NCLEX / NGN UWORLD COMPREHENSIVE STUDY GUIDE Ultra-Compact Reference
Complete High-Yield Q&A Collection (Apr 28 - May 12 Edition) Zero Omissions
Q1. Q4.
The nurse is planning for an 8-year-old client with mild cognitive The nurse taught the caregiver of a client with a
impairment who is hospitalized for Diagnostic testing. Which of ventriculoperitoneal (VP) shunt about when to contact the
the following interventions are appropriate to include in the plan healthcare provider. The caregiver shows understanding of the
of care? Select all that apply instructions by contacting the hcp about which symptom?
• consistently assign the same nurse and unlicensed assistive • A temperature of 99F (37C) that occurs during the evening
Personnel to care for the client • The child cannot recall items eaten for lunch the previous day
• give direct procedural education and explanations to the • The child vomits after awakening from her nap and an hour
parent rather than the client later
• provide appropriate toys based on developmental level rather • The VP shunt is palpated along the posterior-lateral portion of
than chronological age the skull
• reinforce parental limit setting measures for preventing self-
ANS: The child vomits after awakening from her nap and an hour
injurious Behavior
later
• use a picture board to facilitate communication and promote
understanding of procedures Explanation: Vomiting, especially upon awakening, is a hallmark sign of
increased intracranial pressure (ICP) resulting from VP shunt malfunction
ANS: 1, 3, 4, 5 or obstruction. The HCP must be contacted immediately. A temp of 99F is
Explanation: Clients with cognitive impairment or intellectual disability are normal. Palpable shunt tubing under the scalp is normal.
diagnosed prior to adulthood and have limited levels of intellectual
functioning and adaptive skills for their chronological age. Appropriate Q5.
nursing interventions include: maintaining a familiar environment with A client is being admitted for potential cerebellar pathology.
consistent staff assignments (1), providing toys appropriate for Which tasks should the nurse ask a client to perform to assess
developmental (not chronological) age (3), preventing self-injury by cerebellar function is within the defined limits? Select all that
reinforcing parental limit setting (4), and using visual tools like picture
apply
boards for communication (5). Option 2 is incorrect because nurses
should include the child in procedural explanations using methods • Identify the number '8' traced on the palm
appropriate for their cognitive level rather than excluding them. • shrug the shoulders against resistance
• swallow water
• touch each finger of one hand to the hand's thumb
Q2.
A client with stroke symptoms has a blood pressure of 240/124 • walk Heel To Toe
mmhg. The nurse prepares the prescribed nicardipine ANS: Touch each finger of one hand to the hand's thumb, Walk
intravenous infusion solution correctly to yield 0.1 mg/ml. The Heel To Toe
nurse then administers the initial prescription to infuse at 5 mg/hr
by setting the infusion pump at 50 ml/hr. What is the nurse's Explanation: The cerebellum coordinates voluntary movements, balance,
and posture. Cerebellar assessments include gait testing (tandem/heel-to-
priority action at this time?
toe walking) and fine motor coordination (finger-to-thumb tapping, rapid
• assess hourly urinary output alternating movements, finger-to-nose). Tracing figures on the palm tests
• increase pump setting to correct Administration rate 100 ml/hr sensory perception (graphesthesia). Shrugging shoulders tests CN XI.
• keep systolic blood pressure above 170mmHg Swallowing tests CN IX and X.
• monitor for a widening QT interval
ANS: Keep systolic blood pressure above 170mmHg Q6.
The nurse is admitting an eight-year-old client with suspected
Explanation: A client with acute ischemic stroke requires permissive Reye's syndrome. Which of the following information obtained
hypertension (typically keeping BP below 220/120 mmHg, or lowering
during the admission would be most consistent with the
moderately if antihypertensives are used) to maintain cerebral perfusion.
condition?
Lowering BP too rapidly or too drastically can extend ischemic brain
damage. The priority action is to monitor BP continuously to ensure
systolic BP does not drop too low or too fast (maintaining adequate Q1.
perfusion, avoiding dropping below ~170 mmHg precipitously). The pump no history of varicella vaccination
rate setting of 50 mL/hr is correct (5 mg/hr / 0.1 mg/mL = 50 mL/hr).
Q2.
Q3.
previous exposure to Lead-based paint
The nurse is caring for a client after a motor vehicle collision. The
client's injuries include two fractured ribs and a concussion.
Which of the following are expected neurological changes for Q3.
clients with a concussion? Select all that apply recent exposure to bats
• asymmetrical pupillary constriction
• brief period of confusion
Q4.
• Headache recent influenza infection
• loss of vision
• retrograde amnesia ANS: 4 (Recent influenza infection)
Explanation: Reye syndrome typically develops following a viral illness
ANS: Brief period of confusion, Headache, Retrograde amnesia
(most commonly influenza or varicella / chickenpox), especially when
Explanation: Typical clinical manifestations of a concussion (minor aspirin was administered to manage fever. Symptoms include fever, acute
traumatic brain injury) include a brief period of confusion (with or without encephalopathy (vomiting, altered consciousness, seizures), and elevated
loss of consciousness), headache, and retrograde amnesia (loss of liver enzymes/ammonia.
memory for events immediately preceding the injury). Asymmetrical pupils
or visual loss indicate severe intracranial injury/increased ICP, not a simple
concussion.
NCLEX / NGN UWorld High-Yield Comprehensive Review Page 1 of 6
, Q7. Q1.
The nurse is planning to care for a client with suspected ischemic I will let my child drink cocoa as usual the morning of the
stroke who has just arrived at the emergency department with procedure
slurred speech, facial drooping, and right arm weakness that
began 1 hour ago. Which interventions should the nurse
Q2.
anticipate including in the initial plan of care? Select all that
I will wash my child's hair using shampoo the morning of the
apply.
procedure
Q1.
Q3.
Arrange for a speech pathologist consult
My child may have scalp tenderness where the electrodes were
applied
Q2.
Discuss Community Resources with family
Q4.
My child will not remember the procedure
Q3.
ANS: 2 (Wash hair using shampoo)
Obtain a STAT CT scan of the head
Explanation: Washing hair removes scalp oils/products to ensure proper
electrode contact. Caffeine (found in cocoa, cola, tea, coffee) and CNS
Q4. stimulants/depressants should be avoided before an EEG. The test is
Perform a baseline neurologic assessment painless, non-invasive, and does not require general sedation.
Q5. Q11.
Prepare to initiate alteplase within the next 3.5 hours A client with Alzheimer disease is found wandering in the middle
of the street at 3:00 a.m. The community health nurse teaches the
ANS: 3, 4, 5
client's family members about measures to keep the client safe at
Explanation: Acute stroke protocols require a STAT non-contrast CT scan home. What is the most important strategy to prevent wandering?
of the head to rule out hemorrhagic stroke, a baseline neurological
assessment to establish symptom severity, and preparation for
thrombolytic therapy (alteplase / tPA) if eligible (must be given within 3 to Q1.
4.5 hours of symptom onset). Speech therapy and community resources Ensure that the family members never leave the client alone
are secondary interventions for later in the care continuum.
Q2.
Q8. Install a door sensor to alert the family members if the client
The nurse is caring for a client with left-sided weakness from a leaves the home
stroke. When assisting the client to a chair, what should the nurse
do?
Q3.
• Bend at the waist
Notify neighbors and local authorities of the client's tendency to
• Keep the feet close together
wander
• Pivot on the foot proximal to the chair
• Use a transfer belt
Q4.
ANS: Use a transfer belt Place a safe return bracelet on the client's non-dominant hand
Explanation: Using a transfer/gait belt around the client's waist maintains ANS: 2 (Install a door sensor)
proper body mechanics and safety. The nurse should pivot towards the
client's stronger (unaffected) side, keep a wide base of support, and bend Explanation: Environmental modifications (such as door sensors, alarms,
at the knees (not waist). or complex locks) provide immediate alerts if a client attempts to wander
out, drastically reducing the risk of outdoor injury during unmonitored times
(e.g., while caregivers sleep).
Q9.
The nurse provides education for caregivers of a client with
Alzheimer disease. Which instructions should the nurse include? Q12.
Select all that apply. A 22-year-old client presents with acute onset fatigue, left leg
• Complete activities such as bathing and dressing as quickly as weakness, pins and needles sensation, ataxia, elevated reflexes
possible (+3), and a history 6 months ago of transient blurry vision/eye
pain that resolved.
• Decrease the client's anxiety by limiting the number of choices
The nurse suspects: Multiple Sclerosis
offered
Anticipates prescription for: Corticosteroids
• Redirect the client if agitated by asking for help with tasks or
Explanation: Relapsing-remitting neurological symptoms (optic
going for a walk
neuritis, lower extremity sensory changes, upper motor neuron
• Remember to interact with the client as an adult regardless of
signs like hyperreflexia, ataxia) in a young adult are classic for
childlike affect
Multiple Sclerosis. Acute relapses are treated with high-dose
• Use open-ended questions when communicating with the intravenous corticosteroids.
client
ANS: Limit choices, Redirect when agitated, Interact as an adult Q13.
Explanation: Effective Alzheimer's care strategies include reducing choice A 60-year-old client asks: "My hand has been shaking when I try
complexity to lower anxiety, using redirection (e.g., walking, simple tasks) to cut food... could I have Parkinson's disease?" Which response
for agitation, maintaining dignity by addressing them as an adult, and is most helpful?
asking direct yes/no questions (not open-ended, which cause frustration).
ANS: "Tell me more about your symptoms. When did they start?"
Tasks should not be rushed.
Explanation: Asking open-ended questions allows the nurse to gather
Q10. essential subjective data regarding symptom onset, duration, and specific
A child is scheduled to have an electroencephalogram (EEG). characteristics (e.g., resting tremor vs. intentional tremor) to assist with
evaluation.
Which statement by the parent indicates understanding of the
teaching?
NCLEX / NGN UWorld High-Yield Comprehensive Review Page 2 of 6
Complete High-Yield Q&A Collection (Apr 28 - May 12 Edition) Zero Omissions
Q1. Q4.
The nurse is planning for an 8-year-old client with mild cognitive The nurse taught the caregiver of a client with a
impairment who is hospitalized for Diagnostic testing. Which of ventriculoperitoneal (VP) shunt about when to contact the
the following interventions are appropriate to include in the plan healthcare provider. The caregiver shows understanding of the
of care? Select all that apply instructions by contacting the hcp about which symptom?
• consistently assign the same nurse and unlicensed assistive • A temperature of 99F (37C) that occurs during the evening
Personnel to care for the client • The child cannot recall items eaten for lunch the previous day
• give direct procedural education and explanations to the • The child vomits after awakening from her nap and an hour
parent rather than the client later
• provide appropriate toys based on developmental level rather • The VP shunt is palpated along the posterior-lateral portion of
than chronological age the skull
• reinforce parental limit setting measures for preventing self-
ANS: The child vomits after awakening from her nap and an hour
injurious Behavior
later
• use a picture board to facilitate communication and promote
understanding of procedures Explanation: Vomiting, especially upon awakening, is a hallmark sign of
increased intracranial pressure (ICP) resulting from VP shunt malfunction
ANS: 1, 3, 4, 5 or obstruction. The HCP must be contacted immediately. A temp of 99F is
Explanation: Clients with cognitive impairment or intellectual disability are normal. Palpable shunt tubing under the scalp is normal.
diagnosed prior to adulthood and have limited levels of intellectual
functioning and adaptive skills for their chronological age. Appropriate Q5.
nursing interventions include: maintaining a familiar environment with A client is being admitted for potential cerebellar pathology.
consistent staff assignments (1), providing toys appropriate for Which tasks should the nurse ask a client to perform to assess
developmental (not chronological) age (3), preventing self-injury by cerebellar function is within the defined limits? Select all that
reinforcing parental limit setting (4), and using visual tools like picture
apply
boards for communication (5). Option 2 is incorrect because nurses
should include the child in procedural explanations using methods • Identify the number '8' traced on the palm
appropriate for their cognitive level rather than excluding them. • shrug the shoulders against resistance
• swallow water
• touch each finger of one hand to the hand's thumb
Q2.
A client with stroke symptoms has a blood pressure of 240/124 • walk Heel To Toe
mmhg. The nurse prepares the prescribed nicardipine ANS: Touch each finger of one hand to the hand's thumb, Walk
intravenous infusion solution correctly to yield 0.1 mg/ml. The Heel To Toe
nurse then administers the initial prescription to infuse at 5 mg/hr
by setting the infusion pump at 50 ml/hr. What is the nurse's Explanation: The cerebellum coordinates voluntary movements, balance,
and posture. Cerebellar assessments include gait testing (tandem/heel-to-
priority action at this time?
toe walking) and fine motor coordination (finger-to-thumb tapping, rapid
• assess hourly urinary output alternating movements, finger-to-nose). Tracing figures on the palm tests
• increase pump setting to correct Administration rate 100 ml/hr sensory perception (graphesthesia). Shrugging shoulders tests CN XI.
• keep systolic blood pressure above 170mmHg Swallowing tests CN IX and X.
• monitor for a widening QT interval
ANS: Keep systolic blood pressure above 170mmHg Q6.
The nurse is admitting an eight-year-old client with suspected
Explanation: A client with acute ischemic stroke requires permissive Reye's syndrome. Which of the following information obtained
hypertension (typically keeping BP below 220/120 mmHg, or lowering
during the admission would be most consistent with the
moderately if antihypertensives are used) to maintain cerebral perfusion.
condition?
Lowering BP too rapidly or too drastically can extend ischemic brain
damage. The priority action is to monitor BP continuously to ensure
systolic BP does not drop too low or too fast (maintaining adequate Q1.
perfusion, avoiding dropping below ~170 mmHg precipitously). The pump no history of varicella vaccination
rate setting of 50 mL/hr is correct (5 mg/hr / 0.1 mg/mL = 50 mL/hr).
Q2.
Q3.
previous exposure to Lead-based paint
The nurse is caring for a client after a motor vehicle collision. The
client's injuries include two fractured ribs and a concussion.
Which of the following are expected neurological changes for Q3.
clients with a concussion? Select all that apply recent exposure to bats
• asymmetrical pupillary constriction
• brief period of confusion
Q4.
• Headache recent influenza infection
• loss of vision
• retrograde amnesia ANS: 4 (Recent influenza infection)
Explanation: Reye syndrome typically develops following a viral illness
ANS: Brief period of confusion, Headache, Retrograde amnesia
(most commonly influenza or varicella / chickenpox), especially when
Explanation: Typical clinical manifestations of a concussion (minor aspirin was administered to manage fever. Symptoms include fever, acute
traumatic brain injury) include a brief period of confusion (with or without encephalopathy (vomiting, altered consciousness, seizures), and elevated
loss of consciousness), headache, and retrograde amnesia (loss of liver enzymes/ammonia.
memory for events immediately preceding the injury). Asymmetrical pupils
or visual loss indicate severe intracranial injury/increased ICP, not a simple
concussion.
NCLEX / NGN UWorld High-Yield Comprehensive Review Page 1 of 6
, Q7. Q1.
The nurse is planning to care for a client with suspected ischemic I will let my child drink cocoa as usual the morning of the
stroke who has just arrived at the emergency department with procedure
slurred speech, facial drooping, and right arm weakness that
began 1 hour ago. Which interventions should the nurse
Q2.
anticipate including in the initial plan of care? Select all that
I will wash my child's hair using shampoo the morning of the
apply.
procedure
Q1.
Q3.
Arrange for a speech pathologist consult
My child may have scalp tenderness where the electrodes were
applied
Q2.
Discuss Community Resources with family
Q4.
My child will not remember the procedure
Q3.
ANS: 2 (Wash hair using shampoo)
Obtain a STAT CT scan of the head
Explanation: Washing hair removes scalp oils/products to ensure proper
electrode contact. Caffeine (found in cocoa, cola, tea, coffee) and CNS
Q4. stimulants/depressants should be avoided before an EEG. The test is
Perform a baseline neurologic assessment painless, non-invasive, and does not require general sedation.
Q5. Q11.
Prepare to initiate alteplase within the next 3.5 hours A client with Alzheimer disease is found wandering in the middle
of the street at 3:00 a.m. The community health nurse teaches the
ANS: 3, 4, 5
client's family members about measures to keep the client safe at
Explanation: Acute stroke protocols require a STAT non-contrast CT scan home. What is the most important strategy to prevent wandering?
of the head to rule out hemorrhagic stroke, a baseline neurological
assessment to establish symptom severity, and preparation for
thrombolytic therapy (alteplase / tPA) if eligible (must be given within 3 to Q1.
4.5 hours of symptom onset). Speech therapy and community resources Ensure that the family members never leave the client alone
are secondary interventions for later in the care continuum.
Q2.
Q8. Install a door sensor to alert the family members if the client
The nurse is caring for a client with left-sided weakness from a leaves the home
stroke. When assisting the client to a chair, what should the nurse
do?
Q3.
• Bend at the waist
Notify neighbors and local authorities of the client's tendency to
• Keep the feet close together
wander
• Pivot on the foot proximal to the chair
• Use a transfer belt
Q4.
ANS: Use a transfer belt Place a safe return bracelet on the client's non-dominant hand
Explanation: Using a transfer/gait belt around the client's waist maintains ANS: 2 (Install a door sensor)
proper body mechanics and safety. The nurse should pivot towards the
client's stronger (unaffected) side, keep a wide base of support, and bend Explanation: Environmental modifications (such as door sensors, alarms,
at the knees (not waist). or complex locks) provide immediate alerts if a client attempts to wander
out, drastically reducing the risk of outdoor injury during unmonitored times
(e.g., while caregivers sleep).
Q9.
The nurse provides education for caregivers of a client with
Alzheimer disease. Which instructions should the nurse include? Q12.
Select all that apply. A 22-year-old client presents with acute onset fatigue, left leg
• Complete activities such as bathing and dressing as quickly as weakness, pins and needles sensation, ataxia, elevated reflexes
possible (+3), and a history 6 months ago of transient blurry vision/eye
pain that resolved.
• Decrease the client's anxiety by limiting the number of choices
The nurse suspects: Multiple Sclerosis
offered
Anticipates prescription for: Corticosteroids
• Redirect the client if agitated by asking for help with tasks or
Explanation: Relapsing-remitting neurological symptoms (optic
going for a walk
neuritis, lower extremity sensory changes, upper motor neuron
• Remember to interact with the client as an adult regardless of
signs like hyperreflexia, ataxia) in a young adult are classic for
childlike affect
Multiple Sclerosis. Acute relapses are treated with high-dose
• Use open-ended questions when communicating with the intravenous corticosteroids.
client
ANS: Limit choices, Redirect when agitated, Interact as an adult Q13.
Explanation: Effective Alzheimer's care strategies include reducing choice A 60-year-old client asks: "My hand has been shaking when I try
complexity to lower anxiety, using redirection (e.g., walking, simple tasks) to cut food... could I have Parkinson's disease?" Which response
for agitation, maintaining dignity by addressing them as an adult, and is most helpful?
asking direct yes/no questions (not open-ended, which cause frustration).
ANS: "Tell me more about your symptoms. When did they start?"
Tasks should not be rushed.
Explanation: Asking open-ended questions allows the nurse to gather
Q10. essential subjective data regarding symptom onset, duration, and specific
A child is scheduled to have an electroencephalogram (EEG). characteristics (e.g., resting tremor vs. intentional tremor) to assist with
evaluation.
Which statement by the parent indicates understanding of the
teaching?
NCLEX / NGN UWorld High-Yield Comprehensive Review Page 2 of 6
