NCLEX-RN EXAM PREVIEW 2026
QUESTIONS RATIONALES AND
DETAILED CORRECT SOLUTIONS
The charge nurse has received a change-of-shift report on the following clients in
labor.
The charge nurse should ask a staff member to first see the client in th
1. First stage of labor who has an oral temperature of 99.7F (37.6 C)
2. First stage of labor whose contractions are occurring every 30 seconds
3. Second stage of labor who has respirations of 26.
4. Second stage of labor whose contractions are lasting for 60 seconds.
2. First stage of labor whose contractions are occurring every 30 seconds
Rationale:
1. Elevated temperature is normal during labor.
3. Increased respirations are normal during labor "pant-pant-blow" "hee-hee-
hoo" breathing pattern.
4. Contractions shouldn't be longer than 90 seconds, 60 seconds is okay and
normal. Second stage: 2-3 minutes apart, 60-90 seconds long, 10cm dilated,
strong pain.
The nurse is observing a staff member caring for a client who has chickenpox.
Which of the following actions by the staff member would require the nurse to
intervene?
1. Placing the client in a private room with monitored negative air pressure.
2. Placing a box of disposable face shields outside the client's room.
,3. Placing an alcohol-based hand rub in the client's room for hand hygiene.
4. Placing a surgical mask on the client during transport out of the client's room.
2. Placing a box of disposable face shields outside the client's room.
Rationale:
Varicella AKA chicken pox is an airborne precaution. Private, negative pressure
room, universal precautions (hand sanitizer in room) and placing a surgical mask
on client during transport are all correct interventions for varicella.
Nurse's Notes:
11:00: Client reports nausea, loss of appetite, vomiting, fever, and constipation for
the past 2 weeks and abdominal pain rated 7/10 on the Numerical Rating Scale for
1 week. Client states "The abdominal pain started after my 7-year-old child
accidentally kicked me in the stomach." Client plays soccer with the child once a
week. Vital signs: T 103.4 F (39.7 C), P 92, RR 22, BP 130/86, pulse oximetry
reading 98% on room air. No significant past medical or surgical history. Body
mass index (BMI) 32. Drinks alcohol only during social occasions, usually 3
beverages. Smokes cigarettes during social occasions.
For each assessment finding below, click to specify if the finding is consistent with
the disease process of bowel obstruction, appendicitis, or ruptured spleen. Each
finding may support more than 1 disease process.
Bowel obstruction: Appetite, Bowel Pattern, Gastrointestinal Symptoms.
Appendicitis: Pain level.
Ruptured Spleen: Pain level.
Answer:
•Anemia
•Peritonitis
,•Septic Shock
The nurse in the emergency department is caring for a 41-year-old male client.
Nurse's Notes:
11:00: Client reports nausea, loss of appetite, vomiting, fever, and constipation for
the past 2 weeks and abdominal pain rated 7/10 on the Numerical Rating Scale for
1 week. Client states "The abdominal pain started after my 7-year-old child
accidentally kicked me in the stomach." Client plays soccer with the child once a
week. Vital signs: T 103.4 F (39.7 C), P 92, RR 22, BP 130/86, pulse oximetry
reading 98% on room air. No significant past medical or surgical history. Body
mass index (BMI) 32. Drinks alcohol only during social occasions, usually 3
beverages. Smokes cigarettes during social occasions.
Select the 3 complications the client is at risk for developing.
•Anemia
•Peritonitis
•Septic Shock
•Hypovolemia
•Dysrhythmias
•Cardiac Arrest
Answers:
Indicated:
•Clear liquid diet
•Soapsuds enema
•Abdominal girth measurements
•Abdominal Computed Tomography (CT) scan
, 2. Prepare for transcutaneous pacing.
& 5. Assess the client for angina.
Rationale:
1. Beta Blockers would further decrease HR.
2. External pacing stimulates the ventricles to pump at a set rate.
3. Valsalva maneuver would further decrease HR.
4. Chest compressions are for cardiac arrest.
5. Angina (Chest pain) can be caused by both tachycardia (most common) and
bradycardia (rare but can happen). Therefore, assessment of angina is appropriate.
The nurse is caring for a client who reports feeling faint and is experiencing the
cardiac rhythm shown in the electrocardiogram (ECG) strip below.
Which of the following actions would be appropriate for the nurse to take? Select
all that apply.
1. Administer the client's prescribed beta blocker.
2. Prepare for transcutaneous pacing.
3. Instruct the client to perform the Valsalva maneuver.
4. Begin chest compressions.
5. Assess the client for angina.
QUESTIONS RATIONALES AND
DETAILED CORRECT SOLUTIONS
The charge nurse has received a change-of-shift report on the following clients in
labor.
The charge nurse should ask a staff member to first see the client in th
1. First stage of labor who has an oral temperature of 99.7F (37.6 C)
2. First stage of labor whose contractions are occurring every 30 seconds
3. Second stage of labor who has respirations of 26.
4. Second stage of labor whose contractions are lasting for 60 seconds.
2. First stage of labor whose contractions are occurring every 30 seconds
Rationale:
1. Elevated temperature is normal during labor.
3. Increased respirations are normal during labor "pant-pant-blow" "hee-hee-
hoo" breathing pattern.
4. Contractions shouldn't be longer than 90 seconds, 60 seconds is okay and
normal. Second stage: 2-3 minutes apart, 60-90 seconds long, 10cm dilated,
strong pain.
The nurse is observing a staff member caring for a client who has chickenpox.
Which of the following actions by the staff member would require the nurse to
intervene?
1. Placing the client in a private room with monitored negative air pressure.
2. Placing a box of disposable face shields outside the client's room.
,3. Placing an alcohol-based hand rub in the client's room for hand hygiene.
4. Placing a surgical mask on the client during transport out of the client's room.
2. Placing a box of disposable face shields outside the client's room.
Rationale:
Varicella AKA chicken pox is an airborne precaution. Private, negative pressure
room, universal precautions (hand sanitizer in room) and placing a surgical mask
on client during transport are all correct interventions for varicella.
Nurse's Notes:
11:00: Client reports nausea, loss of appetite, vomiting, fever, and constipation for
the past 2 weeks and abdominal pain rated 7/10 on the Numerical Rating Scale for
1 week. Client states "The abdominal pain started after my 7-year-old child
accidentally kicked me in the stomach." Client plays soccer with the child once a
week. Vital signs: T 103.4 F (39.7 C), P 92, RR 22, BP 130/86, pulse oximetry
reading 98% on room air. No significant past medical or surgical history. Body
mass index (BMI) 32. Drinks alcohol only during social occasions, usually 3
beverages. Smokes cigarettes during social occasions.
For each assessment finding below, click to specify if the finding is consistent with
the disease process of bowel obstruction, appendicitis, or ruptured spleen. Each
finding may support more than 1 disease process.
Bowel obstruction: Appetite, Bowel Pattern, Gastrointestinal Symptoms.
Appendicitis: Pain level.
Ruptured Spleen: Pain level.
Answer:
•Anemia
•Peritonitis
,•Septic Shock
The nurse in the emergency department is caring for a 41-year-old male client.
Nurse's Notes:
11:00: Client reports nausea, loss of appetite, vomiting, fever, and constipation for
the past 2 weeks and abdominal pain rated 7/10 on the Numerical Rating Scale for
1 week. Client states "The abdominal pain started after my 7-year-old child
accidentally kicked me in the stomach." Client plays soccer with the child once a
week. Vital signs: T 103.4 F (39.7 C), P 92, RR 22, BP 130/86, pulse oximetry
reading 98% on room air. No significant past medical or surgical history. Body
mass index (BMI) 32. Drinks alcohol only during social occasions, usually 3
beverages. Smokes cigarettes during social occasions.
Select the 3 complications the client is at risk for developing.
•Anemia
•Peritonitis
•Septic Shock
•Hypovolemia
•Dysrhythmias
•Cardiac Arrest
Answers:
Indicated:
•Clear liquid diet
•Soapsuds enema
•Abdominal girth measurements
•Abdominal Computed Tomography (CT) scan
, 2. Prepare for transcutaneous pacing.
& 5. Assess the client for angina.
Rationale:
1. Beta Blockers would further decrease HR.
2. External pacing stimulates the ventricles to pump at a set rate.
3. Valsalva maneuver would further decrease HR.
4. Chest compressions are for cardiac arrest.
5. Angina (Chest pain) can be caused by both tachycardia (most common) and
bradycardia (rare but can happen). Therefore, assessment of angina is appropriate.
The nurse is caring for a client who reports feeling faint and is experiencing the
cardiac rhythm shown in the electrocardiogram (ECG) strip below.
Which of the following actions would be appropriate for the nurse to take? Select
all that apply.
1. Administer the client's prescribed beta blocker.
2. Prepare for transcutaneous pacing.
3. Instruct the client to perform the Valsalva maneuver.
4. Begin chest compressions.
5. Assess the client for angina.
