NCSBN PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ The nurse and a student nurse are discussing the health issues related to a
laboring HBsAg-positive client. Which of these comments by the student is
incorrect and indicates a need for further instruction?
A. "The infant will receive the hepatitis B vaccine within 12 hours after
birth."
B. "The HBsAg-positive mother should be reported to the state or local
health department."
C. "The HBsAg-positive mother should not breastfeed her baby."
D. "The infant will receive the hepatitis B immune globulin within 12 hours
after birth.".
Answer: CAll persons with HBsAg-positive laboratory results should be
reported to the state or local health department. The newborn should receive
the hepatitis B immune globulin and hepatitis B vaccine within 12 hours
after birth, using different sites (the second vaccine is given between 1 and 2
months; the last vaccine is given between 6 and 18 months). HBV is not
spread by breastfeeding, kissing, hugging, coughing, or casual contact.
◍ A nurse is caring for a client who requires a mechanical ventilator for
breathing. The high-pressure alarm goes off on the ventilator. What is an
appropriate action for the nurse to take?
A. Perform a quick assessment of the client's overall condition along with
respiratory effort
B. Call the respiratory therapist for help to troubleshoot the alarm
C. Press the alarm re-set button on the ventilator and observe the client
D. Disconnect the client from the ventilator and use a manual resuscitation
bag.
Answer: AA number of situations can cause the high-pressure alarm to
, sound. It can be as simple as the client coughing. A quick assessment of the
client will alert the nurse to whether it is a more serious or complex situation
that might then require using a manual resuscitation bag and calling the
respiratory therapist.
◍ What is the Allen Test?.
Answer: A test that determines the patency of the radial and ulnar arteries by
compressing one artery site and observing return of skin color as evidence
of patency of the other artery
◍ A client, admitted with palpitations and dyspnea, is diagnosed with atrial
fibrillation (AF). Normal sinus rhythm is later restored using pharmacologic
interventions. In addition to controlling cardiac rate and rhythm, the nurse
understands that treatment for AF must include which of the following
approaches?
A. Catheter ablation
B. Anticoagulation
C. Coronary artery bypass surgery
D. Cardioversion.
Answer: BIn addition to rate and rhythm control, acute management of AF
includes anticoagulation. Effective anticoagulation in clients with AF
significantly reduces the risk of stroke and other thromboembolic events.
When a client does not respond to pharmacologic interventions to restore
sinus rhythm, cardioversion is used. Catheter ablation is used to disconnect
the triggers for AF, but is not the first line of treatment. CABG is not used to
treat AF.
◍ 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,DPromethazine (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 is assisting with the admission of a client who is scheduled for a
colon resection. Which of the following statements made by the client
would be most important for the nurse to clarify?.
Answer: I usually have a few glasses of wine in the evening.
◍ The nurse has reviewed the Nurses' Notes from 11:30 and has collaborated
with the registered nurse. The nurse should recognize that the client is most
likely experiencing....
Answer: autonomic dysreflexia
◍ A client has end-stage renal disease. Which of these statements made by the
client indicates a correct understanding of the issues related to this disease?
A. "I can expect to have periods of little urine and then sometimes a lot of
urine."
B. "I have to go for epoetin (Procrit) injections at the health department."
C. "I know I have a high risk of clot formation since my blood is thick from
too many red cells."
D. "My bones will be stronger with this disease since I will have higher
calcium than normal.".
Answer: BAnemia in end-stage renal failure is caused by reduced
endogenous erythropoietin production in the kidney. Anemia in primary
end-stage renal disease is treated with subcutaneous injections of Procrit or
Epogen to stimulate the bone marrow to produce red blood cells. With
kidney failure, too much phosphorus can build up in the blood and calcium
is pulled from the bones, resulting in weakened bones. The statement about
, producing variable amounts of urine is incorrect, as the client will produce
little to no urine at this stage of the disease.
◍ A nurse is educating parents on accidental poisoning in children. Which
type of accidental poisoning is expected to occur in children under age six?
A. Topical contact
B. Oral ingestion
C. Inhalation
D. Eye splashes.
Answer: BThe greatest risk for young children is from oral ingestion. While
children under age six may come in contact with other poisons or inhale
toxic fumes, these are not as common.
◍ A nurse asks a client with a history of alcoholism about recent drinking
behavior. The client states, "I didn't hurt anyone. I just like to have a good
time, and drinking helps me to relax." The client is using which defense
mechanism?
A. Denial
B. Intellectualization
C. Rationalization
D. Projection.
Answer: CRationalization is justifying illogical or unreasonable ideas,
actions or feelings by the development of acceptable explanations for
unacceptable actions. Both the teller and the listener find the rationalizations
more satisfactory than the reality. Intellectualization is the use of reasoning
in response to confrontation with unconscious conflicts and accompanying
stressful emotions. Projection is the assignment of one's own feelings or
thoughts to others.
◍ The nurse is reinforcing teaching with the parents of a 9-year-old child who
is receiving methylphenidate. Which of the following information should
the nurse reinforce?.
Answer: Increase your child's intake of foods that are high in iron and
potassium.
QUESTIONS WITH ANSWERS GRADED A+
◍ The nurse and a student nurse are discussing the health issues related to a
laboring HBsAg-positive client. Which of these comments by the student is
incorrect and indicates a need for further instruction?
A. "The infant will receive the hepatitis B vaccine within 12 hours after
birth."
B. "The HBsAg-positive mother should be reported to the state or local
health department."
C. "The HBsAg-positive mother should not breastfeed her baby."
D. "The infant will receive the hepatitis B immune globulin within 12 hours
after birth.".
Answer: CAll persons with HBsAg-positive laboratory results should be
reported to the state or local health department. The newborn should receive
the hepatitis B immune globulin and hepatitis B vaccine within 12 hours
after birth, using different sites (the second vaccine is given between 1 and 2
months; the last vaccine is given between 6 and 18 months). HBV is not
spread by breastfeeding, kissing, hugging, coughing, or casual contact.
◍ A nurse is caring for a client who requires a mechanical ventilator for
breathing. The high-pressure alarm goes off on the ventilator. What is an
appropriate action for the nurse to take?
A. Perform a quick assessment of the client's overall condition along with
respiratory effort
B. Call the respiratory therapist for help to troubleshoot the alarm
C. Press the alarm re-set button on the ventilator and observe the client
D. Disconnect the client from the ventilator and use a manual resuscitation
bag.
Answer: AA number of situations can cause the high-pressure alarm to
, sound. It can be as simple as the client coughing. A quick assessment of the
client will alert the nurse to whether it is a more serious or complex situation
that might then require using a manual resuscitation bag and calling the
respiratory therapist.
◍ What is the Allen Test?.
Answer: A test that determines the patency of the radial and ulnar arteries by
compressing one artery site and observing return of skin color as evidence
of patency of the other artery
◍ A client, admitted with palpitations and dyspnea, is diagnosed with atrial
fibrillation (AF). Normal sinus rhythm is later restored using pharmacologic
interventions. In addition to controlling cardiac rate and rhythm, the nurse
understands that treatment for AF must include which of the following
approaches?
A. Catheter ablation
B. Anticoagulation
C. Coronary artery bypass surgery
D. Cardioversion.
Answer: BIn addition to rate and rhythm control, acute management of AF
includes anticoagulation. Effective anticoagulation in clients with AF
significantly reduces the risk of stroke and other thromboembolic events.
When a client does not respond to pharmacologic interventions to restore
sinus rhythm, cardioversion is used. Catheter ablation is used to disconnect
the triggers for AF, but is not the first line of treatment. CABG is not used to
treat AF.
◍ 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,DPromethazine (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 is assisting with the admission of a client who is scheduled for a
colon resection. Which of the following statements made by the client
would be most important for the nurse to clarify?.
Answer: I usually have a few glasses of wine in the evening.
◍ The nurse has reviewed the Nurses' Notes from 11:30 and has collaborated
with the registered nurse. The nurse should recognize that the client is most
likely experiencing....
Answer: autonomic dysreflexia
◍ A client has end-stage renal disease. Which of these statements made by the
client indicates a correct understanding of the issues related to this disease?
A. "I can expect to have periods of little urine and then sometimes a lot of
urine."
B. "I have to go for epoetin (Procrit) injections at the health department."
C. "I know I have a high risk of clot formation since my blood is thick from
too many red cells."
D. "My bones will be stronger with this disease since I will have higher
calcium than normal.".
Answer: BAnemia in end-stage renal failure is caused by reduced
endogenous erythropoietin production in the kidney. Anemia in primary
end-stage renal disease is treated with subcutaneous injections of Procrit or
Epogen to stimulate the bone marrow to produce red blood cells. With
kidney failure, too much phosphorus can build up in the blood and calcium
is pulled from the bones, resulting in weakened bones. The statement about
, producing variable amounts of urine is incorrect, as the client will produce
little to no urine at this stage of the disease.
◍ A nurse is educating parents on accidental poisoning in children. Which
type of accidental poisoning is expected to occur in children under age six?
A. Topical contact
B. Oral ingestion
C. Inhalation
D. Eye splashes.
Answer: BThe greatest risk for young children is from oral ingestion. While
children under age six may come in contact with other poisons or inhale
toxic fumes, these are not as common.
◍ A nurse asks a client with a history of alcoholism about recent drinking
behavior. The client states, "I didn't hurt anyone. I just like to have a good
time, and drinking helps me to relax." The client is using which defense
mechanism?
A. Denial
B. Intellectualization
C. Rationalization
D. Projection.
Answer: CRationalization is justifying illogical or unreasonable ideas,
actions or feelings by the development of acceptable explanations for
unacceptable actions. Both the teller and the listener find the rationalizations
more satisfactory than the reality. Intellectualization is the use of reasoning
in response to confrontation with unconscious conflicts and accompanying
stressful emotions. Projection is the assignment of one's own feelings or
thoughts to others.
◍ The nurse is reinforcing teaching with the parents of a 9-year-old child who
is receiving methylphenidate. Which of the following information should
the nurse reinforce?.
Answer: Increase your child's intake of foods that are high in iron and
potassium.
