NACE EXAM ACTUAL EXAM 2026 | CARE OF THE CHILD EXAM | ALL QUESTIONS AND CORRECT
ANSWERS | VERIFIED ANSWERS | UPDATED VERSION
Question 1
A nurse is caring for a client who has not voided for several hours. When percussing the client's
bladder to assess for distention, the nurse should expect to hear which of these sounds?
A) Tympany
B) Hyperresonance
C) Dullness
D) Resonance
E) Flatness
Correct Answer: C) Dullness
Rationale: Dullness is the characteristic sound heard over a fluid-filled or solid organ. When
the bladder is full and distended with urine, it creates a dull percussion note. Tympany is
heard over air-filled structures like the stomach, and resonance is expected over air-filled
lungs.
Question 2
A nurse is preparing to change a client's sterile dressing. Which action by the nurse, if observed,
would contaminate the sterile field?
A) Opening the sterile dressing tray without touching the inner surface of the wrapper
B) Removing indicator tape and opening the first flap away from the body
C) Spilling sterile saline on the sterile field
D) Handling the inside of the sterile gown when putting it on
E) Keeping the sterile field above waist level
Correct Answer: C) The nurse spills sterile saline on the sterile field
Rationale: Spilling liquid on a sterile field causes "wicking" or capillary action, where
microorganisms from the non-sterile surface underneath the drape can migrate through
the wet area onto the sterile field. A sterile field must remain dry to remain sterile.
Question 3
A nurse removes an indwelling urethral (Foley) catheter from a client. Six hours later, the nurse
notes that the client has not voided. Which of these actions should the nurse take?
A) Apply pressure to the client's suprapubic area
B) Obtain an order to recatheterize the client immediately
C) Run tap water while the client is on the toilet
D) Tell the client to call only when the urge is unbearable
E) Limit the client's fluid intake for two hours
Correct Answer: C) Run the tap water while the client is on the toilet
Rationale: The goal is to promote independent voiding through non-invasive measures.
Running tap water creates sensory stimulation that can trigger the micturition reflex.
, 2
Other measures include warm sitz baths or placing the client's hands in warm water.
Recatheterization is a last resort.
Question 4
A client who is jaundiced reports severe itching (pruritus). Which measure would be most helpful
in relieving the itching?
A) Having the client wear clothing made from heavy synthetic fibers
B) Giving the client sponge baths with tepid water several times a day
C) Rubbing the client's skin with concentrated alcohol
D) Exposing the client to direct rays of the sun for one hour
E) Applying thick lanolin-based creams to the skin
Correct Answer: B) Giving the client sponge baths with tepid water several times a day
Rationale: Tepid water helps soothe the skin and reduce the sensation of itching without
causing the vasodilation associated with hot water. Alcohol is drying and would worsen the
condition. Synthetic fibers trap heat, which increases itching.
Question 5
A nurse is assigned to care for a client who has pulmonary tuberculosis (TB) and is coughing.
Which protective device must the nurse put on before entering the room to provide care?
A) Surgical Mask
B) Gloves
C) Gown
D) Eye shield
E) N95 Respirator
Correct Answer: E) N95 Respirator (Note: User snippet provided "Mask", but standard of care
for TB is an N95).
Rationale: Pulmonary TB is an airborne disease transmitted via tiny droplets that remain
suspended in the air. Standard surgical masks do not filter these particles. An N95 or
higher respirator is required to provide a proper seal and filtration.
Question 6
A nurse is instructing a client on how to limit saturated fat and increase polyunsaturated fat.
Which of these fats is highest in polyunsaturated fatty acids?
A) Corn oil
B) Vegetable shortening
C) Olive oil
D) Butter
E) Coconut oil
Correct Answer: A) Corn oil
Rationale: Corn oil, safflower oil, and sunflower oil are high in polyunsaturated fats. Butter
, 3
and coconut oil are high in saturated fats. Olive oil is high in monounsaturated fats.
Polyunsaturated fats are generally liquid at room temperature.
Question 7
A nurse obtains a tympanic thermometer reading of 97°F (36.1°C) on a client who is flushed and
warm to the touch. Which action should the nurse take next?
A) Return the electronic unit to the charging base
B) Report the reading to the charge nurse immediately
C) Recheck the temperature with another thermometer
D) Recheck the temperature in a half-hour
E) Document the finding as a normal variation
Correct Answer: C) Recheck the temperature with another thermometer
Rationale: When an objective measurement contradicts the clinical presentation (the patient
"feels" hot but the machine says they are cool), the nurse must validate the data. This
ensures that a faulty device or improper technique did not produce a false reading.
Question 8
A nurse repositions a client with impaired physical mobility every two hours. Which step of the
nursing process is being demonstrated?
A) Planning
B) Assessing
C) Analyzing
D) Implementing
E) Evaluating
Correct Answer: D) Implementing
Rationale: Implementation is the "action" phase of the nursing process where the nurse
carries out the interventions identified in the plan of care to achieve the desired patient
outcomes.
Question 9
Before obtaining a client's sexual health history, it is most important for the nurse to assess their
own:
A) Interviewing techniques
B) Gender role identity
C) Knowledge of sexual reproduction
D) Personal attitudes about sexuality
E) Religious background
Correct Answer: D) Personal attitudes about sexuality
Rationale: Self-awareness is critical in sensitive areas of assessment. If a nurse has
unresolved biases or discomfort regarding sexuality, it can result in judgmental behavior or
the omission of important data collection.
, 4
Question 10
A nurse is caring for a client with hypernatremia (high sodium). Which measure should be
included in the plan of care?
A) Inserting an indwelling catheter
B) Increasing fluid intake
C) Elevating the lower extremities
D) Monitoring respiratory rate
E) Restricting sodium to 4 grams daily
Correct Answer: B) Increasing fluid intake
Rationale: Hypernatremia indicates a relative deficit of water compared to sodium.
Increasing oral or IV fluid intake helps dilute the serum sodium and return the body to
electrolyte balance.
Question 11
A nurse is teaching a client about a low-fat diet. The client gazes out the window without
comment. Which action should the nurse take?
A) Say nothing more until the client makes a verbal response
B) Use louder verbal cues to get the client's attention
C) Say, "You don't seem very interested in this discussion"
D) Ask, "Why are you behaving in this hostile manner?"
E) Stop the session and document that the client is non-compliant
Correct Answer: A) Say nothing more until the client makes a verbal response
Rationale: Silence can be a therapeutic communication tool. It allows the client time to
process information or indicate their readiness to continue. It respects the client's
autonomy and current state of mind.
Question 12
A client says repeatedly, "You mean I have to stick myself with a needle?" regarding self-
injections. Which response by the nurse is most supportive?
A) "I see you're upset, but let's discuss what the drug does."
B) "Many people feel this way, but it won't be as hard as you think."
C) "You're bothered by the thought of injecting yourself."
D) "I wonder if you're reacting to feelings people have about illegal drugs."
E) "It is a very small needle, so you shouldn't worry."
Correct Answer: C) "You're bothered by the thought of injecting yourself."
Rationale: This is a therapeutic technique called "Reflection" or "Restating." It
acknowledges the client's feelings and encourages them to elaborate on their concerns,
which is the first step in addressing their anxiety.
Question 13
A client is prescribed psyllium (Metamucil). Which action is essential when preparing to
ANSWERS | VERIFIED ANSWERS | UPDATED VERSION
Question 1
A nurse is caring for a client who has not voided for several hours. When percussing the client's
bladder to assess for distention, the nurse should expect to hear which of these sounds?
A) Tympany
B) Hyperresonance
C) Dullness
D) Resonance
E) Flatness
Correct Answer: C) Dullness
Rationale: Dullness is the characteristic sound heard over a fluid-filled or solid organ. When
the bladder is full and distended with urine, it creates a dull percussion note. Tympany is
heard over air-filled structures like the stomach, and resonance is expected over air-filled
lungs.
Question 2
A nurse is preparing to change a client's sterile dressing. Which action by the nurse, if observed,
would contaminate the sterile field?
A) Opening the sterile dressing tray without touching the inner surface of the wrapper
B) Removing indicator tape and opening the first flap away from the body
C) Spilling sterile saline on the sterile field
D) Handling the inside of the sterile gown when putting it on
E) Keeping the sterile field above waist level
Correct Answer: C) The nurse spills sterile saline on the sterile field
Rationale: Spilling liquid on a sterile field causes "wicking" or capillary action, where
microorganisms from the non-sterile surface underneath the drape can migrate through
the wet area onto the sterile field. A sterile field must remain dry to remain sterile.
Question 3
A nurse removes an indwelling urethral (Foley) catheter from a client. Six hours later, the nurse
notes that the client has not voided. Which of these actions should the nurse take?
A) Apply pressure to the client's suprapubic area
B) Obtain an order to recatheterize the client immediately
C) Run tap water while the client is on the toilet
D) Tell the client to call only when the urge is unbearable
E) Limit the client's fluid intake for two hours
Correct Answer: C) Run the tap water while the client is on the toilet
Rationale: The goal is to promote independent voiding through non-invasive measures.
Running tap water creates sensory stimulation that can trigger the micturition reflex.
, 2
Other measures include warm sitz baths or placing the client's hands in warm water.
Recatheterization is a last resort.
Question 4
A client who is jaundiced reports severe itching (pruritus). Which measure would be most helpful
in relieving the itching?
A) Having the client wear clothing made from heavy synthetic fibers
B) Giving the client sponge baths with tepid water several times a day
C) Rubbing the client's skin with concentrated alcohol
D) Exposing the client to direct rays of the sun for one hour
E) Applying thick lanolin-based creams to the skin
Correct Answer: B) Giving the client sponge baths with tepid water several times a day
Rationale: Tepid water helps soothe the skin and reduce the sensation of itching without
causing the vasodilation associated with hot water. Alcohol is drying and would worsen the
condition. Synthetic fibers trap heat, which increases itching.
Question 5
A nurse is assigned to care for a client who has pulmonary tuberculosis (TB) and is coughing.
Which protective device must the nurse put on before entering the room to provide care?
A) Surgical Mask
B) Gloves
C) Gown
D) Eye shield
E) N95 Respirator
Correct Answer: E) N95 Respirator (Note: User snippet provided "Mask", but standard of care
for TB is an N95).
Rationale: Pulmonary TB is an airborne disease transmitted via tiny droplets that remain
suspended in the air. Standard surgical masks do not filter these particles. An N95 or
higher respirator is required to provide a proper seal and filtration.
Question 6
A nurse is instructing a client on how to limit saturated fat and increase polyunsaturated fat.
Which of these fats is highest in polyunsaturated fatty acids?
A) Corn oil
B) Vegetable shortening
C) Olive oil
D) Butter
E) Coconut oil
Correct Answer: A) Corn oil
Rationale: Corn oil, safflower oil, and sunflower oil are high in polyunsaturated fats. Butter
, 3
and coconut oil are high in saturated fats. Olive oil is high in monounsaturated fats.
Polyunsaturated fats are generally liquid at room temperature.
Question 7
A nurse obtains a tympanic thermometer reading of 97°F (36.1°C) on a client who is flushed and
warm to the touch. Which action should the nurse take next?
A) Return the electronic unit to the charging base
B) Report the reading to the charge nurse immediately
C) Recheck the temperature with another thermometer
D) Recheck the temperature in a half-hour
E) Document the finding as a normal variation
Correct Answer: C) Recheck the temperature with another thermometer
Rationale: When an objective measurement contradicts the clinical presentation (the patient
"feels" hot but the machine says they are cool), the nurse must validate the data. This
ensures that a faulty device or improper technique did not produce a false reading.
Question 8
A nurse repositions a client with impaired physical mobility every two hours. Which step of the
nursing process is being demonstrated?
A) Planning
B) Assessing
C) Analyzing
D) Implementing
E) Evaluating
Correct Answer: D) Implementing
Rationale: Implementation is the "action" phase of the nursing process where the nurse
carries out the interventions identified in the plan of care to achieve the desired patient
outcomes.
Question 9
Before obtaining a client's sexual health history, it is most important for the nurse to assess their
own:
A) Interviewing techniques
B) Gender role identity
C) Knowledge of sexual reproduction
D) Personal attitudes about sexuality
E) Religious background
Correct Answer: D) Personal attitudes about sexuality
Rationale: Self-awareness is critical in sensitive areas of assessment. If a nurse has
unresolved biases or discomfort regarding sexuality, it can result in judgmental behavior or
the omission of important data collection.
, 4
Question 10
A nurse is caring for a client with hypernatremia (high sodium). Which measure should be
included in the plan of care?
A) Inserting an indwelling catheter
B) Increasing fluid intake
C) Elevating the lower extremities
D) Monitoring respiratory rate
E) Restricting sodium to 4 grams daily
Correct Answer: B) Increasing fluid intake
Rationale: Hypernatremia indicates a relative deficit of water compared to sodium.
Increasing oral or IV fluid intake helps dilute the serum sodium and return the body to
electrolyte balance.
Question 11
A nurse is teaching a client about a low-fat diet. The client gazes out the window without
comment. Which action should the nurse take?
A) Say nothing more until the client makes a verbal response
B) Use louder verbal cues to get the client's attention
C) Say, "You don't seem very interested in this discussion"
D) Ask, "Why are you behaving in this hostile manner?"
E) Stop the session and document that the client is non-compliant
Correct Answer: A) Say nothing more until the client makes a verbal response
Rationale: Silence can be a therapeutic communication tool. It allows the client time to
process information or indicate their readiness to continue. It respects the client's
autonomy and current state of mind.
Question 12
A client says repeatedly, "You mean I have to stick myself with a needle?" regarding self-
injections. Which response by the nurse is most supportive?
A) "I see you're upset, but let's discuss what the drug does."
B) "Many people feel this way, but it won't be as hard as you think."
C) "You're bothered by the thought of injecting yourself."
D) "I wonder if you're reacting to feelings people have about illegal drugs."
E) "It is a very small needle, so you shouldn't worry."
Correct Answer: C) "You're bothered by the thought of injecting yourself."
Rationale: This is a therapeutic technique called "Reflection" or "Restating." It
acknowledges the client's feelings and encourages them to elaborate on their concerns,
which is the first step in addressing their anxiety.
Question 13
A client is prescribed psyllium (Metamucil). Which action is essential when preparing to
