NSG 3100 — Exam 3 Practice Exam
Expert-Level NCLEX / ATI-Style Questions — 50 Items
Unit 6: Diagnostic Testing, Bowel Elimination, Urinary Elimination (Ch. 34, 40, 41) | Units 7 & 8: Medication
Administration (Ch. 35)
Instructions: This practice exam is written in NCLEX/ATI clinical-judgment style. Question types include standard
multiple choice, Select All That Apply (SATA), priority/first-action questions, "which finding requires follow-up"
questions, and ordered-response (sequencing) items. Read each stem carefully — many require you to identify the
priority or most urgent action, not just a true statement. Work through all 50 questions before checking the answer key
at the end of this document.
Unit 6 — Diagnostic Testing, Bowel & Urinary Elimination (Questions 1-25)
Priority / First Action
1. A nurse reviews the hourly urine output for a postoperative client and notes 22 mL of urine over the last
hour. Which action should the nurse take first?
A. Document the finding and reassess in 4 hours
B. Encourage the client to increase oral fluid intake
C. Notify the primary care provider immediately
D. Insert a straight catheter to obtain a residual volume
Standard Multiple Choice
2. A client is scheduled for an intravenous pyelogram (IVP) with contrast. Which home medication is most
important for the nurse to confirm the client has held for 48 hours prior to the procedure?
A. Metformin
B. Levothyroxine
C. Amlodipine
D. Acetaminophen
Findings Requiring Follow-Up
3. The nurse is reviewing laboratory results for a client admitted with chest pain 2 hours ago. Which result
requires the most immediate follow-up for a suspected myocardial infarction?
A. Myoglobin within normal limits
B. CK-MB within normal limits
C. Troponin I elevated above normal
D. Total CK within normal limits
Standard Multiple Choice
4. During a guaiac-based fecal occult blood test, the nurse applies developer solution to the test window.
Which result indicates a positive finding?
A. The window turns bluish in color
B. The window remains completely white
C. The stool sample turns bright red
D. The developer solution evaporates within 10 seconds
, Findings Requiring Follow-Up
5. The nurse is caring for a 2-day-old newborn and a 68-year-old client, both of whom have black, tarry
stool. Which statement by the nurse best reflects correct clinical reasoning?
A. Both findings are abnormal and require immediate provider notification
B. The newborn's stool is expected meconium; the older adult's finding suggests melena and needs follow-up
C. Both findings are expected and require no further action
D. The older adult's stool is expected; the newborn's finding suggests a GI bleed
Findings Requiring Follow-Up
6. The nurse assesses a confused, immobile client and notes small amounts of liquid stool leaking
continuously with no formed stool passed in 3 days. Which action should the nurse take first?
A. Administer the prescribed antidiarrheal medication
B. Perform a digital rectal examination to assess for impaction
C. Restrict oral fluid intake
D. Apply a fecal management pouch without further assessment
Standard Multiple Choice
7. The nurse is explaining how a hypertonic enema works to a nursing student. Which statement by the
student indicates correct understanding?
A. "It works by adding bulk and volume to stretch the colon wall."
B. "It pulls fluid out of the surrounding tissues and into the colon by osmosis."
C. "It absorbs into the bowel wall to soften hardened stool."
D. "It delivers medication directly to treat a local colon infection."
Ordered Response
8. Place the following steps for administering a cleansing enema in the correct sequence. 1) Instruct the
client to retain the solution as long as possible 2) Position the client in the left side-lying position with the
right knee flexed 3) Lubricate and insert the tip 6-8 cm toward the umbilicus 4) Raise the solution bag 12-18
inches above the rectum and instill slowly
A. 2, 3, 4, 1
B. 3, 2, 4, 1
C. 2, 4, 3, 1
D. 4, 2, 3, 1
Select All That Apply (SATA)
9. A nurse observes an unlicensed assistive personnel (UAP) cleaning a client's stoma during an appliance
change. Which actions by the UAP require the nurse to intervene? Select all that apply.
A. Cleansing the peristomal skin with warm water only
B. Using a premoistened soap wipe to clean the stoma
C. Scrubbing the peristomal skin vigorously to remove residue
D. Patting the skin dry after cleansing
E. Cutting the wafer opening 1/16 inch larger than the stoma
Expert-Level NCLEX / ATI-Style Questions — 50 Items
Unit 6: Diagnostic Testing, Bowel Elimination, Urinary Elimination (Ch. 34, 40, 41) | Units 7 & 8: Medication
Administration (Ch. 35)
Instructions: This practice exam is written in NCLEX/ATI clinical-judgment style. Question types include standard
multiple choice, Select All That Apply (SATA), priority/first-action questions, "which finding requires follow-up"
questions, and ordered-response (sequencing) items. Read each stem carefully — many require you to identify the
priority or most urgent action, not just a true statement. Work through all 50 questions before checking the answer key
at the end of this document.
Unit 6 — Diagnostic Testing, Bowel & Urinary Elimination (Questions 1-25)
Priority / First Action
1. A nurse reviews the hourly urine output for a postoperative client and notes 22 mL of urine over the last
hour. Which action should the nurse take first?
A. Document the finding and reassess in 4 hours
B. Encourage the client to increase oral fluid intake
C. Notify the primary care provider immediately
D. Insert a straight catheter to obtain a residual volume
Standard Multiple Choice
2. A client is scheduled for an intravenous pyelogram (IVP) with contrast. Which home medication is most
important for the nurse to confirm the client has held for 48 hours prior to the procedure?
A. Metformin
B. Levothyroxine
C. Amlodipine
D. Acetaminophen
Findings Requiring Follow-Up
3. The nurse is reviewing laboratory results for a client admitted with chest pain 2 hours ago. Which result
requires the most immediate follow-up for a suspected myocardial infarction?
A. Myoglobin within normal limits
B. CK-MB within normal limits
C. Troponin I elevated above normal
D. Total CK within normal limits
Standard Multiple Choice
4. During a guaiac-based fecal occult blood test, the nurse applies developer solution to the test window.
Which result indicates a positive finding?
A. The window turns bluish in color
B. The window remains completely white
C. The stool sample turns bright red
D. The developer solution evaporates within 10 seconds
, Findings Requiring Follow-Up
5. The nurse is caring for a 2-day-old newborn and a 68-year-old client, both of whom have black, tarry
stool. Which statement by the nurse best reflects correct clinical reasoning?
A. Both findings are abnormal and require immediate provider notification
B. The newborn's stool is expected meconium; the older adult's finding suggests melena and needs follow-up
C. Both findings are expected and require no further action
D. The older adult's stool is expected; the newborn's finding suggests a GI bleed
Findings Requiring Follow-Up
6. The nurse assesses a confused, immobile client and notes small amounts of liquid stool leaking
continuously with no formed stool passed in 3 days. Which action should the nurse take first?
A. Administer the prescribed antidiarrheal medication
B. Perform a digital rectal examination to assess for impaction
C. Restrict oral fluid intake
D. Apply a fecal management pouch without further assessment
Standard Multiple Choice
7. The nurse is explaining how a hypertonic enema works to a nursing student. Which statement by the
student indicates correct understanding?
A. "It works by adding bulk and volume to stretch the colon wall."
B. "It pulls fluid out of the surrounding tissues and into the colon by osmosis."
C. "It absorbs into the bowel wall to soften hardened stool."
D. "It delivers medication directly to treat a local colon infection."
Ordered Response
8. Place the following steps for administering a cleansing enema in the correct sequence. 1) Instruct the
client to retain the solution as long as possible 2) Position the client in the left side-lying position with the
right knee flexed 3) Lubricate and insert the tip 6-8 cm toward the umbilicus 4) Raise the solution bag 12-18
inches above the rectum and instill slowly
A. 2, 3, 4, 1
B. 3, 2, 4, 1
C. 2, 4, 3, 1
D. 4, 2, 3, 1
Select All That Apply (SATA)
9. A nurse observes an unlicensed assistive personnel (UAP) cleaning a client's stoma during an appliance
change. Which actions by the UAP require the nurse to intervene? Select all that apply.
A. Cleansing the peristomal skin with warm water only
B. Using a premoistened soap wipe to clean the stoma
C. Scrubbing the peristomal skin vigorously to remove residue
D. Patting the skin dry after cleansing
E. Cutting the wafer opening 1/16 inch larger than the stoma
