MARYVILLE UNIVERSITY NUR 405 NCLEX EXAM
3|QUESTIONS AND VERIFIED ANSWERS|GRADED
A+|2026 UPDATE
Questions 1–10
1. Patient with acute MI complains of chest pain radiating to jaw and left arm. Priority
action?
o A) Administer sublingual nitroglycerin
o B) Encourage deep breathing
o C) Apply warm compress
o D) Monitor only
More Information: Nitroglycerin relieves ischemic pain and improves coronary perfusion.
2. Patient with DKA, glucose 600 mg/dL, potassium 3.0 mEq/L. Next intervention?
o A) Administer potassium before insulin
o B) Start insulin infusion immediately
o C) Give oral glucose
o D) Provide sodium bicarbonate
More Information: Correcting hypokalemia first prevents life-threatening arrhythmias.
3. Newborn with hypoglycemia (<40 mg/dL). First nursing action?
o A) Feed immediately
o B) Monitor only
o C) Apply heat
o D) Give water
More Information: Early feeding prevents neurologic injury.
4. Patient with COPD, PaCO₂ 65 mmHg, pH 7.25. Diagnosis?
o A) Respiratory acidosis
, o B) Metabolic alkalosis
o C) Respiratory alkalosis
o D) Metabolic acidosis
More Information: Elevated CO₂ with low pH indicates respiratory acidosis.
5. Patient with left-sided HF develops orthopnea and pulmonary crackles. Nursing
action?
o A) Elevate head of bed
o B) Encourage ambulation
o C) Apply heat
o D) Restrict fluids
More Information: Improves lung expansion and oxygenation.
6. Patient with hyperkalemia, ECG shows peaked T waves. Nursing priority?
o A) Administer insulin with glucose
o B) Monitor only
o C) Encourage potassium intake
o D) Restrict fluids only
More Information: Shifts potassium into cells and prevents fatal arrhythmias.
7. Child with asthma attack, O₂ sat 85%, accessory muscle use. Priority?
o A) Administer nebulized short-acting bronchodilator
o B) Encourage deep breathing
o C) Oral corticosteroids only
o D) High-protein diet
More Information: Immediate bronchodilation prevents respiratory failure.
8. Patient on digoxin reports nausea, vomiting, visual halos. Nursing action?
o A) Hold digoxin and notify provider
o B) Encourage fluids
, o C) Continue as prescribed
o D) Administer antacid
More Information: Early recognition of toxicity prevents cardiac complications.
9. Patient with acute pancreatitis. Nursing priority?
o A) Maintain NPO status
o B) Encourage oral fluids
o C) Apply warm compress
o D) Provide high-protein diet
More Information: Pancreatic rest reduces inflammation and enzyme release.
10. Patient with neutropenia after chemotherapy. Nursing priority?
o A) Implement neutropenic precautions
o B) High-fiber diet
o C) Encourage ambulation
o D) Monitor only
More Information: Prevents infections in immunocompromised patients.
Questions 11–20
11. Patient with CKD and hyperphosphatemia. Nursing intervention?
o A) Administer phosphate binders
o B) Encourage high-phosphate diet
o C) Restrict potassium
o D) Administer calcium only
More Information: Binders prevent phosphate absorption and secondary hypocalcemia.
12. Patient with pulmonary edema, pink frothy sputum. Nursing priority?
o A) Elevate head of bed
o B) Encourage ambulation
3|QUESTIONS AND VERIFIED ANSWERS|GRADED
A+|2026 UPDATE
Questions 1–10
1. Patient with acute MI complains of chest pain radiating to jaw and left arm. Priority
action?
o A) Administer sublingual nitroglycerin
o B) Encourage deep breathing
o C) Apply warm compress
o D) Monitor only
More Information: Nitroglycerin relieves ischemic pain and improves coronary perfusion.
2. Patient with DKA, glucose 600 mg/dL, potassium 3.0 mEq/L. Next intervention?
o A) Administer potassium before insulin
o B) Start insulin infusion immediately
o C) Give oral glucose
o D) Provide sodium bicarbonate
More Information: Correcting hypokalemia first prevents life-threatening arrhythmias.
3. Newborn with hypoglycemia (<40 mg/dL). First nursing action?
o A) Feed immediately
o B) Monitor only
o C) Apply heat
o D) Give water
More Information: Early feeding prevents neurologic injury.
4. Patient with COPD, PaCO₂ 65 mmHg, pH 7.25. Diagnosis?
o A) Respiratory acidosis
, o B) Metabolic alkalosis
o C) Respiratory alkalosis
o D) Metabolic acidosis
More Information: Elevated CO₂ with low pH indicates respiratory acidosis.
5. Patient with left-sided HF develops orthopnea and pulmonary crackles. Nursing
action?
o A) Elevate head of bed
o B) Encourage ambulation
o C) Apply heat
o D) Restrict fluids
More Information: Improves lung expansion and oxygenation.
6. Patient with hyperkalemia, ECG shows peaked T waves. Nursing priority?
o A) Administer insulin with glucose
o B) Monitor only
o C) Encourage potassium intake
o D) Restrict fluids only
More Information: Shifts potassium into cells and prevents fatal arrhythmias.
7. Child with asthma attack, O₂ sat 85%, accessory muscle use. Priority?
o A) Administer nebulized short-acting bronchodilator
o B) Encourage deep breathing
o C) Oral corticosteroids only
o D) High-protein diet
More Information: Immediate bronchodilation prevents respiratory failure.
8. Patient on digoxin reports nausea, vomiting, visual halos. Nursing action?
o A) Hold digoxin and notify provider
o B) Encourage fluids
, o C) Continue as prescribed
o D) Administer antacid
More Information: Early recognition of toxicity prevents cardiac complications.
9. Patient with acute pancreatitis. Nursing priority?
o A) Maintain NPO status
o B) Encourage oral fluids
o C) Apply warm compress
o D) Provide high-protein diet
More Information: Pancreatic rest reduces inflammation and enzyme release.
10. Patient with neutropenia after chemotherapy. Nursing priority?
o A) Implement neutropenic precautions
o B) High-fiber diet
o C) Encourage ambulation
o D) Monitor only
More Information: Prevents infections in immunocompromised patients.
Questions 11–20
11. Patient with CKD and hyperphosphatemia. Nursing intervention?
o A) Administer phosphate binders
o B) Encourage high-phosphate diet
o C) Restrict potassium
o D) Administer calcium only
More Information: Binders prevent phosphate absorption and secondary hypocalcemia.
12. Patient with pulmonary edema, pink frothy sputum. Nursing priority?
o A) Elevate head of bed
o B) Encourage ambulation
