UWorld NCLEX-RN Final Exam 2026-2027 | 280
Complex Practice Questions with Detailed
Rationales | Real Exam Simulation | Verified
Answers | Instant Download
1. A nurse is administering a rituximab infusion to a client with lymphoma in
an oncology clinic. Which client symptom would be a priority to report to the
healthcare provider?
A. Dizziness and sudden diarrhea
B. Nausea and onset of vomiting
C. New-onset tachypnea and dyspnea
D. Temperature of 101 F (38.3 C)
Correct Answer: C
Rationale: New-onset tachypnea and dyspnea during a rituximab infusion are
signs of a severe infusion reaction, which can progress to anaphylaxis and
respiratory arrest. This requires immediate intervention. Dizziness and
diarrhea, nausea and vomiting, and fever are important but are not
immediately life-threatening.
2. A nurse suspects a coworker is diverting controlled substances. Which
action should the nurse take first?
A. Ask another coworker to observe the individual to confirm the suspicion
B. Confront the coworker about the concern and offer emotional support
C. Speak with the nursing supervisor about the concern
D. Telephone the appropriate regulatory agency and make a report
,Correct Answer: C
Rationale: The nurse should first report the suspicion to the nursing
supervisor, who can initiate an investigation. Confronting the coworker or
asking another coworker to observe could compromise the investigation.
Reporting to a regulatory agency may be necessary later but is not the first
step.
3. A nurse is preparing a client for transfer to the morgue after death. Which
action is appropriate?
A. Allow the family to remain with the client at all times
B. Call the next of kin before providing any postmortem care
C. Prepare the client for transfer to the morgue for autopsy
D. Provide a sheet to be placed over the client's face
Correct Answer: A
Rationale: Allowing the family to remain with the client after death supports
the grieving process and respects cultural practices. Calling the next of kin
should have been done earlier. Preparing for autopsy requires specific orders.
Placing a sheet over the face is not standard practice until the family has had
time to say goodbye.
,4. A client with chronic kidney disease is prescribed a renal diet. Which meal
selection indicates understanding?
A. Baked tilapia with lemon wedge, sweet potatoes, and green peas
B. Cream of potato soup and roast beef sandwich on a croissant
C. Sauteed salmon, macaroni and cheese, string beans, and a biscuit
D. Shrimp enchiladas with tomato salsa, rice, cornbread, and refried beans
Correct Answer: A
Rationale: A renal diet limits sodium, potassium, phosphorus, and protein.
Baked tilapia, sweet potatoes, and green peas are appropriate choices. Cream
of potato soup and roast beef sandwich are high in sodium and potassium.
Macaroni and cheese is high in phosphorus. Shrimp enchiladas with refried
beans are high in sodium and potassium.
5. The nurse is preparing to change the dressing of a client's subclavian central
venous catheter. Place the procedural steps in the correct order.
A. Apply CHG patch over catheter insertion site and cover with a sterile
transparent dressing
B. Cleanse the site with CHG for at least 30 seconds using friction; allow to air
dry completely
C. Discard the clean gloves, perform hand hygiene, and apply sterile gloves
, D. Perform hand hygiene, don face mask, place a mask on the client, and
apply clean gloves
E. Remove old dressing and CHG-impregnated patch; assess insertion site
Correct Answer: D, E, C, B, A
Rationale: The correct order is: perform hand hygiene and don mask, remove
old dressing, discard gloves and apply sterile gloves, cleanse with CHG, and
apply new CHG patch and dressing. This sequence minimizes infection risk.
6. A nurse is prioritizing care for four clients. Which client should the nurse
assess first?
A. 2-week-old with tricuspid atresia who has dusky lips and nailbeds
B. 5-week-old with forceful vomiting after every feeding who is crying
C. 12-month-old who was wheezing at home and is now lethargic with no
wheezing
D. 3-year-old with fever who had a brief seizure at home and is asleep
Correct Answer: C
Rationale: A lethargic infant with no wheezing after wheezing at home
indicates silent chest, a life-threatening sign of impending respiratory failure.
This requires immediate assessment. Dusky lips and nailbeds indicate hypoxia
but are less acute. Forceful vomiting suggests pyloric stenosis. A brief seizure
with sleep is less urgent.
Complex Practice Questions with Detailed
Rationales | Real Exam Simulation | Verified
Answers | Instant Download
1. A nurse is administering a rituximab infusion to a client with lymphoma in
an oncology clinic. Which client symptom would be a priority to report to the
healthcare provider?
A. Dizziness and sudden diarrhea
B. Nausea and onset of vomiting
C. New-onset tachypnea and dyspnea
D. Temperature of 101 F (38.3 C)
Correct Answer: C
Rationale: New-onset tachypnea and dyspnea during a rituximab infusion are
signs of a severe infusion reaction, which can progress to anaphylaxis and
respiratory arrest. This requires immediate intervention. Dizziness and
diarrhea, nausea and vomiting, and fever are important but are not
immediately life-threatening.
2. A nurse suspects a coworker is diverting controlled substances. Which
action should the nurse take first?
A. Ask another coworker to observe the individual to confirm the suspicion
B. Confront the coworker about the concern and offer emotional support
C. Speak with the nursing supervisor about the concern
D. Telephone the appropriate regulatory agency and make a report
,Correct Answer: C
Rationale: The nurse should first report the suspicion to the nursing
supervisor, who can initiate an investigation. Confronting the coworker or
asking another coworker to observe could compromise the investigation.
Reporting to a regulatory agency may be necessary later but is not the first
step.
3. A nurse is preparing a client for transfer to the morgue after death. Which
action is appropriate?
A. Allow the family to remain with the client at all times
B. Call the next of kin before providing any postmortem care
C. Prepare the client for transfer to the morgue for autopsy
D. Provide a sheet to be placed over the client's face
Correct Answer: A
Rationale: Allowing the family to remain with the client after death supports
the grieving process and respects cultural practices. Calling the next of kin
should have been done earlier. Preparing for autopsy requires specific orders.
Placing a sheet over the face is not standard practice until the family has had
time to say goodbye.
,4. A client with chronic kidney disease is prescribed a renal diet. Which meal
selection indicates understanding?
A. Baked tilapia with lemon wedge, sweet potatoes, and green peas
B. Cream of potato soup and roast beef sandwich on a croissant
C. Sauteed salmon, macaroni and cheese, string beans, and a biscuit
D. Shrimp enchiladas with tomato salsa, rice, cornbread, and refried beans
Correct Answer: A
Rationale: A renal diet limits sodium, potassium, phosphorus, and protein.
Baked tilapia, sweet potatoes, and green peas are appropriate choices. Cream
of potato soup and roast beef sandwich are high in sodium and potassium.
Macaroni and cheese is high in phosphorus. Shrimp enchiladas with refried
beans are high in sodium and potassium.
5. The nurse is preparing to change the dressing of a client's subclavian central
venous catheter. Place the procedural steps in the correct order.
A. Apply CHG patch over catheter insertion site and cover with a sterile
transparent dressing
B. Cleanse the site with CHG for at least 30 seconds using friction; allow to air
dry completely
C. Discard the clean gloves, perform hand hygiene, and apply sterile gloves
, D. Perform hand hygiene, don face mask, place a mask on the client, and
apply clean gloves
E. Remove old dressing and CHG-impregnated patch; assess insertion site
Correct Answer: D, E, C, B, A
Rationale: The correct order is: perform hand hygiene and don mask, remove
old dressing, discard gloves and apply sterile gloves, cleanse with CHG, and
apply new CHG patch and dressing. This sequence minimizes infection risk.
6. A nurse is prioritizing care for four clients. Which client should the nurse
assess first?
A. 2-week-old with tricuspid atresia who has dusky lips and nailbeds
B. 5-week-old with forceful vomiting after every feeding who is crying
C. 12-month-old who was wheezing at home and is now lethargic with no
wheezing
D. 3-year-old with fever who had a brief seizure at home and is asleep
Correct Answer: C
Rationale: A lethargic infant with no wheezing after wheezing at home
indicates silent chest, a life-threatening sign of impending respiratory failure.
This requires immediate assessment. Dusky lips and nailbeds indicate hypoxia
but are less acute. Forceful vomiting suggests pyloric stenosis. A brief seizure
with sleep is less urgent.
