NCLEX-PN Test 04: Comprehensive Clinical Management

Q: A nurse is getting a client ready for surgery. Which item is most important to remove before the client goes to the operating room?

Contact lenses can scratch the eye while the patient is under anesthesia. They can also be damaged by the tools used during surgery.

Q: A client is about to have surgery but does not understand the risks, even though they signed the form. What should the nurse do?

It is the surgeon's job to make sure the patient understands the surgery. The nurse must call the doctor if the patient is confused.

Q: Which part of a client's history is most important when checking the risk for high phosphate levels?

The kidneys are responsible for removing phosphate from the body. If the kidneys are failing, phosphate builds up to dangerous levels in the blood.

Q: A client has a very high sodium level in their blood. Which behavior is most common for this client?

High sodium makes the brain cells shrink. This causes the patient to feel very restless or confused, and it can even cause seizures.

NCLEX-PN Test 04: Pre-Op & Safety Essentials

This exam evaluates your knowledge of Surgical Protocols, Electrolyte Shifts, and Patient Prioritization.

Informed Consent: If a patient does not understand their surgery, the nurse must stop the process and call the surgeon. The nurse cannot explain the risks themselves.

Infection Precautions: For diseases like whooping cough (pertussis), you must wear a surgical mask. These germs travel in respiratory droplets.

Surgical Prep: Contact lenses must always be removed before surgery. They can cause eye scratches while the patient is under anesthesia.

Edited by: Test-Questions.com

Last Updated: April 04, 2026

Q:1A nurse is getting a client ready for surgery. Which item is most important to remove before the client goes to the operating room?

A hearing aid

Contact lenses

A wedding ring

An artificial eye

Q:2A client is about to have surgery but does not understand the risks, even though they signed the form. What should the nurse do?

Call the surgeon and ask them to explain the surgery again.

Explain the surgery and the risks to the client.

Check the doctor's notes to see if the client understood earlier.

Ask the family if they understand the surgery.

Q:3Which part of a client's history is most important when checking the risk for high phosphate levels?

A history of radiation to the neck area.

A history of a recent bone surgery.

A history of not being very active.

A history of long-term kidney disease.

Q:4A client has a very high sodium level in their blood. Which behavior is most common for this client?

Feeling very angry.

Acting in a manic way.

Feeling very depressed.

Feeling confused or restless.

Q:5An 80-year-old client talks to the nurse. Which statement ... [Show Full Question 5]

"My skin always feels very dry."

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"I have always liked to drink lots of iced tea."

"I sometimes have trouble with urine leaking."

Q:6A client is grieving after their father died. Which statement by the client's ... [Show Full Question 6]

"She still cries sometimes, and it has been 3 months."

"She seems to have forgotten the bad things he did."

"She had a very hard time and felt a lot of longing."

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Q:7A nurse is caring for a client with whooping cough (pertussis). ... [Show Full Question 7]

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A hospital gown.

Medical gloves.

Shoe covers.

Q:8A client with a liver infection (hepatitis) has very itchy ... [Show Full Question 8]

Tell the client to take two warm showers a day.

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Put powder on the client's skin.

Tell the client to rinse with hot water.

Q:9A client with pancreas inflammation is in the intensive care unit. Why ... [Show Full Question 9]

To monitor the blood pressure every 15 minutes.

To see if a stomach tube is needed.

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To see if the bandages need changing.

Q:10A client has special ties called Montgomery straps on ... [Show Full Question 10]

The client is at risk of the wound opening up.

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To help hold the drainage tubes in place.

No stitches were used to close the wound.

Q:11A doctor orders a medicine to be given intrathecally. ... [Show Full Question 11]

Into a vein (IV).

Into the rectum.

Into a muscle.

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Q:12Which client is the best choice for ... [Show Full Question 12]

A client getting cancer medicine (chemo).

A client who just had heart bypass surgery.

A client who had prostate surgery today.

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Q:13A client with heart failure suddenly has trouble breathing and lung ... [Show Full Question 13]

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Perform a heart rhythm test (ECG).

Give the client a water pill (Lasix).

Check the client's weight for the day.

Q:14A client is acting very angry and aggressive. What is the best ... [Show Full Question 14]

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Stand right in front of the client to block them.

Touch the client firmly on the shoulder.

Ask the client many "Why" questions.

Q:15A home health nurse is deciding which client ... [Show Full Question 15]

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A client with a broken leg in a long cast.

A client who had their voice box removed.

A client with sores on their foot from diabetes.

Q:16A baby is under blue lights for yellow skin (jaundice). What helps ... [Show Full Question 16]

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Keeping the baby's temperature at 98.6 degrees.

Touching the baby as little as possible.

Giving the baby fewer calories to eat.

Q:17A patient on a breathing machine is an organ donor. What ... [Show Full Question 17]

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Keep the urine output very high.

Keep the body temperature very high.

Keep the blood count low.

Q:18Which action shows a new nurse needs more training ... [Show Full Question 18]

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The nurse puts an oxygen clip on the ear.

The nurse raises the bed to check blood pressure.

The nurse holds a finger down to get a blood sample.

Q:19A nurse is teaching a client about a breast X-ray (mammogram). ... [Show Full Question 19]

Do not eat fat for a week before the test.

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This test means you do not have to check your own breasts.

This test uses more radiation than a chest X-ray.

Q:20A client just had stomach surgery. Who is ... [Show Full Question 20]

A client with a bowel disease (Crohn's).

A client with a lung infection (pneumonia).

A client with a stomach infection (gastritis).

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Test 04 Study Summary

1. Electrolyte Imbalance High sodium levels (hypernatremia) typically cause confusion or restlessness. Low potassium often results from using too many laxatives.

2. Post-Surgical Skin Care Montgomery straps are used for frequent dressing changes. They stay on the skin so the nurse does not have to pull off tape every time.

3. Psychosocial Care Grieving is abnormal if the person shows no sadness at all. To calm an angry patient, stay calm and keep your arms uncrossed to look non-threatening.

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