Exam
Exam Solution zm
NCLEX App 2026 A+ GRADE ASSURED COMPLETE SOLU zm zm zm zm zm zm zm
TIONS AND VERIFIED ANSWERS (D7CA9) zm zm zm zm
QUESTION 1 zm
While caring for a patient who underwent a percutaneous transluminal coronary angi
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oplasty (PTCA), the nurse prepares to remove the femoral sheath. The heparin infusio
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n was stopped 4 hours ago and there appears to be no evidence of bleeding from the
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insertion site. The nurse will pull the sheath when the partial thromboplastin time (P
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TT) is: zm
ANSWER
After the heparin is discontinued, the PTT should be 50 or less before the nurse can remove the fe
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moral or radial sheath that was used for the procedure
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QUESTION 2 zm
The nurse is monitoring a patient with diverticulitis for the presence of a bowel perfo
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ration. The nurse should be alert to which of the following?
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ANSWER
Perforation causes a board- zm zm zm
like rigidity of the abdomen, guarding of the abdomen, fever, chills, pallor, tachycardia, distention, an
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d restlessness
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QUESTION 3 zm
A patient with a severe allergy to dust mites is receiving instructions from the nurse.
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The nurse should include which of the following to help with his allergic reactions to
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dust mites? zm
ANSWER
To prevent dust mites, the patient should wash all linens in hot water above 130 degrees Fahrenhei
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t • Put zippered allergen-
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impermeable covers on mattresses and pillows reduce dust mite allergies • Keep floors and walls ba
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re and wash throw rugs in hot water frequently • Incorrect: Current literature shows that the use o
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,f indoor air purifiers is limited in effectiveness • Incorrect: Changing pillow cases frequently will not
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mhelp unless the pillowcases are washed in water above 130 degrees Fahrenheit • Incorrect: Cleanin
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g surfaces (dusting) weekly will help relieve allergies, but it should be done by another member of t
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he family who is not allergic to dust mites. Coming into contact with them while cleaning may wors
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en his/her allergies
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QUESTION 4 zm
A patient is seen at the clinic for a routine physical examination. After the patient is a
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ssessed for evidence of peripheral vascular disease, the nurse explains that which of t
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he following tests is typically used to assist in the diagnosis?
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ANSWER
ankle brachial index (ABI) is the blood pressure ratio between the lower legs and the arms. Blood p
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ressure in the lower legs is normally higher than the arms, and abnormalities indicate narrowing of
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arteries.
QUESTION 5 zm
Risk factors for primary hypertension include
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ANSWER
high salt and fat intake, obesity, stress, alcohol consumption, inactivity, caffeine, and vitamin D defici
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ency
QUESTION 6 zm
Signs of cardiac tamponade include:
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ANSWER
Muffled heart tones zm zm
QUESTION 7 zm
Raynaud's disease is characterized by intermittent vasospastic attacks
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ANSWER
These acute attacks are often precipitated by stress, cold temperatures, caffeine, and/or smoking
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QUESTION 8 zm
Alcohol and extreme heat cause vasodilation,
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ANSWER
, not vasospasm
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QUESTION 9 zm
During a myocardial infarction, pain is commonly felt in the chest, but pain also refer
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s (or radiates) to the
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ANSWER
left shoulder or arm, neck, or jaw
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QUESTION 10 zm
Nephritic syndrome symptoms zm zm
ANSWER
Hematuria
QUESTION 11 zm
The nurse is assessing a patient with hypoparathyroidism for electrolyte imbalances.
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The nurse notes a positive Chvostek's sign, indicating:
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ANSWER
Hypocalcemia RATIONAL: A positive Chvostek's sign occurs when the nurse taps the facial nerve at t
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he angle of the jaw, resulting in the facial muscles contracting and twitching. This is caused by low
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serum calcium. zm
QUESTION 12 zm
When an NG tube is plugged and the stomach cannot be suctioned, contents may colle
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ct in the stomach causing discomfort and fullness
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ANSWER
NG patency is a priority
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QUESTION 13 zm
A C-section is not necessary based solely on the mother being
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ANSWER
HIV-positive Elective C- zm zm
section is not necessary if women achieve viral loads below 1,000. If the viral load is higher, c-
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sections are done to minimize the risk of transmission.
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Exam Solution zm
NCLEX App 2026 A+ GRADE ASSURED COMPLETE SOLU zm zm zm zm zm zm zm
TIONS AND VERIFIED ANSWERS (D7CA9) zm zm zm zm
QUESTION 1 zm
While caring for a patient who underwent a percutaneous transluminal coronary angi
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oplasty (PTCA), the nurse prepares to remove the femoral sheath. The heparin infusio
zm zm zm zm zm zm zm zm zm zm zm zm
n was stopped 4 hours ago and there appears to be no evidence of bleeding from the
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insertion site. The nurse will pull the sheath when the partial thromboplastin time (P
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TT) is: zm
ANSWER
After the heparin is discontinued, the PTT should be 50 or less before the nurse can remove the fe
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moral or radial sheath that was used for the procedure
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QUESTION 2 zm
The nurse is monitoring a patient with diverticulitis for the presence of a bowel perfo
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ration. The nurse should be alert to which of the following?
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ANSWER
Perforation causes a board- zm zm zm
like rigidity of the abdomen, guarding of the abdomen, fever, chills, pallor, tachycardia, distention, an
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d restlessness
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QUESTION 3 zm
A patient with a severe allergy to dust mites is receiving instructions from the nurse.
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The nurse should include which of the following to help with his allergic reactions to
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dust mites? zm
ANSWER
To prevent dust mites, the patient should wash all linens in hot water above 130 degrees Fahrenhei
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t • Put zippered allergen-
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impermeable covers on mattresses and pillows reduce dust mite allergies • Keep floors and walls ba
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
re and wash throw rugs in hot water frequently • Incorrect: Current literature shows that the use o
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
,f indoor air purifiers is limited in effectiveness • Incorrect: Changing pillow cases frequently will not
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mhelp unless the pillowcases are washed in water above 130 degrees Fahrenheit • Incorrect: Cleanin
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g surfaces (dusting) weekly will help relieve allergies, but it should be done by another member of t
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he family who is not allergic to dust mites. Coming into contact with them while cleaning may wors
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en his/her allergies
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QUESTION 4 zm
A patient is seen at the clinic for a routine physical examination. After the patient is a
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ssessed for evidence of peripheral vascular disease, the nurse explains that which of t
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he following tests is typically used to assist in the diagnosis?
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ANSWER
ankle brachial index (ABI) is the blood pressure ratio between the lower legs and the arms. Blood p
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
ressure in the lower legs is normally higher than the arms, and abnormalities indicate narrowing of
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arteries.
QUESTION 5 zm
Risk factors for primary hypertension include
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ANSWER
high salt and fat intake, obesity, stress, alcohol consumption, inactivity, caffeine, and vitamin D defici
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ency
QUESTION 6 zm
Signs of cardiac tamponade include:
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ANSWER
Muffled heart tones zm zm
QUESTION 7 zm
Raynaud's disease is characterized by intermittent vasospastic attacks
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ANSWER
These acute attacks are often precipitated by stress, cold temperatures, caffeine, and/or smoking
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QUESTION 8 zm
Alcohol and extreme heat cause vasodilation,
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ANSWER
, not vasospasm
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QUESTION 9 zm
During a myocardial infarction, pain is commonly felt in the chest, but pain also refer
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s (or radiates) to the
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ANSWER
left shoulder or arm, neck, or jaw
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QUESTION 10 zm
Nephritic syndrome symptoms zm zm
ANSWER
Hematuria
QUESTION 11 zm
The nurse is assessing a patient with hypoparathyroidism for electrolyte imbalances.
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The nurse notes a positive Chvostek's sign, indicating:
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ANSWER
Hypocalcemia RATIONAL: A positive Chvostek's sign occurs when the nurse taps the facial nerve at t
zm zm zm zm zm zm zm zm zm zm zm zm zm zm zm
he angle of the jaw, resulting in the facial muscles contracting and twitching. This is caused by low
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serum calcium. zm
QUESTION 12 zm
When an NG tube is plugged and the stomach cannot be suctioned, contents may colle
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ct in the stomach causing discomfort and fullness
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ANSWER
NG patency is a priority
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QUESTION 13 zm
A C-section is not necessary based solely on the mother being
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ANSWER
HIV-positive Elective C- zm zm
section is not necessary if women achieve viral loads below 1,000. If the viral load is higher, c-
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sections are done to minimize the risk of transmission.
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