NCSBN EXAM SCRIPT 2026 NCLEX
READINESS STUDY GUIDE AND QUESTION
FRAMEWORK
◉ A client continuously calls out to the nursing staff when anyone
passes the client's door and asks them to do something in the room.
The charge nurse should take which approach for this client?
A. Reassure the client that a staff person will check frequently to see
if the client needs anything
B. Arrange for each staff member to go into the client's room to
check on needs every hour on the hour
C. Keep the client's room door cracked to minimize the distractions
of people passing by the room
D. Assign a nursing staff member to visit the client at regular
intervals
Answer: D
Regular, frequent, planned contact by a designated staff member is
the best approach to provide a continuity of care and communicate
to the client that care will be available as needed.
◉ A nurse working at a clinic is reviewing a client's blood sugar log
and recognizes that the client is not consistently monitoring blood
,sugar. Which of the following diagnostic tests would assist the nurse
in evaluating the client's overall management of diabetes?
A. Hemoglobin
B. Fasting blood sugar
C. Hemoglobin A1C
D. White blood cell count
Answer: C
The hemoglobin A1C is the best indicator of glycemic control
because it reflects an average of the blood sugar over the life of a red
blood cell (approximately 90 to 120 days). The fasting blood sugar
will only evaluate the client's blood sugar at that specific testing
time. Hemoglobin and a white blood cell count are not used to
determine blood sugar levels.
◉ A client who has returned from surgery reports feeling nauseated
and later has an emesis. The nurse administers promethazine per
standing orders. In addition to relief from nausea, what other effects
of this medication does the nurse expect? (Select all that apply.)
A. Dry mouth
B. Sedation
C. Pinpoint pupils
D. Heart palpitations
,E. Runny nose
Answer: A,B,D
Promethazine (Phenergan) is used as an antihistamine, sedative and
antiemetic. It produces anticholinergic effects, such as dry mouth
and nasal congestion, dilated pupils and urinary retention. Although
promethazine is a sedative, the nurse should understand that it can
cause some people to have heart palpitations and to feel restless and
unable to sleep.
◉ The nurse suspects that the client is in cardiogenic shock. Which
of the following findings supports this information?
A. Bradycardia
B. Increased cardiac output
C. Decreased or muffled heart sounds
D. Bounding pulses
Answer: C
Cardiogenic shock involves decreased cardiac output and evidence
of tissue hypoxia in the presence of adequate intravascular volume;
it is the leading cause of death in acute MI. Findings of cardiogenic
shock include hypotension, rapid and faint peripheral pulses,
distant-sounding heart sounds, cool and mottled skin, oliguria and
altered mental status.
, ◉ The client is admitted with a pressure ulcer that's two inches in
diameter with no tunneling. It is a shallow open ulcer with loss of
dermis and a red/pink wound bed. The nurse observes some serous
drainage. What intervention does the nurse anticipate will be
ordered to treat this wound?
A. Hydrogel dressing
B. Whirlpool treatment and debridement
C. Alginate dressing with silver added
D. Alternating pressure pad overlay for the bed
Answer: A
This ulcer is a partial thickness wound. These types of wounds heal
by tissue regeneration, which is why the nurse would expect a gel
dressing to be ordered. This dressing will keep the wound moist,
provide protection from infection and promote healing; also, the
cool sensation provided by the gel offers pain relief. Pink/red wound
edges are considered normal in the inflammatory stage of healing;
the wound does not require debridement. There is nothing to
indicate that there's an infection, which is why the alginate with
silver is not needed; also, alginate dressings are better for wounds
with moderate-to-heavy drainage and are good for filling cavities or
tracts. An alternating pressure pad overlay would not treat the
wound.
◉ The nurse is evaluating a stage III pressure ulcer while
performing a dressing change. Which wound assessment findings
READINESS STUDY GUIDE AND QUESTION
FRAMEWORK
◉ A client continuously calls out to the nursing staff when anyone
passes the client's door and asks them to do something in the room.
The charge nurse should take which approach for this client?
A. Reassure the client that a staff person will check frequently to see
if the client needs anything
B. Arrange for each staff member to go into the client's room to
check on needs every hour on the hour
C. Keep the client's room door cracked to minimize the distractions
of people passing by the room
D. Assign a nursing staff member to visit the client at regular
intervals
Answer: D
Regular, frequent, planned contact by a designated staff member is
the best approach to provide a continuity of care and communicate
to the client that care will be available as needed.
◉ A nurse working at a clinic is reviewing a client's blood sugar log
and recognizes that the client is not consistently monitoring blood
,sugar. Which of the following diagnostic tests would assist the nurse
in evaluating the client's overall management of diabetes?
A. Hemoglobin
B. Fasting blood sugar
C. Hemoglobin A1C
D. White blood cell count
Answer: C
The hemoglobin A1C is the best indicator of glycemic control
because it reflects an average of the blood sugar over the life of a red
blood cell (approximately 90 to 120 days). The fasting blood sugar
will only evaluate the client's blood sugar at that specific testing
time. Hemoglobin and a white blood cell count are not used to
determine blood sugar levels.
◉ A client who has returned from surgery reports feeling nauseated
and later has an emesis. The nurse administers promethazine per
standing orders. In addition to relief from nausea, what other effects
of this medication does the nurse expect? (Select all that apply.)
A. Dry mouth
B. Sedation
C. Pinpoint pupils
D. Heart palpitations
,E. Runny nose
Answer: A,B,D
Promethazine (Phenergan) is used as an antihistamine, sedative and
antiemetic. It produces anticholinergic effects, such as dry mouth
and nasal congestion, dilated pupils and urinary retention. Although
promethazine is a sedative, the nurse should understand that it can
cause some people to have heart palpitations and to feel restless and
unable to sleep.
◉ The nurse suspects that the client is in cardiogenic shock. Which
of the following findings supports this information?
A. Bradycardia
B. Increased cardiac output
C. Decreased or muffled heart sounds
D. Bounding pulses
Answer: C
Cardiogenic shock involves decreased cardiac output and evidence
of tissue hypoxia in the presence of adequate intravascular volume;
it is the leading cause of death in acute MI. Findings of cardiogenic
shock include hypotension, rapid and faint peripheral pulses,
distant-sounding heart sounds, cool and mottled skin, oliguria and
altered mental status.
, ◉ The client is admitted with a pressure ulcer that's two inches in
diameter with no tunneling. It is a shallow open ulcer with loss of
dermis and a red/pink wound bed. The nurse observes some serous
drainage. What intervention does the nurse anticipate will be
ordered to treat this wound?
A. Hydrogel dressing
B. Whirlpool treatment and debridement
C. Alginate dressing with silver added
D. Alternating pressure pad overlay for the bed
Answer: A
This ulcer is a partial thickness wound. These types of wounds heal
by tissue regeneration, which is why the nurse would expect a gel
dressing to be ordered. This dressing will keep the wound moist,
provide protection from infection and promote healing; also, the
cool sensation provided by the gel offers pain relief. Pink/red wound
edges are considered normal in the inflammatory stage of healing;
the wound does not require debridement. There is nothing to
indicate that there's an infection, which is why the alginate with
silver is not needed; also, alginate dressings are better for wounds
with moderate-to-heavy drainage and are good for filling cavities or
tracts. An alternating pressure pad overlay would not treat the
wound.
◉ The nurse is evaluating a stage III pressure ulcer while
performing a dressing change. Which wound assessment findings
