NCLEX ACTUAL EXAM 2026
EXAMINATION TEST COMPLETE 180
QUESTIONS AND ANSWERS WITH
EXPLANATIONS GUARANTEED TO PASS
⩥ The nurse is taking the health history of a 70-year-old patient being
treated for a Duodenal Ulcer. After being told the patient is complaining
of epigastric pain, the nurse expects to note which assessment finding?
1. Melena
2. Nausea
3. Hernia
4. Hyperthermia. Answer: 1. Melena - CORRECT
Melena is the finding that there are traces of blood in the stool which
presents as black, tarry feces. This is a common manifestation of
Duodenal Ulcers, since the Duodenum is further down the gastric
anatomy.
⩥ A nurse is providing discharge teaching for a patient with severe
Gastroesophogeal Reflux Disease. Which of these statements by the
patient indicates a need for more teaching?
1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion."
,2. "I'm going to make sure to remain upright after meals and elevate my
head when I sleep"
3. "I won't be drinking tea or coffee or eating chocolate any more."
4. "I'm going to start trying to lose some weight.". Answer: 1. "I'm going
to limit my meals to 2-3 per day to reduce acid secretion."
CORRECT - Large meals increase the volume and pressure in the
stomach and delay gastric emptying. It's recommended instead to eat 4-6
small meals a day.
⩥ The nurse in the Emergency Room is treating a patient suspected to
have a Peptic Ulcer. On assessing lab results, the nurse finds that the
patient's blood pressure is 95/60, pulse is 110 beats per minute, and the
patient reports epigastric pain. What is the PRIORITY intervention?
1. Start a large-bore IV in the patient's arm
2. Ask the patient for a stool sample
3. Prepare to insert an NG Tube
4. Administer intramuscular morphine sulphate as ordered. Answer: 1.
Start a large-bore IV in the patient's arm
CORRECT - The nurse should suspect that the patient is haemorrhaging
and will need need a fluid replacement therapy, which requires a large
bore IV.
,⩥ A female patient with atrial fibrillation has the following lab results:
Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and
potassium of 2.7 mEq/L. Which result is critical and should be reported
to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L. Answer: 4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a patient with a history of
dysrhythmia can be life-threatening and can lead to cardiac distress.
⩥ While receiving normal saline infusions to treat a GI bleed, the nurse
notes that the patient's lower legs have become edematous and
auscultates crackles in the lungs. What should the nurse do first?
1. Stop the saline infusion immediately
2. Notify Physician
3. Elevate the patient's legs
4. Continue the infusion, since these are normal findings. Answer: 1.
Stop the saline infusion immediately
, CORRECT - the patient has a fluid volume overload as a result of overly
rapid fluid replacement. The nurse should stop the infusion and notify
the physician.
⩥ The nurse is working in a support group for clients with HIV. Which
point is most important for the nurse to stress?
1. They must inform household members of their condition
2. They must take their medications exactly as prescribed
3. They must abstain from substance use
4. They must avoid large crowds. Answer: 2. They must take their
medications exactly as prescribed
CORRECT - Antiretrovirals must be taken exactly as prescribed to
prevent drug-resistant strains. Even missed doses can reduce the
effectiveness of future treatment.
⩥ A nurse finds a 30-year-old woman experiencing anaphylaxis from a
bee sting. Emergency personnel have been called. The nurse notes the
woman is breathing but short of breath. Which of the following
interventions should the nurse do first?
1. Initiate cardiopulmonary resuscitation
2. Check for a pulse
3. Ask the woman if she carries an emergency medical kit
EXAMINATION TEST COMPLETE 180
QUESTIONS AND ANSWERS WITH
EXPLANATIONS GUARANTEED TO PASS
⩥ The nurse is taking the health history of a 70-year-old patient being
treated for a Duodenal Ulcer. After being told the patient is complaining
of epigastric pain, the nurse expects to note which assessment finding?
1. Melena
2. Nausea
3. Hernia
4. Hyperthermia. Answer: 1. Melena - CORRECT
Melena is the finding that there are traces of blood in the stool which
presents as black, tarry feces. This is a common manifestation of
Duodenal Ulcers, since the Duodenum is further down the gastric
anatomy.
⩥ A nurse is providing discharge teaching for a patient with severe
Gastroesophogeal Reflux Disease. Which of these statements by the
patient indicates a need for more teaching?
1. "I'm going to limit my meals to 2-3 per day to reduce acid secretion."
,2. "I'm going to make sure to remain upright after meals and elevate my
head when I sleep"
3. "I won't be drinking tea or coffee or eating chocolate any more."
4. "I'm going to start trying to lose some weight.". Answer: 1. "I'm going
to limit my meals to 2-3 per day to reduce acid secretion."
CORRECT - Large meals increase the volume and pressure in the
stomach and delay gastric emptying. It's recommended instead to eat 4-6
small meals a day.
⩥ The nurse in the Emergency Room is treating a patient suspected to
have a Peptic Ulcer. On assessing lab results, the nurse finds that the
patient's blood pressure is 95/60, pulse is 110 beats per minute, and the
patient reports epigastric pain. What is the PRIORITY intervention?
1. Start a large-bore IV in the patient's arm
2. Ask the patient for a stool sample
3. Prepare to insert an NG Tube
4. Administer intramuscular morphine sulphate as ordered. Answer: 1.
Start a large-bore IV in the patient's arm
CORRECT - The nurse should suspect that the patient is haemorrhaging
and will need need a fluid replacement therapy, which requires a large
bore IV.
,⩥ A female patient with atrial fibrillation has the following lab results:
Hemoglobin of 11 g/dl, a platelet count of 150,000, an INR of 2.5, and
potassium of 2.7 mEq/L. Which result is critical and should be reported
to the physician immediately?
1. Hemoglobin 11 g/dl
2. Platelet of 150,000
3. INR of 2.5
4. Potassium of 2.7 mEq/L. Answer: 4. Potassium of 2.7 mEq/L
CORRECT - A potassium imbalance for a patient with a history of
dysrhythmia can be life-threatening and can lead to cardiac distress.
⩥ While receiving normal saline infusions to treat a GI bleed, the nurse
notes that the patient's lower legs have become edematous and
auscultates crackles in the lungs. What should the nurse do first?
1. Stop the saline infusion immediately
2. Notify Physician
3. Elevate the patient's legs
4. Continue the infusion, since these are normal findings. Answer: 1.
Stop the saline infusion immediately
, CORRECT - the patient has a fluid volume overload as a result of overly
rapid fluid replacement. The nurse should stop the infusion and notify
the physician.
⩥ The nurse is working in a support group for clients with HIV. Which
point is most important for the nurse to stress?
1. They must inform household members of their condition
2. They must take their medications exactly as prescribed
3. They must abstain from substance use
4. They must avoid large crowds. Answer: 2. They must take their
medications exactly as prescribed
CORRECT - Antiretrovirals must be taken exactly as prescribed to
prevent drug-resistant strains. Even missed doses can reduce the
effectiveness of future treatment.
⩥ A nurse finds a 30-year-old woman experiencing anaphylaxis from a
bee sting. Emergency personnel have been called. The nurse notes the
woman is breathing but short of breath. Which of the following
interventions should the nurse do first?
1. Initiate cardiopulmonary resuscitation
2. Check for a pulse
3. Ask the woman if she carries an emergency medical kit
