NCLEX RN Adult Medical Surgical Online Practice 2026
EXAM QUESTIONS AND STUDY GUIDE COMPLETE &
ACCURATE FINAL EXAM , ACTUAL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (100%
CORRECT VERIFIED SOLUTIONS) CURRENTLY UPDATED
VERSION 2026 EDITION |GUARANTEED PASS 2026-2027
A nurse is caring for a client who has a new prescription for total
parenteral nutrition (TPN). The client is to receive 2,000 kcal per day. The
TPN solution has 500 kcal/L. The IV pump should be set at how many
mL/hr? (Round the answer to the nearest whole number. Use a leading
zero if it applies. Do not use a trailing zero.)
167 mL/hr
Rational:
mL/hr =
4000/24 = 166.6 = 167
A nurse is caring for a client who is 4 hr postoperative following a
totalvaginal hysterectomy.Click to highlight the findings the nurse should
report to the provider immediately.
Perineal pad saturated with blood, large clots present
Change of blood pressure, heart rate of 102/min
Rational:
Perineal pad saturated with blood, large clots present, blood pressure
trend, and heart rate of 102/min are correct. The client has
manifestations of vaginal hemorrhage, including vaginal bleeding, blood
clots, reduced blood pressure, and tachycardia. The nurse should report
these findings to the provider.
,A nurse is preparing to admit a client who has dysphagia. The nurse
should plan to place which of the following items at the client's bedside?
Suction machine
Rational:
The nurse should ensure that a suction machine is at the bedside of a
client who has dysphagia to clear the client's airway as needed and
reduce the risk for aspiration.
A nurse is providing discharge teaching about infection prevention to a
client who is receiving chemotherapy. Which of the following statements
by the client indicates understanding of the teaching?
"I can ask a friend to change my cats litter box."
Rational:
Changing a pet's litter box increases the client's risk of being exposed to
toxoplasmosis. Therefore, the client should wear gloves or avoid
changing the pet's litter box.
A nurse is assessing a client who has had a plaster cast applied to their
left leg 2 hr ago. Which of the following actions should the nurse take?
Check that one finger fits between the cast and the leg.
Rational:
To make sure the cast is not too tight, the nurse should be able to slide
one finger under the cast. It is not uncommon for casts to loosen as
swelling subsides, but that should not be an issue 2 hr after application.
,A nurse is performing a preoperative assessment for a client. The nurse
should identify that an allergy to which of the following foods can
indicate a latex allergy?
Avocados
Rational:
Clients who have an avocado allergy might have an allergic reaction or a
sensitivity to latex. Allergies to certain fruits, such as strawberries and
bananas, can also indicate latex allergy or sensitivity.
A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which
of the following should the nurse plan to administer?
Regular insulin 20 units IV bolus
Rational:
DKA is a complication of diabetes mellitus that results in dehydration,
ketosis, metabolic acidosis, and elevated blood glucose levels.
Management of DKA involves providing hydration, correcting acid-base
imbalances, and decreasing blood glucose levels. Regular insulin is a
fast-acting insulin that can be effective within 10 min when administered
intravenously.
A nurse is providing teaching to a client who has esophageal cancer and
is to undergo radiation therapy. Which of the following statements should
the nurse identify as an indication that the client understands the
teaching?
"I will use my hands rather than a washcloth to clean the radiation area."
Rational:
The client should gently wash the radiation area with their hands using
warm water and mild soap to protect the skin from further irritation.
, A nurse is caring for a client who is experiencing supraventricular
tachycardia. Upon assessing the client, the nurse observes the following
findings: heart rate 200/min, blood pressure 78/40 mm Hg, and
respiratory rate 30/min. Which of the following actions should the nurse
take?
Perform synchronized cardioversion.
Rational:
The nurse should perform synchronized cardioversion for a client who
has supraventricular tachycardia.
A PACU nurse is assessing a client who is postoperative following a right
nephrectomy. The client's initial vital signs were heart rate 80/min, blood
pressure 130/70 mm Hg, respiratory rate 16/min, and temperature 36° C
(96.8° F). Which of the following vital sign changes should alert the nurse
that the client might be hemorrhaging?
Heart rate 110/min.
Rational:
One of the first signs of hemorrhage is an increase in the heart rate from
the client's baseline, which occurs to compensate for blood loss.
A nurse is providing discharge instructions to a client who has active
tuberculosis (TB). Which of the following information should the nurse
include in the instructions?
Sputum specimens are necessary every 2 to 4 weeks until there are three
negative cultures.
Rational:
After three negative sputum cultures, the client is no longer considered
infectious.
EXAM QUESTIONS AND STUDY GUIDE COMPLETE &
ACCURATE FINAL EXAM , ACTUAL QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (100%
CORRECT VERIFIED SOLUTIONS) CURRENTLY UPDATED
VERSION 2026 EDITION |GUARANTEED PASS 2026-2027
A nurse is caring for a client who has a new prescription for total
parenteral nutrition (TPN). The client is to receive 2,000 kcal per day. The
TPN solution has 500 kcal/L. The IV pump should be set at how many
mL/hr? (Round the answer to the nearest whole number. Use a leading
zero if it applies. Do not use a trailing zero.)
167 mL/hr
Rational:
mL/hr =
4000/24 = 166.6 = 167
A nurse is caring for a client who is 4 hr postoperative following a
totalvaginal hysterectomy.Click to highlight the findings the nurse should
report to the provider immediately.
Perineal pad saturated with blood, large clots present
Change of blood pressure, heart rate of 102/min
Rational:
Perineal pad saturated with blood, large clots present, blood pressure
trend, and heart rate of 102/min are correct. The client has
manifestations of vaginal hemorrhage, including vaginal bleeding, blood
clots, reduced blood pressure, and tachycardia. The nurse should report
these findings to the provider.
,A nurse is preparing to admit a client who has dysphagia. The nurse
should plan to place which of the following items at the client's bedside?
Suction machine
Rational:
The nurse should ensure that a suction machine is at the bedside of a
client who has dysphagia to clear the client's airway as needed and
reduce the risk for aspiration.
A nurse is providing discharge teaching about infection prevention to a
client who is receiving chemotherapy. Which of the following statements
by the client indicates understanding of the teaching?
"I can ask a friend to change my cats litter box."
Rational:
Changing a pet's litter box increases the client's risk of being exposed to
toxoplasmosis. Therefore, the client should wear gloves or avoid
changing the pet's litter box.
A nurse is assessing a client who has had a plaster cast applied to their
left leg 2 hr ago. Which of the following actions should the nurse take?
Check that one finger fits between the cast and the leg.
Rational:
To make sure the cast is not too tight, the nurse should be able to slide
one finger under the cast. It is not uncommon for casts to loosen as
swelling subsides, but that should not be an issue 2 hr after application.
,A nurse is performing a preoperative assessment for a client. The nurse
should identify that an allergy to which of the following foods can
indicate a latex allergy?
Avocados
Rational:
Clients who have an avocado allergy might have an allergic reaction or a
sensitivity to latex. Allergies to certain fruits, such as strawberries and
bananas, can also indicate latex allergy or sensitivity.
A nurse is caring for a client who has diabetic ketoacidosis (DKA). Which
of the following should the nurse plan to administer?
Regular insulin 20 units IV bolus
Rational:
DKA is a complication of diabetes mellitus that results in dehydration,
ketosis, metabolic acidosis, and elevated blood glucose levels.
Management of DKA involves providing hydration, correcting acid-base
imbalances, and decreasing blood glucose levels. Regular insulin is a
fast-acting insulin that can be effective within 10 min when administered
intravenously.
A nurse is providing teaching to a client who has esophageal cancer and
is to undergo radiation therapy. Which of the following statements should
the nurse identify as an indication that the client understands the
teaching?
"I will use my hands rather than a washcloth to clean the radiation area."
Rational:
The client should gently wash the radiation area with their hands using
warm water and mild soap to protect the skin from further irritation.
, A nurse is caring for a client who is experiencing supraventricular
tachycardia. Upon assessing the client, the nurse observes the following
findings: heart rate 200/min, blood pressure 78/40 mm Hg, and
respiratory rate 30/min. Which of the following actions should the nurse
take?
Perform synchronized cardioversion.
Rational:
The nurse should perform synchronized cardioversion for a client who
has supraventricular tachycardia.
A PACU nurse is assessing a client who is postoperative following a right
nephrectomy. The client's initial vital signs were heart rate 80/min, blood
pressure 130/70 mm Hg, respiratory rate 16/min, and temperature 36° C
(96.8° F). Which of the following vital sign changes should alert the nurse
that the client might be hemorrhaging?
Heart rate 110/min.
Rational:
One of the first signs of hemorrhage is an increase in the heart rate from
the client's baseline, which occurs to compensate for blood loss.
A nurse is providing discharge instructions to a client who has active
tuberculosis (TB). Which of the following information should the nurse
include in the instructions?
Sputum specimens are necessary every 2 to 4 weeks until there are three
negative cultures.
Rational:
After three negative sputum cultures, the client is no longer considered
infectious.
