Page 1 of 80
NCLEX TYPE QUESTIONS FOR EXAM 2 QUESTIONS AS AT
1-MAY-2026 EXAM QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES LATEST VERSION SOLVED
QUESTIONS & ANSWERS VERIFIED 100 %
Before starting a patient on biologic therapy for RA, the nurse notes no recent
TB test on file. What is the correct nursing action?
A. Start the biologic and schedule TB testing for next visit
B. Administer PPD test and do not start biologic until negative result
confirmed
C. Document the missing test and proceed with therapy
D. Obtain chest x-ray instead of PPD testing
Answer: B - Administer PPD test and do not start biologic until negative result
confirmed
Rationale: The textbook states: "Determine whether the patient has had a recent
negative purified protein derivative (PPD) test for TB. If not, a PPD skin test is
typically administered and the selected BRM is not started until a negative test result
is confirmed." The nurse must "collaborate with the primary health care provider to
ensure that this process is complete."
A patient on biologic therapy for RA asks why TB screening was required
before starting treatment. What is the nurse's best response?
A. "Biologics can cause new TB infections to develop."
B. "TB testing is required for all patients with autoimmune diseases."
C. "Biologics suppress your immune system and can cause TB to flare up." D.
"The medication is made from TB bacteria."
Answer: C - "Biologics suppress your immune system and can cause TB to flare up."
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Rationale: BRMs place patients "at high risk for developing impaired immunity" and
"make patients susceptible to flare-ups" of TB. They don't cause new infections but
can reactivate latent TB or worsen existing disease due to immunosuppression.
Which patient teaching points should the nurse include for a Rheumatoid
Arthritis patient starting biologic therapy? (Select all that apply)
A. Avoid people with infections
B. Avoid large crowds when possible
C. Report fever immediately
D. Take with antacids to prevent GI upset
E. Expect orange-colored urine
Answers: A, B, C
Rationale:
A & B - CORRECT: "Teach patients receiving any one of the BRMs that they are at a
high risk for developing impaired immunity and subsequent infection. Instruct them to
stay away from people with infections and to avoid large crowds if possible."
C - CORRECT: Fever may indicate infection (priority concern with
immunosuppression)
D & E - INCORRECT: These relate to other medications, not biologics
A nurse is reviewing contraindications for biologic therapy. Which patients
should NOT receive BRMs? (Select all that apply)
A. Patient with positive PPD test
B. Patient with multiple sclerosis
C. Patient with hypertension
D. Patient with active tuberculosis
E. Patient with osteoarthritis
Answers: A, B, D
Rationale: The textbook states patients with "multiple sclerosis (MS), tuberculosis
(TB), or a positive TB test...should not receive BRMs because they make patients
susceptible to flare-ups of these diseases." Hypertension and osteoarthritis are not
contraindications.
A 5-year-old child weighing 20 kg experiences anaphylaxis at school. Which
epinephrine autoinjector dose is appropriate?
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A. Auvi-Q 0.1 mg
B. EpiPen Jr. 0.15 mg
C. EpiPen 0.3 mg
D. No epinephrine needed; administer diphenhydramine only
Answer: B - EpiPen Jr. 0.15 mg
Rationale: The EpiPen Jr. (0.15 mg) is appropriate for children weighing less than 30
kg or 8-30 kg. This 20 kg child falls within that range. The Auvi-Q 0.1 mg is for
children 7.5-15 kg, and the EpiPen 0.3 mg is for children over 30 kg. Injectable
epinephrine is the first drug of choice in acute anaphylaxis treatment.
A child is brought to the emergency department after anaphylaxis from a bee
sting. Symptoms resolved after epinephrine administration. What is the
minimum observation time required?
A. 1 hour
B. 2 hours
C. 4-6 hours
D. 24 hours
Answer: C - 4-6 hours
Rationale: All children experiencing anaphylaxis should be "kept for observation at
least 4 to 6 hours after the episode is resolved to ensure prompt intervention should
a biphasic reaction occur." Biphasic reactions can be as severe as the initial reaction
and occur hours to days later.
The school nurse is teaching a parent how to administer an EpiPen. Which
instruction is correct?
A. Inject into the deltoid muscle
B. Hold against the thigh for 3 seconds
C. Remove clothing before injection
D. Hold against upper outer thigh for 10 seconds
Answer: D - Hold against upper outer thigh for 10 seconds
Rationale: "Teach the parent or child to hold the injector against the skin of the upper
outer region of the child's thigh for 10 seconds after administering the injection to
deliver the medication completely. The EpiPen can be injected through clothing."
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Which diagnostic tests may be used to identify allergens after an anaphylactic
episode? (Select all that apply)
A. Serum IgE levels
B. Skin-prick testing
C. Oral food challenge
D. Complete blood count
E. Chest x-ray
Answers: A, B, C
Rationale: "For children with food allergies, a combination of skin-prick testing,
allergen-specific serum IgE levels, and oral food challenge are the gold standard."
Serum studies may reveal elevated IgE for the exposure agent. CBC and chest x-ray
are not standard allergy diagnostic tests.
A child with a peanut allergy will be attending school. Which nursing actions
are appropriate? (Select all that apply)
A. Notify teachers about the allergy
B. Stock extra epinephrine in nurse's office
C. Obtain written anaphylaxis plan from provider
D. Restrict child from all school activities
E. Notify school nutrition personnel
Answers: A, B, C, E
Rationale: "The school nurse must be ready to appropriately care for these children
by stocking extra epinephrine in the nurse's office." "Children should provide the
school nurse with an allergy and anaphylaxis plan written by their primary care
provider." "It is necessary for the school nurse to notify teachers and school nutrition
personnel if a child or children in the school have allergies to peanuts or other
foods." Restricting all activities is unnecessary and not evidence-based.
A nurse is teaching a female patient with SLE about methotrexate therapy.
Which statement by the patient indicates understanding?
A) "I can breastfeed while taking this medication."
B) "I should stop birth control once my symptoms improve."
C) "I need to stop this medication at least 3 months before trying to get
NCLEX TYPE QUESTIONS FOR EXAM 2 QUESTIONS AS AT
1-MAY-2026 EXAM QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES LATEST VERSION SOLVED
QUESTIONS & ANSWERS VERIFIED 100 %
Before starting a patient on biologic therapy for RA, the nurse notes no recent
TB test on file. What is the correct nursing action?
A. Start the biologic and schedule TB testing for next visit
B. Administer PPD test and do not start biologic until negative result
confirmed
C. Document the missing test and proceed with therapy
D. Obtain chest x-ray instead of PPD testing
Answer: B - Administer PPD test and do not start biologic until negative result
confirmed
Rationale: The textbook states: "Determine whether the patient has had a recent
negative purified protein derivative (PPD) test for TB. If not, a PPD skin test is
typically administered and the selected BRM is not started until a negative test result
is confirmed." The nurse must "collaborate with the primary health care provider to
ensure that this process is complete."
A patient on biologic therapy for RA asks why TB screening was required
before starting treatment. What is the nurse's best response?
A. "Biologics can cause new TB infections to develop."
B. "TB testing is required for all patients with autoimmune diseases."
C. "Biologics suppress your immune system and can cause TB to flare up." D.
"The medication is made from TB bacteria."
Answer: C - "Biologics suppress your immune system and can cause TB to flare up."
, Page 2 of 80
Rationale: BRMs place patients "at high risk for developing impaired immunity" and
"make patients susceptible to flare-ups" of TB. They don't cause new infections but
can reactivate latent TB or worsen existing disease due to immunosuppression.
Which patient teaching points should the nurse include for a Rheumatoid
Arthritis patient starting biologic therapy? (Select all that apply)
A. Avoid people with infections
B. Avoid large crowds when possible
C. Report fever immediately
D. Take with antacids to prevent GI upset
E. Expect orange-colored urine
Answers: A, B, C
Rationale:
A & B - CORRECT: "Teach patients receiving any one of the BRMs that they are at a
high risk for developing impaired immunity and subsequent infection. Instruct them to
stay away from people with infections and to avoid large crowds if possible."
C - CORRECT: Fever may indicate infection (priority concern with
immunosuppression)
D & E - INCORRECT: These relate to other medications, not biologics
A nurse is reviewing contraindications for biologic therapy. Which patients
should NOT receive BRMs? (Select all that apply)
A. Patient with positive PPD test
B. Patient with multiple sclerosis
C. Patient with hypertension
D. Patient with active tuberculosis
E. Patient with osteoarthritis
Answers: A, B, D
Rationale: The textbook states patients with "multiple sclerosis (MS), tuberculosis
(TB), or a positive TB test...should not receive BRMs because they make patients
susceptible to flare-ups of these diseases." Hypertension and osteoarthritis are not
contraindications.
A 5-year-old child weighing 20 kg experiences anaphylaxis at school. Which
epinephrine autoinjector dose is appropriate?
, Page 3 of 80
A. Auvi-Q 0.1 mg
B. EpiPen Jr. 0.15 mg
C. EpiPen 0.3 mg
D. No epinephrine needed; administer diphenhydramine only
Answer: B - EpiPen Jr. 0.15 mg
Rationale: The EpiPen Jr. (0.15 mg) is appropriate for children weighing less than 30
kg or 8-30 kg. This 20 kg child falls within that range. The Auvi-Q 0.1 mg is for
children 7.5-15 kg, and the EpiPen 0.3 mg is for children over 30 kg. Injectable
epinephrine is the first drug of choice in acute anaphylaxis treatment.
A child is brought to the emergency department after anaphylaxis from a bee
sting. Symptoms resolved after epinephrine administration. What is the
minimum observation time required?
A. 1 hour
B. 2 hours
C. 4-6 hours
D. 24 hours
Answer: C - 4-6 hours
Rationale: All children experiencing anaphylaxis should be "kept for observation at
least 4 to 6 hours after the episode is resolved to ensure prompt intervention should
a biphasic reaction occur." Biphasic reactions can be as severe as the initial reaction
and occur hours to days later.
The school nurse is teaching a parent how to administer an EpiPen. Which
instruction is correct?
A. Inject into the deltoid muscle
B. Hold against the thigh for 3 seconds
C. Remove clothing before injection
D. Hold against upper outer thigh for 10 seconds
Answer: D - Hold against upper outer thigh for 10 seconds
Rationale: "Teach the parent or child to hold the injector against the skin of the upper
outer region of the child's thigh for 10 seconds after administering the injection to
deliver the medication completely. The EpiPen can be injected through clothing."
, Page 4 of 80
Which diagnostic tests may be used to identify allergens after an anaphylactic
episode? (Select all that apply)
A. Serum IgE levels
B. Skin-prick testing
C. Oral food challenge
D. Complete blood count
E. Chest x-ray
Answers: A, B, C
Rationale: "For children with food allergies, a combination of skin-prick testing,
allergen-specific serum IgE levels, and oral food challenge are the gold standard."
Serum studies may reveal elevated IgE for the exposure agent. CBC and chest x-ray
are not standard allergy diagnostic tests.
A child with a peanut allergy will be attending school. Which nursing actions
are appropriate? (Select all that apply)
A. Notify teachers about the allergy
B. Stock extra epinephrine in nurse's office
C. Obtain written anaphylaxis plan from provider
D. Restrict child from all school activities
E. Notify school nutrition personnel
Answers: A, B, C, E
Rationale: "The school nurse must be ready to appropriately care for these children
by stocking extra epinephrine in the nurse's office." "Children should provide the
school nurse with an allergy and anaphylaxis plan written by their primary care
provider." "It is necessary for the school nurse to notify teachers and school nutrition
personnel if a child or children in the school have allergies to peanuts or other
foods." Restricting all activities is unnecessary and not evidence-based.
A nurse is teaching a female patient with SLE about methotrexate therapy.
Which statement by the patient indicates understanding?
A) "I can breastfeed while taking this medication."
B) "I should stop birth control once my symptoms improve."
C) "I need to stop this medication at least 3 months before trying to get
