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NCLEX-RN Diagnostic tests practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Diagnostic tests sits inside the Reduction of Risk Potential category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Diagnostic tests sample questions

Question 1

A 55-year-old client with a history of peptic ulcer disease presents to the emergency department with sudden severe epigastric pain, board-like abdominal rigidity, and a heart rate of 110 beats/min. The nurse anticipates which diagnostic test to confirm the suspected complication?

  1. A Upper gastrointestinal endoscopy with biopsy.
  2. B Serum amylase and lipase levels.
  3. C Abdominal ultrasound of the gallbladder.
  4. D Upright chest radiograph for free air.
Show the answer and explanation

Correct answer: D

Sudden severe epigastric pain with a board-like abdomen in a client with peptic ulcer disease suggests perforation. An upright chest radiograph showing free air under the diaphragm confirms it quickly.

Why the other options are wrong:
A: Endoscopy is avoided when perforation is suspected because insufflated air can worsen the leak.
B: Amylase and lipase evaluate pancreatitis and do not confirm a perforation.
C: A gallbladder ultrasound evaluates biliary disease, not a perforated ulcer.

Question 2

A 55-year-old client with a history of hypertension and diabetes is scheduled for a cardiac catheterization. The nurse reviews the pre-procedure orders. Which order should the nurse question?

  1. A Continue lisinopril 10 mg orally the morning of the procedure
  2. B Administer 0.9% sodium chloride at 100 mL/hr starting 6 hours before
  3. C Hold metformin for 48 hours before the procedure
  4. D Obtain serum creatinine and blood urea nitrogen levels today
Show the answer and explanation

Correct answer: A

ACE inhibitors such as lisinopril are commonly held for up to 24 hours before cardiac catheterization because they can add to contrast-related kidney injury and procedural hypotension. The nurse should clarify an order to continue it.

Why the other options are wrong:
B: Prehydration with isotonic saline is standard to protect the kidneys from contrast injury.
C: Holding metformin around an intra-arterial contrast procedure is standard to reduce the risk of lactic acidosis if kidney function declines.
D: Baseline creatinine and BUN are needed to assess kidney function before contrast is given.

Question 3

A 55-year-old male with suspected deep vein thrombosis (DVT) in the left calf has a Doppler ultrasound ordered. The nurse prepares the client for the test. Which action should the nurse take to reduce the risk of complications during the procedure?

  1. A Apply a warm compress to the left calf before the test
  2. B Massage the left calf gently to promote blood flow
  3. C Position the client in a prone position with legs straight
  4. D Elevate the left leg on pillows without compressing the calf
Show the answer and explanation

Correct answer: D

Elevating the left leg on pillows without compressing the calf reduces the risk of dislodging a potential thrombus, which could cause a pulmonary embolism. Massaging the calf (the option "Massage the left calf gently to promote blood flow" is contraindicated because it can dislodge a clot. A prone position (the option "Position the client in a prone position with legs straight" is not standard and may be uncomfortable; the client is usually supine or semi-Fowler's. A warm compress (the option "Apply a warm compress to the left calf before the test" may relieve discomfort but does not specifically reduce the risk of thrombus dislodgment.

Question 4

A 48-year-old client in the outpatient clinic is scheduled for a flexible sigmoidoscopy. Which instruction should the nurse include in the preoperative teaching?

  1. A You should follow a clear liquid diet for 24 hours and administer one or two enemas before the procedure
  2. B You must remain on nothing-by-mouth status for 12 hours before the examination begins
  3. C You will need to drink a gallon of polyethylene glycol solution the night before the test
  4. D You will be given a sedative that will make you completely unconscious during the sigmoidoscopy
Show the answer and explanation

Correct answer: A

Flexible sigmoidoscopy examines only the rectum and sigmoid colon, so preparation usually consists of a clear liquid diet and one or two enemas rather than a full bowel prep.

Why the other options are wrong:
B: A 12-hour NPO period is not required for this procedure.
C: Large-volume polyethylene glycol prep cleanses the entire colon for colonoscopy.
D: Sigmoidoscopy is often done with little or no sedation, and the client is not made fully unconscious.

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