NCLEX ACTUAL EXAM 2026 FULL 180
QUESTIONS AND ANSWERS WITH
EXPLANATIONS GRADED A+
⩥ The nurse is observing a staff member caring for a client who has
chickenpox.
Which of the following actions by the staff member would require the
nurse to intervene?
1. placing the client in a private room with monitored negative air
pressure
2. placing a box of disposable face shields outside the client's room
3. placing an alcohol-based hand rub in the client's room for hand
hygiene
4. placing a surgical mask on the client during transport out of the
client's room. Answer: 2. placing a box of disposable face shields
outside the client's room
disposable face masks are not suitable for airborne precautions
Rationale:
Varicella (chickenpox) is airborne precaution. Private, negative pressure
room, universal precautions (hand sanitizer in room) and placing
surgical mask on client during transport are all correct interventions for
Varicilla.
,⩥ The nurse is caring for a client who reports feeling faint and is
experiencing the cardiac rhythm shown in the electrocardiogram (ECG)
strip below.
- BRADYCARDIA (it is more than 5 spaces apart, sinus rhythm)
Which of the following actions would be appropriate for the nurse to
take? Select all that apply:
1. Administer the client's prescribed beta blocker.
2. Prepare for transcutaneous pacing.
3. Instruct the client to perform the Valsalva maneuver.
4. Begin chest compressions.
5. Assess the client for angina.. Answer: 2. transcutaneous pacing
- external pacing that stimulates the ventricles to pump at a set rate
5. Assess the client for angina
- Angina (Chest pain) can be caused by both tachycardia (most common)
and bradycardia (rare but can happen). Assessment of angina is
appropriate
Rationale:
1. Beta blocker would further decrease HR
3. Valsalva maneuver/Vagal stimulation would further decrease HR. (can
be indicated for sinus Tachy)
4. Chest compressions are for cardiac arrest
,⩥ The nurse is planning care for a client with moderate Alzheimer's
disease (AD).
Which of the following interventions should the nurse include in the
client's plan of care?
1. Encourage the client to reminisce about happy memories.
2. Confront the client when inappropriate or agitated behaviors occur.
3. Administer to the client the cholinesterase inhibitor to reverse the
course of AD.
4. Provide the client with information about activity choices in the
morning so the client can make plans for the day.. Answer: 1. Encourage
the client to reminisce about happy memories.
Its possible for AD patients to retain long-term memories
Rationale:
2. Acknowledge feelings --> Redirect is protocol for Dementia. Don't
confront; they can't learn
3. AD is irreversible
4. In moderate AD, dementia has already progressed to where pt needs
help with ADLs and planning daily activities. Asking them to plan can
frustrate them and cause distress.
STRUCTURED pleasant activities that consider the persons likes and
interests are the best.
⩥ The nurse is teaching a client how to ambulate using crutches. Which
of the following information should the nurse include?
, 1. "Use your hands and arms to support your body weight."
2. "Wear slippers when ambulating with the crutches in your home."
3. "Maintain the crutches 12 in (30 cm) in front of your feet while
standing."
4. "Adjust the hand grips of the crutches so that your elbows are fully
extended.". Answer: 1. "Use your hands and arms to support your body
weight."
True! But watch out if it isn't 2-3 finger-widths, crutch paralysis can
occur. s/s: paresis and paresthesias in wrists and hands
Rationales:
2. Fall risk!
3. Should be 6 in. in front and 6 in. lateral
4. Elbows should be bent at 30 degree angle
⩥ The nurse has taught a client with multiple sclerosis (MS).
Which of the following statements by the client would indicate a correct
understanding of the teaching?
1. "I will complete all of my household chores in the morning when I am
well rested."
2. "I have learned how to massage my bladder to help empty my bladder
completely."
3. "I will take a hot bath in the evening to help me relax if I have had a
stressful day at work."
QUESTIONS AND ANSWERS WITH
EXPLANATIONS GRADED A+
⩥ The nurse is observing a staff member caring for a client who has
chickenpox.
Which of the following actions by the staff member would require the
nurse to intervene?
1. placing the client in a private room with monitored negative air
pressure
2. placing a box of disposable face shields outside the client's room
3. placing an alcohol-based hand rub in the client's room for hand
hygiene
4. placing a surgical mask on the client during transport out of the
client's room. Answer: 2. placing a box of disposable face shields
outside the client's room
disposable face masks are not suitable for airborne precautions
Rationale:
Varicella (chickenpox) is airborne precaution. Private, negative pressure
room, universal precautions (hand sanitizer in room) and placing
surgical mask on client during transport are all correct interventions for
Varicilla.
,⩥ The nurse is caring for a client who reports feeling faint and is
experiencing the cardiac rhythm shown in the electrocardiogram (ECG)
strip below.
- BRADYCARDIA (it is more than 5 spaces apart, sinus rhythm)
Which of the following actions would be appropriate for the nurse to
take? Select all that apply:
1. Administer the client's prescribed beta blocker.
2. Prepare for transcutaneous pacing.
3. Instruct the client to perform the Valsalva maneuver.
4. Begin chest compressions.
5. Assess the client for angina.. Answer: 2. transcutaneous pacing
- external pacing that stimulates the ventricles to pump at a set rate
5. Assess the client for angina
- Angina (Chest pain) can be caused by both tachycardia (most common)
and bradycardia (rare but can happen). Assessment of angina is
appropriate
Rationale:
1. Beta blocker would further decrease HR
3. Valsalva maneuver/Vagal stimulation would further decrease HR. (can
be indicated for sinus Tachy)
4. Chest compressions are for cardiac arrest
,⩥ The nurse is planning care for a client with moderate Alzheimer's
disease (AD).
Which of the following interventions should the nurse include in the
client's plan of care?
1. Encourage the client to reminisce about happy memories.
2. Confront the client when inappropriate or agitated behaviors occur.
3. Administer to the client the cholinesterase inhibitor to reverse the
course of AD.
4. Provide the client with information about activity choices in the
morning so the client can make plans for the day.. Answer: 1. Encourage
the client to reminisce about happy memories.
Its possible for AD patients to retain long-term memories
Rationale:
2. Acknowledge feelings --> Redirect is protocol for Dementia. Don't
confront; they can't learn
3. AD is irreversible
4. In moderate AD, dementia has already progressed to where pt needs
help with ADLs and planning daily activities. Asking them to plan can
frustrate them and cause distress.
STRUCTURED pleasant activities that consider the persons likes and
interests are the best.
⩥ The nurse is teaching a client how to ambulate using crutches. Which
of the following information should the nurse include?
, 1. "Use your hands and arms to support your body weight."
2. "Wear slippers when ambulating with the crutches in your home."
3. "Maintain the crutches 12 in (30 cm) in front of your feet while
standing."
4. "Adjust the hand grips of the crutches so that your elbows are fully
extended.". Answer: 1. "Use your hands and arms to support your body
weight."
True! But watch out if it isn't 2-3 finger-widths, crutch paralysis can
occur. s/s: paresis and paresthesias in wrists and hands
Rationales:
2. Fall risk!
3. Should be 6 in. in front and 6 in. lateral
4. Elbows should be bent at 30 degree angle
⩥ The nurse has taught a client with multiple sclerosis (MS).
Which of the following statements by the client would indicate a correct
understanding of the teaching?
1. "I will complete all of my household chores in the morning when I am
well rested."
2. "I have learned how to massage my bladder to help empty my bladder
completely."
3. "I will take a hot bath in the evening to help me relax if I have had a
stressful day at work."
