NCLEX RN ACTUAL EXAM TEST BANK OF REAL
QUESTIONS & ANSWERS NCLEX 2026/2027
QUESTION 1
Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
A. Positive inotropes
B. Vasodilators
C. Diuretics
D. Antidysrhythmics
ANSWER✔✨-: A
Explanation:
(A) Positive inotropic agents should not be administered owing to their action of increasing myocardial
contractility. Increased ventricular contractility would increase outflow tract obstruction in the client
with hypertrophic cardiomyopathy. This can lead to worsening of symptoms and potentially life-
threatening complications.
(B) Vasodilators are not typically prescribed for hypertrophic cardiomyopathy but are not absolutely
contraindicated. They may be used cautiously in specific situations, though they can potentially worsen
outflow obstruction by reducing preload.
(C) Diuretics are used with caution in hypertrophic cardiomyopathy to avoid causing hypovolemia, which
can worsen outflow tract obstruction. They are not absolutely contraindicated but require careful
monitoring.
(D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias that
commonly occur in hypertrophic cardiomyopathy. These medications are often prescribed and are not
contraindicated.
,QUESTION 2
Signs and symptoms of an allergy attack include which of the following?
A. Wheezing on inspiration
B. Increased respiratory rate
C. Circumoral cyanosis
D. Prolonged expiration
ANSWER✔✨-: D
Explanation:
(A) Wheezing occurs during expiration when air movement is impaired because of constricted
edematous bronchial lumen. Wheezing is typically heard on expiration, not inspiration, in allergic
reactions and asthma attacks.
(B) Respirations are difficult during an allergy attack, but the rate is frequently normal. Tachypnea may
occur in severe reactions but is not a characteristic sign of an allergy attack.
(C) The circumoral area is usually pale during an allergic reaction. Cyanosis is an early sign of hypoxia and
indicates a severe, life-threatening reaction requiring immediate intervention.
(D) Expiration is prolonged because the alveoli are greatly distended and air trapping occurs. This is a
classic finding in allergic reactions affecting the respiratory system.
QUESTION 3
A client confides to the nurse that he tasted poison in his evening meal. This would be an example of
what type of hallucination?
A. Auditory
B. Gustatory
C. Olfactory
D. Visceral
ANSWER✔✨-: B
,Explanation:
(A) Auditory hallucinations involve sensory perceptions of hearing. These include hearing voices, sounds,
or music that are not actually present in the environment.
(B) Gustatory hallucinations involve sensory perceptions of taste. The client experiencing a taste
sensation that has no external stimulus, such as tasting poison in food, is experiencing a gustatory
hallucination.
(C) Olfactory hallucinations involve sensory perceptions of smell. These include smelling odors that are
not actually present, such as burning, rotten food, or perfume.
(D) Visceral hallucinations involve sensory perceptions of sensation within the body. These include
feeling internal sensations that have no physical cause, such as organs moving or insects crawling under
the skin.
QUESTION 4
Which of the following findings would be abnormal in a postpartum woman?
A. Chills shortly after delivery
B. Pulse rate of 60 bpm in morning on first postdelivery day
C. Urinary output of 3000 mL on the second day after delivery
D. An oral temperature of 101°F (38.3°C) on the third day after delivery
ANSWER✔✨-: D
Explanation:
(A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a
nervous response or vasomotor changes. If not followed by a fever, it is clinically innocuous and requires
no intervention.
(B) The pulse rate during the immediate postpartum period may be low but presents no cause for alarm.
The body attempts to adapt to the decreased pressures it normally has as well as from the reduction of
blood flow to the vascular bed.
(C) Urinary output increases during the postpartum period (12–24 hours) owing to diuresis. The kidneys
must eliminate an estimated 2000–3000 mL of extracellular fluid associated with a normal pregnancy.
, (D) A temperature of 100.4°F (38°C) may occur after delivery as a result of exertion and dehydration of
labor. However, any temperature greater than 100.4°F needs further investigation to identify any
infectious process.
QUESTION 5
A six-month-old infant has been admitted to the emergency room with febrile seizures. In the teaching
of the parents, nurse states that:
A. Sustained temperature elevation over 103°F is generally related to febrile seizures
B. Febrile seizures do not usually recur
C. There is little risk of neurological deficit and mental retardation as sequelae to febrile seizures
D. Febrile seizures are associated with diseases of the central nervous system
ANSWER✔✨-: C
Explanation:
(A) The temperature elevation related to febrile seizures generally exceeds 101°F, and seizures occur
during the temperature rise rather than after a prolonged elevation. The rapid increase in temperature
is the trigger, not the sustained elevation.
(B) Febrile seizures may recur and are more likely to do so when the first seizure occurs in the 1st year of
life. Approximately 30-40% of children who experience a febrile seizure will have a recurrence.
(C) There is little risk of neurological deficit, mental retardation, or other behavior secondary to febrile
seizures. Simple febrile seizures do not cause brain damage or developmental delays.
(D) Febrile seizures are not associated with diseases of the central nervous system. They are benign
events triggered by fever in otherwise healthy children aged 6 months to 5 years.
QUESTION 6
A client diagnosed with bipolar disorder continues to be hyperactive and to lose weight. Which of the
following nutritional interventions would be most therapeutic for him at this time?
A. Small, frequent feedings of foods that can be carried
B. Tube feedings with nutritional supplements
QUESTIONS & ANSWERS NCLEX 2026/2027
QUESTION 1
Which classification of drugs is contraindicated for the client with hypertrophic cardiomyopathy?
A. Positive inotropes
B. Vasodilators
C. Diuretics
D. Antidysrhythmics
ANSWER✔✨-: A
Explanation:
(A) Positive inotropic agents should not be administered owing to their action of increasing myocardial
contractility. Increased ventricular contractility would increase outflow tract obstruction in the client
with hypertrophic cardiomyopathy. This can lead to worsening of symptoms and potentially life-
threatening complications.
(B) Vasodilators are not typically prescribed for hypertrophic cardiomyopathy but are not absolutely
contraindicated. They may be used cautiously in specific situations, though they can potentially worsen
outflow obstruction by reducing preload.
(C) Diuretics are used with caution in hypertrophic cardiomyopathy to avoid causing hypovolemia, which
can worsen outflow tract obstruction. They are not absolutely contraindicated but require careful
monitoring.
(D) Antidysrhythmics are typically needed to treat both atrial and ventricular dysrhythmias that
commonly occur in hypertrophic cardiomyopathy. These medications are often prescribed and are not
contraindicated.
,QUESTION 2
Signs and symptoms of an allergy attack include which of the following?
A. Wheezing on inspiration
B. Increased respiratory rate
C. Circumoral cyanosis
D. Prolonged expiration
ANSWER✔✨-: D
Explanation:
(A) Wheezing occurs during expiration when air movement is impaired because of constricted
edematous bronchial lumen. Wheezing is typically heard on expiration, not inspiration, in allergic
reactions and asthma attacks.
(B) Respirations are difficult during an allergy attack, but the rate is frequently normal. Tachypnea may
occur in severe reactions but is not a characteristic sign of an allergy attack.
(C) The circumoral area is usually pale during an allergic reaction. Cyanosis is an early sign of hypoxia and
indicates a severe, life-threatening reaction requiring immediate intervention.
(D) Expiration is prolonged because the alveoli are greatly distended and air trapping occurs. This is a
classic finding in allergic reactions affecting the respiratory system.
QUESTION 3
A client confides to the nurse that he tasted poison in his evening meal. This would be an example of
what type of hallucination?
A. Auditory
B. Gustatory
C. Olfactory
D. Visceral
ANSWER✔✨-: B
,Explanation:
(A) Auditory hallucinations involve sensory perceptions of hearing. These include hearing voices, sounds,
or music that are not actually present in the environment.
(B) Gustatory hallucinations involve sensory perceptions of taste. The client experiencing a taste
sensation that has no external stimulus, such as tasting poison in food, is experiencing a gustatory
hallucination.
(C) Olfactory hallucinations involve sensory perceptions of smell. These include smelling odors that are
not actually present, such as burning, rotten food, or perfume.
(D) Visceral hallucinations involve sensory perceptions of sensation within the body. These include
feeling internal sensations that have no physical cause, such as organs moving or insects crawling under
the skin.
QUESTION 4
Which of the following findings would be abnormal in a postpartum woman?
A. Chills shortly after delivery
B. Pulse rate of 60 bpm in morning on first postdelivery day
C. Urinary output of 3000 mL on the second day after delivery
D. An oral temperature of 101°F (38.3°C) on the third day after delivery
ANSWER✔✨-: D
Explanation:
(A) Frequently the mother experiences a shaking chill immediately after delivery, which is related to a
nervous response or vasomotor changes. If not followed by a fever, it is clinically innocuous and requires
no intervention.
(B) The pulse rate during the immediate postpartum period may be low but presents no cause for alarm.
The body attempts to adapt to the decreased pressures it normally has as well as from the reduction of
blood flow to the vascular bed.
(C) Urinary output increases during the postpartum period (12–24 hours) owing to diuresis. The kidneys
must eliminate an estimated 2000–3000 mL of extracellular fluid associated with a normal pregnancy.
, (D) A temperature of 100.4°F (38°C) may occur after delivery as a result of exertion and dehydration of
labor. However, any temperature greater than 100.4°F needs further investigation to identify any
infectious process.
QUESTION 5
A six-month-old infant has been admitted to the emergency room with febrile seizures. In the teaching
of the parents, nurse states that:
A. Sustained temperature elevation over 103°F is generally related to febrile seizures
B. Febrile seizures do not usually recur
C. There is little risk of neurological deficit and mental retardation as sequelae to febrile seizures
D. Febrile seizures are associated with diseases of the central nervous system
ANSWER✔✨-: C
Explanation:
(A) The temperature elevation related to febrile seizures generally exceeds 101°F, and seizures occur
during the temperature rise rather than after a prolonged elevation. The rapid increase in temperature
is the trigger, not the sustained elevation.
(B) Febrile seizures may recur and are more likely to do so when the first seizure occurs in the 1st year of
life. Approximately 30-40% of children who experience a febrile seizure will have a recurrence.
(C) There is little risk of neurological deficit, mental retardation, or other behavior secondary to febrile
seizures. Simple febrile seizures do not cause brain damage or developmental delays.
(D) Febrile seizures are not associated with diseases of the central nervous system. They are benign
events triggered by fever in otherwise healthy children aged 6 months to 5 years.
QUESTION 6
A client diagnosed with bipolar disorder continues to be hyperactive and to lose weight. Which of the
following nutritional interventions would be most therapeutic for him at this time?
A. Small, frequent feedings of foods that can be carried
B. Tube feedings with nutritional supplements
