U-World NCLEX-PN 2026 NEWEST EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS\ACTUAL
TEST BANK FINAL EXAM WITH RATIONALES \LATEST
VERSION
Q1. A client comes to the emergency department with severe dyspnea
and a cough. Vital signs are temperature 99.2 F (37.3 C), blood pressure
108/70 mm Hg, heart rate 88/min, and respirations 24/min. The client has
a history of chronic obstructive pulmonary disease and chronic heart
failure. Which diagnostic test will be most useful to the nurse in
determining if this is an exacerbation of heart failure?
1. Arterial blood gases (ABGs)
2. B-type natriuretic peptide (BNP)
3. Cardiac enzyme (CK-MB)
4. Chest x-ray
CORRECT ANSWER: 2
B-type natriuretic peptide (BNP) is a peptide that causes natriuresis. BNPs
are made, stored, and released primarily by the ventricles. They are
produced in response to stretching of the ventricles due to the increased
blood volume and higher levels of extracellular fluid (fluid overload) that
accompany heart failure. Elevation of BNP >100 pg/mL (>28.9 pmol/L) helps
to distinguish cardiac from respiratory causes of dyspnea (Option 2 is
correct).
(Option 1 is wrong.) Arterial blood gases (ABGs) will be helpful in
, determining the client's oxygenation status and acid-base balance but will
not determine whether the cause of the dyspnea is cardiac or respiratory.
(Option 3 is wrong.) Cardiac enzymes (CK-MB) is a cardiospecific isozyme
that is released in the presence of myocardial tissue injury. Elevations are
highly indicative of a myocardial infarction but not specific for heart failure.
(Option 4 is wrong.) A chest x-ray can show heart enlargement in the case of heart
failure and may show infiltrations in the lungs. Pneumonia can also exacerbate
chronic obstructive pulmonary disease and can be confused with heart failure
infiltrates. Chest x-ray is not as specific to heart failure as the BNP lab test.
Q2. The clinic nurse reinforces teaching to a client with systemic lupus
erythematous. Which instructions will the nurse include? Select all that
apply.
1. Avoid annual influenza vaccination
2. Avoid situations that cause physical and emotional stress
3. Avoid sun exposure and ultraviolet light when possible
4. Notify the health care provider if you have fever
5. Use antibiotic soap to cleanse skin rashes
,CORRECT ANSWER: 2, 3, 4
Systemic lupus erythematosus (SLE) is an autoimmune disorder (the body's
immune system erroneously attacks body tissues) that results in
inflammation and damage to many body parts. Symptoms vary widely
among affected individuals, but most experience painful/swollen joints,
extreme fatigue, skin rashes, and kidney problems. The symptoms typically
appear for periods of time (called flares) alternating with periods of
remission.
There is no cure for SLE, but it can be treated with immunosuppressants (eg,
corticosteroids) or immunomodulators (eg, hydroxychloroquine).
Pneumonia and annual influenza vaccinations are recommended for those
with SLE as thev are more susceptible to infections. These individuals should
avoid contact with sick people and report fever to their health care provider
(Options 1 is wrong. Option 4 is correct).
Both physical and emotional stress can exacerbate SLE. Therefore, clients
should follow a healthy lifestyle (eg, 7-8 hours of sleep, no smoking).
Balanced exercise with alternating periods of rest is recommended (Option
, Sunlight is known to worsen the rash of SLE and should be avoided when
possible (especially between 10 AM-4 PM); protective clothing and
sunscreen application are recommended during periods of sun exposure
Harsh soap and chemicals should be avoided. The rash is not due to
bacterial infection.
QUESTIONS AND CORRECT DETAILED ANSWERS\ACTUAL
TEST BANK FINAL EXAM WITH RATIONALES \LATEST
VERSION
Q1. A client comes to the emergency department with severe dyspnea
and a cough. Vital signs are temperature 99.2 F (37.3 C), blood pressure
108/70 mm Hg, heart rate 88/min, and respirations 24/min. The client has
a history of chronic obstructive pulmonary disease and chronic heart
failure. Which diagnostic test will be most useful to the nurse in
determining if this is an exacerbation of heart failure?
1. Arterial blood gases (ABGs)
2. B-type natriuretic peptide (BNP)
3. Cardiac enzyme (CK-MB)
4. Chest x-ray
CORRECT ANSWER: 2
B-type natriuretic peptide (BNP) is a peptide that causes natriuresis. BNPs
are made, stored, and released primarily by the ventricles. They are
produced in response to stretching of the ventricles due to the increased
blood volume and higher levels of extracellular fluid (fluid overload) that
accompany heart failure. Elevation of BNP >100 pg/mL (>28.9 pmol/L) helps
to distinguish cardiac from respiratory causes of dyspnea (Option 2 is
correct).
(Option 1 is wrong.) Arterial blood gases (ABGs) will be helpful in
, determining the client's oxygenation status and acid-base balance but will
not determine whether the cause of the dyspnea is cardiac or respiratory.
(Option 3 is wrong.) Cardiac enzymes (CK-MB) is a cardiospecific isozyme
that is released in the presence of myocardial tissue injury. Elevations are
highly indicative of a myocardial infarction but not specific for heart failure.
(Option 4 is wrong.) A chest x-ray can show heart enlargement in the case of heart
failure and may show infiltrations in the lungs. Pneumonia can also exacerbate
chronic obstructive pulmonary disease and can be confused with heart failure
infiltrates. Chest x-ray is not as specific to heart failure as the BNP lab test.
Q2. The clinic nurse reinforces teaching to a client with systemic lupus
erythematous. Which instructions will the nurse include? Select all that
apply.
1. Avoid annual influenza vaccination
2. Avoid situations that cause physical and emotional stress
3. Avoid sun exposure and ultraviolet light when possible
4. Notify the health care provider if you have fever
5. Use antibiotic soap to cleanse skin rashes
,CORRECT ANSWER: 2, 3, 4
Systemic lupus erythematosus (SLE) is an autoimmune disorder (the body's
immune system erroneously attacks body tissues) that results in
inflammation and damage to many body parts. Symptoms vary widely
among affected individuals, but most experience painful/swollen joints,
extreme fatigue, skin rashes, and kidney problems. The symptoms typically
appear for periods of time (called flares) alternating with periods of
remission.
There is no cure for SLE, but it can be treated with immunosuppressants (eg,
corticosteroids) or immunomodulators (eg, hydroxychloroquine).
Pneumonia and annual influenza vaccinations are recommended for those
with SLE as thev are more susceptible to infections. These individuals should
avoid contact with sick people and report fever to their health care provider
(Options 1 is wrong. Option 4 is correct).
Both physical and emotional stress can exacerbate SLE. Therefore, clients
should follow a healthy lifestyle (eg, 7-8 hours of sleep, no smoking).
Balanced exercise with alternating periods of rest is recommended (Option
, Sunlight is known to worsen the rash of SLE and should be avoided when
possible (especially between 10 AM-4 PM); protective clothing and
sunscreen application are recommended during periods of sun exposure
Harsh soap and chemicals should be avoided. The rash is not due to
bacterial infection.
