COMPREHENSIVE NCLEX-RN
CHALLENGE EXAM #2
Chamberlain University
Comprehensive NCLEX-RN Challenge Exam #2 –
2025 High-Yield Practice Questions with Rationales
| Next Gen NCLEX Prep for RN Licensure 100%
Guaranteed Pass!!!| Chamberlain University
,Comprehensive NCLEX-RN Challenge Exam #2
1. 2. Question
Category: Management of Care
A nurse on the surgical floor is prioritizing care for clients after receiving
the report from the previous shift. Which of the following patients should
the nurse assess first?
A. A 35-year-old patient admitted three hours ago for a gunshot wound,
with a 1.5 cm area of dark drainage noted on the dressing.
B. A 43-year-old patient who underwent a mastectomy two days ago, with
23 ml of serosanguinous fluid in the Jackson-Pratt drain.
C. A 59-year-old patient with a history of a collapsed lung from an
accident, with no drainage noted in the chest tube in the past eight hours.
E. A 54-year-old patient with a total knee replacement two days ago, with
moderate swelling at the surgical site.
E. A 47-year-old patient who had a laparoscopic cholecystectomy
yesterday, complaining of mild pain at the incision site.
F. A 62-year-old patient who had an abdominal-perineal resection three
days ago, now reporting chills.
Correct answer ✔✔
Answer: F. A 62-year-old patient who had an abdominal-perineal
resection three days ago, now reporting chills.
The client is at risk for peritonitis; should be assessed for further symptoms
and infection.
2. 3. Question
Category: Physiological Adaptation
A nurse in a post-surgical unit is monitoring a 46-year-old patient who
underwent a thyroidectomy 12 hours ago for the treatment of Grave’s
, disease. Which of the following observations should most concern the
nurse?
A. Blood pressure 138/82 mmHg, respirations 16 per minute, oral
temperature 37.2ºC or 99º F.
B. The patient carefully supports their head and neck when turning their
head to the right.
C. The patient expresses difficulty in swallowing but can manage liquids.
D. The patient appears drowsy and complains of a sore throat.
E. The patient shows involuntary flexion of their wrist when blood pressure
is measured.
Correct answer ✔✔
F. The patient has a hoarse voice when speaking.
Answer: E. The patient shows involuntary flexion of their wrist when
blood pressure is measured.
Carpal spasms (Trousseau’s sign) indicate hypocalcemia which can occur
after thyroidectomy due to accidental removal or damage to the
parathyroid glands. Hypocalcemia is a serious complication and requires
immediate attention. The other options, while they might warrant
monitoring, are not as immediately concerning as a potential sign of
hypocalcemia.
• Option A: The vital signs are all within the normal range.
• Option B: Supporting the head and neck while turning protects
the surgical site from dehiscence.
• Option C: Common side effect of neck surgery.
• Option D: Drowsiness may be a side effect of the anesthesia used
during surgery and will fade away eventually; a sore throat is a
normal finding after thyroid surgery.
• Option F: Hoarseness of voice is a common side effect of post-op
thyroidectomy due to one or more of the nerves irritated during
the procedure of due to inflammation that occurs after surgery.
3. 4. Question
, Category: Physiological Adaptation
A 38-year-old patient is admitted to the emergency department with
severe pain in the lower right quadrant of the abdomen, nausea, and a
low-grade fever, raising concerns about possible appendicitis. The nurse is
considering pain relief strategies. Which of the following actions should the
nurse prioritize?
A. Encourage the patient to change positions frequently in bed.
B. Administer Demerol 50 mg IM q 4 hours and PRN, as prescribed.
C. Apply warmth to the abdomen with a heating pad.
D. Use comfort measures and pillows to position the patient comfortably.
Correct answer ✔✔
E. Administer an antiemetic as prescribed for nausea relief.
Answer: D. Use comfort measures and pillows to position the patient
comfortably.
Using comfort measures and pillows to position the client is a non-
pharmacological method of pain relief.
• Option A: Gentle position changes can help alleviate pain, but
changing positions often might aggravate the pain felt by the
client.
• Option B: Demerol may be given if prescribed by the physician.
• Option C: The client may be experiencing acute appendicitis;
warm compresses may cause rupture of the inflamed appendix.
• Option E: Addressing associated symptoms like nausea can
improve overall comfort but is not the priority as of the moment.
4. 5. Question
Category: Physiological Adaptation
A 56-year-old patient, recently diagnosed with end-stage renal disease, is
preparing for their first peritoneal dialysis session in a clinic. The patient
has a history of diabetes and hypertension, and has been experiencing
increasing fatigue and fluid retention. Upon arrival, the nurse notes that the
CHALLENGE EXAM #2
Chamberlain University
Comprehensive NCLEX-RN Challenge Exam #2 –
2025 High-Yield Practice Questions with Rationales
| Next Gen NCLEX Prep for RN Licensure 100%
Guaranteed Pass!!!| Chamberlain University
,Comprehensive NCLEX-RN Challenge Exam #2
1. 2. Question
Category: Management of Care
A nurse on the surgical floor is prioritizing care for clients after receiving
the report from the previous shift. Which of the following patients should
the nurse assess first?
A. A 35-year-old patient admitted three hours ago for a gunshot wound,
with a 1.5 cm area of dark drainage noted on the dressing.
B. A 43-year-old patient who underwent a mastectomy two days ago, with
23 ml of serosanguinous fluid in the Jackson-Pratt drain.
C. A 59-year-old patient with a history of a collapsed lung from an
accident, with no drainage noted in the chest tube in the past eight hours.
E. A 54-year-old patient with a total knee replacement two days ago, with
moderate swelling at the surgical site.
E. A 47-year-old patient who had a laparoscopic cholecystectomy
yesterday, complaining of mild pain at the incision site.
F. A 62-year-old patient who had an abdominal-perineal resection three
days ago, now reporting chills.
Correct answer ✔✔
Answer: F. A 62-year-old patient who had an abdominal-perineal
resection three days ago, now reporting chills.
The client is at risk for peritonitis; should be assessed for further symptoms
and infection.
2. 3. Question
Category: Physiological Adaptation
A nurse in a post-surgical unit is monitoring a 46-year-old patient who
underwent a thyroidectomy 12 hours ago for the treatment of Grave’s
, disease. Which of the following observations should most concern the
nurse?
A. Blood pressure 138/82 mmHg, respirations 16 per minute, oral
temperature 37.2ºC or 99º F.
B. The patient carefully supports their head and neck when turning their
head to the right.
C. The patient expresses difficulty in swallowing but can manage liquids.
D. The patient appears drowsy and complains of a sore throat.
E. The patient shows involuntary flexion of their wrist when blood pressure
is measured.
Correct answer ✔✔
F. The patient has a hoarse voice when speaking.
Answer: E. The patient shows involuntary flexion of their wrist when
blood pressure is measured.
Carpal spasms (Trousseau’s sign) indicate hypocalcemia which can occur
after thyroidectomy due to accidental removal or damage to the
parathyroid glands. Hypocalcemia is a serious complication and requires
immediate attention. The other options, while they might warrant
monitoring, are not as immediately concerning as a potential sign of
hypocalcemia.
• Option A: The vital signs are all within the normal range.
• Option B: Supporting the head and neck while turning protects
the surgical site from dehiscence.
• Option C: Common side effect of neck surgery.
• Option D: Drowsiness may be a side effect of the anesthesia used
during surgery and will fade away eventually; a sore throat is a
normal finding after thyroid surgery.
• Option F: Hoarseness of voice is a common side effect of post-op
thyroidectomy due to one or more of the nerves irritated during
the procedure of due to inflammation that occurs after surgery.
3. 4. Question
, Category: Physiological Adaptation
A 38-year-old patient is admitted to the emergency department with
severe pain in the lower right quadrant of the abdomen, nausea, and a
low-grade fever, raising concerns about possible appendicitis. The nurse is
considering pain relief strategies. Which of the following actions should the
nurse prioritize?
A. Encourage the patient to change positions frequently in bed.
B. Administer Demerol 50 mg IM q 4 hours and PRN, as prescribed.
C. Apply warmth to the abdomen with a heating pad.
D. Use comfort measures and pillows to position the patient comfortably.
Correct answer ✔✔
E. Administer an antiemetic as prescribed for nausea relief.
Answer: D. Use comfort measures and pillows to position the patient
comfortably.
Using comfort measures and pillows to position the client is a non-
pharmacological method of pain relief.
• Option A: Gentle position changes can help alleviate pain, but
changing positions often might aggravate the pain felt by the
client.
• Option B: Demerol may be given if prescribed by the physician.
• Option C: The client may be experiencing acute appendicitis;
warm compresses may cause rupture of the inflamed appendix.
• Option E: Addressing associated symptoms like nausea can
improve overall comfort but is not the priority as of the moment.
4. 5. Question
Category: Physiological Adaptation
A 56-year-old patient, recently diagnosed with end-stage renal disease, is
preparing for their first peritoneal dialysis session in a clinic. The patient
has a history of diabetes and hypertension, and has been experiencing
increasing fatigue and fluid retention. Upon arrival, the nurse notes that the
