2026 NCLEX RN Questions - Nursing Mock
Exam (25 Confusing Questions with
Answers and Detailed Explanations)
Question one.
A nurse is caring for a client who is prescribed warerin. Which of the following lab values should
the nurse monitor closely to determine the effectiveness of the medication?
A. Activated partial thromboplastin time apt.
B. International normalized ratio INR.
C. Platelet count.
D. Hemoglobin HGB.
Answer B. International normalized ratio INR.
Explanation.
This question tests your knowledge of medication monitoring specifically for anti-coagulants like
warerin. The key is to remember that warerin is an oral anti-coagulant used to prevent blood
clots and its effectiveness is primarily monitored by the international normalized ratio INR which
standardizes prothroen time PT results. An appropriate INR ensures the blood is thin enough to
prevent clots but not so thin that it causes excessive bleeding. For example, if a client's INR is
too low, the warerin dose may need to be increased to prevent clot formation. Always connect
warerin directly with INR monitoring to ensure patient safety.
Question two,
a client diagnosed with diverticulitis is experiencing acute abdominal pain. Which dietary
instruction should the nurse provide to help manage the client's symptoms during an acute flare
up?
A. Increase intake of high-fiber foods such as whole grains and raw vegetables.
B. Consume a clear liquid diet and gradually advance as tolerated.
C. Eat small frequent meals high in insoluble fiber.
D. Avoid all dairy products and lactose.
Answer B. Consume a clear liquid diet and gradually advance as tolerated.
Explanation.
This question assesses your understanding of dietary management for acute diverticulitis. The
critical concept here is managing inflammation. During an acute flare up, the inflamed diverticula
need rest, making high-fiber foods detrimental. A clear liquid diet provides hydration and some
nutrients without irritating the colon, allowing the bowel to rest and inflammation to subside. For
instance, a client might start with broth, gelatin, and clear juices, slowly adding soft, low- fiber
foods as symptoms improve. Remember, while fiber is important for preventing diverticulitis,
during an acute attack, the focus shifts to bowel rest.
, Question three.
A nurse is assessing a 4-year-old child admitted with dehydration. Which finding is the most
reliable indicator of fluid status in pediatric clients?
A skin tur.
B Capillary refill time.
C. Number of wet diapers.
D. Presence of tears.
Answer C. Number of wet diapers.
Explanation.
This question evaluates your knowledge of fluid status assessment in pediatric clients,
specifically infants and young children. While other signs like skin tur or capillary refill can
indicate dehydration, the most objective and reliable indicator for a toddler is often the number
of wet diapers as it directly reflects kidney profusion and urine output. For example, a child who
has not had a wet diaper in 8 hours is a strong indicator of significant dehydration and warrants
immediate attention. Always prioritize objective measures of output in young children as their
compensatory mechanisms can mask other signs until dehydration is severe.
Question four.
A client who underwent abdominal surgery 24 hours ago reports sharp stabbing pain localized
at the incision site. Rated 8 out of 10. The client received pain medication 3 hours ago. What is
the nurse's priority action?
A. Administer the prescribed PRN opioid analesic.
B. Reposition the client for comfort.
C. Assess the surgical incision for signs of dehissence.
D. Educate the client on the importance of reporting pain early.
Answer: A. Administer the prescribed PRN opioid analesic.
Explanation.
This question tests your prioritization skills in post-operative pain management. The keywords
sharp stabbing pain 8 out of 10 and received pain medication 3 hours ago indicate the client is
experiencing acute severe pain and is likely due for more medication if available or the previous
dose was insufficient. Administering the prescribed PRN opioid analesic addresses the client's
immediate severe discomfort which is a priority in post-operative care to promote healing and
mobility. For example, if a client has a PRN order for hydromorphone every 4 hours and it has
been 3 hours, reassess to see if it is due soon or if a different intervention is needed if it is not
due. Always prioritize pain relief as part of holistic patient care, especially after surgery.
Question five,
a nurse is educating a client with heart failure about managing their condition at home. Which
statement by the client indicates a need for further teaching?
A. I will weigh myself every morning and report any sudden gain.
B. I should call the doctor if I feel more short of breath than usual.
C. I can use salt substitutes freely to flavor my food.
Exam (25 Confusing Questions with
Answers and Detailed Explanations)
Question one.
A nurse is caring for a client who is prescribed warerin. Which of the following lab values should
the nurse monitor closely to determine the effectiveness of the medication?
A. Activated partial thromboplastin time apt.
B. International normalized ratio INR.
C. Platelet count.
D. Hemoglobin HGB.
Answer B. International normalized ratio INR.
Explanation.
This question tests your knowledge of medication monitoring specifically for anti-coagulants like
warerin. The key is to remember that warerin is an oral anti-coagulant used to prevent blood
clots and its effectiveness is primarily monitored by the international normalized ratio INR which
standardizes prothroen time PT results. An appropriate INR ensures the blood is thin enough to
prevent clots but not so thin that it causes excessive bleeding. For example, if a client's INR is
too low, the warerin dose may need to be increased to prevent clot formation. Always connect
warerin directly with INR monitoring to ensure patient safety.
Question two,
a client diagnosed with diverticulitis is experiencing acute abdominal pain. Which dietary
instruction should the nurse provide to help manage the client's symptoms during an acute flare
up?
A. Increase intake of high-fiber foods such as whole grains and raw vegetables.
B. Consume a clear liquid diet and gradually advance as tolerated.
C. Eat small frequent meals high in insoluble fiber.
D. Avoid all dairy products and lactose.
Answer B. Consume a clear liquid diet and gradually advance as tolerated.
Explanation.
This question assesses your understanding of dietary management for acute diverticulitis. The
critical concept here is managing inflammation. During an acute flare up, the inflamed diverticula
need rest, making high-fiber foods detrimental. A clear liquid diet provides hydration and some
nutrients without irritating the colon, allowing the bowel to rest and inflammation to subside. For
instance, a client might start with broth, gelatin, and clear juices, slowly adding soft, low- fiber
foods as symptoms improve. Remember, while fiber is important for preventing diverticulitis,
during an acute attack, the focus shifts to bowel rest.
, Question three.
A nurse is assessing a 4-year-old child admitted with dehydration. Which finding is the most
reliable indicator of fluid status in pediatric clients?
A skin tur.
B Capillary refill time.
C. Number of wet diapers.
D. Presence of tears.
Answer C. Number of wet diapers.
Explanation.
This question evaluates your knowledge of fluid status assessment in pediatric clients,
specifically infants and young children. While other signs like skin tur or capillary refill can
indicate dehydration, the most objective and reliable indicator for a toddler is often the number
of wet diapers as it directly reflects kidney profusion and urine output. For example, a child who
has not had a wet diaper in 8 hours is a strong indicator of significant dehydration and warrants
immediate attention. Always prioritize objective measures of output in young children as their
compensatory mechanisms can mask other signs until dehydration is severe.
Question four.
A client who underwent abdominal surgery 24 hours ago reports sharp stabbing pain localized
at the incision site. Rated 8 out of 10. The client received pain medication 3 hours ago. What is
the nurse's priority action?
A. Administer the prescribed PRN opioid analesic.
B. Reposition the client for comfort.
C. Assess the surgical incision for signs of dehissence.
D. Educate the client on the importance of reporting pain early.
Answer: A. Administer the prescribed PRN opioid analesic.
Explanation.
This question tests your prioritization skills in post-operative pain management. The keywords
sharp stabbing pain 8 out of 10 and received pain medication 3 hours ago indicate the client is
experiencing acute severe pain and is likely due for more medication if available or the previous
dose was insufficient. Administering the prescribed PRN opioid analesic addresses the client's
immediate severe discomfort which is a priority in post-operative care to promote healing and
mobility. For example, if a client has a PRN order for hydromorphone every 4 hours and it has
been 3 hours, reassess to see if it is due soon or if a different intervention is needed if it is not
due. Always prioritize pain relief as part of holistic patient care, especially after surgery.
Question five,
a nurse is educating a client with heart failure about managing their condition at home. Which
statement by the client indicates a need for further teaching?
A. I will weigh myself every morning and report any sudden gain.
B. I should call the doctor if I feel more short of breath than usual.
C. I can use salt substitutes freely to flavor my food.
