Page 1 of 575
NEW NCLEX UWORLD ,ARCHER REVIEW ,
BOOTCAMP AND HURST REVIEW PRACTICE
QUESTIONS FOR EXAM WITH CORRECT
ANSWERS,RATIONALES AND WHY THE
OTHERS ARE NOT CORRECT NEWEST 2026
EXAM VERIFIED
***HURST REVIEW NCLEX-RN Readiness Exam 1***
The charge nurse is evaluating knowledge of tracheostomy suctioning of a
new nurse prior to that procedure being performed. Which statement by the
new nurse would indicate to the charge nurse that additional education is
needed?
1. "Prior to suctioning, I will hyper-oxygenate the client."
2. "I will instill normal saline bullets to liquefy secretions."
3. "I will allow at least 20 seconds between suctioning passes."
4. "Suctioning will be limited to a maximum of three catheter passes."
2
Why the Correct Option Is Right
• 2. "I will instill normal saline bullets to liquefy secretions."
o The Key Phrase: The question asks which statement shows that
additional education is needed (a negative-stem question).
o Clinical Danger: Routinely instilling normal saline drops or "bullets"
directly into a tracheostomy or endotracheal tube prior to suctioning is
no longer an approved clinical practice.
o The Consequences: Research shows that instilling saline does not
effectively liquefy deep secretions. Instead, it breaks up bacterial
biofilms and forces pathogens deeper into the lower respiratory tract,
significantly increasing the client's risk for Ventilator-Associated
, Page 2 of 575
Pneumonia (VAP) or tracheostomy infections. It also strips away
protective bronchial surfactant and causes a sudden, temporary drop in
the client's oxygen saturation levels. [1, 2]
Why the Other Options Are Correct Practices (Do Not Need
Correction)
• ❌ 1. "Prior to suctioning, I will hyper-oxygenate the client."
o This is excellent, standard nursing practice. Tracheal suctioning
removes both secretions and vital air from the lungs, which drops
oxygen levels. Providing 100% oxygen before starting protects the
patient from sudden hypoxemia and cardiac arrhythmias. [1, 2]
• ❌ 3. "I will allow at least 20 seconds between suctioning passes."
o This is a correct practice. Pausing for at least 20 to 30 seconds
between each catheter pass gives the client time to breathe, re-
oxygenate their blood, and recover from the stress of the procedure. [1,
2]
• ❌ 4. "Suctioning will be limited to a maximum of three catheter
passes."
o This is a correct practice. Limiting the entire suctioning session to a
maximum of 3 passes minimizes trauma to the sensitive tracheal
mucosa and prevents severe oxygen depletion
The nurse observes a client at a follow-up appointment using correct cane
walking technique but losing balance each time the quad cane is lifted off of
the floor. The client reports a history of recent falls. What is the best action for
the nurse to take?
1. Inform the primary healthcare provider of the observations made regarding
quad cane use, and imbalance assessment.
2. Inform client that there are only a few assistive devices available to help
with ambulation.
3. Instruct the client on proper quad cane use.
4. Notify the primary healthcare provider after consulting with the neighbor.
1
Why the Correct Option Is Right
• 1. Inform the primary healthcare provider of the observations made
regarding quad cane use, and imbalance assessment.
o Clinical Real-World Assessment: The nurse assesses that the client is
already using the correct cane technique, yet they are still losing their
balance and have a dangerous history of recent falls. This indicates
that a quad cane is no longer providing enough physical stability to
keep the client safe.
, Page 3 of 575
o Advocacy and Safety: The nurse's immediate priority is to
communicate these specific clinical findings to the primary healthcare
provider (HCP). This reporting prompts a necessary medical referral for
a physical therapy evaluation or an upgraded mobility device (such as
a rolling walker) to prevent a catastrophic fall injury.
Why the Other Options Are Wrong
• ❌ 2. Inform client that there are only a few assistive devices available
to help with ambulation.
o This statement is factually inaccurate and unhelpful. There is a wide
array of mobility and assistive equipment available—ranging from
single-point canes and hemi-walkers to standard walkers, rolling
walkers, and specialized wheelchairs—tailored to meet a client's
evolving physical needs.
• ❌ 3. Instruct the client on proper quad cane use.
o The question explicitly states that the nurse observed the client using
the correct cane walking technique. Re-teaching a skill that the client
has already mastered will not fix their underlying balance deficit or
solve the immediate safety hazard.
• ❌ 4. Notify the primary healthcare provider after consulting with the
neighbor.
o Consulting a neighbor regarding a client’s medical care or mobility
status is a severe violation of patient privacy laws (HIPAA). A nurse
must never share clinical information with unauthorized individuals
before contacting the healthcare provider.
The nurse is caring for a newly diagnosed diabetic in diabetic hyperosmolar
hyperglycemic nonketotic (HHNK) state. What does the nurse anticipate the
immediate treatment plan for this client will include?
1. NPH insulin.
2. Potassium 40 mEq (40 mmol/L) slow intravenous push.
3. Intravenous administration of isotonic saline.
4. Intravenous sodium bicarbonate.
3
What is most important for the nurse to do prior to initiating peritoneal
dialysis?
1. Aspirate for placement.
2. Have the client void.
, Page 4 of 575
3. Irrigate the catheter for patency.
4. Warm the dialysate fluid.
4
The nurse in the outpatient clinic performs an assessment on a client who
takes propranolol for management of palpitations associated with mitral valve
prolapse. Which statement by the client should be reported immediately to the
primary healthcare provider?
1. "My resting pulse was 60 this morning."
2. "I feel a little short of breath when walking."
3. "I have lost 5 pounds in the last 2 weeks."
4. "My blood pressure (BP) was lower this visit than last time."
2
Blood and urine samples are sent to the laboratory for a client who has had a
spinal cord injury. After reviewing these results, the nurse would expect which
finding?
Exhibit
1. Gross hematuria
2. Septicemia
3. Urinary tract infection
4. Anemia
3
The nurse is instructing a client on achieving relaxation using deep breathing
exercises. Which statement by the client indicates to the nurse that further
teaching is necessary?
1. "I can perform deep breathing exercises anywhere and at any time that I feel
tension and anxiety."
2. "I should sit or lie in a comfortable position, making sure my back is
straight."
3. "I will inhale slowly and deeply through my mouth focusing on my chest
expansion."
NEW NCLEX UWORLD ,ARCHER REVIEW ,
BOOTCAMP AND HURST REVIEW PRACTICE
QUESTIONS FOR EXAM WITH CORRECT
ANSWERS,RATIONALES AND WHY THE
OTHERS ARE NOT CORRECT NEWEST 2026
EXAM VERIFIED
***HURST REVIEW NCLEX-RN Readiness Exam 1***
The charge nurse is evaluating knowledge of tracheostomy suctioning of a
new nurse prior to that procedure being performed. Which statement by the
new nurse would indicate to the charge nurse that additional education is
needed?
1. "Prior to suctioning, I will hyper-oxygenate the client."
2. "I will instill normal saline bullets to liquefy secretions."
3. "I will allow at least 20 seconds between suctioning passes."
4. "Suctioning will be limited to a maximum of three catheter passes."
2
Why the Correct Option Is Right
• 2. "I will instill normal saline bullets to liquefy secretions."
o The Key Phrase: The question asks which statement shows that
additional education is needed (a negative-stem question).
o Clinical Danger: Routinely instilling normal saline drops or "bullets"
directly into a tracheostomy or endotracheal tube prior to suctioning is
no longer an approved clinical practice.
o The Consequences: Research shows that instilling saline does not
effectively liquefy deep secretions. Instead, it breaks up bacterial
biofilms and forces pathogens deeper into the lower respiratory tract,
significantly increasing the client's risk for Ventilator-Associated
, Page 2 of 575
Pneumonia (VAP) or tracheostomy infections. It also strips away
protective bronchial surfactant and causes a sudden, temporary drop in
the client's oxygen saturation levels. [1, 2]
Why the Other Options Are Correct Practices (Do Not Need
Correction)
• ❌ 1. "Prior to suctioning, I will hyper-oxygenate the client."
o This is excellent, standard nursing practice. Tracheal suctioning
removes both secretions and vital air from the lungs, which drops
oxygen levels. Providing 100% oxygen before starting protects the
patient from sudden hypoxemia and cardiac arrhythmias. [1, 2]
• ❌ 3. "I will allow at least 20 seconds between suctioning passes."
o This is a correct practice. Pausing for at least 20 to 30 seconds
between each catheter pass gives the client time to breathe, re-
oxygenate their blood, and recover from the stress of the procedure. [1,
2]
• ❌ 4. "Suctioning will be limited to a maximum of three catheter
passes."
o This is a correct practice. Limiting the entire suctioning session to a
maximum of 3 passes minimizes trauma to the sensitive tracheal
mucosa and prevents severe oxygen depletion
The nurse observes a client at a follow-up appointment using correct cane
walking technique but losing balance each time the quad cane is lifted off of
the floor. The client reports a history of recent falls. What is the best action for
the nurse to take?
1. Inform the primary healthcare provider of the observations made regarding
quad cane use, and imbalance assessment.
2. Inform client that there are only a few assistive devices available to help
with ambulation.
3. Instruct the client on proper quad cane use.
4. Notify the primary healthcare provider after consulting with the neighbor.
1
Why the Correct Option Is Right
• 1. Inform the primary healthcare provider of the observations made
regarding quad cane use, and imbalance assessment.
o Clinical Real-World Assessment: The nurse assesses that the client is
already using the correct cane technique, yet they are still losing their
balance and have a dangerous history of recent falls. This indicates
that a quad cane is no longer providing enough physical stability to
keep the client safe.
, Page 3 of 575
o Advocacy and Safety: The nurse's immediate priority is to
communicate these specific clinical findings to the primary healthcare
provider (HCP). This reporting prompts a necessary medical referral for
a physical therapy evaluation or an upgraded mobility device (such as
a rolling walker) to prevent a catastrophic fall injury.
Why the Other Options Are Wrong
• ❌ 2. Inform client that there are only a few assistive devices available
to help with ambulation.
o This statement is factually inaccurate and unhelpful. There is a wide
array of mobility and assistive equipment available—ranging from
single-point canes and hemi-walkers to standard walkers, rolling
walkers, and specialized wheelchairs—tailored to meet a client's
evolving physical needs.
• ❌ 3. Instruct the client on proper quad cane use.
o The question explicitly states that the nurse observed the client using
the correct cane walking technique. Re-teaching a skill that the client
has already mastered will not fix their underlying balance deficit or
solve the immediate safety hazard.
• ❌ 4. Notify the primary healthcare provider after consulting with the
neighbor.
o Consulting a neighbor regarding a client’s medical care or mobility
status is a severe violation of patient privacy laws (HIPAA). A nurse
must never share clinical information with unauthorized individuals
before contacting the healthcare provider.
The nurse is caring for a newly diagnosed diabetic in diabetic hyperosmolar
hyperglycemic nonketotic (HHNK) state. What does the nurse anticipate the
immediate treatment plan for this client will include?
1. NPH insulin.
2. Potassium 40 mEq (40 mmol/L) slow intravenous push.
3. Intravenous administration of isotonic saline.
4. Intravenous sodium bicarbonate.
3
What is most important for the nurse to do prior to initiating peritoneal
dialysis?
1. Aspirate for placement.
2. Have the client void.
, Page 4 of 575
3. Irrigate the catheter for patency.
4. Warm the dialysate fluid.
4
The nurse in the outpatient clinic performs an assessment on a client who
takes propranolol for management of palpitations associated with mitral valve
prolapse. Which statement by the client should be reported immediately to the
primary healthcare provider?
1. "My resting pulse was 60 this morning."
2. "I feel a little short of breath when walking."
3. "I have lost 5 pounds in the last 2 weeks."
4. "My blood pressure (BP) was lower this visit than last time."
2
Blood and urine samples are sent to the laboratory for a client who has had a
spinal cord injury. After reviewing these results, the nurse would expect which
finding?
Exhibit
1. Gross hematuria
2. Septicemia
3. Urinary tract infection
4. Anemia
3
The nurse is instructing a client on achieving relaxation using deep breathing
exercises. Which statement by the client indicates to the nurse that further
teaching is necessary?
1. "I can perform deep breathing exercises anywhere and at any time that I feel
tension and anxiety."
2. "I should sit or lie in a comfortable position, making sure my back is
straight."
3. "I will inhale slowly and deeply through my mouth focusing on my chest
expansion."
