NCSBN FINAL ASSESSMENT PAPER 2026
COMPLETE QUESTIONS AND VERIFIED
SOLUTIONS
◉ The mother of a 2 month-old baby calls a pediatrician's nurse two
days after the first DTaP, inactivated polio vaccine (IPV), Hepatitis B
and Haemophilus influenzae type B (HIB) immunizations. She
reports that the baby feels very warm, cries inconsolably for as long
as three hours, and has had several shaking spells. Which
immunization would the nurse expect to be primarily responsible
with these findings?
A. DTaP
B. IPV
C. Hepatitis B
D. HIB
Answer: A
DTaP immunization is a vaccine that protects against diptheria,
tetanus and pertussis (whooping cough). The majority of reactions
described in this question occur with the administration of the DTaP
vaccination. Contraindications to giving repeat DTaP immunizations
include the occurrence of severe side effects after a previous dose, as
well as signs of encephalopathy within seven days of the
immunization.
,◉ A client diagnosed with angina has been instructed about the use
of sublingual nitroglycerin. Which statement made by the client is
incorrect and indicates a need for further teaching?
A. "I'll call the health care provider if pain continues after three
tablets five minutes apart."
B. "I will rest briefly right after taking one tablet."
C. "I understand that the medication should be kept in the dark
bottle."
D. "I can swallow two or three tablets at once if I have severe pain."
Answer: D
Clients must understand that just one sublingual tablet should be
taken at a time and placed under the tongue. After rest and a five-
minute interval, a second and then eventually a third tablet may be
necessary.
◉ The nurse is working with victims of domestic abuse. The nurse
should understand which of these factors is a reason why domestic
violence or emotional abuse remains extensively undetected?
A. The expenses due to police and court costs are prohibitive
B. Little knowledge is known about batterers and battering
relationships
,C. There are typically many series of minor, vague complaints
D. Few people who have been battered seek medical care
Answer: C
Signs of domestic violence or emotional abuse may not be clearly
manifested and include many series of a minor complaints such as
headache, abdominal pain, insomnia, back pain and dizziness. These
may be covert indications of violence or abuse that go undetected.
These complaints may be vague and reflect ambivalence about the
disclosure of any violence or abuse.
◉ The nurse is obtaining an aerobic wound culture from a client
with stage two pressure injury. The nurse first removes a gauze
dressing and observes a moderate amount of purulent drainage on
the dressing and then the nurse performs hand hygiene. What is the
next correct step in the procedure?
A. Swab the gauze dressing that was removed from the wound
B. Irrigate the wound with normal saline
C. Obtain a culture by rotating a sterile swab in the open wound
D. Remove wound exudate from the wound edges with a cotton tip
applicator
Answer: B
After removing the dressing and performing hand hygiene, the
wound needs to be irrigated to remove surface pathogens before the
nurse can obtain a wound culture. Cultures are not obtained from
, wound exudate on the dressing or wounds that have not been
irrigated since the exudate may be contaminated with normal skin
flora.
◉ The nurse is caring for a client who is experiencing frightening
hallucinations that are markedly increased at night. The client's
partner asks to stay a few hours beyond the visiting time, in the
client's private room. What would be the best response by the
nurse?
A. "Yes, staying with the client and orienting the client to the
surroundings may decrease any anxiety."
B. "No, your presence may cause the client to become more anxious."
C. "No, it would be best if you brought the client some reading
material that the client could read at night."
D. "Yes, would you like to spend the night when the client's behavior
indicates that the client is or will be frightened?"
Answer: A
Encouragement of a family member or a close friend to stay with the
client in a quiet surrounding cannot only help increase orientation,
but can also minimize confusion and anxiety. The visitor could also
report to the nurse any unusual findings of the client. This would be
the most supportive approach for this client.
COMPLETE QUESTIONS AND VERIFIED
SOLUTIONS
◉ The mother of a 2 month-old baby calls a pediatrician's nurse two
days after the first DTaP, inactivated polio vaccine (IPV), Hepatitis B
and Haemophilus influenzae type B (HIB) immunizations. She
reports that the baby feels very warm, cries inconsolably for as long
as three hours, and has had several shaking spells. Which
immunization would the nurse expect to be primarily responsible
with these findings?
A. DTaP
B. IPV
C. Hepatitis B
D. HIB
Answer: A
DTaP immunization is a vaccine that protects against diptheria,
tetanus and pertussis (whooping cough). The majority of reactions
described in this question occur with the administration of the DTaP
vaccination. Contraindications to giving repeat DTaP immunizations
include the occurrence of severe side effects after a previous dose, as
well as signs of encephalopathy within seven days of the
immunization.
,◉ A client diagnosed with angina has been instructed about the use
of sublingual nitroglycerin. Which statement made by the client is
incorrect and indicates a need for further teaching?
A. "I'll call the health care provider if pain continues after three
tablets five minutes apart."
B. "I will rest briefly right after taking one tablet."
C. "I understand that the medication should be kept in the dark
bottle."
D. "I can swallow two or three tablets at once if I have severe pain."
Answer: D
Clients must understand that just one sublingual tablet should be
taken at a time and placed under the tongue. After rest and a five-
minute interval, a second and then eventually a third tablet may be
necessary.
◉ The nurse is working with victims of domestic abuse. The nurse
should understand which of these factors is a reason why domestic
violence or emotional abuse remains extensively undetected?
A. The expenses due to police and court costs are prohibitive
B. Little knowledge is known about batterers and battering
relationships
,C. There are typically many series of minor, vague complaints
D. Few people who have been battered seek medical care
Answer: C
Signs of domestic violence or emotional abuse may not be clearly
manifested and include many series of a minor complaints such as
headache, abdominal pain, insomnia, back pain and dizziness. These
may be covert indications of violence or abuse that go undetected.
These complaints may be vague and reflect ambivalence about the
disclosure of any violence or abuse.
◉ The nurse is obtaining an aerobic wound culture from a client
with stage two pressure injury. The nurse first removes a gauze
dressing and observes a moderate amount of purulent drainage on
the dressing and then the nurse performs hand hygiene. What is the
next correct step in the procedure?
A. Swab the gauze dressing that was removed from the wound
B. Irrigate the wound with normal saline
C. Obtain a culture by rotating a sterile swab in the open wound
D. Remove wound exudate from the wound edges with a cotton tip
applicator
Answer: B
After removing the dressing and performing hand hygiene, the
wound needs to be irrigated to remove surface pathogens before the
nurse can obtain a wound culture. Cultures are not obtained from
, wound exudate on the dressing or wounds that have not been
irrigated since the exudate may be contaminated with normal skin
flora.
◉ The nurse is caring for a client who is experiencing frightening
hallucinations that are markedly increased at night. The client's
partner asks to stay a few hours beyond the visiting time, in the
client's private room. What would be the best response by the
nurse?
A. "Yes, staying with the client and orienting the client to the
surroundings may decrease any anxiety."
B. "No, your presence may cause the client to become more anxious."
C. "No, it would be best if you brought the client some reading
material that the client could read at night."
D. "Yes, would you like to spend the night when the client's behavior
indicates that the client is or will be frightened?"
Answer: A
Encouragement of a family member or a close friend to stay with the
client in a quiet surrounding cannot only help increase orientation,
but can also minimize confusion and anxiety. The visitor could also
report to the nurse any unusual findings of the client. This would be
the most supportive approach for this client.
