4/11/26, 10:15 PM NCLEX EXAM
NCLEX EXAM PREVIEW || MOST RECENT EXAM ACTUAL
COMPLETE REAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+ |
GUARANTEED SUCCESS!! NEWEST EXAM | JUST
RELEASED!!
The charge nurse has received a change-of-shift report on the following
clients in labor. The charge nurse should ask a staff member to first see the
client in the
1. first stage of labor who has an oral temperature of 99.7° F (37.6° C)
2. first stage of labor whose contractions are occurring every 30 seconds
3. second stage of labor who has respirations of 26
4. second stage of labor whose contractions are lasting for 60 seconds
2. first stage of labor whose contractions are occurring every 30 seconds
Contractions should be no longer than 90 secs and no closer than 2 mins
(120 secs) 90 secs is the duration, 2 mins is the frequency.
Rationale:
1. Elevated temp is normal during labor
3. Increased resps are normal during labor "pant-pant-blow" "hee-hee-hoo"
breathing pattern
4. Contractions shouldn't be longer than 90 secs, 60 secs is okay and
normal Second stage: 2-3 mins apart, 60-90 secs long, 10 cm dilated,
strong pain
/ 1/65
,4/11/26, 10:15 PM NCLEX EXAM
The nurse is observing a staff member caring for a client who has
chickenpox. Which of the following actions by the staff member would
require the nurse to intervene?
1. placing the client in a private room with monitored negative air pressure
2. placing a box of disposable face shields outside the client's room
3. placing an alcohol-based hand rub in the client's room for hand hygiene
4. placing a surgical mask on the client during transport out of the client's
room
2. placing a box of disposable face shields outside the client's room
disposable face masks are not suitable for airborne precautions
Rationale:
Varicella (chickenpox) is airborne precaution. Private, negative pressure
room, universal precautions (hand sanitizer in room) and placing surgical
mask on client during transport are all correct interventions for Varicilla.
/ 2/65
,4/11/26, 10:15 PM NCLEX EXAM
The nurse is caring for a client who reports feeling faint and is experiencing
the cardiac rhythm shown in the electrocardiogram (ECG) strip below.
- BRADYCARDIA (it is more than 5 spaces apart, sinus rhythm)
Which of the following actions would be appropriate for the nurse to take?
Select all that apply:
1. Administer the client's prescribed beta blocker.
2. Prepare for transcutaneous pacing.
3. Instruct the client to perform the Valsalva maneuver.
4. Begin chest compressions.
5. Assess the client for angina.
2. transcutaneous pacing
- external pacing that stimulates the ventricles to pump at a set rate
5. Assess the client for angina
- Angina (Chest pain) can be caused by both tachycardia (most common)
and bradycardia (rare but can happen). Assessment of angina is
appropriate
Rationale:
1. Beta blocker would further decrease HR
3. Valsalva maneuver/Vagal stimulation would further decrease HR. (can be
indicated for sinus Tachy)
4. Chest compressions are for cardiac arrest
/ 3/65
, 4/11/26, 10:15 PM NCLEX EXAM
The nurse is planning care for a client with moderate Alzheimer's disease
(AD). Which of the following interventions should the nurse include in the
client's plan of care?
1. Encourage the client to reminisce about happy memories.
2. Confront the client when inappropriate or agitated behaviors occur.
3. Administer to the client the cholinesterase inhibitor to reverse the course of
AD.
4. Provide the client with information about activity choices in the
morning so the client can make plans for the day.
1. Encourage the client to reminisce about happy
memories. Its possible for AD patients to retain
long-term memories
Rationale:
2. Acknowledge feelings --> Redirect is protocol for Dementia. Don't
confront; they can't learn
3. AD is irreversible
4. In moderate AD, dementia has already progressed to where pt needs
help with ADLs and planning daily activities. Asking them to plan can
frustrate them and cause distress.
STRUCTURED pleasant activities that consider the persons likes and
interests are the best.
/ 4/65
NCLEX EXAM PREVIEW || MOST RECENT EXAM ACTUAL
COMPLETE REAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED A+ |
GUARANTEED SUCCESS!! NEWEST EXAM | JUST
RELEASED!!
The charge nurse has received a change-of-shift report on the following
clients in labor. The charge nurse should ask a staff member to first see the
client in the
1. first stage of labor who has an oral temperature of 99.7° F (37.6° C)
2. first stage of labor whose contractions are occurring every 30 seconds
3. second stage of labor who has respirations of 26
4. second stage of labor whose contractions are lasting for 60 seconds
2. first stage of labor whose contractions are occurring every 30 seconds
Contractions should be no longer than 90 secs and no closer than 2 mins
(120 secs) 90 secs is the duration, 2 mins is the frequency.
Rationale:
1. Elevated temp is normal during labor
3. Increased resps are normal during labor "pant-pant-blow" "hee-hee-hoo"
breathing pattern
4. Contractions shouldn't be longer than 90 secs, 60 secs is okay and
normal Second stage: 2-3 mins apart, 60-90 secs long, 10 cm dilated,
strong pain
/ 1/65
,4/11/26, 10:15 PM NCLEX EXAM
The nurse is observing a staff member caring for a client who has
chickenpox. Which of the following actions by the staff member would
require the nurse to intervene?
1. placing the client in a private room with monitored negative air pressure
2. placing a box of disposable face shields outside the client's room
3. placing an alcohol-based hand rub in the client's room for hand hygiene
4. placing a surgical mask on the client during transport out of the client's
room
2. placing a box of disposable face shields outside the client's room
disposable face masks are not suitable for airborne precautions
Rationale:
Varicella (chickenpox) is airborne precaution. Private, negative pressure
room, universal precautions (hand sanitizer in room) and placing surgical
mask on client during transport are all correct interventions for Varicilla.
/ 2/65
,4/11/26, 10:15 PM NCLEX EXAM
The nurse is caring for a client who reports feeling faint and is experiencing
the cardiac rhythm shown in the electrocardiogram (ECG) strip below.
- BRADYCARDIA (it is more than 5 spaces apart, sinus rhythm)
Which of the following actions would be appropriate for the nurse to take?
Select all that apply:
1. Administer the client's prescribed beta blocker.
2. Prepare for transcutaneous pacing.
3. Instruct the client to perform the Valsalva maneuver.
4. Begin chest compressions.
5. Assess the client for angina.
2. transcutaneous pacing
- external pacing that stimulates the ventricles to pump at a set rate
5. Assess the client for angina
- Angina (Chest pain) can be caused by both tachycardia (most common)
and bradycardia (rare but can happen). Assessment of angina is
appropriate
Rationale:
1. Beta blocker would further decrease HR
3. Valsalva maneuver/Vagal stimulation would further decrease HR. (can be
indicated for sinus Tachy)
4. Chest compressions are for cardiac arrest
/ 3/65
, 4/11/26, 10:15 PM NCLEX EXAM
The nurse is planning care for a client with moderate Alzheimer's disease
(AD). Which of the following interventions should the nurse include in the
client's plan of care?
1. Encourage the client to reminisce about happy memories.
2. Confront the client when inappropriate or agitated behaviors occur.
3. Administer to the client the cholinesterase inhibitor to reverse the course of
AD.
4. Provide the client with information about activity choices in the
morning so the client can make plans for the day.
1. Encourage the client to reminisce about happy
memories. Its possible for AD patients to retain
long-term memories
Rationale:
2. Acknowledge feelings --> Redirect is protocol for Dementia. Don't
confront; they can't learn
3. AD is irreversible
4. In moderate AD, dementia has already progressed to where pt needs
help with ADLs and planning daily activities. Asking them to plan can
frustrate them and cause distress.
STRUCTURED pleasant activities that consider the persons likes and
interests are the best.
/ 4/65
