UWORLD NCLEX-RN PRACTICE TEST 2
QUESTIONS AND ANSWERS
1. A client with chronic heart failure is prescribed digoxin. Which assessment finding is most
critical for the nurse to report to the healthcare provider prior to administration?
A. Occasional premature ventricular contractions
B. Heart rate of 62 beats per minute
C. Potassium level of 4.8 mEq/L
D. Visual disturbances such as yellow-green halos
Answer: D
Conceptual Explanation: Visual disturbances, nausea, and vomiting are classic signs of
digoxin toxicity. A heart rate of 62 is within the acceptable range for administration
(usually >60). A potassium level of 4.8 is normal, though hypokalemia increases toxicity
risk.
2. The nurse is caring for a client with preeclampsia receiving a magnesium sulfate infusion.
Which finding indicates magnesium toxicity?
A. Hyperactive deep tendon reflexes
,B. Respiratory rate of 10 breaths per minute
C. Urine output of 50 mL/hour
D. Blood pressure of 150/95 mmHg
Answer: B
Conceptual Explanation: Magnesium sulfate is a CNS depressant. Signs of toxicity include
respiratory depression (<12/min), loss of deep tendon reflexes, and decreased urine
output (<30 mL/hr).
3. A client with bipolar disorder is taking lithium carbonate. Which statement by the client
indicates a need for further teaching?
A. I will call my doctor if I have persistent diarrhea.
B. I will limit my salt intake to prevent swelling.
C. I will drink 2 to 3 liters of water every day.
D. I need to have my blood levels checked regularly.
Answer: B
Conceptual Explanation: Lithium is a salt. Decreasing sodium intake or excessive
sweating can lead to lithium retention and toxicity. Clients should maintain consistent
sodium intake.
, 4. The nurse is educating the parents of a child with cystic fibrosis. Which instruction is most
important regarding pancreatic enzyme replacement?
A. Give enzymes only with breakfast and dinner.
B. Give enzymes with every meal and snack.
C. Crush the enteric-coated beads if the child cannot swallow them.
D. Administer enzymes 2 hours after meals.
Answer: B
Conceptual Explanation: Pancreatic enzymes are necessary for digestion and must be
taken with every meal and snack. Beads should not be crushed or chewed.
5. A child is admitted with suspected intussusception. Which clinical manifestation should the
nurse expect to observe?
A. Stool mixed with blood and mucus (currant jelly stool)
B. Projectile vomiting immediately after feeding
C. Ribbon-like, foul-smelling stools
D. Pain in the lower right quadrant with rebound tenderness
Answer: A
Conceptual Explanation: Intussusception typically presents with sudden abdominal pain
and ‘currant jelly’ stools. Projectile vomiting suggests pyloric stenosis, and ribbon-like
stools suggest Hirschsprung disease.
QUESTIONS AND ANSWERS
1. A client with chronic heart failure is prescribed digoxin. Which assessment finding is most
critical for the nurse to report to the healthcare provider prior to administration?
A. Occasional premature ventricular contractions
B. Heart rate of 62 beats per minute
C. Potassium level of 4.8 mEq/L
D. Visual disturbances such as yellow-green halos
Answer: D
Conceptual Explanation: Visual disturbances, nausea, and vomiting are classic signs of
digoxin toxicity. A heart rate of 62 is within the acceptable range for administration
(usually >60). A potassium level of 4.8 is normal, though hypokalemia increases toxicity
risk.
2. The nurse is caring for a client with preeclampsia receiving a magnesium sulfate infusion.
Which finding indicates magnesium toxicity?
A. Hyperactive deep tendon reflexes
,B. Respiratory rate of 10 breaths per minute
C. Urine output of 50 mL/hour
D. Blood pressure of 150/95 mmHg
Answer: B
Conceptual Explanation: Magnesium sulfate is a CNS depressant. Signs of toxicity include
respiratory depression (<12/min), loss of deep tendon reflexes, and decreased urine
output (<30 mL/hr).
3. A client with bipolar disorder is taking lithium carbonate. Which statement by the client
indicates a need for further teaching?
A. I will call my doctor if I have persistent diarrhea.
B. I will limit my salt intake to prevent swelling.
C. I will drink 2 to 3 liters of water every day.
D. I need to have my blood levels checked regularly.
Answer: B
Conceptual Explanation: Lithium is a salt. Decreasing sodium intake or excessive
sweating can lead to lithium retention and toxicity. Clients should maintain consistent
sodium intake.
, 4. The nurse is educating the parents of a child with cystic fibrosis. Which instruction is most
important regarding pancreatic enzyme replacement?
A. Give enzymes only with breakfast and dinner.
B. Give enzymes with every meal and snack.
C. Crush the enteric-coated beads if the child cannot swallow them.
D. Administer enzymes 2 hours after meals.
Answer: B
Conceptual Explanation: Pancreatic enzymes are necessary for digestion and must be
taken with every meal and snack. Beads should not be crushed or chewed.
5. A child is admitted with suspected intussusception. Which clinical manifestation should the
nurse expect to observe?
A. Stool mixed with blood and mucus (currant jelly stool)
B. Projectile vomiting immediately after feeding
C. Ribbon-like, foul-smelling stools
D. Pain in the lower right quadrant with rebound tenderness
Answer: A
Conceptual Explanation: Intussusception typically presents with sudden abdominal pain
and ‘currant jelly’ stools. Projectile vomiting suggests pyloric stenosis, and ribbon-like
stools suggest Hirschsprung disease.
