UWORLD NCLEX-RN TEST 2
QUESTIONS AND ANSWERS
1. A nurse is caring for a client with a potassium level of 2.8 mEq/L. Which ECG change should
the nurse expect to observe?
A. Tall, peaked T waves
B. Prominent U waves
C. Widened QRS complex
D. Shortened QT interval
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) typically manifests on an
ECG as prominent U waves, ST-segment depression, and flat or inverted T waves. Tall
peaked T waves are associated with hyperkalemia.
2. Which assessment finding in a client with a history of pheochromocytoma requires
immediate intervention?
A. Glucose 130 mg/dL
B. Heart rate 90 bpm
,C. Report of a mild headache
D. Blood pressure 210/110 mmHg
Answer: D
Conceptual Explanation: Pheochromocytoma is a tumor of the adrenal medulla that
secretes catecholamines. The primary risk is a hypertensive crisis, which can lead to stroke
or organ failure. A BP of 210/110 mmHg is a critical emergency.
3. A client with a T4 spinal cord injury reports a severe throbbing headache and nasal
congestion. The nurse notes flush skin above the level of injury. What is the priority action?
A. Administer prescribed PRN acetaminophen
B. Perform a digital rectal exam to check for impaction
C. Place the client in a high-Fowler position
D. Check the urinary catheter for kinks
Answer: C
Conceptual Explanation: These symptoms indicate autonomic dysreflexia. The first
priority is to sit the client up (high-Fowler) to help lower the blood pressure through
orthostatic effect, followed by identifying and removing the triggering stimulus (e.g.,
bladder distension).
, 4. A nurse is preparing to administer lithium to a client with bipolar disorder. Which lab result
should the nurse verify before administration?
A. Serum sodium level
B. Serum calcium level
C. Prothrombin time (PT)
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Lithium is a salt. Low sodium levels (hyponatremia) cause the
kidneys to retain lithium, leading to lithium toxicity. It is crucial to ensure the client is not
hyponatremic and is maintaining adequate fluid intake.
5. Which instruction is most important for a client starting a new prescription for rifampin to
treat tuberculosis?
A. Limit intake of green leafy vegetables
B. Take the medication with a high-fat meal
C. Double the dose if you miss a day
D. Wear glasses instead of soft contact lenses
Answer: D
QUESTIONS AND ANSWERS
1. A nurse is caring for a client with a potassium level of 2.8 mEq/L. Which ECG change should
the nurse expect to observe?
A. Tall, peaked T waves
B. Prominent U waves
C. Widened QRS complex
D. Shortened QT interval
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) typically manifests on an
ECG as prominent U waves, ST-segment depression, and flat or inverted T waves. Tall
peaked T waves are associated with hyperkalemia.
2. Which assessment finding in a client with a history of pheochromocytoma requires
immediate intervention?
A. Glucose 130 mg/dL
B. Heart rate 90 bpm
,C. Report of a mild headache
D. Blood pressure 210/110 mmHg
Answer: D
Conceptual Explanation: Pheochromocytoma is a tumor of the adrenal medulla that
secretes catecholamines. The primary risk is a hypertensive crisis, which can lead to stroke
or organ failure. A BP of 210/110 mmHg is a critical emergency.
3. A client with a T4 spinal cord injury reports a severe throbbing headache and nasal
congestion. The nurse notes flush skin above the level of injury. What is the priority action?
A. Administer prescribed PRN acetaminophen
B. Perform a digital rectal exam to check for impaction
C. Place the client in a high-Fowler position
D. Check the urinary catheter for kinks
Answer: C
Conceptual Explanation: These symptoms indicate autonomic dysreflexia. The first
priority is to sit the client up (high-Fowler) to help lower the blood pressure through
orthostatic effect, followed by identifying and removing the triggering stimulus (e.g.,
bladder distension).
, 4. A nurse is preparing to administer lithium to a client with bipolar disorder. Which lab result
should the nurse verify before administration?
A. Serum sodium level
B. Serum calcium level
C. Prothrombin time (PT)
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Lithium is a salt. Low sodium levels (hyponatremia) cause the
kidneys to retain lithium, leading to lithium toxicity. It is crucial to ensure the client is not
hyponatremic and is maintaining adequate fluid intake.
5. Which instruction is most important for a client starting a new prescription for rifampin to
treat tuberculosis?
A. Limit intake of green leafy vegetables
B. Take the medication with a high-fat meal
C. Double the dose if you miss a day
D. Wear glasses instead of soft contact lenses
Answer: D
