2024/2025 NCLEX RN Uworld Comprehensive Study Guide 360
Pages PDF Download Bonus 2,600 + Nclex Practice Questions +
Rationals
The nurse performs nasogastric (NG) tube insertion using a large-bore NG tube on a hospitalized client
with a gastrointestinal bleed. During the insertion, after the tube passes the nasopharynx, the client
begins to cough and gag. Which action should the nurse take first? - ------CORRECT ANSWER -----Pull
back on the tube slightly and then pause to give the client time to breath.
A young adult with obesity comes to the free clinic for a 2-week post-antibiotic follow-up visit for a
superficial abdominal skin abscess. The client has a history of major depressive disorder and was
hospitalized twice in the past 6 months for attempted suicide. The client now reports feeling
"emotionally upset, alone, and at the end of my rope," due to difficulty finding a job and inability to
qualify for medical insurance. The client is currently prescribed fluoxetine but has not been able to
follow up with the prescribing health care provider (HCP). What is the priority nursing diagnosis (ND) at
this time? - ------CORRECT ANSWER -----Risk for suicide.
A nurse is discussing the fine motor abilities of a 10-month-old infant with the infant's parent. Which are
developmentally appropriate skills for an infant of this age? Select all that apply. - ------CORRECT
ANSWER -----1. Grasps a small doll by the arm.
3. Transfers small objects from hand to hand.
5. Uses a basic pincer grasp.
A nurse is observing a nursing student reinforce teaching to a client on how to take sucralfate. Which
statement made by the student would require intervention by the nurse? - ------CORRECT ANSWER -----
"Take this with your other stomach medications."
,The women's health nurse is caring for a 30-year-old client who wants to use the ethinyl estradiol and
norelgestromin patch for contraception. Regarding this method of birth control, which finding should be
most concerning to the nurse? - ------CORRECT ANSWER -----History of deep venous thrombosis.
A client with type 1 diabetes has a prescription for 30 units of insulin glargine at bedtime. Fingerstick
blood glucose measurements are prescribed before meals and at bedtime with regular insulin based on
a sliding scale. At 9 PM, the client's blood glucose measurement is 180 mg/dL (10.0 mmol/L). What
action should the nurse take? Click on the exhibit button for additional information - ------CORRECT
ANSWER -----Administer 30 units of glargine and 2 units of regular insulin in 2 different injections.
Insulin glargine - ------CORRECT ANSWER -----A long-acting (basal) insulin, has no peak and may last 24
hours or longer.
- should not be mixed in a syringe with any other insulin.
- safe to be administered with short-acting insulins.
- Short-acting insulins peak 2-5 hours after administration and last approximately 5-8 hours
The nurse on the IV therapy team is making rounds in the intensive care unit on clients with central
venous catheters. Which central line should be removed earliest to prevent infection? - ------CORRECT
ANSWER -----Femoral line inserted in emergency department post cardiac arrest 48 hours ago.
The nurse is performing an assessment on a 2-day-old infant with suspected Hirschsprung disease.
Which findings should the nurse anticipate? Select all that apply. - ------CORRECT ANSWER -----2.
Distended abdomen.
3. Has not passed stool (meconium)
5. Refusal to feed.
- Hirschsprung disease occurs when a child is born with some sections of the distal large intestine
missing nerve cells; this renders the internal anal sphincter unable to relax. As a result, there is no
peristalsis and stool is not passed. Newborns exhibit symptoms of distal intestinal obstruction. they have
a distended abdomen and will not pass meconium within the expected 24-48 hours. They will also have
difficulty feeding and often vomit green bile.
A newborn client is seen in the emergency department for vomiting. Which assessment finding indicates
a possible emergency? - ------CORRECT ANSWER -----Vomit that is green.
,- Bile made by the liver is green and is released into the duodenum on eating to aid digestion. When
there is an obstruction in the intestines and stool cannot pass, it may come back up as green vomit. A
bowel obstruction is an emergency that can lead to bowel rupture, peritonitis, and sepsis.
The nurse is caring for a hospitalized elderly client who is admitted with pneumonia. Which assessment
finding is most consistent with the diagnosis of delirium? - ------CORRECT ANSWER -----Client is
inattentive and hallucinating.
Confusion Assessment Method (CAM) - ------CORRECT ANSWER -----Used to determine delirium.
- signs are acute mental changes that fluctuate and inattention with disorganized thinking and/or
altered level of consciousness.
- disorganized thinking includes hallucinations.
- risk factors: older age, prior cognitive impairment, presence of infection, severe illness or multiple
comorbidities, dehydration, psychotropic medication use, alcoholism, vision impairment, and pain
- delirium has an abrupt onset and is a symptom of other problems
- up to 60% of hospitalized elderly clients have delirium prior to or during hospitalization
The nurse is preparing to irrigate the ears of a 67-year-old client with impacted cerumen. Place the
following steps for ear irrigation in the correct order. All options must be used. - ------CORRECT ANSWER
-----1. Assess the client for fever, ear infection, or tympanic membrane injury.
4. Place the client in a sitting position with the head tilted toward the affected ear
3. Place a towel and an emesis basin under the ear
5. Straighten the ear canal by pulling the pinna up and back.
6. Gently irrigate the ear.
The clinic nurse evaluates the treatment plan of a client with long-standing rheumatoid arthritis. Which
question is most important for the nurse to ask? - ------CORRECT ANSWER -----"How is your pain control
with the current medication regimen?"
The parent of a 2-year-old tells the nurse at the well-child clinic, "I am concerned because my child does
not like to be cuddled, does not respond when called by name, and does not make eye contact when
being fed." What is the priority question for the nurse to ask when completing the health history? - ------
CORRECT ANSWER -----"How many words can your child say?"
, The client is brought to the emergency department after falling off a roof and landing on his back. A T1
spinal fracture is diagnosed. The client's blood pressure is 74/40 mm Hg, pulse is 50/min, and skin is pink
and dry. What nursing action is a priority? - ------CORRECT ANSWER -----Administer IV normal saline.
The emergency department nurse is triaging clients. Which client is a priority for diagnostic workup and
definitive care? - ------CORRECT ANSWER -----Took a handful of amitriptyline tablets after a fight with
spouse.
Following a motor vehicle crash, the nurse stops to help a victim who has a laceration with spurting
blood. The nurse giving reasonable assistance could be held liable despite Good Samaritan laws in which
situations? Select all that apply. - ------CORRECT ANSWER -----1. The nurse accepts money from the
victim.
3. The nurse does not apply direct pressure to the artery.
A laboring client, gravida 3 para 2, is admitted to the labor unit reporting severe perineal pressure and
urgently requesting pain relief. The client's cervix is 10 cm dilated and 100% effaced, with the fetal head
at 0 station. Which pain management technique is most appropriate for this client's report of perineal
pressure? - ------CORRECT ANSWER -----Pudendal nerve block.
Pudendal nerve block - ------CORRECT ANSWER -----Infiltrates local anesthesia (lidocaine) into the areas
surrounding the pudendal nerves that innervate the lower vagina, perineum, and vulva.
- When birth is imminent a pudendal block provides the best pain relief with the least
maternal/newborn side effects and could be administered quickly by the health care provider.
- It does not relieve contraction pain but does relieve perineal pressure when administered in the late
second stage of labor.
- in clients without an epidural, pudendal blocks may be used in preparation for forceps-assisted birth or
laceration repair.
The parent of a child treated for injuries consistent with suspected child abuse has been told that a
report will be made Child Protective Services (CPS). The parent says angrily to the nurse, "I don't know
why this is being reported. I told the health care provider (HCP) that it was an accident." What is the
best response by the nurse? - ------CORRECT ANSWER -----"Reporting your child's injuries is required by
law. It is for your child's safety and protection."
Pages PDF Download Bonus 2,600 + Nclex Practice Questions +
Rationals
The nurse performs nasogastric (NG) tube insertion using a large-bore NG tube on a hospitalized client
with a gastrointestinal bleed. During the insertion, after the tube passes the nasopharynx, the client
begins to cough and gag. Which action should the nurse take first? - ------CORRECT ANSWER -----Pull
back on the tube slightly and then pause to give the client time to breath.
A young adult with obesity comes to the free clinic for a 2-week post-antibiotic follow-up visit for a
superficial abdominal skin abscess. The client has a history of major depressive disorder and was
hospitalized twice in the past 6 months for attempted suicide. The client now reports feeling
"emotionally upset, alone, and at the end of my rope," due to difficulty finding a job and inability to
qualify for medical insurance. The client is currently prescribed fluoxetine but has not been able to
follow up with the prescribing health care provider (HCP). What is the priority nursing diagnosis (ND) at
this time? - ------CORRECT ANSWER -----Risk for suicide.
A nurse is discussing the fine motor abilities of a 10-month-old infant with the infant's parent. Which are
developmentally appropriate skills for an infant of this age? Select all that apply. - ------CORRECT
ANSWER -----1. Grasps a small doll by the arm.
3. Transfers small objects from hand to hand.
5. Uses a basic pincer grasp.
A nurse is observing a nursing student reinforce teaching to a client on how to take sucralfate. Which
statement made by the student would require intervention by the nurse? - ------CORRECT ANSWER -----
"Take this with your other stomach medications."
,The women's health nurse is caring for a 30-year-old client who wants to use the ethinyl estradiol and
norelgestromin patch for contraception. Regarding this method of birth control, which finding should be
most concerning to the nurse? - ------CORRECT ANSWER -----History of deep venous thrombosis.
A client with type 1 diabetes has a prescription for 30 units of insulin glargine at bedtime. Fingerstick
blood glucose measurements are prescribed before meals and at bedtime with regular insulin based on
a sliding scale. At 9 PM, the client's blood glucose measurement is 180 mg/dL (10.0 mmol/L). What
action should the nurse take? Click on the exhibit button for additional information - ------CORRECT
ANSWER -----Administer 30 units of glargine and 2 units of regular insulin in 2 different injections.
Insulin glargine - ------CORRECT ANSWER -----A long-acting (basal) insulin, has no peak and may last 24
hours or longer.
- should not be mixed in a syringe with any other insulin.
- safe to be administered with short-acting insulins.
- Short-acting insulins peak 2-5 hours after administration and last approximately 5-8 hours
The nurse on the IV therapy team is making rounds in the intensive care unit on clients with central
venous catheters. Which central line should be removed earliest to prevent infection? - ------CORRECT
ANSWER -----Femoral line inserted in emergency department post cardiac arrest 48 hours ago.
The nurse is performing an assessment on a 2-day-old infant with suspected Hirschsprung disease.
Which findings should the nurse anticipate? Select all that apply. - ------CORRECT ANSWER -----2.
Distended abdomen.
3. Has not passed stool (meconium)
5. Refusal to feed.
- Hirschsprung disease occurs when a child is born with some sections of the distal large intestine
missing nerve cells; this renders the internal anal sphincter unable to relax. As a result, there is no
peristalsis and stool is not passed. Newborns exhibit symptoms of distal intestinal obstruction. they have
a distended abdomen and will not pass meconium within the expected 24-48 hours. They will also have
difficulty feeding and often vomit green bile.
A newborn client is seen in the emergency department for vomiting. Which assessment finding indicates
a possible emergency? - ------CORRECT ANSWER -----Vomit that is green.
,- Bile made by the liver is green and is released into the duodenum on eating to aid digestion. When
there is an obstruction in the intestines and stool cannot pass, it may come back up as green vomit. A
bowel obstruction is an emergency that can lead to bowel rupture, peritonitis, and sepsis.
The nurse is caring for a hospitalized elderly client who is admitted with pneumonia. Which assessment
finding is most consistent with the diagnosis of delirium? - ------CORRECT ANSWER -----Client is
inattentive and hallucinating.
Confusion Assessment Method (CAM) - ------CORRECT ANSWER -----Used to determine delirium.
- signs are acute mental changes that fluctuate and inattention with disorganized thinking and/or
altered level of consciousness.
- disorganized thinking includes hallucinations.
- risk factors: older age, prior cognitive impairment, presence of infection, severe illness or multiple
comorbidities, dehydration, psychotropic medication use, alcoholism, vision impairment, and pain
- delirium has an abrupt onset and is a symptom of other problems
- up to 60% of hospitalized elderly clients have delirium prior to or during hospitalization
The nurse is preparing to irrigate the ears of a 67-year-old client with impacted cerumen. Place the
following steps for ear irrigation in the correct order. All options must be used. - ------CORRECT ANSWER
-----1. Assess the client for fever, ear infection, or tympanic membrane injury.
4. Place the client in a sitting position with the head tilted toward the affected ear
3. Place a towel and an emesis basin under the ear
5. Straighten the ear canal by pulling the pinna up and back.
6. Gently irrigate the ear.
The clinic nurse evaluates the treatment plan of a client with long-standing rheumatoid arthritis. Which
question is most important for the nurse to ask? - ------CORRECT ANSWER -----"How is your pain control
with the current medication regimen?"
The parent of a 2-year-old tells the nurse at the well-child clinic, "I am concerned because my child does
not like to be cuddled, does not respond when called by name, and does not make eye contact when
being fed." What is the priority question for the nurse to ask when completing the health history? - ------
CORRECT ANSWER -----"How many words can your child say?"
, The client is brought to the emergency department after falling off a roof and landing on his back. A T1
spinal fracture is diagnosed. The client's blood pressure is 74/40 mm Hg, pulse is 50/min, and skin is pink
and dry. What nursing action is a priority? - ------CORRECT ANSWER -----Administer IV normal saline.
The emergency department nurse is triaging clients. Which client is a priority for diagnostic workup and
definitive care? - ------CORRECT ANSWER -----Took a handful of amitriptyline tablets after a fight with
spouse.
Following a motor vehicle crash, the nurse stops to help a victim who has a laceration with spurting
blood. The nurse giving reasonable assistance could be held liable despite Good Samaritan laws in which
situations? Select all that apply. - ------CORRECT ANSWER -----1. The nurse accepts money from the
victim.
3. The nurse does not apply direct pressure to the artery.
A laboring client, gravida 3 para 2, is admitted to the labor unit reporting severe perineal pressure and
urgently requesting pain relief. The client's cervix is 10 cm dilated and 100% effaced, with the fetal head
at 0 station. Which pain management technique is most appropriate for this client's report of perineal
pressure? - ------CORRECT ANSWER -----Pudendal nerve block.
Pudendal nerve block - ------CORRECT ANSWER -----Infiltrates local anesthesia (lidocaine) into the areas
surrounding the pudendal nerves that innervate the lower vagina, perineum, and vulva.
- When birth is imminent a pudendal block provides the best pain relief with the least
maternal/newborn side effects and could be administered quickly by the health care provider.
- It does not relieve contraction pain but does relieve perineal pressure when administered in the late
second stage of labor.
- in clients without an epidural, pudendal blocks may be used in preparation for forceps-assisted birth or
laceration repair.
The parent of a child treated for injuries consistent with suspected child abuse has been told that a
report will be made Child Protective Services (CPS). The parent says angrily to the nurse, "I don't know
why this is being reported. I told the health care provider (HCP) that it was an accident." What is the
best response by the nurse? - ------CORRECT ANSWER -----"Reporting your child's injuries is required by
law. It is for your child's safety and protection."
