A client with ESRD who has ammonia breath
- A client with ESRD who has numbness and tingling around the mouth.
Correct

Incorrect
Question 26 of 35

26. Question
Which of the following clients should the nurse assess FIRST?
- A client with myasthenia gravis who is on pyridostigmine and reports muscle cramps.
- A client with pericarditis who has a systolic blood pressure that is 25mm Hg higher during expiration than during inspiration.
- A client reported to have an isolated premature ventricular contraction (PVC).
- A peritoneal dialysis client admitted for right ankle surgery who is reporting fever and chills.
Correct

Incorrect
Question 27 of 35

27. Question
Which of the following clients should the nurse assess FIRST?
- A client with Guillain Barre with reported decreased vital capacity.
- A client on clopidogrel who reports unexplained bruising to arms and legs.
- A client on extended release niacin who is having flushing of the face and neck and is on the call light.
- A client who had the foley catheter removed 6 hours ago and has not voided yet.
Correct

Incorrect
Question 28 of 35

28. Question
The nurse has been made aware of the following client situations. Which client needs immediate follow up?
- A client with gout with an uric acid level of 8mg/dL
- A client with chronic renal failure with urine output of 5 ml in the last 2 hours.
- A client admitted for acute renal failure that will be having a CT scan with contrast in 2 hours.
- A client with mononucleosis with cervical lymphadenopathy
Correct

Incorrect
Question 29 of 35

29. Question
Which of the following clients requires immediate follow up?
- A client who had a laparoscopic surgery 5 hours ago and now has upper abdominal pain that radiates to the shoulder.
- A client with diabetes type 1 who reports double vision, headache, and irritability.
- A client with a subtotal gastrectomy who reports diaphoresis and weakness after eating a meal.
- A client with liver cirrhosis who reports spontaneous bruising to trunk and arms
Correct

Incorrect
Question 30 of 35

30. Question
Which of the following clients should the nurse see FIRST?
- A 51-year-old client with pneumonia who was extubated today and has noisy breathing.
- A 23-year-old male client who was admitted yesterday with multiple injuries after a motor vehicle accident.
- A client with acute myocardial infarction with a history of diabetes and hypertension.
- A client with rheumatic fever who will be discharged today and needs extensive teaching.
Correct

Incorrect
Question 31 of 35

31. Question
Which of the following clients should the nurse see FIRST?
- A 24-year-old male client with a pleural effusion who has a chest tube with continuous bubbling in the water seal.
- A 54-year-old female with a large pneumothorax who has a chest tube with small amount of intermittent bubbling in the water seal.
- A 70-year-old male client who had open heart surgery yesterday and has a chest tube to suction with continuous bubbling in the suction chamber.
- A 45-year-old female client with a pleural effusion who has a chest tube with tidaling in the water seal chamber.
Correct

Incorrect
Question 32 of 35

32. Question
Which of the following clients should the nurse assess FIRST?
- A 55-year-old male client admitted with angina who received morphine 4 mg IVP and now has a respiratory rate of 14 breaths/minute.
- A 12-year-old female client admitted with asthma exacerbation who had loud audible wheezes, but lungs sounds are now diminished.
- A 54-year-old male client with pernicious anemia just admitted with a hemoglobin of 8 mg/dl.
- A 67-year-old female client on chemotherapy who has an oral temperature of 101 º F.
Correct

Incorrect
Question 33 of 35

33. Question
Which of the following clients should the nurse assess First?
- A 55-year-old male client admitted with a myocardial infarction who has a heart rate of 55 and is sitting on a chair talking to his wife.
- A 65-year-old male client admitted with heart failure on daily digoxin who is complaining that his vision is "fuzzy" and feels dizzy.
- A 45-year-old female client admitted with hypothyroidism who has a pressure of 110/55 and reports fatigue.
- A 80-year-old male client admitted with pneumonia who has bilateral crackles and a fever of 100.4 º F.
Correct

Incorrect
Question 34 of 35

34. Question
Which of the following clients should the RN assess first?
- A client with chemotherapy-induced neutropenia who has a temperature of 101 º F.
- A client with a pleural effusion who had a chest tube inserted 3 days ago and now has minimal chest tube output.
- A male client with testicular cancer who states, "I am too young to die."
- A client admitted with dehydration with stable vital signs but tenting of the skin on the forearms.
Correct

Incorrect
Question 35 of 35

35. Question
Which of the following clients should the nurse assess first?
- A client who is having a thyroidectomy today and is reporting chills.
- A client who is refusing to take his morning colace.
- A client who had a chest tube inserted yesterday due to a pleural effusion.
- A client who had an appendectomy yesterday and is requesting his pain medication because it is due now.
Correct

Incorrect

Adult Nursing NCLEX Review

Prioritizing NCLEX-like Critical Thinking Questions

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