NCSBN NCLEX RN 2026 Online EXAM Actual Questions And Correct Detailed Answers New Update
1.A.client has heen hospitalized after an automobile aceident. A full leg cast was applied in the emergency room. The mest importunt
reason for the nurse to elevate the casted leg is to
A) Promote the client's comfort
B) Reduce the drying time
C) Decrease irritation to the skin
D) Improve venous return
D: Improve venous retum. Elevating the leg both improves venous relurn and reduces swelling. Client comfort will be improved as well.
2. The nurse is reviewing with a clicnt how to colfect a clean eatch urine specimen. What is the appropriate sequence to teach the client?
A) Clean the meatus,begin voiding, then catch urine stream
B) Void a little,cleanthe meatus,then collect specimen
C) Clean the meatus, then urinate into contriner
D) Void continuously and catch some of the urine
A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions.
Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating
the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it's best to just slip the container into the
stream. Other responses do not reflect correct technique
3. Following change-of-shift report on an orthopedic unit, which client should the nurse sec first?
A) 16 year-old who had an open reduction of a fractured wrist 10 hours ago
B) 20 year-old in skeletal traction for 2 wecks since a motor cyele aecident
C) 72 year-old recovering from surgery after a hip replacement 2 hours ago
D) 75 year-old who is in skin traction prioe to planned hip pinning surgery.
C: Look for the client who has the most imminent risks and scule vulnerability. The client who returned from surgery 2 hours ago is at risk
for life threatening hemorriage and should be seen first. The 16 year-old should be seen next because it is still the first post-op day. The 75
year-old is potentially vulnerable to ago-related physical and cognitive consequences in skin traction should be seen next. The client who
can safely be seen last is the 20 yecar-old who is 2 wecks post-injury.
4. A client with Guillain Barre is in a nonresponsive state, yer vitalsigns are stable and breathing is independent. What should the nurse
document to most accurately describe the client's condition?
A) Comatose, breathing unlabored
B) Glascow Coman Seale 8,respirations regulur
C) Appear 1o be slecping,vital signs stable
D) Glascow Coma Scale 13,no ventilator required
B: Glascow Coma Scale 8, respirations regular. The Glascow Coma Scale provides a standard reference for assessing or monitoring level of
consciousness. Any seore less than 13 indicates a neurologieal impairment. Using the term comntose provides tou much roomn for
interpretation and is not very precise.
5. When caring for a client receiving warfarin sodium (Coumadin), which lab lest would the nurse monitor to determine therapeutic
response to the drug?
A) Bleeding time
B) Coagulation time
C) Prothrombin time
D) Partial thromboplastin time
C: Prothrombin time. Coumadin is ordered daily, based on the elient's prothrumbin time (PT). This test evaluates the adequncy of the
extrinsic system and common pathway in the clotting cascade: Coumadin affects the Vitamin K. dependent clotting factors.
6.A client with moderate persistent asthma is admitted for a minor surgical procedure. On admission the peak flow meter is measured at
480 liters/minute. Post-operatively the client is complaining of chest tightness. The peak flow has dropped to 200 liters/minute.What
should the narse do first?
A) Notify both the surgeon and provider
B) Administer the prn dose of albuterol
C) Apply oxygen a1 2 liters per nasal caanula
D) Repeat the peak flow reading in 30 minutes
B:Administer the pm dose of albuterol. Peak flow monitoring during exacerbations of asthma is recommended for elients with moderate-
to-severe persistent asthma to determine the severity of the exacerbation and to guide the treatment. A peak flow reading of less than
50% of the client's baseline reading is a medical alert condition and a short-acting beta-agonist must be taken immediately.
7.A client had 20 mg of Lasix (furosemide) PO at 10 AM. Which would be essential for the nurse to include at the change of shin report?
A) The client lost 2 pounds in 24 hours
1
, B) The client's potassium level is 4 mEq/liter.
C) The client's urine output was 1500 ce in 5 hours
D) The client is to receive another dose of Lasix at 10 PM
C: The client's urine output was 1500 cc in 5 hours. Although all of these may be correct information to include in report. the essential piece
would be the urine output.
8.A client has been tentatively diagnosed with Graves' disease (hyperthyroidism). Which of these findings noted on the initialnursing
assessment requires quick intervention by the nurse?
A) a report of 10 pounds weight loss in the last month
B) a comment by the client "I just can't sit still."
C) the appearance of eyeballs that appear to "pop" out of theclient's cye sockets
D) a report of the sudden onset of irritability in the past 2 weeks
C: the appearance of eyeballs that appear to "pop" out of the client's eye sockets. Exophthalmos or protruding eyeballs is a distinctive
characteristic of Graves" Disease. It can result in comeal abrasions with severe eye pain or damage when the cyelid is unable to blink down
aver the: protruding eyeball. Eye drops or ointment may be needed.
9. The nurse has performed the initial assessments of 4 clients admitted with an acute episode of asthma. Which assessment finding would
cause the nurse to call the provider iminediately?
A) prolonged inspiration with each breath
B) expiratory wheezes that are suddenly absent in I lobe
C) expectoration of large amounts of purulent mucous
D) appearance of the use of abdominal muscles for breathing
B: expiratory wheezes that are suddenly absent in I lobe. Acute asthma is characterized by expiratory wheezes caused by obstruction of the
airways. Wheezes are a high pitched musical sounds produced by air moving through narowed airways.Clients often associate wheezes with
the feeling of tightness in the chest. However, sudden cessation of wheezing is an ominous or bad sign that indicates an emergency-- the small
airways are now collapsed.
10.During the initial home visit, a nurse is discussing the care ofa client newly diagnosed with Alzheimer's disease with family members. Which
of these interventions would be most helpful at this time?
A) leave a book about relaxation techniques
B) write out a daily exercise routine for them to assist the client to do
C) list actions to improve the client's daily nutritional intake
D) suggest communication strategies
D:suggest communication strategies. Alzheimer's discase, a progressive chronic illness, greatly challenges caregivers. The nurse can be of
greatest assistance in helping the family to use communication strategies to enhance their ability to relate to the client.By use of select verbal
and nonverbal communication strategies the family can best support the client's strengths and cope with any aberrant behavior.
1 1.An 80 year-old client admitted with a diagnosis of possible cerebral vascular accident has had a blood pressure from 160/100 to 180/110
over the past 2 hours. The nurse has also noted increased lethargy. Which assessment finding should the nurse report immediately to the
provider?
A) Slurred speech
B) Incontinence
C) Muscle weakness
D) Rapid pulse
A: Slurred speech. Changes in speech patterns and level of conscious can be indicators of continued intracranial bleeding or extension of the
stroke. Further diagnostic testing may be indicated.
12. A school-aged child has had a long leg (hipto ankle) synthetic east applied 4 hours ago. Which statement from the parent indicates that
teaching has been inadequate?
A) "I will keep the cast uncovered for the next day to prevent buring of the skin."
B) "I can apply an iee pack over the area to relieve itching inside the cast."
C) "The cast should be propped on at least 2 pillows when mny child is lying down."
D) "I think I remember that my child should not stand until after 72 hours."
D:"I think I remember that my child should not stand until after 72 hous.". Synthetic casts will typically set up in 30 mimttes and dry in a few
hours. Thus, the client may stand within the initial 24 hours. With plaster casts, the set up and drying time,especially in a long leg cast which
is thicker than an arm cast, can take up to 72 hours. Both types of casts give offa lot of heat when drying and it is preferable to keep the cast
uncovered for the tirst 24 hours. Clients may complain of a chill from the wet cast and therefore can simply be covered lightly with a sheet or
blanket. Applying ice is a safe method ofrelieving the itching.
13. Which blood serum finding in a client with diabetic ketoacidosis alerts the nurse that immediate action is required?
A) pH below 7.3
B) Potassium of 5.0
C) HCT of 60
Di Pa O:of 79%
1
, C: HCT of 60. This high hematocrit is indicative of severe dehydration which requires priovity attention in diabetic ketoacidosis.Without
sufficient hydrution, all systems of the body are at risk for hypoxia from a lack of or sluggish circulation. In theabsence of insulin,which
facilitates the transport of glucose into the cell, the body breaks down fats and proteins to supply cnergy
ketones, a by-product of fat metabolism. These accumulate causing metabolic acidosis(pH<7.3),which would be the second concern for this
client. The potassium and PaO: levels are near normal.
14. The nurse is preparing a client with a deep vein thrombosis (DVT) for a Venous Doppler evaluation. Which of the following wotld be
necessary for preparing the client for this test?
A) Client should be NPO after midnight
B) Client should receive a sedalive medication prior to the test
C) Discontinue anti-congulant therupy prior to the test
D) No special preparation is necessary
D: No special preparation is necessary. This is a nom-invasive procedure and does not require preparation other than client education.
15. A client is admitted with infective endocarditis (IE). Which finding would alert the nurse to a complication of this condition?
A) dyspnea
B) heart murmur
C) macular rash
D) Hemorrhage
B: heart murmur. Large, soft, rapidly developing vegctations attach to the heart valves. They have a tendency to break off.causing emboli
and leaving ulcerations on the valve leatlets. These emboli produce findings of cardiac murmur, fever, anorexia.malaise and neurologie
sequelae of emboli. Furthermore, the vegetations may travel to various organs such as spleen. kidney.coronary artery, brain and lungs, and
obstruct blood flow.
16. The nurse explains an autograft to a client scheduled for excision of a skin tumor. The nurse knows the client understands the procedure
when the client says, "I will receivetissue from
A) a tissue bank,"
B) a pig."
C)my thigh."
D) synthetie skin."
C: my thigh.". Autografts are done with tissue transplanted from the client"s own skin.
17.A client is admitted to the emergency room following an acute asthma attack. Which of the following assessments would be expected by
the nurse?
A) Diffuse expiratory wheezing
B) Loose,productive cough
C) No relief from inhalant
D) Fever and chills
A:Diffuse expiratory wheezing. In asthma, the airways are narrowed,creating difficulty getting air in. A wheezing sound results.
18. A client has been admitted with a fractured femur and has bcen placed in skeletal traction. Which of the following nursing interventions
should receive priority?
A) Maintaining proper body alignment
B) Frequent neurovascular assessments of the affected leg
C) Inspection of pin sites for evidence of drainage or intlammation
D) Applying an over-bed trapeze to assist the client with movement in bed
B: Frequent neurovascular assessments of the affected leg. The most important activity for the nurse is to assess neurovascular status.
Compartment syndrome is a serious complication of fractures. Prompt recognition of this neurovascular problem and carly intervention may
prevent permanent limb damage.
19. The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. The client has many questions about this
condition. What area is a priority for the nurse to discuss at this time?
A) Daily needs and concems
B) The overview cardiac rehabilitation
C) Medication and diet guideline
D) Activity and rest guidelines
A: Daily needs and concerns. At 2 days post-MI, the client's education should be focused on the immediate needs and concems for the day.
20. A 3 year-old child is brought to the clinic by his grandmother to be seen for "scratching his bottom and wetting the bed at night."Based
on these complaints, the nurse would initially assess for which problem?
A)allergies
B) scabies
C) regression
D) pinworms
1.A.client has heen hospitalized after an automobile aceident. A full leg cast was applied in the emergency room. The mest importunt
reason for the nurse to elevate the casted leg is to
A) Promote the client's comfort
B) Reduce the drying time
C) Decrease irritation to the skin
D) Improve venous return
D: Improve venous retum. Elevating the leg both improves venous relurn and reduces swelling. Client comfort will be improved as well.
2. The nurse is reviewing with a clicnt how to colfect a clean eatch urine specimen. What is the appropriate sequence to teach the client?
A) Clean the meatus,begin voiding, then catch urine stream
B) Void a little,cleanthe meatus,then collect specimen
C) Clean the meatus, then urinate into contriner
D) Void continuously and catch some of the urine
A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions.
Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating
the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it's best to just slip the container into the
stream. Other responses do not reflect correct technique
3. Following change-of-shift report on an orthopedic unit, which client should the nurse sec first?
A) 16 year-old who had an open reduction of a fractured wrist 10 hours ago
B) 20 year-old in skeletal traction for 2 wecks since a motor cyele aecident
C) 72 year-old recovering from surgery after a hip replacement 2 hours ago
D) 75 year-old who is in skin traction prioe to planned hip pinning surgery.
C: Look for the client who has the most imminent risks and scule vulnerability. The client who returned from surgery 2 hours ago is at risk
for life threatening hemorriage and should be seen first. The 16 year-old should be seen next because it is still the first post-op day. The 75
year-old is potentially vulnerable to ago-related physical and cognitive consequences in skin traction should be seen next. The client who
can safely be seen last is the 20 yecar-old who is 2 wecks post-injury.
4. A client with Guillain Barre is in a nonresponsive state, yer vitalsigns are stable and breathing is independent. What should the nurse
document to most accurately describe the client's condition?
A) Comatose, breathing unlabored
B) Glascow Coman Seale 8,respirations regulur
C) Appear 1o be slecping,vital signs stable
D) Glascow Coma Scale 13,no ventilator required
B: Glascow Coma Scale 8, respirations regular. The Glascow Coma Scale provides a standard reference for assessing or monitoring level of
consciousness. Any seore less than 13 indicates a neurologieal impairment. Using the term comntose provides tou much roomn for
interpretation and is not very precise.
5. When caring for a client receiving warfarin sodium (Coumadin), which lab lest would the nurse monitor to determine therapeutic
response to the drug?
A) Bleeding time
B) Coagulation time
C) Prothrombin time
D) Partial thromboplastin time
C: Prothrombin time. Coumadin is ordered daily, based on the elient's prothrumbin time (PT). This test evaluates the adequncy of the
extrinsic system and common pathway in the clotting cascade: Coumadin affects the Vitamin K. dependent clotting factors.
6.A client with moderate persistent asthma is admitted for a minor surgical procedure. On admission the peak flow meter is measured at
480 liters/minute. Post-operatively the client is complaining of chest tightness. The peak flow has dropped to 200 liters/minute.What
should the narse do first?
A) Notify both the surgeon and provider
B) Administer the prn dose of albuterol
C) Apply oxygen a1 2 liters per nasal caanula
D) Repeat the peak flow reading in 30 minutes
B:Administer the pm dose of albuterol. Peak flow monitoring during exacerbations of asthma is recommended for elients with moderate-
to-severe persistent asthma to determine the severity of the exacerbation and to guide the treatment. A peak flow reading of less than
50% of the client's baseline reading is a medical alert condition and a short-acting beta-agonist must be taken immediately.
7.A client had 20 mg of Lasix (furosemide) PO at 10 AM. Which would be essential for the nurse to include at the change of shin report?
A) The client lost 2 pounds in 24 hours
1
, B) The client's potassium level is 4 mEq/liter.
C) The client's urine output was 1500 ce in 5 hours
D) The client is to receive another dose of Lasix at 10 PM
C: The client's urine output was 1500 cc in 5 hours. Although all of these may be correct information to include in report. the essential piece
would be the urine output.
8.A client has been tentatively diagnosed with Graves' disease (hyperthyroidism). Which of these findings noted on the initialnursing
assessment requires quick intervention by the nurse?
A) a report of 10 pounds weight loss in the last month
B) a comment by the client "I just can't sit still."
C) the appearance of eyeballs that appear to "pop" out of theclient's cye sockets
D) a report of the sudden onset of irritability in the past 2 weeks
C: the appearance of eyeballs that appear to "pop" out of the client's eye sockets. Exophthalmos or protruding eyeballs is a distinctive
characteristic of Graves" Disease. It can result in comeal abrasions with severe eye pain or damage when the cyelid is unable to blink down
aver the: protruding eyeball. Eye drops or ointment may be needed.
9. The nurse has performed the initial assessments of 4 clients admitted with an acute episode of asthma. Which assessment finding would
cause the nurse to call the provider iminediately?
A) prolonged inspiration with each breath
B) expiratory wheezes that are suddenly absent in I lobe
C) expectoration of large amounts of purulent mucous
D) appearance of the use of abdominal muscles for breathing
B: expiratory wheezes that are suddenly absent in I lobe. Acute asthma is characterized by expiratory wheezes caused by obstruction of the
airways. Wheezes are a high pitched musical sounds produced by air moving through narowed airways.Clients often associate wheezes with
the feeling of tightness in the chest. However, sudden cessation of wheezing is an ominous or bad sign that indicates an emergency-- the small
airways are now collapsed.
10.During the initial home visit, a nurse is discussing the care ofa client newly diagnosed with Alzheimer's disease with family members. Which
of these interventions would be most helpful at this time?
A) leave a book about relaxation techniques
B) write out a daily exercise routine for them to assist the client to do
C) list actions to improve the client's daily nutritional intake
D) suggest communication strategies
D:suggest communication strategies. Alzheimer's discase, a progressive chronic illness, greatly challenges caregivers. The nurse can be of
greatest assistance in helping the family to use communication strategies to enhance their ability to relate to the client.By use of select verbal
and nonverbal communication strategies the family can best support the client's strengths and cope with any aberrant behavior.
1 1.An 80 year-old client admitted with a diagnosis of possible cerebral vascular accident has had a blood pressure from 160/100 to 180/110
over the past 2 hours. The nurse has also noted increased lethargy. Which assessment finding should the nurse report immediately to the
provider?
A) Slurred speech
B) Incontinence
C) Muscle weakness
D) Rapid pulse
A: Slurred speech. Changes in speech patterns and level of conscious can be indicators of continued intracranial bleeding or extension of the
stroke. Further diagnostic testing may be indicated.
12. A school-aged child has had a long leg (hipto ankle) synthetic east applied 4 hours ago. Which statement from the parent indicates that
teaching has been inadequate?
A) "I will keep the cast uncovered for the next day to prevent buring of the skin."
B) "I can apply an iee pack over the area to relieve itching inside the cast."
C) "The cast should be propped on at least 2 pillows when mny child is lying down."
D) "I think I remember that my child should not stand until after 72 hours."
D:"I think I remember that my child should not stand until after 72 hous.". Synthetic casts will typically set up in 30 mimttes and dry in a few
hours. Thus, the client may stand within the initial 24 hours. With plaster casts, the set up and drying time,especially in a long leg cast which
is thicker than an arm cast, can take up to 72 hours. Both types of casts give offa lot of heat when drying and it is preferable to keep the cast
uncovered for the tirst 24 hours. Clients may complain of a chill from the wet cast and therefore can simply be covered lightly with a sheet or
blanket. Applying ice is a safe method ofrelieving the itching.
13. Which blood serum finding in a client with diabetic ketoacidosis alerts the nurse that immediate action is required?
A) pH below 7.3
B) Potassium of 5.0
C) HCT of 60
Di Pa O:of 79%
1
, C: HCT of 60. This high hematocrit is indicative of severe dehydration which requires priovity attention in diabetic ketoacidosis.Without
sufficient hydrution, all systems of the body are at risk for hypoxia from a lack of or sluggish circulation. In theabsence of insulin,which
facilitates the transport of glucose into the cell, the body breaks down fats and proteins to supply cnergy
ketones, a by-product of fat metabolism. These accumulate causing metabolic acidosis(pH<7.3),which would be the second concern for this
client. The potassium and PaO: levels are near normal.
14. The nurse is preparing a client with a deep vein thrombosis (DVT) for a Venous Doppler evaluation. Which of the following wotld be
necessary for preparing the client for this test?
A) Client should be NPO after midnight
B) Client should receive a sedalive medication prior to the test
C) Discontinue anti-congulant therupy prior to the test
D) No special preparation is necessary
D: No special preparation is necessary. This is a nom-invasive procedure and does not require preparation other than client education.
15. A client is admitted with infective endocarditis (IE). Which finding would alert the nurse to a complication of this condition?
A) dyspnea
B) heart murmur
C) macular rash
D) Hemorrhage
B: heart murmur. Large, soft, rapidly developing vegctations attach to the heart valves. They have a tendency to break off.causing emboli
and leaving ulcerations on the valve leatlets. These emboli produce findings of cardiac murmur, fever, anorexia.malaise and neurologie
sequelae of emboli. Furthermore, the vegetations may travel to various organs such as spleen. kidney.coronary artery, brain and lungs, and
obstruct blood flow.
16. The nurse explains an autograft to a client scheduled for excision of a skin tumor. The nurse knows the client understands the procedure
when the client says, "I will receivetissue from
A) a tissue bank,"
B) a pig."
C)my thigh."
D) synthetie skin."
C: my thigh.". Autografts are done with tissue transplanted from the client"s own skin.
17.A client is admitted to the emergency room following an acute asthma attack. Which of the following assessments would be expected by
the nurse?
A) Diffuse expiratory wheezing
B) Loose,productive cough
C) No relief from inhalant
D) Fever and chills
A:Diffuse expiratory wheezing. In asthma, the airways are narrowed,creating difficulty getting air in. A wheezing sound results.
18. A client has been admitted with a fractured femur and has bcen placed in skeletal traction. Which of the following nursing interventions
should receive priority?
A) Maintaining proper body alignment
B) Frequent neurovascular assessments of the affected leg
C) Inspection of pin sites for evidence of drainage or intlammation
D) Applying an over-bed trapeze to assist the client with movement in bed
B: Frequent neurovascular assessments of the affected leg. The most important activity for the nurse is to assess neurovascular status.
Compartment syndrome is a serious complication of fractures. Prompt recognition of this neurovascular problem and carly intervention may
prevent permanent limb damage.
19. The nurse is assigned to care for a client who had a myocardial infarction (MI) 2 days ago. The client has many questions about this
condition. What area is a priority for the nurse to discuss at this time?
A) Daily needs and concems
B) The overview cardiac rehabilitation
C) Medication and diet guideline
D) Activity and rest guidelines
A: Daily needs and concerns. At 2 days post-MI, the client's education should be focused on the immediate needs and concems for the day.
20. A 3 year-old child is brought to the clinic by his grandmother to be seen for "scratching his bottom and wetting the bed at night."Based
on these complaints, the nurse would initially assess for which problem?
A)allergies
B) scabies
C) regression
D) pinworms
