HURST NCLEX REVIEW 2026 QUESTIONS
WITH SOLUTIONS TESTED QUESTIONS.
■ A client has been admitted to the medical unit after sustaining a stroke.
The admitting nurse initiates a nursing diagnosis of unilateral neglect
related to a decrease in visual field and hemianopia from
cerebrovascular problems as evidenced by consistent inattention to
stimuli on the affected side. What nursing interventions should the nurse
initiate for this client?
1. Instruct client to scan from left to right to visualize the entire
environment.
2. Encourage client to practice exercises independently.
3. Position bed in room so that individuals approach the client on the
unaffected side.
4. Apply splints to achieve stability of affected joints.
5. Touch unaffected shoulder when initiating conversation with client.
6. Position personal items within view on the unaffected side.. Answer-
1., 3., 5., & 6. Correct: Instructing the client to scan from left to right
will help the client to visualize the entire environment. The client has to
be reminded to do this since only one side of the client's visual field is
working. By positioning the bed so that individuals approach the client
from the unaffected side and by touching the client on the unaffected
shoulder, the client is not surprised or frightened when realizing
someone is in the room. Placing personal items where the client can see
them will allow the client to use the material. Then gradually move
,personal items and activity to the affected side as the client demonstrates
an ability to compensate for neglect.
2. Incorrect: Practicing exercises independently focuses on impaired
physical mobility rather than unilateral neglect.
4. Incorrect: Applying splints to affected joints focuses on impaired
physical mobility rather than unilateral neglect.
■ What electrolyte imbalance should the nurse monitor for when caring
for a client diagnosed with chronic alcoholism?
1. Hypochloremia
2. Hypokalemia
3. Hypophosphatemia
4. Hypomagnesemia
5. Hypocalcemia. Answer- 2., 3., 4., & 5. Correct: The number one way
of getting rid of potassium is through the kidneys. What does alcohol
make you do? Diuresis. Acute hypophosphatemia is seen in up to 50% of
patients over the first 2-3 days after they are hospitalized for alcohol
overuse. Hypophosphatemia is manifested as rhabdomyolysis (muscle
breakdown) and weakness of the skeletal muscles. Magnesium
deficiency occurs due to that increase in diuresis as well.
Hypomagnesemia is often accompanied by hypocalcemia, or lowered
calcium levels, which may be aggravated by a deficiency of vitamin D.
1. Incorrect: Hypochloremia is usually caused by excess use of loop
diuretics, nasogastric suction, vomiting or diarrhea due to small bowel
abnormalities, and loss of fluids through the skin occurring because of
trauma such as burns.
,■ A client has been admitted with a diagnosis of pneumocystis carinii
pneumonia (PCP). What initial assessment findings would the nurse
expect? (Select All That Apply).
1. Fever
2. Night sweats
3. Hemoptysis
4. Dry cough
5. Dyspnea. Answer- 1, 4 and 5. CORRECT: Pneumocystis carinii
pneumonia, now known as pneumocystis jirovecii, is caused by a fungus
and occurs in clients with weakened immune systems. Expected
assessment findings include fever, dry non-productive cough and
dyspnea. Any additional symptoms are related to other co-morbidities
and not the pneumonia itself.
2. INCORRECT: Night sweats are an early symptom of active
tuberculosis and are often the definitive symptom, along with a
productive cough, that indicates the need for immediate testing and
isolation.
3. INCORRECT: Hemoptysis is among the late signs of lung cancer, in
addition to weight loss. Lung cancer is asymptomatic in its early stages
■ An elderly client returns to a surgical room from the post anesthesia
care unit (PACU) following an open reduction and fixation of a fractured
ankle. Which nursing assessment of the client takes priority?
, 1. Level of consciousness
2. Complete vital signs
3. Surgical dressing
4. Pedal pulses. Answer- 2. CORRECT. Orthopedic surgeries can lead to
multiple complications, particularly in elderly clients. An early change in
vital signs, especially the blood pressure, can indicate complications
from the surgery. Though vitals were taken prior to leaving the PACU,
problems can occur during transfer back to the unit. Vitals should be
taken as soon as the client is placed into bed.
1. INCORRECT. The client may be semi-conscious upon return to the
unit since anesthesia is not yet completely cleared from the body. While
the client's level of consciousness must be assessed and documented, it
is not the nurse's first priority.
3. INCORRECT. Observation of the surgical dressing can provide
valuable data about any potential or occurring complications such as
bleeding. While this is a necessary assessment, the nurse knows there is
another important first step.
4. INCORRECT. A neurovascular check of the surgical site, comparing
that to the non-surgical side, is important following invasive orthopedic
surgery. Pedal pulses could indicate problems at the surgical site;
however, this is not the most immediate priority.
■ A nurse receives a client in the post anesthesia care unit following
application of a long leg cast to the left leg due to a fractured tibia and
fibula. Which interventions should the nurse initiate?
1. Elevate foot of bed 30 degrees.
WITH SOLUTIONS TESTED QUESTIONS.
■ A client has been admitted to the medical unit after sustaining a stroke.
The admitting nurse initiates a nursing diagnosis of unilateral neglect
related to a decrease in visual field and hemianopia from
cerebrovascular problems as evidenced by consistent inattention to
stimuli on the affected side. What nursing interventions should the nurse
initiate for this client?
1. Instruct client to scan from left to right to visualize the entire
environment.
2. Encourage client to practice exercises independently.
3. Position bed in room so that individuals approach the client on the
unaffected side.
4. Apply splints to achieve stability of affected joints.
5. Touch unaffected shoulder when initiating conversation with client.
6. Position personal items within view on the unaffected side.. Answer-
1., 3., 5., & 6. Correct: Instructing the client to scan from left to right
will help the client to visualize the entire environment. The client has to
be reminded to do this since only one side of the client's visual field is
working. By positioning the bed so that individuals approach the client
from the unaffected side and by touching the client on the unaffected
shoulder, the client is not surprised or frightened when realizing
someone is in the room. Placing personal items where the client can see
them will allow the client to use the material. Then gradually move
,personal items and activity to the affected side as the client demonstrates
an ability to compensate for neglect.
2. Incorrect: Practicing exercises independently focuses on impaired
physical mobility rather than unilateral neglect.
4. Incorrect: Applying splints to affected joints focuses on impaired
physical mobility rather than unilateral neglect.
■ What electrolyte imbalance should the nurse monitor for when caring
for a client diagnosed with chronic alcoholism?
1. Hypochloremia
2. Hypokalemia
3. Hypophosphatemia
4. Hypomagnesemia
5. Hypocalcemia. Answer- 2., 3., 4., & 5. Correct: The number one way
of getting rid of potassium is through the kidneys. What does alcohol
make you do? Diuresis. Acute hypophosphatemia is seen in up to 50% of
patients over the first 2-3 days after they are hospitalized for alcohol
overuse. Hypophosphatemia is manifested as rhabdomyolysis (muscle
breakdown) and weakness of the skeletal muscles. Magnesium
deficiency occurs due to that increase in diuresis as well.
Hypomagnesemia is often accompanied by hypocalcemia, or lowered
calcium levels, which may be aggravated by a deficiency of vitamin D.
1. Incorrect: Hypochloremia is usually caused by excess use of loop
diuretics, nasogastric suction, vomiting or diarrhea due to small bowel
abnormalities, and loss of fluids through the skin occurring because of
trauma such as burns.
,■ A client has been admitted with a diagnosis of pneumocystis carinii
pneumonia (PCP). What initial assessment findings would the nurse
expect? (Select All That Apply).
1. Fever
2. Night sweats
3. Hemoptysis
4. Dry cough
5. Dyspnea. Answer- 1, 4 and 5. CORRECT: Pneumocystis carinii
pneumonia, now known as pneumocystis jirovecii, is caused by a fungus
and occurs in clients with weakened immune systems. Expected
assessment findings include fever, dry non-productive cough and
dyspnea. Any additional symptoms are related to other co-morbidities
and not the pneumonia itself.
2. INCORRECT: Night sweats are an early symptom of active
tuberculosis and are often the definitive symptom, along with a
productive cough, that indicates the need for immediate testing and
isolation.
3. INCORRECT: Hemoptysis is among the late signs of lung cancer, in
addition to weight loss. Lung cancer is asymptomatic in its early stages
■ An elderly client returns to a surgical room from the post anesthesia
care unit (PACU) following an open reduction and fixation of a fractured
ankle. Which nursing assessment of the client takes priority?
, 1. Level of consciousness
2. Complete vital signs
3. Surgical dressing
4. Pedal pulses. Answer- 2. CORRECT. Orthopedic surgeries can lead to
multiple complications, particularly in elderly clients. An early change in
vital signs, especially the blood pressure, can indicate complications
from the surgery. Though vitals were taken prior to leaving the PACU,
problems can occur during transfer back to the unit. Vitals should be
taken as soon as the client is placed into bed.
1. INCORRECT. The client may be semi-conscious upon return to the
unit since anesthesia is not yet completely cleared from the body. While
the client's level of consciousness must be assessed and documented, it
is not the nurse's first priority.
3. INCORRECT. Observation of the surgical dressing can provide
valuable data about any potential or occurring complications such as
bleeding. While this is a necessary assessment, the nurse knows there is
another important first step.
4. INCORRECT. A neurovascular check of the surgical site, comparing
that to the non-surgical side, is important following invasive orthopedic
surgery. Pedal pulses could indicate problems at the surgical site;
however, this is not the most immediate priority.
■ A nurse receives a client in the post anesthesia care unit following
application of a long leg cast to the left leg due to a fractured tibia and
fibula. Which interventions should the nurse initiate?
1. Elevate foot of bed 30 degrees.
