NCLEX FUNDAMENTALS (UWORLD) EXAM
QUESTIONS WITH
CORRECT VERIFIED ANSWERS | ALREADY GRADED
A+ STUDY GUIDE 2026/2027
Measuring Nasogastric Tube - ✔✔✔ANSWER>>>>Because distance from the
nares to the stomach varies with each client, it is important to measure and
mark the NG tube prior to insertion to ensure its correct placement in the
stomach. The Traditional Method is most commonly used for large-bore NG
tube placement.
Traditional Method: Using the end of the tube that will eventually rest in the
stomach, measure from the tip of the nose, extend the tube to the earlobe and then
down to the xiphoid process. Mark the distance with a small piece of tape that can
be easily removed.
Pseudohyperkalemia - ✔✔✔ANSWER>>>>With the exception of clients with
end-stage renal disease, a serum potassium value >6.5 mEq/L (6.5 mmol/L) in a
client who is walking and talking should raise suspicion for an erroneously
elevated serum potassium
(pseudohyperkalemia) level due to poor hematology technique. A serum potassium
level of 7.0 mEq/L (7.0 mmol/L) constitutes a life-threatening electrolyte
imbalance that would cause severe weakness or paralysis, unstable arrhythmias,
and eventual cardiac arrest.
Page 1 of 31
,Assessment focuses on evaluating cardiac symptoms and muscle strength and
should be reported to the registered nurse (RN). It is likely that a repeat blood
draw would be prescribed.
Pseudohyperkalemia can be avoided on the repeat blood draw through
minimal use of a tourniquet and fist clenching and use of a larger gauge
needle and heparin-impregnated hematology vials to prevent clotting.
IV Occlusion - ✔✔✔ANSWER>>>>IV infusion pumps display an occlusion
alarm when
IV solution cannot be infused due to pressure in the line. Common causes of
occlusion include clamped or kinked IV tubing, clotting in the IV catheter, and
kinking in the IV catheter with extremity movement (eg, elbow, wrist). The nurse
should assess the tubing and IV site and flush the IV catheter to check patency.
In the absence of identifiable occlusion, an alarming IV pump should be
exchanged for a different one (Option 2). Malfunctioning equipment may harm the
client and should be removed from the care area. The malfunctioning equipment is
labeled as out of service and is sent for maintenance.
Promoting normal sleep pattern for critically ill - ✔✔✔ANSWER>>>>It is
important to maintain the client's normal circadian rhythms in the intensive care
unit (ICU). Interventions that help to maintain the normal sleep-wake cycle
include dimming the lights at night, allowing quiet and uninterrupted periods of
sleep when possible, scheduling interventions and activities during the day,
frequently reorienting the client as necessary, and opening the window shades in
the morning. Excessive stimuli and lack of sleep can predispose the client to
delirium.
Page 2 of 31
,Unless the client is awake and chooses to have the television turned on, this extra
stimulus is disruptive to sleep.
Turning the alarms off in the client's room would pose a risk to safety as the nurse
may not be alerted to a change in condition or equipment failure. If possible, alarm
parameters should be adjusted according to the client's routine to prevent
unnecessary awakening.
NG Tube Insertion - ✔✔✔ANSWER>>>>During NG tube insertion, the tube
sometimes slips into the larynx or coils in the throat, which can result in coughing
and gagging. The nurse should withdraw the tube slightly and then stop or pause
while the client takes a few breaths. After the client stops coughing, the nurse can
proceed with advancement, asking the client to take small sips of water to
facilitate advancement to the stomach. The client should not be asked to swallow
during coughing or aspiration may occur. If resistance or obstruction occurs
during tube advancement, the nurse should rotate the tube while trying to advance
it. If resistance continues, the tube should be withdrawn and inserted into the
other naris if possible.
Ear irrigation - ✔✔✔ANSWER>>>>may be prescribed to remove impacted or
excess cerumen; the following steps describe this procedure:
Assess client for contraindications (eg, fever, ear infection). Use an otoscope to
inspect the external ear canal. Verify that the tympanic membrane is intact and
ensure there are no foreign bodies.
Explain the procedure to the client, including possible sensations (eg, vertigo,
fullness, warmth).
Page 3 of 31
, Place the client in a side-lying or sitting position with the head tilted toward the
affected ear.Place a towel and an emesis basin under the ear.
Verify that the irrigation solution is at body temperature (98.6 F [37 C]) to
minimize discomfort.
Straighten the ear canal, pulling the pinna up and back for adults or down and back
for children age ≤3 years.
Irrigate gently with a slow, steady flow of solution, directing the syringe tip toward
the top of the ear canal. Avoid occluding the canal to prevent increased pressure and
rupture of the tympanic membrane. Stop immediately if the client experiences
severe pain, nausea, or dizziness.
Repeat as tolerated until the ear canal is clear or the prescribed amount is instilled.
Document the type, temperature, and volume of solution; exudate characteristics;
response to the irrigation; and client teaching.
Ascending Stairs with Crutches - ✔✔✔ANSWER>>>>Assume the tripod position
(ie, crutch stance) and place body weight on the crutches while preparing to move
the unaffected leg.
Place the unaffected leg (ie, good leg) onto the step.
Transfer body weight from the crutches to the unaffected leg and then use the
unaffected leg (ie, good leg) to raise the body up onto the step.
Advance the affected leg and the crutches together up the step.
Page 4 of 31
QUESTIONS WITH
CORRECT VERIFIED ANSWERS | ALREADY GRADED
A+ STUDY GUIDE 2026/2027
Measuring Nasogastric Tube - ✔✔✔ANSWER>>>>Because distance from the
nares to the stomach varies with each client, it is important to measure and
mark the NG tube prior to insertion to ensure its correct placement in the
stomach. The Traditional Method is most commonly used for large-bore NG
tube placement.
Traditional Method: Using the end of the tube that will eventually rest in the
stomach, measure from the tip of the nose, extend the tube to the earlobe and then
down to the xiphoid process. Mark the distance with a small piece of tape that can
be easily removed.
Pseudohyperkalemia - ✔✔✔ANSWER>>>>With the exception of clients with
end-stage renal disease, a serum potassium value >6.5 mEq/L (6.5 mmol/L) in a
client who is walking and talking should raise suspicion for an erroneously
elevated serum potassium
(pseudohyperkalemia) level due to poor hematology technique. A serum potassium
level of 7.0 mEq/L (7.0 mmol/L) constitutes a life-threatening electrolyte
imbalance that would cause severe weakness or paralysis, unstable arrhythmias,
and eventual cardiac arrest.
Page 1 of 31
,Assessment focuses on evaluating cardiac symptoms and muscle strength and
should be reported to the registered nurse (RN). It is likely that a repeat blood
draw would be prescribed.
Pseudohyperkalemia can be avoided on the repeat blood draw through
minimal use of a tourniquet and fist clenching and use of a larger gauge
needle and heparin-impregnated hematology vials to prevent clotting.
IV Occlusion - ✔✔✔ANSWER>>>>IV infusion pumps display an occlusion
alarm when
IV solution cannot be infused due to pressure in the line. Common causes of
occlusion include clamped or kinked IV tubing, clotting in the IV catheter, and
kinking in the IV catheter with extremity movement (eg, elbow, wrist). The nurse
should assess the tubing and IV site and flush the IV catheter to check patency.
In the absence of identifiable occlusion, an alarming IV pump should be
exchanged for a different one (Option 2). Malfunctioning equipment may harm the
client and should be removed from the care area. The malfunctioning equipment is
labeled as out of service and is sent for maintenance.
Promoting normal sleep pattern for critically ill - ✔✔✔ANSWER>>>>It is
important to maintain the client's normal circadian rhythms in the intensive care
unit (ICU). Interventions that help to maintain the normal sleep-wake cycle
include dimming the lights at night, allowing quiet and uninterrupted periods of
sleep when possible, scheduling interventions and activities during the day,
frequently reorienting the client as necessary, and opening the window shades in
the morning. Excessive stimuli and lack of sleep can predispose the client to
delirium.
Page 2 of 31
,Unless the client is awake and chooses to have the television turned on, this extra
stimulus is disruptive to sleep.
Turning the alarms off in the client's room would pose a risk to safety as the nurse
may not be alerted to a change in condition or equipment failure. If possible, alarm
parameters should be adjusted according to the client's routine to prevent
unnecessary awakening.
NG Tube Insertion - ✔✔✔ANSWER>>>>During NG tube insertion, the tube
sometimes slips into the larynx or coils in the throat, which can result in coughing
and gagging. The nurse should withdraw the tube slightly and then stop or pause
while the client takes a few breaths. After the client stops coughing, the nurse can
proceed with advancement, asking the client to take small sips of water to
facilitate advancement to the stomach. The client should not be asked to swallow
during coughing or aspiration may occur. If resistance or obstruction occurs
during tube advancement, the nurse should rotate the tube while trying to advance
it. If resistance continues, the tube should be withdrawn and inserted into the
other naris if possible.
Ear irrigation - ✔✔✔ANSWER>>>>may be prescribed to remove impacted or
excess cerumen; the following steps describe this procedure:
Assess client for contraindications (eg, fever, ear infection). Use an otoscope to
inspect the external ear canal. Verify that the tympanic membrane is intact and
ensure there are no foreign bodies.
Explain the procedure to the client, including possible sensations (eg, vertigo,
fullness, warmth).
Page 3 of 31
, Place the client in a side-lying or sitting position with the head tilted toward the
affected ear.Place a towel and an emesis basin under the ear.
Verify that the irrigation solution is at body temperature (98.6 F [37 C]) to
minimize discomfort.
Straighten the ear canal, pulling the pinna up and back for adults or down and back
for children age ≤3 years.
Irrigate gently with a slow, steady flow of solution, directing the syringe tip toward
the top of the ear canal. Avoid occluding the canal to prevent increased pressure and
rupture of the tympanic membrane. Stop immediately if the client experiences
severe pain, nausea, or dizziness.
Repeat as tolerated until the ear canal is clear or the prescribed amount is instilled.
Document the type, temperature, and volume of solution; exudate characteristics;
response to the irrigation; and client teaching.
Ascending Stairs with Crutches - ✔✔✔ANSWER>>>>Assume the tripod position
(ie, crutch stance) and place body weight on the crutches while preparing to move
the unaffected leg.
Place the unaffected leg (ie, good leg) onto the step.
Transfer body weight from the crutches to the unaffected leg and then use the
unaffected leg (ie, good leg) to raise the body up onto the step.
Advance the affected leg and the crutches together up the step.
Page 4 of 31
