NCLEX PN Questions 31-40

The content of the NCLEX PN Questions will test your knowledge to meet the client needs.

31. The registered nurse is conducting an in-service for colleagues about peptic ulcers. The nurse would be correct in identifying which of the following as a causative factor?

A. N. gonorrhea
B. H. influenza
C. H. pylori
D. E. coli .

32. The nurse is caring for the patient’s post-surgical removal of a 6mm oral cancerous lesion. The priority nursing measure would be to:
A. Maintain a patent airway
B. Perform meticulous oral care every 2 hours
C. Ensure that the incisional area is kept as dry as possible
D. Assess the client frequently for pain using the visual analogue scale

33. NCLEX PN Questions about the nurse who is assisting in the care of a patient with diverticulosis. Which of the following assessment findings would necessitate a report to the doctor?

A. Bowel sounds of 5–20 seconds
B. Intermittent left lower-quadrant pain
C. Constipation alternating with diarrhea
D. Hemoglobin 26% and hematocrit 32

34. The nurse is assessing the client admitted for possible oral cancer. The nurse identifies which of the following as a late-occurring symptom of oral cancer?

A. Warmth
B. Odor
C. Pain
D. Ulcer with flat edges

35. An obstetrical client decides to have an epidural anesthetic to relieve pain during labor. Following administration of the anesthesia, the nurse should:

A. Monitor the client for seizures
B. Monitor the client for orthostatic hypotension
C. Monitor the client for respiratory depression
D. Monitor the client for hematuria

36. NCLEX PN Questions about the who nurse is performing an assessment of an elderly client with a total hip repair. Based on this assessment, the nurse decides to medicate the client with an analgesic. Which finding most likely prompted the nurse to decide to administer the analgesic?

A. The client’s blood pressure is 130/ 86.
B. The client is unable to concentrate.
C. The client’s pupils are dilated.
D. The client grimaces during care.

37. A client who has chosen to breastfeed complains to the nurse that her nipples became very sore while she was breastfeeding her older child. Which measure will help her to avoid soreness of the nipples?

A. Feeding the baby during the first 48 hours after delivery
B. Breaking suction by placing a finger between the baby’s mouth and the breast when she terminates the feeding
C. Applying warm, moist soaks to the breast several times per day
D. Wearing a support bra

38. The nurse asked the client if he has an advance directive. The reason for asking the client this question is:

A. She is curious about his plans regarding funeral arrangements.
B. Much confusion can occur with the client’s family if he does not have an advanced directive.
C. An advanced directive allows the medical personnel to make all decisions for the client.
D. An advanced directive allows active euthanasia.

39. The doctor has ordered a Transcutaneous Electrical Nerve Stimulation (TENS) unit for the client with chronic back pain. The nurse teaching the client with a TENS unit should tell the client:

A. “You may be electrocuted if you use water with this unit.”
B. “Please report skin irritation to the doctor.”
C. “The unit may be used anywhere on the body without fear of adverse reactions.”
D. “A cream should be applied to the skin before applying the unit.”

40. The doctor has ordered a patient-controlled analgesia (PCA) pump for the client with chronic pain. The client asks the nurse if he can become overdosed with pain medication using this machine. The nurse demonstrates understanding of the PCA if she states:

A. “The machine will administer only the amount that you need to control your pain without your taking any action.”
B. “The machine has a locking device that prevents overdosing to occur.”
C. “The machine will administer one large dose every 4 hours to relieve your pain.”
D. “The machine is set to deliver medication only if you need it.”



Answers and Rationale for
NCLEX PN Questions

31) C
- H. pylori bacteria has been linked to peptic ulcer. Answers A, B, and D are not typically cultured within the stomach, duodenum, or esophagus, and are not related to the development of peptic ulcers.

32) A
- NCLEX PN Questions Rationale:  Maintaining a patient’s airway is paramount in the post-operative period. This is the priority of nursing care. Answers B, C, and D are applicable but are not the priority. The nurse should instruct the client to perform mouth care using a soft sponge toothette or irrigate the mouth with normal saline. The incision should be kept as dry as possible, and pain should be treated. Pain medications should be administered PRN.

33) D
- Low hemoglobin and hematocrit might indicate intestinal bleeding. Answers A, B, and C are normal lab values.

34) C
- Pain is a late sign of oral cancer. Answers A, B, and D are incorrect because a feeling of warmth, odor, and a flat ulcer in the mouth are all early occurrences of oral cancer.

35) C
- NCLEX PN Questions Rationale: Epidural anesthesia involves injecting an anesthetic into the epidural space. If the anesthetic rises above the respiratory center, the client will have impaired breathing; thus, monitoring for respiratory depression is necessary. Answer A, seizure activity, is not likely after an epidural. Answer B, orthostatic hypotension, occurs when the client stands up but is not a monitoring action. The client with an epidural anesthesia must remain flat on her back and should not stand up for 24 hours. Answer D, hematuria, is not related to epidural anesthesia.

36) D
- Facial grimace is an indication of pain. The blood pressure in answer A is within normal limits. The client’s inability to concentrate, along with dilated pupils, as stated in answers B and C, may be related to the anesthesia that he received during surgery.

37) B
- To decrease the potential for soreness of the nipples, the client should be taught to break the suction before removing the baby from the breast. Answer A is incorrect because feeding the baby during the first 48 hours after delivery will provide colostrum but will not help the soreness of the nipples. Answers C and D are incorrect because applying warm, moist soaks and wearing a support bra will help with engorgement but will not help the nipples.

38) B
- NCLEX PN Questions Rationale: An advanced directive allows the client to make known his wishes regarding care if he becomes unable to act on his own. Much confusion regarding life-saving measures can occur if the client does not have an advanced directive. Answers A, C, and D are incorrect because the nurse doesn’t need to know about funeral plans and cannot make decisions for the client, and active euthanasia is illegal in most states in the United States.

39) B
- Skin irritation can occur if the TENS unit is used for prolonged periods of time. To prevent skin irritations, the client should change the location of the electrodes often. Electrocution is not a risk because it uses a battery pack; thus, answer A is incorrect. Answer C is incorrect because the unit should not be used on sensitive areas of the body. Answer D is incorrect because no creams are to be used with the device.

40) B
- The client is concerned about overdosing himself. The machine will deliver a set amount as ordered and allow the client to self-administer a small amount of medication. PCA pumps usually are set to lock out the amount of medication that the client can give himself at 5-to 15-minute intervals. Answer A does not address the client’s concerns, answer C is incorrect, and answer D does not address the client’s concerns.


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NCLEX PN Questions  41-50


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NCLEX PN Questions 1-10

NCLEX PN Questions 21-30

To become an LPN/LVN, passing the NCLEX PN Questions is important. Without passing the test, one can't even start their nursing career

 21. A 60-year-old diabetic is taking glyburide (Diabeta) 1.25mg daily to treat Type II diabetes mellitus. Which statement indicates the need for further teaching?

A. “I will keep candy with me just in case my blood sugar drops.”
B. “I need to stay out of the sun as much as possible.”
C. “I often skip dinner because I don’t feel hungry.”
D. “I always wear my medical identification.”

22. The physician prescribes regular insulin, 5 units subcutaneous. Regular insulin begins to exert an effect:

A. In 5–10 minutes
B. In 10–20 minutes
C. In 30–60 minutes
D. In 60–120 minutes

23. The client is admitted from the emergency room with multiple injuries sustained from an auto accident. His doctor prescribes a histamine blocker. The reason for this order is:

A. To treat general discomfort
B. To correct electrolyte imbalances
C. To prevent stress ulcers
D. To treat nausea

24. NCLEX PN Questions about the client with a recent liver transplant who asks the nurse how long he will have to take cyclosporine (Sandimmune). Which response is correct?

A. 1 year
B. 5 years
C. 10 years
D. The rest of his life

25. Shortly after the client was admitted to the postpartum unit, the nurse notes heavy lochia rubra with large clots. The nurse should anticipate an order for:

A. Methergine
B. Stadol
C. Magnesium sulfate
D. Phenergan

26. The client is scheduled to have an intravenous cholangiogram. Before the procedure, the nurse should assess the patient for:

A. Shellfish allergies
B. Reactions to blood transfusions
C. Gallbladder disease
D. Egg allergies

27. A new diabetic is learning to administer his insulin. He receives 10U of NPH and 12U of regular insulin each morning. Which of the following statements reflects understanding of the nurse’s teaching?

A. “When drawing up my insulin, I should draw up the regular insulin first.”
B. “When drawing up my insulin, I should draw up the NPH insulin first.”
C. “It doesn’t matter which insulin I draw up first.”
D. “I cannot mix the insulin, so I will need two shots.”

28. A client with osteomylitis has an order for a trough level to be done because he is taking Gentamycin. When should the nurse call the lab to obtain the trough level?

A. Before the first dose
B. 30 minutes before the fourth dose
C. 30 minutes after the first dose
D. 30 minutes after the fourth dose

29. A 4-year-old with cystic fibrosis has a prescription for Viokase pancreatic enzymes to prevent malabsorption. The correct time to give pancreatic enzyme is:

A. 1 hour before meals
B. 2 hours after meals
C. With each meal and snack
D. On an empty stomach

30. Isoniazid (INH) has been prescribed for a family member exposed to tuberculosis. The nurse is aware that the length of time that the medication will be taken is:

A. 6 months
B. 3 months
C. 18 months
D. 24 months





Answers to NCLEX PN Questions

21) C 
- The client should be taught to eat his meals even if he is not hungry, to prevent a hypoglycemic reaction. Answers A, B, and D are incorrect because they indicate an understanding of the nurse’s teaching.

22) C
- The time of onset for regular insulin is 30–60 minutes; therefore, answers A, B, and D are incorrect.

23) C
- Histamine blockers are frequently ordered for clients who are hospitalized for prolonged periods and who are in a stressful situation. They are not used to treat discomfort, correct electrolytes, or treat nausea; therefore, answers A, B, and D are incorrect.

24) D
- Cyclosporin is an immunosuppressant, and the client with a liver transplant will be on immunosuppressants for the rest of his life. Answers A, B, and C, therefore, are incorrect.

25) A
- NCLEX PN Questions Rationale: Methergine is a drug that causes uterine contractions. It is used for postpartal bleeding that is not controlled by Pitocin. Answers B, C, and D are incorrect: Stadol is an analgesic; magnesium sulfate is used for preeclampsia; and phenergan is an antiemetic.

26) A
- Clients having dye procedures should be assessed for allergies to iodine or shellfish. Answers B and D are incorrect because there is no need for the client to be assessed for reactions to blood or eggs. Because an IV cholangiogram is done to detect gallbladder disease, there is no need to ask about answer C.

27) A
- Regular insulin should be drawn up before the NPH. They can be given together, so there is no need for two injections, making answer D incorrect. Answer B is obviously incorrect, and answer C is incorrect because it does matter which is drawn first: Contamination of NPH into regular insulin will result in a hypoglycemic reaction at unexpected times.

28) B
Trough levels are the lowest blood levels and should be done 30 minutes before the third IV dose or 30 minutes before the fourth IM dose. Answers A, C, and D are incorrect.

29) C
Viokase is a pancreatic enzyme that is used to facilitate digestion. It should be given with meals and snacks, and it works well in foods such as applesauce. Answers A, B, and D are incorrect times to administer this medication.

30) A
- The expected time for contact to tuberculosis is 1 year. Therefore, answers B, C, and D are incorrect.


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NCLEX PN Questions  31-40


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NCLEX PN Questions 1-10

2018 NCLEX PN Practice Questions 11-20

Check out our premium quality NCLEX PN Practice Questions to take your studying to the next level. 

11. The nurse is making assignments for the day. Which client should be assigned to the nursing assistant?

A. A client with Alzheimer’s disease
B. A client with pneumonia
C. A client with appendicitis
D. A client with thrombophebitis

12. A client with cancer develops xerostomia. The nurse can help alleviate the discomfort associated with xerostomia by:

A. Offering hard candy
B. Administering analgesic medications
C. Splinting swollen joints
D. Providing saliva substitute

13. NCLEX PN Practice Questions about a home health nurse who is making preparations for morning visits. Which one of the following clients should the nurse visit first?


A. A client with brain attack (stroke) with tube feedings
B. A client with congestive heart failure complaining of nighttime dyspnea
C. A client with a thoracotomy 6 months ago
D. A client with Parkinson’s disease

14. A client with glomerulonephritis is placed on a low-sodium diet. Which of the following snacks is suitable for the client with sodium restriction?

A. Peanut butter cookies
B. Grilled cheese sandwich
C. Cottage cheese and fruit
D. Fresh peach

15. Due to a high census, it has been necessary for a number of clients to be transferred to other units within the hospital. Which client should be transferred to the postpartum unit?


A. A 66-year-old female with a gastroenteritis
B. A 40-year-old female with a hysterectomy
C. A 27-year-old male with severe depression
D. A 28-year-old male with ulcerative colitis

16. During the change of shift, the oncoming nurse notes a discrepancy in the number of Percocet (Oxycodone) listed and the number present in the narcotic drawer. The nurse’s first action should be to:

A. Notify the hospital pharmacist
B. Notify the nursing supervisor
C. Notify the Board of Nursing
D. Notify the director of nursing

17. NCLEX PN Practice Questions about the nurse who is assigning staff for the day. Which assignment should be given to the nursing assistant?

A. Taking the vital signs of the 5-month-old with bronchiolitis
B. Taking the vital signs of the 10-year-old with a 2-day post-appendectomy
C. Administering medication to the 2-year-old with periorbital cellulites
D. Adjusting the traction of the 1-year-old with a fractured tibia

18. A new nursing graduate indicates in charting entries that he is a licensed practical nurse, although he has not yet received the results of the licensing exam. The graduate’s action can result in what type of charge:

A. Fraud
B. Tort
C. Malpractice
D. Negligence

19. A client with acute leukemia develops a low white blood cell count. In addition to the institution of isolation, the nurse should:

A. Request that foods be served with disposable utensils
B. Ask the client to wear a mask when visitors are present
C. Prep IV sites with mild soap and water and alcohol
D. Provide foods in sealed single-serving packages

20. A 70-year-old male who is recovering from a strike exhibits signs of unilateral neglect. Which behavior is suggestive of unilateral neglect?

A. The client is observed shaving only one side of his face.
B. The client is unable to distinguish between two tactile stimuli presented simultaneously.
C. The client is unable to complete a range of vision without turning his head side to side.
D. The client is unable to carry out cognitive and motor activity at the same time.




Answers to NCLEX PN Practice Questions

11) A
- The client with Alzheimer’s disease is the most stable of these clients and can be assigned to the nursing assistant, who can perform duties such as feeding and assisting the client with activities of daily living. The clients in answers B, C, and D are less stable and should be attended by a registered nurse.

12) D
- Xerostomia is dry mouth, and offering the client a saliva substitute will help the most. Eating hard candy in answer A can further irritate the mucosa and cut the tongue and lips. Administering an analgesic might not be necessary; thus, answer B is incorrect. Splinting swollen joints, in answer C, is not associated with xerostomia.

13) B
- NCLEX PN Practice Questions Rationale: The client with congestive heart failure who is complaining of nighttime dyspnea should be seen first because airway is number one in nursing care. In answers A, C, and D, the clients are more stable.

14) D
- The fresh peach is the lowest in sodium of these choices. Answers A, B, and C have much higher amounts of sodium.

15) B
- The best client to transport to the postpartum unit is the 40-year-old female with a hysterectomy. The nurses on the postpartum unit will be aware of normal amounts of bleeding and will be equipped to care for this client. The clients in answers A and D will be best cared for on a medical-surgical unit. The client with depression in answer C should be transported to the psychiatric unit.

16) B
- The first action the nurse should take is to report the finding to the nurse supervisor and follow the chain of command. If it is found that the pharmacy is in error, it should be notified, as stated in answer A. Answers C and D, notifying the director of nursing and the Board of Nursing, might be necessary if theft is found, but not as a first step; thus, these are incorrect answers.

17) B
- NCLEX PN Practice Questions Rationale: The client with the appendectomy is the most stable of these clients and can be assigned to a nursing assistant. The client with bronchiolitis has an alteration in the airway, the client with periorbital cellulitis has an infection, and the client with a fracture might be an abused child. Therefore, answers A, C, and D are incorrect.

18) A
- Identifying oneself as a nurse without a license defrauds the public and can be prosecuted. A tort is a wrongful act; malpractice is failing to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to perform care. Therefore, answers B, C, and D are incorrect.

19) D
- Because the client is immune-suppressed, foods should be served in sealed containers, to avoid food contaminants. Answer B is incorrect because of possible infection from visitors. Answer A is not necessary, but the utensils should be cleaned thoroughly and rinsed in hot water. Answer C might be a good idea, but alcohol can be drying and can cause the skin to break down.

20) A
- The client with unilateral neglect will neglect one side of the body. Answers B, C, and D are not associated with unilateral neglect.


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 NCLEX PN Practice Questions  21-30


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NCLEX PN Practice Questions 1-10

2018 NCLEX PN Practice Questions 1-10

We recommend you to try and answer all NCLEX PN Practice Questions  below to be well-equipped for the exam.

1. A home health nurse is planning for her daily visits. Which client should the home health nurse visit first?

A. A client with AIDS being treated with Foscarnet
B. A client with a fractured femur in a long leg cast
C. A client with laryngeal cancer with a laryngetomy
D. A client with diabetic ulcers to the left foot

2. The nurse is assigned to care for an infant with physiologic jaundice. Which action by the nurse would facilitate elimination of the bilirubin?

A. Increasing the infant’s fluid intake
B. Maintaining the infant’s body temperature at 98.6 ° F
C. Minimizing tactile stimulation
D. Decreasing caloric intake

3. The graduate licensed practical nurse is assigned to care for the client on ventilator support, pending organ donation. Which goal should receive priority?

A. Maintain the client’s systolic blood pressure at 70mmHg or greater
B. Maintain the client’s urinary output greater than 300cc per hour
C. Maintain the client’s body temperature of greater than 33 ° F rectal
D. Maintain the client’s hematocrit less than 30%

4.  NCLEX PN Practice Questions: Which action by the novice nurse indicates a need for further teaching?

A. The nurse fails to wear gloves to remove a dressing.
B. The nurse applies an oxygen saturation monitor to the ear lobe.
C. The nurse elevates the head of the bed to check the blood pressure.
D. The nurse places the extremity in a dependent position to acquire a peripheral blood sample.

5. The nurse is preparing a client for mammography. To prepare the client for a mammogram, the nurse should tell the client:

A. To restrict her fat intake for 1 week before the test
B. To omit creams, powders, or deodorants before the exam
C. That mammography replaces the need for self-breast exams
D. That mammography requires a higher dose of radiation than an x-ray

6. Which of the following roommates would be best for the client newly admitted with gastric resection?

A. A client with Crohn’s disease
B. A client with pneumonia
C. A client with gastritis
D. A client with phlebitis

7. The licensed practical nurse is working with a registered nurse and a patient care assistant. Which of the following clients should be cared for by the registered nurse?

A. A client 2 days post-appendectomy
B. A client 1 week post-thyroidectomy
C. A client 3 days post-splenectomy
D. A client 2 days post-thoracotomy

8. NCLEX PN Practice Questions about the licensed practical nurse who is observing a graduate nurse as she assesses the central venous pressure. Which observation would indicate that the graduate needs further teaching?

A. The graduate places the client in a supine position to read the manometer.
B. The graduate turns the stop-cock to the off position from the IV fluid to the client.
C. The graduate instructs the client to perform the Valsalva maneuver during the CVP reading.
D. The graduate notes the level at the top of the meniscus.

9. Which of the following roommates would be most suitable for the client with myasthenia gravis?

A. A client with hypothyroidism
B. A client with Crohn’s disease
C. A client with pylonephritis
D. A client with bronchitis

10. The nurse employed in the emergency room is responsible for triage of four clients injured in a motor vehicle accident. Which of the following clients should receive priority in care?

A. A 10-year-old with lacerations of the face
B. A 15-year-old with sternal bruises
C. A 34-year-old with a fractured femur
D. A 50-year-old with dislocation of the elbow



Answers to NCLEX PN Practice Questions

1) C
- The client with laryngeal cancer has a potential airway alteration and should be seen first. The clients in answers A, B, and D are not in immediate danger and can be seen later in the day.

2) A
- Bilirubin is excreted through the kidneys, thus the need for increased fluids. Maintaining the body temperature is important but will not assist in eliminating bilirubin; therefore, answer B is incorrect. Answers C and D are incorrect because they do not relate to the question.

3) A
-  NCLEX PN Practice Questions Rationale: When the cadaver client is being prepared to donate an organ, the systolic blood pressure should be maintained at 70mmHg or greater to ensure a blood supply to the donor organ. Answers B, C, and D are incorrect because they are unnecessary actions for organ donation.

4) A 
- The nurse who fails to wear gloves to remove a contaminated dressing needs further instruction. Answers B, C, and D are incorrect because they indicate an understanding of the correct method of completing these tasks.

5) B
- The client having a mammogram should be instructed to omit deodorants or powders beforehand because powders and deodorants can be interpreted as abnormal. Answer A is incorrect because there is no need for dietary restrictions before a mammogram. Answer C is incorrect because the mammogram does not replace the need for self-breast exams. Answer D is incorrect because a mammogram does not require higher doses of radiation than an x-ray.

6) D
-  NCLEX PN Practice Questions Rationale: The most suitable roommate for the client with gastric resection is the client with phlebitis because phlebitis is an inflammation of the blood vessel and is not infectious. Crohn’s disease clients, in answer A, have frequent stools that might spread infections to the surgical client. The client in answer B with pneumonia is coughing and will disturb the gastric client. The client with gastritis, in answer C, is vomiting and has diarrhea, which also will disturb the gastric client.

7) D
- The most critical client should be assigned to the registered nurse; in this case, that is the client 2 days post-thoracotomy. The clients in answers A and B are ready for discharge, and the client in answer C who had a splenectomy 3 days ago is stable enough to be assigned to an LPN.

8) C
- The client should breathe normally during a central venous pressure monitor reading. Answer A indicates understanding because the client should be placed supine if he can tolerate being in that position. Answers B and D indicate understanding because the stop-cock should be turned off to the IV fluid, and the reading should be done at the top of the meniscus.

9) A
-  NCLEX PN Practice Questions Rationale: The most suitable roommate for the client with myasthenia gravis is the client with hypothyroidism because he is quiet. The client with Crohn’s disease in answer B will be up to the bathroom frequently; the client with pylonephritis in answer C has a kidney infection and will be up to urinate frequently. The client in answer D with bronchitis will be coughing and will disturb any roommate.

10) B
- The teenager with sternal bruising might be experiencing airway and oxygenation problems and, thus, should be seen first. In answer A, the 10-year-old with lacerations might look bad but is not in distress. The client in answer C with a fractured femur should be immobilized but can be seen after the client with sternal bruising. The client in answer D with the dislocated elbow can be seen later as well.


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NCLEX PN Practice Questions 11-20

Musculoskeletal NCLEX Questions 1-9

This 10-item Musculoskeletal NCLEX Questions will help  broaden your knowledge about the actual exam.

1. The nurse has given a client instructions about crutch safety. Which client statement indicates that the client understands the instructions? Select all that apply.

a) ”I should not use someone else’s crutches.”
b) “I need to remove any scatter rugs at home.”
c) “I can use crutch tips even when they are wet.”
d) “I need to have spare crutches and tips available.”
e) “When I’m using the crutches my arms need to be completely straight.”

2. Musculoskeletal NCLEX Questions about the nurse who is caring for a client being treated for fat embolus after multiple fractures. Which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus?

a) Clear mentation
b) Minimal dyspnea
c) Oxygen saturation of 85%
d) Arterial oxygen level of 78 mm Hg

3. The nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. The nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome?

a) Cold, bluish-colored fingers
b) Numbness and tingling in the fingers
c) Pain that increases when the arm is dependent
d) Pain that is out of proportion to the severity of the fracture

4. Musculoskeletal NCLEX Questions about a client with diabetes mellitus who has had a right below-knee amputation. Given the client’s history of diabetes mellitus, which should the nurse specifically observe in the postoperative period?

 a) Hemorrhage
b) Edema of the residual limb
c) Slight redness of the incision
d) Separation of the wound edges

5. The nurse is caring for a client who had an above-knee amputation 2 days ago. The residual limb was wrapped with an elastic compression bandage, which has come off. Which immediate action should the nurse take?

a) Apply ice to the site.
b) Call the health care provider (HCP).
c) Apply a dry sterile dressing and elevate it on one pillow.
d) Rewrap the residual limb with an elastic compression bandage.

6. Musculoskeletal NCLEX Questions about a client who is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor?

 a) Bed rest
b) Bending or lifting
c) Application of heat
d) Ibuprofen (Motrin IB)

7. The nurse is caring for a client who has had spinal fusion, with insertion of hardware. The nurse would be most concerned with which assessment finding?

a) Temperature of 101.6 ° F orally
b) Complaints of discomfort during repositioning
c) Old bloody drainage outlined on the surgical dressing
d) Discomfort during coughing and deep-breathing exercises

8. Musculoskeletal NCLEX Questions about the nurse who is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client?

 a) Calcium level of 9.0 mg/ dL
b) Uric acid level of 8.6 mg/ dL
c) Potassium level of 4.1 mEq/ L
d) Phosphorus level of 3.1 mg/ dL

9. A client with a hip fracture asks the nurse why Buck’s (extension) traction is being applied before surgery. The nurse provides a response based on which purpose of Buck’s (extension) traction?

a) Allows bony healing to begin before surgery
b) Provides rigid immobilization of the fracture site
c) Lengthens the fractured leg to prevent severing of blood vessels
d) Provides comfort by reducing muscle spasms and provides fracture immobilization


Musculoskeletal NCLEX Questions
Answers and Rationale

1) A, B, D
- Rationale: The client should use only crutches measured for the client. When assessing for home safety, make sure the client knows to remove any scatter rugs and does not walk on highly waxed floors. The tips should be inspected for wear, and spare crutches and tips should be available if needed. Crutch tips should remain dry. If crutch tips get wet, the client should dry them with a cloth or paper towel. When walking with crutches, both elbows need to be flexed not more than 30 degrees when the palms are on the handle.

- Test-Taking Strategy: Focus on the subject, client understanding of instructions of using crutches. Read each option and think about the safety associated with each instruction. This will assist in answering correctly.

2) A
- Musculoskeletal NCLEX Questions Rationale: An altered mental state is an early indication of fat emboli; therefore, clear mentation is a good indicator that a fat embolus is resolving. Eupnea, not minimal dyspnea, is a normal sign. Arterial oxygen levels should be 80 to 100 mm Hg. Oxygen saturation should be higher than 95%.

 - Test-Taking Strategy: Note the strategic word most. Knowing that the arterial oxygen and oxygen saturation levels are below normal helps eliminate options C and D. Dyspnea, even at a minimal level, is not normal, so eliminate option B.

3) B
- Rationale: The earliest symptom of compartment syndrome is paresthesia (numbness and tingling in the fingers). Other symptoms include pain unrelieved by opioids, pain that increases with limb elevation, and pallor and coolness to the distal limb. Cyanosis is a late sign. Pain that is out of proportion to the severity of the fracture, along with other symptoms associated with the pain, is not an early manifestation.

- Test-Taking Strategy: Note the strategic word early. Knowing that compartment syndrome is characterized by insufficient circulation and ischemia caused by pressure will direct you to the correct option.

4) D
- Rationale: Clients with diabetes mellitus are more prone to wound infection and delayed wound healing because of the disease. Postoperative edema of the residual limb and hemorrhage are complications in the immediate postoperative period that apply to any client with an amputation. Slight redness of the incision is considered normal, as long as it is dry and intact.

- Test-Taking Strategy: Focus on the subject, the client with diabetes mellitus. Recalling that diabetes mellitus increases the client’s chances of developing infection and delayed wound healing will direct you to the correct option.

5) D
- Musculoskeletal NCLEX Questions Rationale: If the client with an amputation has a cast or elastic compression bandage that slips off, the nurse must wrap the residual limb immediately with another elastic compression bandage. Otherwise, excessive edema will form rapidly, which could cause a significant delay in rehabilitation. If the client had a cast that slipped off, the nurse would have to call the HCP so that a new one could be applied. Elevation on one pillow is not going to impede the development of edema greatly once compression is released. Ice would be of limited value in controlling edema from this cause. If the HCP were called, the prescription likely would be to reapply the compression dressing anyway.

- Test-Taking Strategy: Note the strategic word immediate and focus on the data in the question. Recalling that excessive edema can form rapidly in the residual limb will direct you to the correct option.

6) B
- Rationale: Low back pain that radiates into one leg (sciatica) is consistent with herniated lumbar disk. The nurse assesses the client to see whether the pain is aggravated by events that increase intraspinal pressure, such as bending, lifting, sneezing, and coughing, or by lifting the leg straight up while supine (straight leg-raising test). Bed rest, heat (or sometimes ice), and nonsteroidal antiinflammatory drugs usually relieve back pain.

- Musculoskeletal NCLEX Questions Test-Taking Strategy: Focus on the subject, factors that aggravate back pain. Recall that bed rest, heat (or sometimes ice), and nonsteroidal anti-inflammatory drugs usually relieve back pain, whereas bending, lifting, and straining aggravate it.

7) A
- Rationale: The nursing assessment conducted after spinal surgery is similar to that done after other surgical procedures. For this specific type of surgery, the nurse assesses the neurovascular status of the lower extremities, watches for signs and symptoms of infection, and inspects the surgical site for evidence of cerebrospinal fluid leakage (drainage is clear and tests positive for glucose). A mild temperature is expected after insertion of hardware, but a temperature of 101.6 ° F should be reported.

- Test-Taking Strategy: Note the strategic word most. Thus, you are looking for the option that has the greatest deviation from normal. Options B and D are expected after surgery and, although the nurse tries to minimize discomfort, the client is likely to have some discomfort, even with proper analgesic use. The words old and outlined in option C indicate that this is not a new occurrence. This leaves the temperature of 101.6 ° F, which is excessive and should be reported.

8) B
- Rationale: In addition to the presence of clinical manifestations, gout is diagnosed by the presence of persistent hyperuricemia, with a uric acid level higher than 8 mg/ dL; a normal value ranges from 2.5 to 8 mg/ dL. Options A, C, and D indicate normal laboratory values. In addition, the presence of uric acid in an aspirated sample of synovial fluid confirms the diagnosis.

- Musculoskeletal NCLEX QuestionsTest-Taking Strategy: Focus on the subject, manifestation of gout. Use knowledge of normal laboratory values. Recalling that increased uric acid levels occur in gout and noting that the correct option has the only abnormal value will assist you in answering the question.

9) D
- Rationale: Buck’s (extension) traction is a type of skin traction often applied after hip fracture before the fracture is reduced in surgery. Traction reduces muscle spasms and helps immobilize the fracture. Traction does not allow for bony healing to begin or provide rigid immobilization. Traction does not lengthen the leg for the purpose of preventing blood vessel severance.

- Test-Taking Strategy: Focus on the subject, use of traction following a hip fracture. Read each option carefully. Noting the words provides comfort and fracture immobilization will direct you to the correct option.


After you reviewed your answers through its rationale, you can go to the next page to continue your review: 

Musculoskeletal NCLEX Questions 11-20