1
UWorld NCLEX-RN Final Exam Version B 2026-2027 |
280 New Complex Practice Questions with Detailed
Rationales | Real Exam Simulation | Verified
Answers | Instant Download
1. A nurse is caring for a client receiving a continuous heparin infusion. The
client's aPTT is 95 seconds. Which action should the nurse take?
A. Continue the infusion at the current rate
B. Stop the infusion and notify the healthcare provider
C. Decrease the infusion rate
D. Administer vitamin K
Correct Answer: B
Rationale: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times the
control value, or approximately 60 to 80 seconds. An aPTT of 95 seconds is
supratherapeutic and increases the risk of hemorrhage. The nurse should stop
the infusion and notify the healthcare provider.
2. A client with a new below-the-knee amputation reports a burning sensation
in the missing foot. Which response by the nurse is appropriate?
A. "This is a sign of infection and requires immediate attention."
B. "This is a phantom sensation and is a normal experience after amputation."
C. "You are imagining the pain and should try to ignore it."
D. "This means the surgery was not successful."
Correct Answer: B
, 2
Rationale: Phantom limb sensation is a common and normal experience after
amputation. It involves feeling sensations in the missing limb. The nurse
should acknowledge the sensation and provide reassurance.
3. A nurse is assessing a client with suspected meningitis. Which finding
indicates meningeal irritation?
A. Positive Babinski sign
B. Positive Brudzinski sign
C. Positive Homans sign
D. Positive Trousseau sign
Correct Answer: B
Rationale: A positive Brudzinski sign indicates meningeal irritation. It occurs
when flexion of the neck causes involuntary flexion of the hips and knees.
Babinski sign indicates upper motor neuron dysfunction. Homans sign is
associated with DVT. Trousseau sign is associated with hypocalcemia.
4. A client with type 2 diabetes is prescribed glipizide. Which instruction
should the nurse include?
A. "Take this medication with breakfast."
B. "Take this medication at bedtime."
C. "Take this medication on an empty stomach."
D. "Take this medication every 6 hours."
Correct Answer: A
, 3
Rationale: Glipizide is a sulfonylurea that stimulates insulin release. It should
be taken 30 minutes before breakfast to coincide with the peak glucose rise
from the meal.
5. A nurse is caring for a client with an epidural infusion. Which finding
requires immediate intervention?
A. Pain relief at a level of 2 out of 10
B. Urinary retention
C. Respiratory rate of 10 breaths/min
D. Bilateral leg numbness
Correct Answer: C
Rationale: A respiratory rate of 10 breaths/min indicates respiratory
depression, which can occur with epidural opioid administration. This requires
immediate intervention.
6. A client with a tracheostomy is being suctioned. Which finding indicates the
need to stop suctioning?
A. The client's oxygen saturation drops from 98% to 95%
B. The client's heart rate increases from 80 to 110 bpm
C. The client's heart rate drops from 80 to 50 bpm
D. The client produces clear sputum
, 4
Correct Answer: C
Rationale: Bradycardia during suctioning indicates vagal stimulation and
requires stopping the procedure immediately. Oxygen desaturation and
tachycardia are also concerning but bradycardia is most urgent.
7. A nurse is teaching a client with heart failure about daily weight
monitoring. Which instruction is correct?
A. "Weigh yourself once a week in the morning."
B. "Weigh yourself daily at the same time using the same scale."
C. "Weigh yourself after exercise."
D. "Weigh yourself in the evening before bed."
Correct Answer: B
Rationale: Daily weights should be obtained at the same time each day using
the same scale, preferably in the morning after voiding and before breakfast.
This provides the most accurate assessment of fluid balance.
8. A client with a new diagnosis of hypothyroidism is prescribed
levothyroxine. Which instruction should the nurse include?
A. "Take this medication at bedtime."
B. "Take this medication on an empty stomach in the morning."
C. "Take this medication with calcium supplements."
UWorld NCLEX-RN Final Exam Version B 2026-2027 |
280 New Complex Practice Questions with Detailed
Rationales | Real Exam Simulation | Verified
Answers | Instant Download
1. A nurse is caring for a client receiving a continuous heparin infusion. The
client's aPTT is 95 seconds. Which action should the nurse take?
A. Continue the infusion at the current rate
B. Stop the infusion and notify the healthcare provider
C. Decrease the infusion rate
D. Administer vitamin K
Correct Answer: B
Rationale: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times the
control value, or approximately 60 to 80 seconds. An aPTT of 95 seconds is
supratherapeutic and increases the risk of hemorrhage. The nurse should stop
the infusion and notify the healthcare provider.
2. A client with a new below-the-knee amputation reports a burning sensation
in the missing foot. Which response by the nurse is appropriate?
A. "This is a sign of infection and requires immediate attention."
B. "This is a phantom sensation and is a normal experience after amputation."
C. "You are imagining the pain and should try to ignore it."
D. "This means the surgery was not successful."
Correct Answer: B
, 2
Rationale: Phantom limb sensation is a common and normal experience after
amputation. It involves feeling sensations in the missing limb. The nurse
should acknowledge the sensation and provide reassurance.
3. A nurse is assessing a client with suspected meningitis. Which finding
indicates meningeal irritation?
A. Positive Babinski sign
B. Positive Brudzinski sign
C. Positive Homans sign
D. Positive Trousseau sign
Correct Answer: B
Rationale: A positive Brudzinski sign indicates meningeal irritation. It occurs
when flexion of the neck causes involuntary flexion of the hips and knees.
Babinski sign indicates upper motor neuron dysfunction. Homans sign is
associated with DVT. Trousseau sign is associated with hypocalcemia.
4. A client with type 2 diabetes is prescribed glipizide. Which instruction
should the nurse include?
A. "Take this medication with breakfast."
B. "Take this medication at bedtime."
C. "Take this medication on an empty stomach."
D. "Take this medication every 6 hours."
Correct Answer: A
, 3
Rationale: Glipizide is a sulfonylurea that stimulates insulin release. It should
be taken 30 minutes before breakfast to coincide with the peak glucose rise
from the meal.
5. A nurse is caring for a client with an epidural infusion. Which finding
requires immediate intervention?
A. Pain relief at a level of 2 out of 10
B. Urinary retention
C. Respiratory rate of 10 breaths/min
D. Bilateral leg numbness
Correct Answer: C
Rationale: A respiratory rate of 10 breaths/min indicates respiratory
depression, which can occur with epidural opioid administration. This requires
immediate intervention.
6. A client with a tracheostomy is being suctioned. Which finding indicates the
need to stop suctioning?
A. The client's oxygen saturation drops from 98% to 95%
B. The client's heart rate increases from 80 to 110 bpm
C. The client's heart rate drops from 80 to 50 bpm
D. The client produces clear sputum
, 4
Correct Answer: C
Rationale: Bradycardia during suctioning indicates vagal stimulation and
requires stopping the procedure immediately. Oxygen desaturation and
tachycardia are also concerning but bradycardia is most urgent.
7. A nurse is teaching a client with heart failure about daily weight
monitoring. Which instruction is correct?
A. "Weigh yourself once a week in the morning."
B. "Weigh yourself daily at the same time using the same scale."
C. "Weigh yourself after exercise."
D. "Weigh yourself in the evening before bed."
Correct Answer: B
Rationale: Daily weights should be obtained at the same time each day using
the same scale, preferably in the morning after voiding and before breakfast.
This provides the most accurate assessment of fluid balance.
8. A client with a new diagnosis of hypothyroidism is prescribed
levothyroxine. Which instruction should the nurse include?
A. "Take this medication at bedtime."
B. "Take this medication on an empty stomach in the morning."
C. "Take this medication with calcium supplements."
