SAUNDERS NCLEX CORE EXAM SET 2025/2026 QUESTIONS
WITH SOLUTIONS MARKED A+
✔✔The nurse is caring for a postoperative client who has just returned from surgery for
creation of a colostomy. The nurse inspects the colostomy stoma and recognizes that
which is a normal assessment finding for this client?
1. A pale color
2.A purple color
3.A brick-red color
4.A large amount of red drainage - ✔✔3.A brick-red color
Normal characteristics of a stoma include a rose to brick-red color indicating viable
mucosa, mild to moderate edema during the initial postoperative period, and a small
amount of oozing blood from the stoma mucosa (because of its high vascularity) when it
is touched. A pale color may indicate anemia. A stoma that is dark red to purple
indicates inadequate blood supply to the stoma or bowel due to adhesions, low blood
flow state, or excessive tension on the bowel at the time of construction. A small amount
of bleeding is considered normal, but a moderate to large amount of bleeding from the
stoma mucosa could indicate coagulation factor deficiency, stomal varices secondary to
portal hypertension, or lower gastrointestinal bleeding.
✔✔A client with peptic ulcer disease states that stress frequently causes exacerbation
of the disease. The nurse determines that which item mentioned by the client is most
likely to be responsible for the exacerbation?
1. Sleeping 8 to 10 hours a night
2. Ability to work at home periodically
3. Eating 5 or 6 small meals per day
4. Frequent need to work overtime on short notice - ✔✔Psychological or emotional
stressors that exacerbate peptic ulcer disease may be found either at home or in the
workplace. Of the items listed, the frequent need to work overtime on short notice is
potentially the most stressful because it is the item over which the client has the least
control. An ability to work at home periodically is not necessarily stressful because it
allows increased client control over timing and location of work. Adequate rest and a
proper dietary pattern (options 1 and 3) should alleviate symptoms, not worsen them.
✔✔The nurse is caring for a client with a diagnosis of celiac disease. The nurse
recognizes that client teaching has been effective when the client makes which
statement?
1. "I can eat whatever I want."
2."I will eat rice cereal for breakfast."
3."I will eat beef barley soup for lunch."
,4."I will eat only wheat bread for a snack." - ✔✔A client with celiac disease should be
instructed to avoid gluten-containing products such as wheat, barley, oats, and rye.
✔✔The nurse is caring for a client experiencing an exacerbation of Crohn's disease.
Which intervention should the nurse anticipate the primary health care provider
prescribing?
1. Enteral feedings
2.Fluid restrictions
3.Oral corticosteroids
4.Activity restrictions - ✔✔Crohn's disease is a form of inflammatory bowel disease that
is a chronic inflammation of the gastrointestinal (GI) tract. It is characterized by periods
of remission interspersed with periods of exacerbation. Oral corticosteroids are used to
treat the inflammation of Crohn's disease, so option 3 is the correct one. In addition to
treating the GI inflammation of Crohn's disease with medications, it is also treated by
resting the bowel. Therefore, option 1 is incorrect. Option 2 is incorrect, as clients with
Crohn's disease typically have diarrhea and would not be on fluid restrictions. Option 4,
activity restrictions, is not indicated. The client can do activities as tolerated but should
avoid stress and strain.
✔✔The nurse is caring for a client with a peptic ulcer who has just had an
esophagogastroduodenoscopy (EGD). Which client problem should be the priority?
1. Risk for dehydration caused by bleeding in the gastrointestinal tract
2. Risk for choking and aspiration related to a poor gag reflex post procedure
3. Lack of knowledge of post procedure care related to not having had an EGD before
4. Sore throat related to passage of the endoscope through the pharyngeal region
during EGD - ✔✔2. Risk for choking and aspiration related to a poor gag reflex post
procedure
EGD is a visual inspection of the esophagus, stomach, and duodenum using a fiber
optic endoscope. All the client problems listed as options are potentially appropriate for
a client who just had an EGD. After the procedure, the client is recovering from the use
of conscious sedation and the administration of a local anesthetic to the throat.
Therefore, the client problem in option 2 is most important at this point because of the
potential for airway problems.
✔✔The nurse is providing discharge teaching for a client with newly diagnosed Crohn's
disease about dietary measures to implement during exacerbation episodes. Which
statement made by the client indicates a need for further instruction?
1. "I should increase the fiber in my diet."
2."I will need to avoid caffeinated beverages."
3."I'm going to learn some stress reduction techniques." 4."I can have exacerbations
and remissions with Crohn's disease." - ✔✔Crohn's disease is an inflammatory disease
, that can occur anywhere in the gastrointestinal tract but most often affects the terminal
ileum and leads to thickening and scarring, a narrowed lumen, fistulas, ulcerations, and
abscesses. It is characterized by exacerbations and remissions. If stress increases the
symptoms of the disease, the client is taught stress management techniques and may
require additional counseling. The client is taught to avoid gastrointestinal stimulants
containing caffeine and to follow a high-calorie and high-protein diet. A low-fiber diet
may be prescribed, especially during periods of exacerbation.
✔✔A client has just had a hemorrhoidectomy. Which nursing interventions are
appropriate for this client? Select all that apply.
1. Administer stool softeners as prescribed.
2.Instruct the client to limit fluid intake to avoid urinary retention.
3.Encourage a high-fiber diet to promote bowel movements without straining.
4.Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
5.Help the client to a Fowler's position to place pressure on the rectal area and
decrease bleeding. - ✔✔1. Administer stool softeners as prescribed.
3.Encourage a high-fiber diet to promote bowel movements without straining.
4.Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
Nursing interventions after a hemorrhoidectomy are aimed at management of pain and
avoidance of bleeding and incision rupture. Stool softeners and a high-fiber diet will help
the client avoid straining, thereby reducing the chances of rupturing the incision. An ice
pack will increase comfort and decrease bleeding. Options 2 and 5 are incorrect
interventions.
✔✔The nurse is evaluating the effect of dietary counseling on the client with
cholecystitis. The nurse determines that the client understands the instructions given if
the client states that which food item(s) are acceptable in the diet?
1. Baked fish
2.Fried chicken
3.Sauces and gravies
4.Fresh whipped cream - ✔✔1. Baked fish
The client with cholecystitis should decrease overall intake of dietary fat. Foods that
should be avoided include sauces and gravies, fatty meats, fried foods, products made
with cream, and heavy desserts. The correct option is baked fish, which is low in fat.
✔✔A client with a new colostomy is concerned about the odor from stool in the ostomy
drainage bag. The nurse should teach the client to include which food in the diet to
reduce odor?
1. Eggs
WITH SOLUTIONS MARKED A+
✔✔The nurse is caring for a postoperative client who has just returned from surgery for
creation of a colostomy. The nurse inspects the colostomy stoma and recognizes that
which is a normal assessment finding for this client?
1. A pale color
2.A purple color
3.A brick-red color
4.A large amount of red drainage - ✔✔3.A brick-red color
Normal characteristics of a stoma include a rose to brick-red color indicating viable
mucosa, mild to moderate edema during the initial postoperative period, and a small
amount of oozing blood from the stoma mucosa (because of its high vascularity) when it
is touched. A pale color may indicate anemia. A stoma that is dark red to purple
indicates inadequate blood supply to the stoma or bowel due to adhesions, low blood
flow state, or excessive tension on the bowel at the time of construction. A small amount
of bleeding is considered normal, but a moderate to large amount of bleeding from the
stoma mucosa could indicate coagulation factor deficiency, stomal varices secondary to
portal hypertension, or lower gastrointestinal bleeding.
✔✔A client with peptic ulcer disease states that stress frequently causes exacerbation
of the disease. The nurse determines that which item mentioned by the client is most
likely to be responsible for the exacerbation?
1. Sleeping 8 to 10 hours a night
2. Ability to work at home periodically
3. Eating 5 or 6 small meals per day
4. Frequent need to work overtime on short notice - ✔✔Psychological or emotional
stressors that exacerbate peptic ulcer disease may be found either at home or in the
workplace. Of the items listed, the frequent need to work overtime on short notice is
potentially the most stressful because it is the item over which the client has the least
control. An ability to work at home periodically is not necessarily stressful because it
allows increased client control over timing and location of work. Adequate rest and a
proper dietary pattern (options 1 and 3) should alleviate symptoms, not worsen them.
✔✔The nurse is caring for a client with a diagnosis of celiac disease. The nurse
recognizes that client teaching has been effective when the client makes which
statement?
1. "I can eat whatever I want."
2."I will eat rice cereal for breakfast."
3."I will eat beef barley soup for lunch."
,4."I will eat only wheat bread for a snack." - ✔✔A client with celiac disease should be
instructed to avoid gluten-containing products such as wheat, barley, oats, and rye.
✔✔The nurse is caring for a client experiencing an exacerbation of Crohn's disease.
Which intervention should the nurse anticipate the primary health care provider
prescribing?
1. Enteral feedings
2.Fluid restrictions
3.Oral corticosteroids
4.Activity restrictions - ✔✔Crohn's disease is a form of inflammatory bowel disease that
is a chronic inflammation of the gastrointestinal (GI) tract. It is characterized by periods
of remission interspersed with periods of exacerbation. Oral corticosteroids are used to
treat the inflammation of Crohn's disease, so option 3 is the correct one. In addition to
treating the GI inflammation of Crohn's disease with medications, it is also treated by
resting the bowel. Therefore, option 1 is incorrect. Option 2 is incorrect, as clients with
Crohn's disease typically have diarrhea and would not be on fluid restrictions. Option 4,
activity restrictions, is not indicated. The client can do activities as tolerated but should
avoid stress and strain.
✔✔The nurse is caring for a client with a peptic ulcer who has just had an
esophagogastroduodenoscopy (EGD). Which client problem should be the priority?
1. Risk for dehydration caused by bleeding in the gastrointestinal tract
2. Risk for choking and aspiration related to a poor gag reflex post procedure
3. Lack of knowledge of post procedure care related to not having had an EGD before
4. Sore throat related to passage of the endoscope through the pharyngeal region
during EGD - ✔✔2. Risk for choking and aspiration related to a poor gag reflex post
procedure
EGD is a visual inspection of the esophagus, stomach, and duodenum using a fiber
optic endoscope. All the client problems listed as options are potentially appropriate for
a client who just had an EGD. After the procedure, the client is recovering from the use
of conscious sedation and the administration of a local anesthetic to the throat.
Therefore, the client problem in option 2 is most important at this point because of the
potential for airway problems.
✔✔The nurse is providing discharge teaching for a client with newly diagnosed Crohn's
disease about dietary measures to implement during exacerbation episodes. Which
statement made by the client indicates a need for further instruction?
1. "I should increase the fiber in my diet."
2."I will need to avoid caffeinated beverages."
3."I'm going to learn some stress reduction techniques." 4."I can have exacerbations
and remissions with Crohn's disease." - ✔✔Crohn's disease is an inflammatory disease
, that can occur anywhere in the gastrointestinal tract but most often affects the terminal
ileum and leads to thickening and scarring, a narrowed lumen, fistulas, ulcerations, and
abscesses. It is characterized by exacerbations and remissions. If stress increases the
symptoms of the disease, the client is taught stress management techniques and may
require additional counseling. The client is taught to avoid gastrointestinal stimulants
containing caffeine and to follow a high-calorie and high-protein diet. A low-fiber diet
may be prescribed, especially during periods of exacerbation.
✔✔A client has just had a hemorrhoidectomy. Which nursing interventions are
appropriate for this client? Select all that apply.
1. Administer stool softeners as prescribed.
2.Instruct the client to limit fluid intake to avoid urinary retention.
3.Encourage a high-fiber diet to promote bowel movements without straining.
4.Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
5.Help the client to a Fowler's position to place pressure on the rectal area and
decrease bleeding. - ✔✔1. Administer stool softeners as prescribed.
3.Encourage a high-fiber diet to promote bowel movements without straining.
4.Apply cold packs to the anal-rectal area over the dressing until the packing is
removed.
Nursing interventions after a hemorrhoidectomy are aimed at management of pain and
avoidance of bleeding and incision rupture. Stool softeners and a high-fiber diet will help
the client avoid straining, thereby reducing the chances of rupturing the incision. An ice
pack will increase comfort and decrease bleeding. Options 2 and 5 are incorrect
interventions.
✔✔The nurse is evaluating the effect of dietary counseling on the client with
cholecystitis. The nurse determines that the client understands the instructions given if
the client states that which food item(s) are acceptable in the diet?
1. Baked fish
2.Fried chicken
3.Sauces and gravies
4.Fresh whipped cream - ✔✔1. Baked fish
The client with cholecystitis should decrease overall intake of dietary fat. Foods that
should be avoided include sauces and gravies, fatty meats, fried foods, products made
with cream, and heavy desserts. The correct option is baked fish, which is low in fat.
✔✔A client with a new colostomy is concerned about the odor from stool in the ostomy
drainage bag. The nurse should teach the client to include which food in the diet to
reduce odor?
1. Eggs
