UWORLD NCLEX-RN TEST 2
QUESTIONS AND ANSWERS
1. The nurse is caring for a client who is 6 hours post-thyroidectomy. The client reports a
feeling of fullness in the neck and is making a high-pitched sound on inspiration. Which action
should the nurse take first?
A. Assess the surgical dressing for bleeding
B. Administer prescribed PRN morphine for pain
C. Notify the Rapid Response Team
D. Monitor the client’s oxygen saturation
Answer: C
Conceptual Explanation: Stridor and neck fullness after thyroidectomy indicate airway
obstruction from laryngeal edema or hematoma. This is a medical emergency requiring
immediate intervention.
2. A client with chronic heart failure is prescribed digoxin. Which assessment finding would
most likely indicate digoxin toxicity?
A. Increased urinary output
,B. Visual disturbances such as yellow halos
C. Heart rate of 88 beats per minute
D. Occasional premature ventricular contractions
Answer: B
Conceptual Explanation: Classic signs of digoxin toxicity include gastrointestinal distress
(nausea/vomiting) and neurological/visual changes like yellow-green halos or blurred
vision.
3. The nurse evaluates the laboratory results of a client with a history of cirrhosis. Which
finding is most concerning?
A. Prothrombin time (PT) of 14 seconds
B. Bilirubin level of 1.5 mg/dL
C. Ammonia level of 120 mcg/dL
D. Albumin level of 3.2 g/dL
Answer: C
Conceptual Explanation: High ammonia levels in cirrhosis can cross the blood-brain
barrier, leading to hepatic encephalopathy, a life-threatening complication.
4. A client presents to the emergency department with a suspected myocardial infarction.
Which cardiac marker is the most sensitive and specific for myocardial injury?
A. Troponin I
, B. Myoglobin
C. Creatine kinase-MB (CK-MB)
D. Lactate dehydrogenase (LDH)
Answer: A
Conceptual Explanation: Troponin I is the gold standard for diagnosing MI due to its high
sensitivity and specificity for cardiac muscle damage.
5. The nurse is caring for a client receiving Magnesium Sulfate for preeclampsia. The nurse
notes deep tendon reflexes (DTRs) of 0 and a respiratory rate of 10/min. What is the priority
action?
A. Notify the healthcare provider
B. Administer Calcium Gluconate intravenously
C. Assess the fetal heart rate
D. Stop the Magnesium Sulfate infusion
Answer: D
Conceptual Explanation: The first priority in magnesium toxicity is to stop the infusion
immediately to prevent further toxicity before administering the antidote.
6. Which client should the nurse assess first after receiving the change-of-shift report?
A. Client with DM1 who is diaphoretic and trembling
B. Client with a chest tube who has 100 mL of drainage in the last hour
QUESTIONS AND ANSWERS
1. The nurse is caring for a client who is 6 hours post-thyroidectomy. The client reports a
feeling of fullness in the neck and is making a high-pitched sound on inspiration. Which action
should the nurse take first?
A. Assess the surgical dressing for bleeding
B. Administer prescribed PRN morphine for pain
C. Notify the Rapid Response Team
D. Monitor the client’s oxygen saturation
Answer: C
Conceptual Explanation: Stridor and neck fullness after thyroidectomy indicate airway
obstruction from laryngeal edema or hematoma. This is a medical emergency requiring
immediate intervention.
2. A client with chronic heart failure is prescribed digoxin. Which assessment finding would
most likely indicate digoxin toxicity?
A. Increased urinary output
,B. Visual disturbances such as yellow halos
C. Heart rate of 88 beats per minute
D. Occasional premature ventricular contractions
Answer: B
Conceptual Explanation: Classic signs of digoxin toxicity include gastrointestinal distress
(nausea/vomiting) and neurological/visual changes like yellow-green halos or blurred
vision.
3. The nurse evaluates the laboratory results of a client with a history of cirrhosis. Which
finding is most concerning?
A. Prothrombin time (PT) of 14 seconds
B. Bilirubin level of 1.5 mg/dL
C. Ammonia level of 120 mcg/dL
D. Albumin level of 3.2 g/dL
Answer: C
Conceptual Explanation: High ammonia levels in cirrhosis can cross the blood-brain
barrier, leading to hepatic encephalopathy, a life-threatening complication.
4. A client presents to the emergency department with a suspected myocardial infarction.
Which cardiac marker is the most sensitive and specific for myocardial injury?
A. Troponin I
, B. Myoglobin
C. Creatine kinase-MB (CK-MB)
D. Lactate dehydrogenase (LDH)
Answer: A
Conceptual Explanation: Troponin I is the gold standard for diagnosing MI due to its high
sensitivity and specificity for cardiac muscle damage.
5. The nurse is caring for a client receiving Magnesium Sulfate for preeclampsia. The nurse
notes deep tendon reflexes (DTRs) of 0 and a respiratory rate of 10/min. What is the priority
action?
A. Notify the healthcare provider
B. Administer Calcium Gluconate intravenously
C. Assess the fetal heart rate
D. Stop the Magnesium Sulfate infusion
Answer: D
Conceptual Explanation: The first priority in magnesium toxicity is to stop the infusion
immediately to prevent further toxicity before administering the antidote.
6. Which client should the nurse assess first after receiving the change-of-shift report?
A. Client with DM1 who is diaphoretic and trembling
B. Client with a chest tube who has 100 mL of drainage in the last hour
