NCLEX-RN — Practice Questions, Part 1 flashcards
6 of 75 questions free to study here · 24 topics · the whole deck is built into Willys
Multiple-choice practice questions, one best answer each, on fluids and electrolytes, lab values and ABGs, MI, heart failure, dysrhythmias, shock, COPD, asthma and chest tubes.
Practice deck · part of NCLEX-RN · written against: NCSBN 2026 NCLEX-RN Test Plan, in effect from 1 April 2026 (Next Generation NCLEX; client-needs categories and percentages unchanged from 2023, fact-checked 2026-10-11). Updated 2026-10-10.
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An older adult client is admitted after three days of vomiting and is receiving IV fluids. Which measure gives the nurse the most reliable picture of the client's fluid balance from day to day?
A) The client's own report of how thirsty they feel
B) Daily weight at the same time on the same scale
C) Moisture of the oral mucous membranes each shift
D) Skin turgor checked over the back of the handB) Daily weight at the same time on the same scaleFluid Balance
Weight change is the most reliable gauge of fluid gain or loss, since 1 kg is about 1 liter of fluid. Skin turgor is unreliable in older adults, and aging blunts the thirst response, so neither can be trusted on its own. -
A client who had a total thyroidectomy this morning reports tingling around the mouth and in the fingertips. Which medication should the nurse make sure is available at the bedside?
A) IV magnesium sulfate
B) IV potassium chloride
C) IV calcium gluconate
D) Oral sodium bicarbonateC) IV calcium gluconateElectrolytes
Tingling after thyroid surgery suggests hypocalcemia from parathyroid injury, which can progress to laryngospasm and seizures, so calcium gluconate and emergency airway equipment belong at the bedside. Magnesium sulfate would not correct the calcium deficit. -
A client walking in the hallway of a medical unit stops and reports sudden pressure in the chest. Which action should the nurse take first?
A) Help the client sit down and rest
B) Go to the medication room for nitroglycerin
C) Call the provider for a cardiology consult
D) Send a troponin level to the laboratoryA) Help the client sit down and restAngina & MI
Stopping the activity lowers the heart's oxygen demand and comes first, followed by vital signs, a 12-lead ECG within 10 minutes, and the ordered nitroglycerin and aspirin. The nurse stays with the client rather than leaving to gather supplies. -
Two days after a large MI, a client has a blood pressure of 82/50, cool clammy skin, crackles in both lungs and distended neck veins. Which type of shock is most likely?
A) Hypovolemic shock
B) Septic shock
C) Cardiogenic shock
D) Neurogenic shockC) Cardiogenic shockShock
Cardiogenic shock is pump failure, so poor perfusion comes with fluid backing up: crackles, neck-vein distention and a high central venous pressure. Hypovolemic shock also causes cool, clammy hypotension, but the neck veins are flat. -
A client admitted with pneumonia has a sputum culture and the first IV antibiotic dose prescribed. Which action should the nurse take?
A) Give an antipyretic, then collect the specimen later
B) Hold the antibiotic until the culture results return
C) Give the antibiotic, then collect the sputum specimen
D) Collect the sputum specimen, then give the antibioticD) Collect the sputum specimen, then give the antibioticPneumonia
The culture comes first because an antibiotic given before the specimen can make it falsely negative, and the antibiotic then follows without delay. Waiting for culture results would postpone treatment for days. -
A post-operative client becomes newly restless and anxious and asks for something to calm down. Which action should the nurse take first?
A) Dim the lights and reduce stimulation
B) Apply soft wrist restraints for safety
C) Check the SpO2 and respiratory status
D) Give the prescribed PRN sedativeC) Check the SpO2 and respiratory statusHypoxia & Respiratory Assessment
Restlessness, anxiety and irritability are early signs of hypoxia, so oxygenation is checked before any sedative, which could depress breathing further. Cyanosis is a late sign and should not be waited for.
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About these cards
Review status: Second-reader reviewed, with corrections applied.
Checked against:
- Checked against Open RN Nursing Fundamentals, Health Alterations and Nursing Skills (Chippewa Valley Technical College, CC BY 4.0) and MedlinePlus (U.S. National Library of Medicine); reference only, no text copied.
- OpenStax Anatomy and Physiology 2e, consulted as a reference; no text copied.
- Resuscitation and reperfusion principles cross-checked against the 2025 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care (adult advanced life support) and the 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for acute coronary syndromes; tuberculosis principles against CDC tuberculosis guidance (public domain); peak flow zones against the NHLBI Expert Panel Report 3 asthma guidelines (public domain); reference only.
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