Can You Pass the NCLEX?

EMPLOYMENT

Torrance Grey

7 Min Quiz

Image: skaman306/Moment/Getty Images

About This Quiz

The National Council Licensing Exam is a hurdle that every aspiring nurse in the United States or Canada must clear on their way to getting a license. Written by nurses and nursing teachers, it's a formidable test. However, students who have been working steadily and conscientiously in school shouldn't have too much difficulty with it. In fact, the better-prepared the student, the less time the exam will take. It's "cognitively adaptive," meaning that the computer responds to how the test-taker is performing, so that someone who answers correctly and quickly most of the time will be able to skip over easier questions, and finish earlier. Slower, less-adept students will see more questions, and easier ones, before they advance to difficult topics. 

The largest subject area on the test is called "physiological integrity," and covers disease signs and symptoms, their diagnosis, and treatment procedures. However, smaller segments cover patient safety and comfort, behavioral health, health maintenance and more. These sections may ask the potential nurse about signs of child abuse, for example, or ethical dilemmas. 

Note: We said before that the NCLEX is a "formidable" test; our quiz isn't going to be quite as hard, since it's for a general audience. Finally, though we've done everything possible to ensure this test is accurate and similar to the NCLEX, remember that it's for entertainment purposes only. If you're really prepping for the NCLEX, get yourself to a legitimate test-prep provider for sample exams with answer explanations. After all, we're counting on you, future nurses of the world!

True or false: Some NCLEX questions will ask you simply to define vocabulary words in nursing.

Terminology is extremely important in nursing, and you'll see some simple vocabulary questions on this quiz. However, the actual NCLEX is a test of judgment and decision-making. The questions will be short, but multi-sentence, describing a particular situation and asking questions based on that.

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A, B, AB and O refer to which of these?

These are the four essential blood types. You don't necessarily have to be a medical professional to know this; people who give blood regularly also know their blood type.

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Which of these is rarely an answer to an NCLEX question?

Of course there are times when nurses will need to notify a physician about a patient's status or ask about care. But beware of "call the physician" responses on the NCLEX, because the test is designed to find out what *you* know about signs, symptoms, procedures, medications and more; "notify a doctor" does not clarify any of this.

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The abbreviation "WNL" means that something is "Within _____ Limits."

As a nurse, you'll see the abbreviation "WNL" often; it means that one of a patient's stats is acceptable and healthy. However, cynics in the medical profession joke that this shorthand stands for "We Never Looked."

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When "mg" is lowercased, it means "milligram." What does it mean when written "Mg"?

Magnesium is the 11th-most common element in the human body, and there is a recommended daily dietary intake. It's about 400 mg for men and 300 for women.

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Which of the following is a behavioral-care issue?

Behavioral issues are ones of mental health, like the PTSD the veteran might be exhibiting. Other behavioral health issues include alcoholism, drug abuse and suicidal thoughts.

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A physician's orders require that a patient take a medication "bid." What does this mean?

This is an abbreviation for "bis in die," which is Latin for "twice a day." If Latin isn't your jam, you can remember it by thinking of "bi-" as the prefix for "two" and "d" for "day." (Note: if Latin isn't your jam, though, you're going to have some trouble with medical terminology overall.)

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If a patient leaves the hospital unexpectedly and cannot be found, he is said to have done what?

This term is the common one in nursing homes or behavioral-care facilities. To the rest of the world, though, it has romantic implications -- lovers running off to get married.

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How much smaller than a milligram is a microgram?

We bring this up because it underscores the need for clear communication, and especially good handwriting. The abbreviations "mg" and "mcg" are easily confused with each other if not written clearly, and could result in an overdose by a measure of 1,000!

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A "dose" of medication is the amount. What, then, is "dosage"?

Many people use these words interchangeably, but that's not right. "Dosage" refers to the timing of medication, whether once a day, twice a day, as needed, or so on.

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Which of these patients would receive an APGAR score?

The APGAR score was named for Virginia Apgar, an anesthesiologist with an interest in obstetrics. She developed this test of a newborn's condition in hopes of increasing the survival rate for infants in their first 24 hours.

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"ADL" stands for "Activities of Daily Living." In which nursing assignment would this term most often arise?

Home health care nurses often make visits to discharged patients who have had a permanent or semi-permanent change in status; for example, a stroke in which full recovery is unlikely. A nurse will assess how well this patient can perform the "activities of daily living" in their own home, without help.

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Which of these is NOT part of the APGAR score?

"APGAR" is both an acronym and a name in honor of its creator. As the former, it stands for "Appearance, Pulse, Grimace, Activity and Respiration." It does not include taking a baby's blood pressure.

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A percentage of the NCLEX question will deal with "management of care." Which of the following falls under that heading?

Management of care is a sort of "meta" category. It deals with good administration and best practices for working with patients and with other practitioners, whether they're your superiors or your subordinates. It won't include questions about signs, symptoms, medications and the like.

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A newly diagnosed cancer patient expresses anxiety to you, saying, "I don't think I can beat this." Which of these is the best response?

It's best not to offer false assurance, or turn the attention to an anecdote of your own. Nor is this a special situation that requires a clergy member. Offering an open-ended, empathetic response is the best choice.

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Under what circumstances can you tell a patient's friend about his or her test results?

Confidentiality is an extremely important concept in medical care. The "yeah, but" circumstances above might sound tempting, and a friend might push you for information on those grounds, but you need to stand firm.

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Which of these is the best meal for a recovering heart patient?

The meal of chicken and green beans offers the best nutrition without including high-fat or high-calorie elements.

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A patient from a very religious family is refusing a blood transfusion. You're not sure whether this decision represents the patient's own wishes, or the family's. What should you do?

Nurses with a grounding in modern, evidence-based medicine can have a hard time understanding the mindset of people who refuse care on religious or cultural grounds. But calling a clergy member or pressuring the family is beyond the scope of a nurse's duties.

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For one of your patients, the doctor has ordered a partial thromboplastin time test. What bodily process is the doctor interested in?

A "PTT" tests how long it takes a patient's blood to clot; unnaturally slow clotting can indicate an underlying blood disorder that could be life-threatening.

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Which of these is a longer-than-normal PTT?

A normal partial thromboplastin time is 20 to 45 seconds. 10 seconds is rather fast, which might be a whole other issue ... but as long as 55 seconds falls in the "too long" category.

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Which of these drugs or supplements would cause clotting time to be longer than usual?

Many drugs or herbs (feverfew, above, is an herbal supplement) have have an effect on clotting time, often a lengthening one. Heparin is of special note, because its purpose, as diagnosed, is to thin the blood. If a patient is on any of these, you should expect a longer PTT, and this is acceptable.

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Frontal, parietal and temporal all refer to what?

These are lobes, or regions, of the brain. Different lobes are responsible for different functions, but many important functions are "global," or seated in several places in the brain, so that a traumatic injury won't wholly wipe out important things like memory. This is why memory loss is often partial, not total.

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An elderly patient is brought in by his stepson for a sprained wrist. During the exam, you notice what look like round burn marks on the inside of his arm, some new and some fading. How would you chart this?

While you might have a strong intuition about what's going on, only what you literally see goes in the chart. Suspicions of abuse should be followed up on, though, in a discussion with your supervisor.

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For which of these suspected conditions would a physician order an arterial blood gas test?

"Arterial blood gas" is an unfamiliar term to many non-medical people, and sounds a bit scary. However, it refers to the levels of oxygen and carbon dioxide in the bloodstream, which can tell a doctor or nurse if the patient is hypoxic, or low on oxygen.

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You are discharging a patient after treatment for a heart attack. Which of these, stated by the patient, suggests she needs more counseling before going home?

Any decision to discontinue medication should be discussed with one's doctor. The patient needs to be made (politely) to understand this before she leaves, in order to prevent another heart attack.

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Blood pH is the measure of blood's acidity versus its what?

You've probably heard health gurus preaching about the importance of being alkaline. This makes health practitioners crazy. Blood pH can't be controlled with diet any more than you control your body temperature by eating hot or cold foods. In addition, "alkaline" does not mean "benign" -- highly alkaline substances are very corrosive, like the interior of an alkaline battery.

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In the clinical setting, levels of a medication, hormone, etc., in the blood are called ____ levels.

"Serum" is a word that might remind you of skincare products or miracle treatments in sci-fi movies. But it's the preferred term for blood levels of, for example, testosterone.

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Which of these can cause ketoacidosis?

Poorly-controlled diabetes can cause ketoacidosis, which is a buildup of acids called ketones in the blood. During the high-protein diet craze of the 2000s, there was some concern that followers would get ketoacidosis -- but it's hard for a non-diabetic person to diet themselves into ketoacidosis, fortunately.

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Which of these is a symptom of ketoacidosis?

Headache isn't generally a symptom of ketoacidosis. The signs to look out for are, in addition to the above, confusion, shortness of breath, fatigue, frequent urination and excessive thirst.

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Which of these is NOT the responsibility of a nurse in a pre-op unit?

The other three choices are within the bounds of a what a nurse does, though they might not be solely his or her responsibility. But explaining a procedure to the patient should be done by the patient's doctor or the surgeon who'll perform it.

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Which of these can be delegated to a nursing assistant?

Taking a patient to the bathroom is the task above that requires the least amount of medical knowledge, and falls within the skill set of a nursing assistant. Knowing how to safely delegate jobs is an important part of being a nurse.

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If a patient tells you that the lights of the helipad on the hospital roof are signals to aliens who are trying to find him, which of these might you suspect?

Paranoid and irrational thinking are signs of schizophrenia, a serious mental disorder with a genetic component. The other three conditions are mental disorders, but rarely involve a break with reality as severe as the ones schizophrenics have.

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What does the term "parenteral" refer to?

This term confuses people outside the medical world, because it doesn't have anything to do with "parents." It's refers to something extra-intestinal, like parenteral nutrition administered with an IV.

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Who donates the blood for an autologous blood transfusion?

"Autologous" means that that patient's own blood is used. This cuts the risk of a bad reaction to the blood, and it also lessens the demand on the blood supply from agencies like the Red Cross. The patient should have the blood drawn about six weeks before it'll be needed.

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Which of these is a warning that a patient has not understood discharge instructions about medication?

Often, it's OK to crush medication, or open capsules, and take medication in soft food. However, a time-release capsule must be swallowed whole in order to get the time-release effect.

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