NCLEX EXAM PREVIEW Q&A Page 1
The charge nurse has received a change-of-shift 2. first stage of labor whose contractions are occurring every 30 seconds
report on the following clients in labor. The charge Contractions should be no longer than 90 secs and no closer than 2 mins
nurse should ask a staff member to first see the client (120 secs)
in the 90 secs is the duration, 2 mins is the frequency.
1. first stage of labor who has an oral temperature of
99.7° F (37.6° C) Rationale:
2. first stage of labor whose contractions are 1. Elevated temp is normal during labor
occurring every 30 seconds 3. Increased resps are normal during labor "pant-pant-blow" "hee-hee-hoo"
3. second stage of labor who has respirations of 26 breathing pattern
4. second stage of labor whose contractions are 4. Contractions shouldn't be longer than 90 secs, 60 secs is okay and normal
lasting for 60 seconds Second stage: 2-3 mins apart, 60-90 secs long, 10 cm dilated, strong pain
NCLEX EXAM PREVIEW Q&A 2/5/2026
,NCLEX EXAM PREVIEW Q&A Page 2
The nurse is observing a staff member caring for a 2. placing a box of disposable face shields outside the client's room
client who has chickenpox. disposable face masks are not suitable for airborne precautions
Which of the following actions by the staff member
would require the nurse to intervene? Rationale:
1. placing the client in a private room with monitored Varicella (chickenpox) is airborne precaution. Private, negative pressure
negative air pressure room, universal precautions (hand sanitizer in room) and placing surgical
2. placing a box of disposable face shields outside mask on client during transport are all correct interventions for Varicilla.
the client's room
3. placing an alcohol-based hand rub in the client's
room for hand hygiene
4. placing a surgical mask on the client during
transport out of the client's room
NCLEX EXAM PREVIEW Q&A 2/5/2026
,NCLEX EXAM PREVIEW Q&A Page 3
The nurse is caring for a client who reports feeling 2. transcutaneous pacing
faint and is experiencing the cardiac rhythm shown in - external pacing that stimulates the ventricles to pump at a set rate
the electrocardiogram (ECG) strip below. 5. Assess the client for angina
- BRADYCARDIA (it is more than 5 spaces apart, sinus - Angina (Chest pain) can be caused by both tachycardia (most common)
rhythm) and bradycardia (rare but can happen). Assessment of angina is appropriate
Which of the following actions would be appropriate
for the nurse to take? Select all that apply: Rationale:
1. Administer the client's prescribed beta blocker. 1. Beta blocker would further decrease HR
2. Prepare for transcutaneous pacing. 3. Valsalva maneuver/Vagal stimulation would further decrease HR. (can be
3. Instruct the client to perform the Valsalva indicated for sinus Tachy)
maneuver. 4. Chest compressions are for cardiac arrest
4. Begin chest compressions.
5. Assess the client for angina.
NCLEX EXAM PREVIEW Q&A 2/5/2026
, NCLEX EXAM PREVIEW Q&A Page 4
The nurse is planning care for a client with moderate 1. Encourage the client to reminisce about happy memories.
Alzheimer's disease (AD). Its possible for AD patients to retain long-term memories
Which of the following interventions should the nurse
include in the client's plan of care? Rationale:
1. Encourage the client to reminisce about happy 2. Acknowledge feelings --> Redirect is protocol for Dementia. Don't
memories. confront; they can't learn
2. Confront the client when inappropriate or agitated 3. AD is irreversible
behaviors occur. 4. In moderate AD, dementia has already progressed to where pt needs help
3. Administer to the client the cholinesterase inhibitor with ADLs and planning daily activities. Asking them to plan can frustrate
to reverse the course of AD. them and cause distress.
4. Provide the client with information about activity STRUCTURED pleasant activities that consider the persons likes and interests
choices in the morning so the client can make plans are the best.
for the day.
NCLEX EXAM PREVIEW Q&A 2/5/2026
The charge nurse has received a change-of-shift 2. first stage of labor whose contractions are occurring every 30 seconds
report on the following clients in labor. The charge Contractions should be no longer than 90 secs and no closer than 2 mins
nurse should ask a staff member to first see the client (120 secs)
in the 90 secs is the duration, 2 mins is the frequency.
1. first stage of labor who has an oral temperature of
99.7° F (37.6° C) Rationale:
2. first stage of labor whose contractions are 1. Elevated temp is normal during labor
occurring every 30 seconds 3. Increased resps are normal during labor "pant-pant-blow" "hee-hee-hoo"
3. second stage of labor who has respirations of 26 breathing pattern
4. second stage of labor whose contractions are 4. Contractions shouldn't be longer than 90 secs, 60 secs is okay and normal
lasting for 60 seconds Second stage: 2-3 mins apart, 60-90 secs long, 10 cm dilated, strong pain
NCLEX EXAM PREVIEW Q&A 2/5/2026
,NCLEX EXAM PREVIEW Q&A Page 2
The nurse is observing a staff member caring for a 2. placing a box of disposable face shields outside the client's room
client who has chickenpox. disposable face masks are not suitable for airborne precautions
Which of the following actions by the staff member
would require the nurse to intervene? Rationale:
1. placing the client in a private room with monitored Varicella (chickenpox) is airborne precaution. Private, negative pressure
negative air pressure room, universal precautions (hand sanitizer in room) and placing surgical
2. placing a box of disposable face shields outside mask on client during transport are all correct interventions for Varicilla.
the client's room
3. placing an alcohol-based hand rub in the client's
room for hand hygiene
4. placing a surgical mask on the client during
transport out of the client's room
NCLEX EXAM PREVIEW Q&A 2/5/2026
,NCLEX EXAM PREVIEW Q&A Page 3
The nurse is caring for a client who reports feeling 2. transcutaneous pacing
faint and is experiencing the cardiac rhythm shown in - external pacing that stimulates the ventricles to pump at a set rate
the electrocardiogram (ECG) strip below. 5. Assess the client for angina
- BRADYCARDIA (it is more than 5 spaces apart, sinus - Angina (Chest pain) can be caused by both tachycardia (most common)
rhythm) and bradycardia (rare but can happen). Assessment of angina is appropriate
Which of the following actions would be appropriate
for the nurse to take? Select all that apply: Rationale:
1. Administer the client's prescribed beta blocker. 1. Beta blocker would further decrease HR
2. Prepare for transcutaneous pacing. 3. Valsalva maneuver/Vagal stimulation would further decrease HR. (can be
3. Instruct the client to perform the Valsalva indicated for sinus Tachy)
maneuver. 4. Chest compressions are for cardiac arrest
4. Begin chest compressions.
5. Assess the client for angina.
NCLEX EXAM PREVIEW Q&A 2/5/2026
, NCLEX EXAM PREVIEW Q&A Page 4
The nurse is planning care for a client with moderate 1. Encourage the client to reminisce about happy memories.
Alzheimer's disease (AD). Its possible for AD patients to retain long-term memories
Which of the following interventions should the nurse
include in the client's plan of care? Rationale:
1. Encourage the client to reminisce about happy 2. Acknowledge feelings --> Redirect is protocol for Dementia. Don't
memories. confront; they can't learn
2. Confront the client when inappropriate or agitated 3. AD is irreversible
behaviors occur. 4. In moderate AD, dementia has already progressed to where pt needs help
3. Administer to the client the cholinesterase inhibitor with ADLs and planning daily activities. Asking them to plan can frustrate
to reverse the course of AD. them and cause distress.
4. Provide the client with information about activity STRUCTURED pleasant activities that consider the persons likes and interests
choices in the morning so the client can make plans are the best.
for the day.
NCLEX EXAM PREVIEW Q&A 2/5/2026
