UWORLD NCLEX-RN FINAL EXAM ACTUAL QUESTIONS
AND SOLUTIONS RATED A+
✔✔The nurse checks a client's blood pressure using an automatic, noninvasive
machine. The nurse notes that the machine inflates for an unusually long amount of
time, and the client reports intense pain in the arm with the cuff. The device suddenly
stops inflation and displays an error message. Which action by the nurse is
appropriate?
1.
Place a soft washcloth under the cuff and repeat the measurement
2.
Repeat the measurement after moving the cuff to the opposite arm
3.
Repeat the measurement using a new cuff that is a size larger than the client needs
4.
Send the machine for maintenance and repeat the measurement manually - ✔✔4
✔✔An elderly client with diabetes comes to the clinic in winter reporting numbness of
the feet. After removing the client's shoes and socks, the nurse notes that the feet are
ice cold to the touch and appear waxy and pale. What is the appropriate nursing action?
1.
Assist the client with ambulation to promote circulation
2.
Bring the client warm blankets and a warm beverage
3.
Massage the client's hands and feet to promote warming
4.
Soak the client's lower legs in a warm water bath - ✔✔4
✔✔The nurse has just received report on 4 clients. Which client should the nurse see
first?
1.
Client 2 days post hip replacement who is reporting intense itching at the incision site
2.
Client receiving normal saline IV at 250 mL/hr who is reporting puffy legs and a new
cough
3.
Client who is becoming increasingly angry due to a 2-hour delay in being discharged
4.
Client with a potassium level of 5.0 mEq/L (5.0 mmol/L) receiving NS with 20 mEq/L (20
mmol/L) potassium chloride - ✔✔2
✔✔The nurse is teaching a seminar about atypical presentation of myocardial infarction.
The nurse teaches about which factor that increases a client's risk of experiencing
atypical symptoms?
,1.
Female gender
2.
History of smoking
3.
Hyperlipidemia
4.
Hypertension - ✔✔1.
✔✔Which client presenting to the women's health clinic should the nurse assess first?
1.
Client at 9 weeks gestation who reports intractable nausea and vomiting for past 6
hours
2.
Client at 37 weeks gestation with twins who reports irregular contractions
3.
Client whose last menstrual period was 7 weeks ago and reports severe pelvic pain
4.
Primigravida client at 19 weeks gestation who has not yet felt fetal movement - ✔✔3
✔✔A female client is visiting the clinic for an annual well-woman examination. The client
reports having had sex with women. Which question will help the nurse determine the
client's risk for sexually transmitted infections?
1.
"Are you a lesbian, or do you have sex with both men and women?"
2.
"Are you in a monogamous relationship with a female partner?"
3.
"What barrier methods do you and your partner(s) use?"
4.
"What types of sexual acts do you engage in with your partner(s)?" - ✔✔3
✔✔The nurse is caring for a client prescribed 500 mg of daptomycin in 50 mL of normal
saline IV to be administered over 30 minutes every 24 hours. The nurse has IV tubing
with a drip factor of 45 gtt/mL. At what rate in drips per minute (gtt/min) should the nurse
administer the IV daptomycin? Record your answer using a whole number.
Answer: (gtt/min) - ✔✔Answer: 75 (gtt/min)
✔✔A nurse is sent to triage victims at a mass casualty incident site following a disaster
and correctly identifies which client as the priority for transport to a hospital?
1.
Client who has no respirations or palpable pulses and is receiving CPR by bystanders
2.
Client who is cool and clammy with a glass shard penetrating the chest wall
3.
, Client with an open tibial fracture and palpable distal extremity pulses
4.
Client with superficial burns and minor lacerations on the forearms bilaterally - ✔✔2
✔✔The nurse in a psychiatric unit is approached by an aggressive client who grabs the
nurse's stethoscope and attempts to strangle the nurse with it. The nurse is able to
escape the client's grasp unharmed. Which action should the nurse take first?
1.
Begin escorting other clients out of the room
2.
Calmly ask the client to verbally express feelings
3.
Escort the client into a secluded room
4.
Place the client in restraints until calm - ✔✔1
✔✔The clinic nurse is listening to voicemail messages in the office. Which client should
the nurse call back first?
1.
Client started on capsaicin cream 2 days ago reports sudden burning in the eyes
2.
Client started on carbidopa-levodopa a day ago reports dizziness on standing
3.
Client started on hydroxyzine 3 days ago reports urinary difficulty and hesitancy
4.
Client started on phenytoin a week ago reports blistered lesions on the face and trunk -
✔✔4
✔✔The nurse responds to a neighbor's calls for help and finds the neighbor's infant is
choking but still responsive. Which intervention is most appropriate at this time?
1.
Call 911 and begin cardiopulmonary resuscitation
2.
Perform 5 back slaps followed by 5 downward chest thrusts
3.
Perform a finger sweep of the mouth to assess for foreign objects
4.
Place the infant on the nurse's lap and perform abdominal thrusts - ✔✔2
✔✔The nurse is teaching a client about newly prescribed cyclosporine. Which client
statement indicates a need for further teaching?
1.
"I am going to a concert with my friends this weekend."
2.
"I can use a hair removal cream for excess hair growth."
AND SOLUTIONS RATED A+
✔✔The nurse checks a client's blood pressure using an automatic, noninvasive
machine. The nurse notes that the machine inflates for an unusually long amount of
time, and the client reports intense pain in the arm with the cuff. The device suddenly
stops inflation and displays an error message. Which action by the nurse is
appropriate?
1.
Place a soft washcloth under the cuff and repeat the measurement
2.
Repeat the measurement after moving the cuff to the opposite arm
3.
Repeat the measurement using a new cuff that is a size larger than the client needs
4.
Send the machine for maintenance and repeat the measurement manually - ✔✔4
✔✔An elderly client with diabetes comes to the clinic in winter reporting numbness of
the feet. After removing the client's shoes and socks, the nurse notes that the feet are
ice cold to the touch and appear waxy and pale. What is the appropriate nursing action?
1.
Assist the client with ambulation to promote circulation
2.
Bring the client warm blankets and a warm beverage
3.
Massage the client's hands and feet to promote warming
4.
Soak the client's lower legs in a warm water bath - ✔✔4
✔✔The nurse has just received report on 4 clients. Which client should the nurse see
first?
1.
Client 2 days post hip replacement who is reporting intense itching at the incision site
2.
Client receiving normal saline IV at 250 mL/hr who is reporting puffy legs and a new
cough
3.
Client who is becoming increasingly angry due to a 2-hour delay in being discharged
4.
Client with a potassium level of 5.0 mEq/L (5.0 mmol/L) receiving NS with 20 mEq/L (20
mmol/L) potassium chloride - ✔✔2
✔✔The nurse is teaching a seminar about atypical presentation of myocardial infarction.
The nurse teaches about which factor that increases a client's risk of experiencing
atypical symptoms?
,1.
Female gender
2.
History of smoking
3.
Hyperlipidemia
4.
Hypertension - ✔✔1.
✔✔Which client presenting to the women's health clinic should the nurse assess first?
1.
Client at 9 weeks gestation who reports intractable nausea and vomiting for past 6
hours
2.
Client at 37 weeks gestation with twins who reports irregular contractions
3.
Client whose last menstrual period was 7 weeks ago and reports severe pelvic pain
4.
Primigravida client at 19 weeks gestation who has not yet felt fetal movement - ✔✔3
✔✔A female client is visiting the clinic for an annual well-woman examination. The client
reports having had sex with women. Which question will help the nurse determine the
client's risk for sexually transmitted infections?
1.
"Are you a lesbian, or do you have sex with both men and women?"
2.
"Are you in a monogamous relationship with a female partner?"
3.
"What barrier methods do you and your partner(s) use?"
4.
"What types of sexual acts do you engage in with your partner(s)?" - ✔✔3
✔✔The nurse is caring for a client prescribed 500 mg of daptomycin in 50 mL of normal
saline IV to be administered over 30 minutes every 24 hours. The nurse has IV tubing
with a drip factor of 45 gtt/mL. At what rate in drips per minute (gtt/min) should the nurse
administer the IV daptomycin? Record your answer using a whole number.
Answer: (gtt/min) - ✔✔Answer: 75 (gtt/min)
✔✔A nurse is sent to triage victims at a mass casualty incident site following a disaster
and correctly identifies which client as the priority for transport to a hospital?
1.
Client who has no respirations or palpable pulses and is receiving CPR by bystanders
2.
Client who is cool and clammy with a glass shard penetrating the chest wall
3.
, Client with an open tibial fracture and palpable distal extremity pulses
4.
Client with superficial burns and minor lacerations on the forearms bilaterally - ✔✔2
✔✔The nurse in a psychiatric unit is approached by an aggressive client who grabs the
nurse's stethoscope and attempts to strangle the nurse with it. The nurse is able to
escape the client's grasp unharmed. Which action should the nurse take first?
1.
Begin escorting other clients out of the room
2.
Calmly ask the client to verbally express feelings
3.
Escort the client into a secluded room
4.
Place the client in restraints until calm - ✔✔1
✔✔The clinic nurse is listening to voicemail messages in the office. Which client should
the nurse call back first?
1.
Client started on capsaicin cream 2 days ago reports sudden burning in the eyes
2.
Client started on carbidopa-levodopa a day ago reports dizziness on standing
3.
Client started on hydroxyzine 3 days ago reports urinary difficulty and hesitancy
4.
Client started on phenytoin a week ago reports blistered lesions on the face and trunk -
✔✔4
✔✔The nurse responds to a neighbor's calls for help and finds the neighbor's infant is
choking but still responsive. Which intervention is most appropriate at this time?
1.
Call 911 and begin cardiopulmonary resuscitation
2.
Perform 5 back slaps followed by 5 downward chest thrusts
3.
Perform a finger sweep of the mouth to assess for foreign objects
4.
Place the infant on the nurse's lap and perform abdominal thrusts - ✔✔2
✔✔The nurse is teaching a client about newly prescribed cyclosporine. Which client
statement indicates a need for further teaching?
1.
"I am going to a concert with my friends this weekend."
2.
"I can use a hair removal cream for excess hair growth."
