NCLEX Preparation

NCLEX PREPARATION BY TOPIC

By Csilla Bonacci, RN

Hello, future nurses! My name is Csilla Bonacci, and I’m a registered nurse with a deep passion for both patient care and nursing education. Like you, I once faced the challenge of preparing for the NCLEX, navigating through endless study materials, practice questions, and test-taking strategies. I understand the stress, the self-doubt, and the long hours that come with preparing for this critical exam, but I also know what it takes to succeed.

My journey in nursing has given me firsthand experience in a variety of healthcare settings, from fast-paced hospital units to specialized care environments. Along the way, I’ve developed a love for mentoring and helping aspiring nurses not just pass the NCLEX, but truly understand the core concepts that will make them confident, competent professionals.

This book is designed to be more than just a review guide; it’s a roadmap to success. I’ve crafted it with practical insights, simplified explanations, and real-world applications to help you bridge the gap between theory and practice. Whether you’re a first-time test taker or retesting, my goal is to equip you with the knowledge, strategies, and confidence to pass the NCLEX and begin your career with a strong foundation. The book is organized with questions and answers and rationales by body systems.

You’ve made it this far, and I’m here to help you cross the finish line. Let’s get started!

THE NERVOUS SYSTEM

Here are five NCLEX-style questions about the nervous system:

1. A nurse is assessing a client with increased intracranial pressure (ICP). Which of the following findings should the nurse report immediately to the provider?

a) Bradycardia

b) Hypotension

c) Decreased body temperature

d) Pupillary constriction

Answer: a) Bradycardia

Rationale: Cushing’s triad (bradycardia, hypertension, and irregular respirations) is a late sign of increased ICP and indicates brainstem herniation, requiring immediate intervention.

2. A client with myasthenia gravis is receiving pyridostigmine. Which finding suggests that the medication is effective?

a) Decreased muscle strength

b) Increased ability to swallow

c) Increased ptosis

d) Decreased deep tendon reflexes

Answer: b) Increased ability to swallow

Rationale: Pyridostigmine is a cholinesterase inhibitor that improves neuromuscular transmission, leading to better muscle strength, including the muscles needed for swallowing.

3. A nurse is providing discharge teaching to a client who had a transient ischemic attack (TIA). Which statement by the client indicates a need for further education?

a) I should take my prescribed aspirin daily.

b) A TIA increases my risk of having a stroke.

c) I don’t need to worry because TIAs don’t cause permanent damage. d) I will monitor my blood pressure regularly.

Answer: c) I don’t need to worry because TIAs don’t cause permanent damage. Rationale: While TIAs do not cause permanent damage, they are warning signs of a potential stroke, and preventive measures should be taken seriously.

4. Which intervention should the nurse include in the plan of care for a client with Parkinson’s disease to promote mobility? a) Encourage the client to take long strides when walking b) Teach the client to rock back and forth to initiate movement c) Advise the client to avoid assistive devices to maintain independence d) Instruct the client to keep their arms close to the body when walking

Answer: b) Teach the client to rock back and forth to initiate movement Rationale: Clients with Parkinson’s disease often experience freezing episodes, and rocking back and forth helps initiate movement.

5. A nurse is assessing a client with suspected meningitis. Which of the following findings is consistent with meningeal irritation?

a) Positive Romberg’s test

b) Nuchal rigidity

c) Hyperglycemia

d) Decreased deep tendon reflexes

Answer: b) Nuchal rigidity

Rationale: Nuchal rigidity (stiff neck) is a hallmark sign of meningitis due to irritation of the meninges.

6. A nurse is assessing a client who has suffered a stroke affecting the left cerebral hemisphere. Which of the following findings should the nurse expect?

a) Impulsive behavior

b) Left-sided hemiplegia

c) Impaired speech and language

d) Poor spatial awareness

Answer: c) Impaired speech and language

Rationale: The left cerebral hemisphere is responsible for language and speech (Broca’s and Wernicke’s areas). Damage to this side often results in aphasia.

7. A client with multiple sclerosis (MS) reports increased fatigue. Which recommendation should the nurse provide?

a) Take a hot bath to relax your muscles.

b) Increase your daily physical activity significantly. c) Plan rest periods throughout the day.

d) Avoid fluid intake in the morning.

Answer: c) Plan rest periods throughout the day.

Rationale: Clients with MS experience fatigue, which can be managed by balancing activity with rest periods to prevent overexertion. 8. A nurse is caring for a client with a suspected epidural hematoma after a head injury. Which of the following is the most critical symptom to monitor?

a)