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UNIVERSITY NURS LATEST EXAM EDITION 150+
NCLEX-STYLE QUESTIONS WITH DETAILED
RATIONALES HIGH-YIELD CONTENT – PASS
GUARANTEED
# Unit 1: Advanced Health Assessment (Questions 1-25)
**Question 1**
A 58-year-old male presents with intermittent chest pressure that occurs
with exertion and resolves with rest. He describes it as "squeezing"
without radiation. What is the most appropriate initial question?
A. "Does the pain worsen with deep inspiration?"
B. "Have you had any recent weight loss or night sweats?"
C. "Can you rate the pain on a scale of 0-10?"
D. "Does the pain change with position or palpation?"
**Rationale:**
Correct answer: **C**. This describes stable angina. Pain rating is
essential for baseline assessment and monitoring treatment response.
Option A suggests pleuritic pain (pericarditis/pneumonia). Option B
suggests malignancy or infection. Option D suggests musculoskeletal
pain (costochondritis).
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**Question 2**
A 72-year-old female reports dizziness when standing up from a seated
position over the past 2 weeks. Her medications include lisinopril and
metformin. Vital signs: supine BP 130/80, HR 72; standing BP 100/60,
HR 95. What is the most likely diagnosis?
A. Orthostatic hypotension
B. Vasovagal syncope
C. Hypoglycemia
D. Atrial fibrillation
**Rationale:**
Correct answer: **A**. Orthostatic hypotension defined as BP drop >20
mmHg systolic or >10 mmHg diastolic with symptoms upon standing.
The HR increase (compensatory tachycardia) is appropriate.
Hypoglycemia (C) would have sweating, confusion. Atrial fibrillation
(D) would have irregularly irregular pulse.
---
**Question 3**
A 45-year-old obese female presents with right upper quadrant pain after
fatty meals. She reports nausea but no vomiting. Murphy's sign is
positive. What is the most likely diagnosis?
A. Peptic ulcer disease
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B. Acute pancreatitis
C. Cholecystitis
D. Gastroesophageal reflux disease
**Rationale:**
Correct answer: **C**. Positive Murphy's sign (inspiratory arrest with
palpation of RUQ) is classic for cholecystitis. Pain after fatty meals
suggests gallbladder pathology. Peptic ulcer (A) would be epigastric.
Pancreatitis (B) would have epigastric pain radiating to back.
---
**Question 4**
A 35-year-old pregnant patient at 28 weeks gestation presents with
headache, blurred vision, and epigastric pain. BP 160/100, urine dipstick
shows 3+ protein. What is the priority intervention?
A. Administer labetalol IV
B. Start magnesium sulfate IV
C. Prepare for immediate delivery
D. Give oral nifedipine
**Rationale:**
Correct answer: **B**. This is severe preeclampsia with symptoms of
end-organ damage (headache, vision changes, epigastric pain).
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Magnesium sulfate is indicated for seizure prophylaxis. Labetalol (A)
treats BP but does not prevent seizures. Delivery (C) is definitive but not
first priority in this question.
---
**Question 5**
A 22-year-old college student reports sore throat, fever, and fatigue for 5
days. Exam shows pharyngeal erythema, exudates, and anterior cervical
lymphadenopathy. What is the most appropriate next step?
A. Prescribe amoxicillin empirically
B. Order rapid strep test and throat culture
C. Prescribe acyclovir
D. Recommend symptomatic care only
**Rationale:**
Correct answer: **B**. Centor criteria (fever, exudates,
lymphadenopathy, absence of cough) suggest GABHS pharyngitis.
Rapid strep test should be obtained. Amoxicillin (A) without testing
contributes to resistance. Acyclovir (C) for viral pharyngitis not
indicated.
---
UNIVERSITY NURS LATEST EXAM EDITION 150+
NCLEX-STYLE QUESTIONS WITH DETAILED
RATIONALES HIGH-YIELD CONTENT – PASS
GUARANTEED
# Unit 1: Advanced Health Assessment (Questions 1-25)
**Question 1**
A 58-year-old male presents with intermittent chest pressure that occurs
with exertion and resolves with rest. He describes it as "squeezing"
without radiation. What is the most appropriate initial question?
A. "Does the pain worsen with deep inspiration?"
B. "Have you had any recent weight loss or night sweats?"
C. "Can you rate the pain on a scale of 0-10?"
D. "Does the pain change with position or palpation?"
**Rationale:**
Correct answer: **C**. This describes stable angina. Pain rating is
essential for baseline assessment and monitoring treatment response.
Option A suggests pleuritic pain (pericarditis/pneumonia). Option B
suggests malignancy or infection. Option D suggests musculoskeletal
pain (costochondritis).
,2|Page
**Question 2**
A 72-year-old female reports dizziness when standing up from a seated
position over the past 2 weeks. Her medications include lisinopril and
metformin. Vital signs: supine BP 130/80, HR 72; standing BP 100/60,
HR 95. What is the most likely diagnosis?
A. Orthostatic hypotension
B. Vasovagal syncope
C. Hypoglycemia
D. Atrial fibrillation
**Rationale:**
Correct answer: **A**. Orthostatic hypotension defined as BP drop >20
mmHg systolic or >10 mmHg diastolic with symptoms upon standing.
The HR increase (compensatory tachycardia) is appropriate.
Hypoglycemia (C) would have sweating, confusion. Atrial fibrillation
(D) would have irregularly irregular pulse.
---
**Question 3**
A 45-year-old obese female presents with right upper quadrant pain after
fatty meals. She reports nausea but no vomiting. Murphy's sign is
positive. What is the most likely diagnosis?
A. Peptic ulcer disease
,3|Page
B. Acute pancreatitis
C. Cholecystitis
D. Gastroesophageal reflux disease
**Rationale:**
Correct answer: **C**. Positive Murphy's sign (inspiratory arrest with
palpation of RUQ) is classic for cholecystitis. Pain after fatty meals
suggests gallbladder pathology. Peptic ulcer (A) would be epigastric.
Pancreatitis (B) would have epigastric pain radiating to back.
---
**Question 4**
A 35-year-old pregnant patient at 28 weeks gestation presents with
headache, blurred vision, and epigastric pain. BP 160/100, urine dipstick
shows 3+ protein. What is the priority intervention?
A. Administer labetalol IV
B. Start magnesium sulfate IV
C. Prepare for immediate delivery
D. Give oral nifedipine
**Rationale:**
Correct answer: **B**. This is severe preeclampsia with symptoms of
end-organ damage (headache, vision changes, epigastric pain).
, 4|Page
Magnesium sulfate is indicated for seizure prophylaxis. Labetalol (A)
treats BP but does not prevent seizures. Delivery (C) is definitive but not
first priority in this question.
---
**Question 5**
A 22-year-old college student reports sore throat, fever, and fatigue for 5
days. Exam shows pharyngeal erythema, exudates, and anterior cervical
lymphadenopathy. What is the most appropriate next step?
A. Prescribe amoxicillin empirically
B. Order rapid strep test and throat culture
C. Prescribe acyclovir
D. Recommend symptomatic care only
**Rationale:**
Correct answer: **B**. Centor criteria (fever, exudates,
lymphadenopathy, absence of cough) suggest GABHS pharyngitis.
Rapid strep test should be obtained. Amoxicillin (A) without testing
contributes to resistance. Acyclovir (C) for viral pharyngitis not
indicated.
---
