SAUNDERS NCLEX MAIN EXAMINATION MANUAL
2025/2026 QUESTIONS WITH SOLUTIONS MARKED A+
✔✔746. A postoperative client requests medication for flatulence (gas pains). Which
medication from the following PRN list should the nurse administer to this client?
1. Ondansetron (Zofran)
2. Simethicone (Mylicon)
3. Acetaminophen (Tylenol)
4. Magnesium hydroxide (milk of magnesia, MOM) - ✔✔746. 2
Rationale: Simethicone is an antiflatulent used in the relief of pain caused by excessive
gas in the gastrointestinal tract. Ondansetron is used to treat postoperative nausea and
vomiting. Acetaminophen is a nonopioid analgesic. Magnesium hydroxide is an antacid
and laxative.
Test-Taking Strategy: Note the subject, a medication to treat flatulence (gas pains).
Recalling the classifications of the medications in the options will direct you to the
correct option. Review: simethicone (Mylicon).
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology: Gastrointestinal Medications
Priority Concepts: Clinical Judgment, Pain
Reference(s): Hodgson, Kizior (2015), pp. 1104-1105.
✔✔747. A client is admitted to the hospital with a diagnosis of major depression. During
the admission interview, the nurse determines that a major concern is the client's
altered nutrition related to poor nutritional intake. Which nursing intervention related to
altered nutrition should be the initial choice?
1. Weigh the client three times per week, before breakfast.
2. Explain to the client the importance of a good nutritional intake.
3. Report the nutritional concern to the psychiatrist and obtain a nutritional consult as
soon as possible.
4. Offer the client several small, frequent meals daily, and schedule brief nursing
interactions with the client during these times. - ✔✔747. 4
Rationale: Change in appetite is one of the major symptoms of depression. Offering the
client several small, frequent meals and the nurse's presence at that time to support,
encourage, or perhaps even feed the client is the most appropriate intervention. A client
with depression experiences poor concentration and will not understand the importance
of an adequate nutritional intake. Weighing the client does not address how to increase
nutritional intake. Reporting the nutritional problems to the psychiatrist is correct to
some degree, but it does not address how one might increase food intake.
Test-Taking Strategy: Note the strategic word, initial, and focus on the subject, the poor
nutritional intake. The correct option is the only option that addresses the altered
nutrition concretely and designs a method in which the client will feasibly increase the
nutritional intake. Review: nutritional concerns with depression.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
,Integrated Process: Nursing Process/Implementation
Content Area: Mental Health
Priority Concepts: Mood and Affect, Nutrition
Reference(s): deWit, Kumagai (2013), p. 1058.
✔✔748. A client received 20 units of NPH insulin subcutaneously at 8:00 am. The nurse
should check the client for a potential hypoglycemic reaction at which time?
1. 5:00 pm
2. 10:00 am
3. 11:00 am
4. 11:00 pm - ✔✔748. 1
Rationale: NPH is intermediate-acting insulin. Its onset of action is 1 to 2½ hours, it
peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions
most likely occur during peak time.
Test-Taking Strategy: Focus on the subject, NPH insulin. Recalling that peak action is
between 4 and 12 hours will direct you to the correct option. Review: the characteristics
of NPH insulin.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology: Endocrine Medications974
Priority Concepts: Clinical Judgment, Glucose Regulation
Reference(s): Lehne (2013), p. 712.
✔✔749. The nurse assists in developing a plan of care for a client with
hyperparathyroidism receiving calcitonin-human (Cibacalcin). Which outcome has the
highest priority regarding this medication?
1. Relief of pain
2. Absence of side effects
3. Reaching normal serum calcium levels
4. Verbalization of appropriate medication knowledge - ✔✔
✔✔750. The nursing instructor asks a nursing student about the cause of hemophilia.
The student correctly responds by telling the instructor which fact about hemophilia?
1. Hemophilia is a Y-linked hereditary disorder.
2. A splenectomy resolves the bleeding disorders.
3. Hemophilia A results from deficiency of factor VIII.
4. A bone marrow transplant is the treatment of choice. - ✔✔
✔✔751. A 4-year-old child is admitted to the hospital with suspected acute lymphocytic
leukemia (ALL). The nurse understands that which diagnostic study should confirm this
diagnosis?
1. A platelet count
2. A lumbar puncture
3. Bone marrow biopsy
, 4. White blood cell (WBC) count - ✔✔
✔✔752. A child with leukemia is experiencing nausea related to medication therapy.
The nurse, concerned about the child's nutritional status, should offer which during an
episode of nausea?
1. Low-calorie foods
2. Cool, clear liquids
3. Low-protein foods
4. The child's favorite foods - ✔✔
✔✔753. To ensure a safe environment for a child admitted to the hospital for a
craniotomy to remove a brain tumor, the nurse should include which in the plan of care?
1. Initiating seizure precautions
2. Using a wheelchair for out-of-bed activities
3. Assisting the child with ambulation at all times
4. Avoiding contact with other children on the nursing unit - ✔✔
✔✔754. The nurse is preparing to suction an adult client through the client's
tracheostomy tube. Which interventions should the nurse perform for this procedure?
Select all that apply.
1. Apply suction for up to 10 to 15 seconds.
2. Hyperoxygenate the client before suctioning.
3. Set the wall suction unit pressure at 160 mm Hg.
4. Apply suction while gently inserting the catheter.
5. Apply intermittent suction while rotating and withdrawing the catheter.
6. Advance the catheter until resistance is met and then pull the catheter back 1 cm. -
✔✔
✔✔755. The nurse is assisting in caring for a client who has a placenta previa. The
nurse understands that a cervical examination should not be performed on the client
primarily because it could do which?
1. Cause hemorrhage
2. Initiate premature labor
3. Rupture the fetal membranes
4. Increase the chance of infection - ✔✔
✔✔756. A mother is breastfeeding her newborn. The mother complains to the nurse
that she is experiencing severe nipple soreness. The nurse should provide which
suggestion to the client?
1. Avoid rotating breastfeeding positions so that the nipple will toughen.
2. Stop nursing during the period of nipple soreness to allow the nipples to heal.
3. Nurse the newborn infant less frequently and substitute a bottle feeding until the
nipples become less sore.
4. Position the newborn infant with the ear, shoulder, and hip in straight alignment and
with the baby's stomach against the mother's. - ✔✔
2025/2026 QUESTIONS WITH SOLUTIONS MARKED A+
✔✔746. A postoperative client requests medication for flatulence (gas pains). Which
medication from the following PRN list should the nurse administer to this client?
1. Ondansetron (Zofran)
2. Simethicone (Mylicon)
3. Acetaminophen (Tylenol)
4. Magnesium hydroxide (milk of magnesia, MOM) - ✔✔746. 2
Rationale: Simethicone is an antiflatulent used in the relief of pain caused by excessive
gas in the gastrointestinal tract. Ondansetron is used to treat postoperative nausea and
vomiting. Acetaminophen is a nonopioid analgesic. Magnesium hydroxide is an antacid
and laxative.
Test-Taking Strategy: Note the subject, a medication to treat flatulence (gas pains).
Recalling the classifications of the medications in the options will direct you to the
correct option. Review: simethicone (Mylicon).
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology: Gastrointestinal Medications
Priority Concepts: Clinical Judgment, Pain
Reference(s): Hodgson, Kizior (2015), pp. 1104-1105.
✔✔747. A client is admitted to the hospital with a diagnosis of major depression. During
the admission interview, the nurse determines that a major concern is the client's
altered nutrition related to poor nutritional intake. Which nursing intervention related to
altered nutrition should be the initial choice?
1. Weigh the client three times per week, before breakfast.
2. Explain to the client the importance of a good nutritional intake.
3. Report the nutritional concern to the psychiatrist and obtain a nutritional consult as
soon as possible.
4. Offer the client several small, frequent meals daily, and schedule brief nursing
interactions with the client during these times. - ✔✔747. 4
Rationale: Change in appetite is one of the major symptoms of depression. Offering the
client several small, frequent meals and the nurse's presence at that time to support,
encourage, or perhaps even feed the client is the most appropriate intervention. A client
with depression experiences poor concentration and will not understand the importance
of an adequate nutritional intake. Weighing the client does not address how to increase
nutritional intake. Reporting the nutritional problems to the psychiatrist is correct to
some degree, but it does not address how one might increase food intake.
Test-Taking Strategy: Note the strategic word, initial, and focus on the subject, the poor
nutritional intake. The correct option is the only option that addresses the altered
nutrition concretely and designs a method in which the client will feasibly increase the
nutritional intake. Review: nutritional concerns with depression.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
,Integrated Process: Nursing Process/Implementation
Content Area: Mental Health
Priority Concepts: Mood and Affect, Nutrition
Reference(s): deWit, Kumagai (2013), p. 1058.
✔✔748. A client received 20 units of NPH insulin subcutaneously at 8:00 am. The nurse
should check the client for a potential hypoglycemic reaction at which time?
1. 5:00 pm
2. 10:00 am
3. 11:00 am
4. 11:00 pm - ✔✔748. 1
Rationale: NPH is intermediate-acting insulin. Its onset of action is 1 to 2½ hours, it
peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions
most likely occur during peak time.
Test-Taking Strategy: Focus on the subject, NPH insulin. Recalling that peak action is
between 4 and 12 hours will direct you to the correct option. Review: the characteristics
of NPH insulin.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Pharmacology: Endocrine Medications974
Priority Concepts: Clinical Judgment, Glucose Regulation
Reference(s): Lehne (2013), p. 712.
✔✔749. The nurse assists in developing a plan of care for a client with
hyperparathyroidism receiving calcitonin-human (Cibacalcin). Which outcome has the
highest priority regarding this medication?
1. Relief of pain
2. Absence of side effects
3. Reaching normal serum calcium levels
4. Verbalization of appropriate medication knowledge - ✔✔
✔✔750. The nursing instructor asks a nursing student about the cause of hemophilia.
The student correctly responds by telling the instructor which fact about hemophilia?
1. Hemophilia is a Y-linked hereditary disorder.
2. A splenectomy resolves the bleeding disorders.
3. Hemophilia A results from deficiency of factor VIII.
4. A bone marrow transplant is the treatment of choice. - ✔✔
✔✔751. A 4-year-old child is admitted to the hospital with suspected acute lymphocytic
leukemia (ALL). The nurse understands that which diagnostic study should confirm this
diagnosis?
1. A platelet count
2. A lumbar puncture
3. Bone marrow biopsy
, 4. White blood cell (WBC) count - ✔✔
✔✔752. A child with leukemia is experiencing nausea related to medication therapy.
The nurse, concerned about the child's nutritional status, should offer which during an
episode of nausea?
1. Low-calorie foods
2. Cool, clear liquids
3. Low-protein foods
4. The child's favorite foods - ✔✔
✔✔753. To ensure a safe environment for a child admitted to the hospital for a
craniotomy to remove a brain tumor, the nurse should include which in the plan of care?
1. Initiating seizure precautions
2. Using a wheelchair for out-of-bed activities
3. Assisting the child with ambulation at all times
4. Avoiding contact with other children on the nursing unit - ✔✔
✔✔754. The nurse is preparing to suction an adult client through the client's
tracheostomy tube. Which interventions should the nurse perform for this procedure?
Select all that apply.
1. Apply suction for up to 10 to 15 seconds.
2. Hyperoxygenate the client before suctioning.
3. Set the wall suction unit pressure at 160 mm Hg.
4. Apply suction while gently inserting the catheter.
5. Apply intermittent suction while rotating and withdrawing the catheter.
6. Advance the catheter until resistance is met and then pull the catheter back 1 cm. -
✔✔
✔✔755. The nurse is assisting in caring for a client who has a placenta previa. The
nurse understands that a cervical examination should not be performed on the client
primarily because it could do which?
1. Cause hemorrhage
2. Initiate premature labor
3. Rupture the fetal membranes
4. Increase the chance of infection - ✔✔
✔✔756. A mother is breastfeeding her newborn. The mother complains to the nurse
that she is experiencing severe nipple soreness. The nurse should provide which
suggestion to the client?
1. Avoid rotating breastfeeding positions so that the nipple will toughen.
2. Stop nursing during the period of nipple soreness to allow the nipples to heal.
3. Nurse the newborn infant less frequently and substitute a bottle feeding until the
nipples become less sore.
4. Position the newborn infant with the ear, shoulder, and hip in straight alignment and
with the baby's stomach against the mother's. - ✔✔
