Free NCLEX RN Practice Questions With Rationale

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NCLEX Free Questions 2018

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Q:1-A nurse is evaluating a postoperative patient and notes a moderate amount of serous drainage on the dressing 24 hours after surgery. Which of the following is the appropriate nursing action?
Mark one answer:

Notify the surgeon about evidence of infection immediately.
Leave the dressing intact to avoid disturbing the wound site.
Remove the dressing and leave the wound site open to air.
Change the dressing and document the clean appearance of the wound site.

Q:2-A patient returns to the emergency department less than 24 hours after having a fiberglass cast applied for a fractured right radius. Which of the following patient complaints would cause the nurse to be concerned about impaired perfusion to the limb?
Mark one answer:

Severe itching under the cast.
Severe pain in the right shoulder.
Severe pain in the right lower arm.
Increased warmth in the fingers.

Q:3-An older patient with osteoarthritis is preparing for discharge. Which of the following information is correct.
Mark one answer:

Increased physical activity and daily exercise will help decrease discomfort associated with the condition.
Joint pain will diminish after a full night of rest.
Nonsteroidal anti-inflammatory medications should be taken on an empty stomach.
Acetaminophen (Tylenol) is a more effective anti-inflammatory than ibuprofen (Motrin).

Q:4-Which patient should NOT be prescribed alendronate (Fosamax) for osteoporosis?
Mark one answer:

A female patient being treated for high blood pressure with an ACE inhibitor.
A patient who is allergic to iodine/shellfish.
A patient on a calorie restricted diet.
A patient on bed rest who must maintain a supine position.

Q:5-Which of the following strategies is NOT effective for prevention of Lyme disease?
Mark one answer:

Insect repellant on the skin and clothes when in a Lyme endemic area.
Long sleeved shirts and long pants.
Prophylactic antibiotic therapy prior to anticipated exposure to ticks.
Careful examination of skin and hair for ticks following anticipated exposure.

Q:6-A nurse is performing routine assessment of an IV site in a patient receiving both IV fluids and medications through the line. Which of the following would indicate the need for discontinuation of the IV line as the next nursing action?
Mark one answer:

The patient complains of pain on movement.
The area proximal to the insertion site is reddened, warm, and painful.
The IV solution is infusing too slowly, particularly when the limb is elevated.
A hematoma is visible in the area of the IV insertion site.

Q:7-A hospitalized patient has received transfusions of 2 units of blood over the past few hours. A nurse enters the room to find the patient sitting up in bed, dyspneic and uncomfortable. On assessment, crackles are heard in the bases of both lungs, probably indicating that the patient is experiencing a complication of transfusion. Which of the following complications is most likely the cause of the patient’s symptoms?
Mark one answer:

Febrile non-hemolytic reaction.
Allergic transfusion reaction.
Acute hemolytic reaction.
Fluid overload.

Q:8-A patient in labor and delivery has just received an amniotomy. Which of the following is not correct?
Mark one answer:

Frequent checks for cervical dilation will be needed after the procedure.
Contractions may rapidly become stronger and closer together after the procedure.
The FHR (fetal heart rate) will be followed closely after the procedure due to the possibility of cord compression.
The procedure is usually painless and is followed by a gush of amniotic fluid.

Q:9-A nurse is counseling the mother of a newborn infant with hyperbilirubinemia. Which of the following instructions by the nurse is NOT correct?
Mark one answer:

Continue to breastfeed frequently, at least every 2-4 hours.
Follow up with the infant’s physician within 72 hours of discharge for a recheck of the serum bilirubin and exam.
Watch for signs of dehydration, including decreased urinary output and changes in skin turgor.
Keep the baby quiet and swaddled, and place the bassinet in a dimly lit area.

Q:10-A nurse is giving discharge instructions to the parents of a healthy newborn. Which of the following instructions should the nurse provide regarding car safety and the trip home from the hospital?
Mark one answer:

The infant should be restrained in an infant car seat, properly secured in the back seat in a rear-facing position.
The infant should be restrained in an infant car seat, properly secured in the front passenger seat.
The infant should be restrained in an infant car seat facing forward or rearward in the back seat.
For the trip home from the hospital, the parent may sit in the back seat and hold the newborn.

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