If you’re planning to pass the Next Generation NCLEX, then you might want to give this week’s episode of NCLEX Ready a listen!
The NCLEX can be a difficult exam even for the most brilliant nursing graduates, however, with these 10 difficult Next Generation NCLEX questions and answers, you’ll be ready for the big test in no time.
So, grab a pen and paper (or just your phone, whatever floats your boat), and answer these questions with me.
And remember, no cheating!
Are you ready to get the confidence boost you need to pass the NCLEX?
Then keep reading.
NCLEX Question #1:
Nurse Kayla is reviewing the laboratory results of a patient with cirrhosis. Which result indicates that the patient’s condition is worsening?
- Decreased serum ammonia
- Increased serum ammonia
- Decreased serum creatinine
- Increased serum creatinine
Answer: Increased serum ammonia.
Rationale: An increase in serum ammonia levels indicates that the patient diagnosed with cirrhosis is getting worse. Decreased serum creatinine should be eliminated because it indicates improvement with renal impairment. Increased serum creatinine is related to renal impairment.
NCLEX Question #2:
Nurse Logan is listening to a 50-year-old patient who stated “Will I add any value to the world?” According to Erikson’s stage of growth and development, the patient’s statement is associated with which of the following?
- Generativity vs. stagnation
- Initiative vs. guilt
- Autonomy vs. shame and doubt
- Trust vs. mistrust
Answer: Generativity vs. stagnation.
Rationale: Generativity is based on making a positive impact and giving back to the world. This can be through meaningful work or raising children. Stagnation is feeling a lack of purpose. The hint is also noted in the patient’s age. This stage usually affects those who are between 40 to 65 years old.
Trust vs. mistrust is normally seen in infants up to 18 months old. Autonomy vs. shame and doubt is the second stage, which we see up to 3 years old. Initiative vs. guilt is seen in those aged 3 to 5 years old.
NCLEX Question #3:
Nurse Ana is monitoring a patient who is using bronchodilators. Which of the following common side effects should nurse Ana observe for?
- Bradycardia
- Tinnitus
- Bradypnea
- Tachycardia
Answer: Tachycardia.
Rationale: Tachycardia is a common side effect of bronchodilators, so you can automatically eliminate bradycardia. Tinnitus and bradypnea are not common side effects of bronchodilators. Other side effects include headaches, nervous tension, muscle cramps, and trembling.
NCLEX Question #4:
Nurse Justin is providing care for a patient with end-stage renal disease who received a kidney transplant 4 days ago. Which of the following signs should Nurse Justin monitor as an early sign of transplant rejection?
- Redness at the incision site
- Increased urinary output
- Weight loss
- Decreased urinary output
Answer: Decreased urinary output.
Rationale: An early sign of transplant rejection is decreased urinary output, so you can eliminate Increased urinary output. Weight gain is usually expected, not weight loss. Redness at the incision site is normally several days after a surgical procedure, but infection signs at the incision site should be reported immediately.
NCLEX Question #5:
Which of the following findings is expected in a patient diagnosed with right-sided heart failure?
- S3 heart sound
- Lung crackles
- Dyspnea
- Peripheral edema
Answer: Peripheral edema.
Rationale: You need to know the difference between right-sided heart failure and left-sided heart failure. In right-sided heart failure, the right side of the heart is not pumping blood to the lungs efficiently. Signs and symptoms occur due to a backup of blood in the venous system. Peripheral edema occurs as a result of fluid buildup due to poor blood circulation.
With left-sided heart failure, the heart is unable to pump blood out to the systemic circulation efficiently, resulting in fluid buildup in the lungs. S3 heart crackles, lung crackles, and dyspnea are signs and symptoms of left-sided heart failure.
NCLEX Question #6:
Nurse Ana is providing education to a patient diagnosed with Raynaud’s disease. Which of the following statements indicates that the patient has an understanding of Raynaud’s disease?
- “I will avoid exposure to the cold air.”
- “I will avoid a high-potassium diet.”
- “I should remain on bed rest.”
- “I should use a cane for ambulatory support.”
Answer: “I will avoid exposure to the cold air.”
Rationale: Raynaud’s disease is a condition that affects the blood flow to parts of the body. It commonly affects the fingers and toes. The blood vessels constrict in response to stress, such as the cold, so a temporary decrease in blood flow occurs. The patient should be educated on avoiding exposure to a cold environment. Avoiding a high-potassium diet, remaining on bed rest, and using a cane will not affect the patient’s blood flow.
NCLEX Question #7:
Nurse Jackie is providing care for a child with a ventriculoperitoneal shunt. Which of the following signs and symptoms indicate that the ventriculoperitoneal shunt is failing?
- Abdominal distention
- Decreased blood pressure
- Increased urinary output
- Projectile vomiting
Answer: Projectile vomiting.
Rationale: Ventriculoperitoneal shunt is implanted to treat hydrocephalus. Excess cerebrospinal fluid is getting diverted from the brain’s ventricles to the peritoneal cavity. Projectile vomiting is a sign of increased intracranial pressure, which indicates failure of a ventriculoperitoneal shunt. Decreased blood pressure, abdominal distention, and increased urinary output would not indicate failure.
NCLEX Question #8:
Nurse Ben is providing education on insulin-dependent diabetes management. Which of the following statements indicates that the patient has an understanding of the signs and symptoms of hypoglycemia?
- “I should report if my blood glucose level falls below 130 mg/dL.”
- “Tremors and sweating are signs and symptoms of hypoglycemia.”
- “Diabetic ketoacidosis is a result of hypoglycemia.”
- “Early signs of hypoglycemia include increased thirst and fruity-smelling breath.”
Answer: “Tremors and sweating are signs and symptoms of hypoglycemia.”
Rationale: Hypoglycemia is a complication for people with diabetes, so the patient should be educated on what to look out for. Tremors and sweating are signs and symptoms of hypoglycemia. Hypoglycemia typically occurs when the blood glucose levels fall below 70 mg/dL so answer no. 1 can be eliminated. Diabetic ketoacidosis would be related to hyperglycemia, not hypoglycemia. Increased thirst is an early sign of hyperglycemia and fruity-smelling breath is a late sign of hyperglycemia so you can also eliminate answer no. 4.
NCLEX Question #9:
Nurse Gene is providing education to a nursing student on the difference between presumptive signs and probable signs of pregnancy. Which of the following is a probable sign of pregnancy?
- Hegar’s sign
- Amenorrhea
- Breast sensitivity
- Weight gain
Answer: Hegar’s sign.
Rationale: Hegar’s sign is a probable sign of pregnancy, which is the softening of the cervix. This may appear between weeks 6 and 12. Amenorrhea is the absence of menstruation, which is a presumptive sign. Breast sensitivity and weight gain are also presumptive signs of pregnancy. Presumptive signs of pregnancy are subjective signs of pregnancy. Probable signs are more conclusive, but still not entirely definite signs of pregnancy.
NCLEX Question #10:
Nurse Ferlina is providing care for a patient who states that she is pregnant. Which of the following are definitive and positive signs of pregnancy? Select all that applies.
- Fetal heart tones
- Leopold’s maneuver
- Ultrasound
- Amenorrhea
Answer: Fetal heart tones, Leopold’s maneuver, and ultrasound.
Rationale: Fetal heart tones can be detected as early as 5 to 6 weeks after conception through an ultrasound. Leopold’s maneuver is a way to determine the fetus’ position inside the uterus, which is a definitive and positive sign of pregnancy. Amenorrhea is the absence of menstruation, which is a presumptive sign of pregnancy, not a definitive one.
