1|Page
UWORLD NCLEX - PN TEST 1 |
COMPREHENSIVE QUESTIONS WITH ANSWERS
& RATIONALES 2025 | GRADED A+
Viral hepatitis is a disease of the liver characterized by inflammation, necrosis, and
cirrhosis. One of the most common viral strains that causes hepatitis is hepatitis B
The transmission of hepatitis B is primarily through contact with blood, semen,
and vaginal secretions (mnemonic: B for body fluids), commonly through
unprotected sexual intercourse and intravenous illicit drug use (Options 1, 3, and 5
are correct). Infants born to infected mothers are also at risk for vertical
transmission of hepatitis B Although kissing, sneezing, sharing drinks/utensils, and
breastfeeding are not known routes of transmission, hepatitis B could possibly be
transmitted through saliva entering the bloodstream via sharing a toothbrush or
receiving a bite.
Hepatitis B has an insidious onset of illness, and clients may be asymptomatic
carriers. Early symptoms are often nonspecific (eg, malaise, nausea, vomiting,
abdominal pain). Hepatitis B may produce jaundice, weight loss, clay-colored
stools, and thrombocytopenia in late stages of illness. An effective vaccine is
widely available for hepatitis B.
(Option 2 is wrong) The transmission of hepatitis A occurs through the fecal-oral
route via poor hand hygiene and improper food handling. Therefore, this infection
is seen primarily in developing countries. Hepatitis B is not transmitted through
feces.
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(Option 4 is wrong) Urine is not known to be a mode of transmission for any form
of hepatitis.
The nurse is caring for a client admitted 3 days ago with bacterial pneumonia who
has become short of breath, restless, and difficult to rouse. Which additional
finding indicates to the nurse that the client may be developing sepsis?
1. Capillary refill time of 5 seconds
2. Diminished breath sounds in the lung bases
3. Hyperactive bowel sounds
4. Urine output of 35 mL/hr - correct-answer-CORRECT ANSWER: 1
Sepsis is an exaggerated, life-threatening response by the body to a bloodstream
infection that can result in hemodynamic instability, respiratory failure, and
multiorgan dysfunction. Sepsis typically occurs when bacteria from a local or
regional infection (eg, pneumonia, urinary tract infection) enters the bloodstream.
Clients with sepsis often have manifestations of a systemic inflammatory response
(eg, tachycardia, fever, elevated WBCs) and may exhibit signs of impaired organ
function, such as:
• Absent bowel sounds: lleus occurs in response to sepsis as blood is shunted
away from the gastrointestinal tract to vital organ systems (eg, brain, lungs).
,3|Page
• Capillary refill time >3 seconds (in adults): Prolonged capillary refill indicates
inadequate perfusion of peripheral tissues (Option 1 is correct).
• Increased blood glucose in the absence of diabetes: Gluconeogenesis occurs in
response to the physiologic stress of infection.
• Altered mentation: Changes in mental status (eg, difficulty rousing, agitation,
confusion) occur from impaired cerebral perfusion and oxygenation.
(Option 2 is wrong) Diminished breath sounds in the lung bases are expected in a
client with pneumonia.
(Option 3 is wrong) Hyperactive bowel sounds are associated with gastrointestinal
distress, not sepsis.
(Option 4 is wrong) Urine output of 35 mL/hr is within normal range (ie, ≥ 30
mL/hr or ≥ 0.5 mL/kg/hr). Oliguria is a possible sign of sepsis, however.
The nurse is caring for a client who had a laparoscopic cholecystectomy 3 days
ago. The client's WBC count has increased from 11,200/mm³ (11.2 x 10⁹/L) to
14,600/mm³ (14.6 x 10⁹/L) over the last 24 hours. The nurse understands that
which of the following assessment findings indicate potential infection. Select all
that apply.
1. Client rating left shoulder pain as 4 on a scale of 0-10
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2. Greenish-grey drainage noted on surgical dressing
3. Productive cough with thick, green sputum
4. Stiff abdomen with rebound tenderness on palpation
5. Warm, reddened area around the incision site - correct-answer-CORRECT
ANSWER: 2, 3, 4, 5
Cholecystectomy (removal of the gallbladder) is performed through laparoscopic
or open surgery. Signs of postoperative infection typically appear 3-7 days after
surgery. Systemic signs may include fever, elevated WBC count, and fatigue.
See image: https://imgur.com/9jzaX1U
Some potential postoperative infections include:
• Pneumonia can occur when atelectasis (alveolar collapse) prevents clearing of
secretions, promoting bacterial growth. Symptoms include cough with or without
sputum, tachypnea, and shortness of breath. Postoperative incentive spirometry,
ambulation, and cough/deep breathing exercises help keep alveoli open and
prevent pneumonia (Option 3 is correct).
• Surgical site infections present with localized redness, warmth, swelling, and
purulent drainage. Proper wound care and sterile dressing changes help prevent
infection (Options 2 and 5 are correct).
UWORLD NCLEX - PN TEST 1 |
COMPREHENSIVE QUESTIONS WITH ANSWERS
& RATIONALES 2025 | GRADED A+
Viral hepatitis is a disease of the liver characterized by inflammation, necrosis, and
cirrhosis. One of the most common viral strains that causes hepatitis is hepatitis B
The transmission of hepatitis B is primarily through contact with blood, semen,
and vaginal secretions (mnemonic: B for body fluids), commonly through
unprotected sexual intercourse and intravenous illicit drug use (Options 1, 3, and 5
are correct). Infants born to infected mothers are also at risk for vertical
transmission of hepatitis B Although kissing, sneezing, sharing drinks/utensils, and
breastfeeding are not known routes of transmission, hepatitis B could possibly be
transmitted through saliva entering the bloodstream via sharing a toothbrush or
receiving a bite.
Hepatitis B has an insidious onset of illness, and clients may be asymptomatic
carriers. Early symptoms are often nonspecific (eg, malaise, nausea, vomiting,
abdominal pain). Hepatitis B may produce jaundice, weight loss, clay-colored
stools, and thrombocytopenia in late stages of illness. An effective vaccine is
widely available for hepatitis B.
(Option 2 is wrong) The transmission of hepatitis A occurs through the fecal-oral
route via poor hand hygiene and improper food handling. Therefore, this infection
is seen primarily in developing countries. Hepatitis B is not transmitted through
feces.
,2|Page
(Option 4 is wrong) Urine is not known to be a mode of transmission for any form
of hepatitis.
The nurse is caring for a client admitted 3 days ago with bacterial pneumonia who
has become short of breath, restless, and difficult to rouse. Which additional
finding indicates to the nurse that the client may be developing sepsis?
1. Capillary refill time of 5 seconds
2. Diminished breath sounds in the lung bases
3. Hyperactive bowel sounds
4. Urine output of 35 mL/hr - correct-answer-CORRECT ANSWER: 1
Sepsis is an exaggerated, life-threatening response by the body to a bloodstream
infection that can result in hemodynamic instability, respiratory failure, and
multiorgan dysfunction. Sepsis typically occurs when bacteria from a local or
regional infection (eg, pneumonia, urinary tract infection) enters the bloodstream.
Clients with sepsis often have manifestations of a systemic inflammatory response
(eg, tachycardia, fever, elevated WBCs) and may exhibit signs of impaired organ
function, such as:
• Absent bowel sounds: lleus occurs in response to sepsis as blood is shunted
away from the gastrointestinal tract to vital organ systems (eg, brain, lungs).
,3|Page
• Capillary refill time >3 seconds (in adults): Prolonged capillary refill indicates
inadequate perfusion of peripheral tissues (Option 1 is correct).
• Increased blood glucose in the absence of diabetes: Gluconeogenesis occurs in
response to the physiologic stress of infection.
• Altered mentation: Changes in mental status (eg, difficulty rousing, agitation,
confusion) occur from impaired cerebral perfusion and oxygenation.
(Option 2 is wrong) Diminished breath sounds in the lung bases are expected in a
client with pneumonia.
(Option 3 is wrong) Hyperactive bowel sounds are associated with gastrointestinal
distress, not sepsis.
(Option 4 is wrong) Urine output of 35 mL/hr is within normal range (ie, ≥ 30
mL/hr or ≥ 0.5 mL/kg/hr). Oliguria is a possible sign of sepsis, however.
The nurse is caring for a client who had a laparoscopic cholecystectomy 3 days
ago. The client's WBC count has increased from 11,200/mm³ (11.2 x 10⁹/L) to
14,600/mm³ (14.6 x 10⁹/L) over the last 24 hours. The nurse understands that
which of the following assessment findings indicate potential infection. Select all
that apply.
1. Client rating left shoulder pain as 4 on a scale of 0-10
, 4|Page
2. Greenish-grey drainage noted on surgical dressing
3. Productive cough with thick, green sputum
4. Stiff abdomen with rebound tenderness on palpation
5. Warm, reddened area around the incision site - correct-answer-CORRECT
ANSWER: 2, 3, 4, 5
Cholecystectomy (removal of the gallbladder) is performed through laparoscopic
or open surgery. Signs of postoperative infection typically appear 3-7 days after
surgery. Systemic signs may include fever, elevated WBC count, and fatigue.
See image: https://imgur.com/9jzaX1U
Some potential postoperative infections include:
• Pneumonia can occur when atelectasis (alveolar collapse) prevents clearing of
secretions, promoting bacterial growth. Symptoms include cough with or without
sputum, tachypnea, and shortness of breath. Postoperative incentive spirometry,
ambulation, and cough/deep breathing exercises help keep alveoli open and
prevent pneumonia (Option 3 is correct).
• Surgical site infections present with localized redness, warmth, swelling, and
purulent drainage. Proper wound care and sterile dressing changes help prevent
infection (Options 2 and 5 are correct).
