NCLEX EXAM vc
Exam Solution vc
Final Exam NCLEX Questions 2026 A+ GRADE ASSURED vc vc vc vc vc vc vc vc
COMPLETE SOLUTIONS AND VERIFIED ANSWERS (1D0A vc vc vc vc vc
9)
QUESTION 1 vc
A patient arrives at the emergency department complaining of mid-
vc vc vc vc vc vc vc vc vc
sternal chest pain. Which of the following nursing action should take priority?
vc vc vc vc vc vc vc vc vc vc vc
A. A complete history with emphasis on preceding events.
vc vc vc vc vc vc vc vc
B. An electrocardiogram.
vc vc
C. Careful assessment of vital signs.
vc vc vc vc vc
D. Chest exam with auscultation.
vc vc vc vc
ANSWER
Answer: C The priority nursing action for a patient arriving at the ED in distress is always assessment of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
vital signs. This indicates the extent of physical compromise and provides a baseline by which to plan f
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
urther assessment and treatment. A thorough medical history, including onset of symptoms, will be nece
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ssary and it is likely that an electrocardiogram will be performed as well, but these are not the first prio
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
rity. Similarly, chest exam with auscultation may offer useful information after vital signs are assessed.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 2 vc
A nurse is caring for a patient who has had hip replacement. The nurse should be most c
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
oncerned about which of the following findings? vc vc vc vc vc vc
A. Complaints of pain during repositioning.
vc vc vc vc vc
B. Scant bloody discharge on the surgical dressing.
vc vc vc vc vc vc vc
C. Complaints of pain following physical therapy.
vc vc vc vc vc vc
D. Temperature of 101.8 F (38.7 C).
vc vc vc vc vc vc
ANSWER
Answer: D Post- vc vc
surgical nursing assessment after hip replacement should be principally concerned with the risk of neur
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ovascular complications and the development of infection. A temperature of 101.8 F (38.7
vc vc vc vc vc vc vc vc vc vc vc vc
C) postoperatively is higher than the low grade that is to be expected and should raise concern. Some p
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ain during repositioning and following physical therapy is to be expected and can be managed with anal
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gesics. A small amount of bloody drainage on the surgical dressing is a result of normal healing.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
,QUESTION 3 vc
A nurse cares for a patient who has a nasogastric tube attached to low suction because of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
a suspected bowel obstruction. Which of the following arterial blood gas results might b
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e expected in this patient?
vc vc vc vc
A. pH 7.52, PCO2 54 mm Hg.
vc vc vc vc vc vc
B. pH 7.42, PCO2 40 mm Hg.
vc vc vc vc vc vc
C. pH 7.25, PCO2 25 mm Hg.
vc vc vc vc vc vc
D. pH 7.38, PCO2 36 mm Hg.
vc vc vc vc vc vc
ANSWER
Answer: A A patient on nasogastric suction is at risk of metabolic alkalosis as a result of loss of hydrochl
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
oric acid in gastric fluid. Of the answers given, only answer A (pH 7.52, PCO2 54 mm Hg) represents alk
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
alosis. Answer B is a normal blood gas. Answer C represents respiratory acidosis. Answer D is borderlin
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e normal with slightly low PCO2.
vc vc vc vc vc
QUESTION 4 vc
The healthcare provider is caring for a patient who has septic shock. Which of these sho
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uld the healthcare provider administer to the patient first? a.) Antibiotics to treat the un
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
derlying infection. b.) Corticosteroids to reduce inflammation. c.) IV fluids to increase int
vc vc vc vc vc vc vc vc vc vc vc vc
ravascular volume. d.) Vasopressors to increase blood pressure. vc vc vc vc vc vc vc
ANSWER
c.) IV fluids to increase intravascular volume. Rationale: Circulation and perfusion are addressed first so
vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
IV fluids will be started immediately. After blood cultures are obtained, broad-
c vc vc vc vc vc vc vc vc vc vc vc
spectrum antibiotics should be administered without delay. Vasopressors are administered if the patient
vc vc vc vc vc vc vc vc vc vc vc vc
is not responding to the fluid challenge. Corticosteroids may be considered to address the inflammatory
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
-induced vasodilation and capillary leakage vc vc vc vc
QUESTION 5 vc
Which of the following assessment findings is an early indication of hypovolemic shock?
vc vc vc vc vc vc vc vc vc vc vc vc vc
a.) Diminished bowel sounds b.) Increased urinary output c.) Tachycardia d.) Hypertensi
vc vc vc vc vc vc vc vc vc vc vc
on
ANSWER
c.) Tachycardia Rationale: Tachycardia is an early symptom as the body compensates for a declining blo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
od pressure the heart rate increases to circulate the blood faster to prevent tissue hypoxia.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 6 vc
When compensatory mechanisms for hypovolemic shock are activated, the nurse would
vc vc vc vc vc vc vc vc vc vc vc
expect which two patient findings to normalize? a.) Intensity of peripheral pulses and bo
vc vc vc vc vc vc vc vc vc vc vc vc vc
, dy temperature. b.) Peripheral pulses and heart rate (HR). c.) Metabolic alkalosis and ox
vc vc vc vc vc vc vc vc vc vc vc vc vc
ygen saturation. d.) Cardiac output (CO) and blood pressure (BP).
vc vc vc vc vc vc vc vc vc
ANSWER
d.) Cardiac output (CO) and blood pressure (BP).
vc vc vc vc vc vc vc
QUESTION 7 vc
A client is progressing into the third stage of shock. The nurse will expect this client to d
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
emonstrate: Choose all that apply: a.) Intractable circulatory failure. b.) Neuroendocrine
vc vc vc vc vc vc vc vc vc vc vc
responses. c.) Demonstrating MODS. d.) Buildup of metabolic wastes. e.) Profound hypote
vc vc vc vc vc vc vc vc vc vc vc
nsion. f.) Increase in lactic acidosis.
vc vc vc vc vc
ANSWER
c.) Demonstrating MODS. d.) Buildup of metabolic wastes.
vc vc vc vc vc vc vc
QUESTION 8 vc
A client has been diagnosed with sepsis. The nurse will most likely find which of the follo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
wing when assessing this client: Select all that apply: a.) Rapid shallow respirations. b.) S
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
evere hypotension. c.) Mental status changes. d.) Elevated temperature. e.) Lactic acidosi
vc vc vc vc vc vc vc vc vc vc vc
s. f.) Oliguria.
vc vc
ANSWER
a.) Rapid shallow respirations. d.) Elevated temperature.
vc vc vc vc vc vc
QUESTION 9 vc
Dobutamine (Dobutrex) is used to treat a client experiencing cardiogenic shock. Nursing
vc vc vc vc vc vc vc vc vc vc vc vc
intervention includes: a.) Monitoring for fluid overload. b.) Monitoring for cardiac dysrh
vc vc vc vc vc vc vc vc vc vc vc
ythmias. c.) Monitoring respiratory status. d.) Monitoring for hypotension.
vc vc vc vc vc vc vc vc
ANSWER
b.) Monitoring for cardiac dysrhythmias. Rationale: Dobutamine is beneficial in cases where shock is cau
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
sed by heart failure. The drug increases contractility, and has the potential to cause dysrhythmias.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 10 vc
A patient with massive trauma and possible spinal cord injury is admitted to the ED. The
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
nurse suspects that the patient may be experiencing neurogenic shock in addition to hyp
c vc vc vc vc vc vc vc vc vc vc vc vc vc
ovolemic shock, based on the finding of a.) cool, clammy skin. b.) shortness of breath. c.)
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
heart rate of 48 beats/min d.) BP of 82/40 mm Hg.
vc vc vc vc vc vc vc vc vc vc
ANSWER
Exam Solution vc
Final Exam NCLEX Questions 2026 A+ GRADE ASSURED vc vc vc vc vc vc vc vc
COMPLETE SOLUTIONS AND VERIFIED ANSWERS (1D0A vc vc vc vc vc
9)
QUESTION 1 vc
A patient arrives at the emergency department complaining of mid-
vc vc vc vc vc vc vc vc vc
sternal chest pain. Which of the following nursing action should take priority?
vc vc vc vc vc vc vc vc vc vc vc
A. A complete history with emphasis on preceding events.
vc vc vc vc vc vc vc vc
B. An electrocardiogram.
vc vc
C. Careful assessment of vital signs.
vc vc vc vc vc
D. Chest exam with auscultation.
vc vc vc vc
ANSWER
Answer: C The priority nursing action for a patient arriving at the ED in distress is always assessment of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
vital signs. This indicates the extent of physical compromise and provides a baseline by which to plan f
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
urther assessment and treatment. A thorough medical history, including onset of symptoms, will be nece
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ssary and it is likely that an electrocardiogram will be performed as well, but these are not the first prio
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
rity. Similarly, chest exam with auscultation may offer useful information after vital signs are assessed.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 2 vc
A nurse is caring for a patient who has had hip replacement. The nurse should be most c
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
oncerned about which of the following findings? vc vc vc vc vc vc
A. Complaints of pain during repositioning.
vc vc vc vc vc
B. Scant bloody discharge on the surgical dressing.
vc vc vc vc vc vc vc
C. Complaints of pain following physical therapy.
vc vc vc vc vc vc
D. Temperature of 101.8 F (38.7 C).
vc vc vc vc vc vc
ANSWER
Answer: D Post- vc vc
surgical nursing assessment after hip replacement should be principally concerned with the risk of neur
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ovascular complications and the development of infection. A temperature of 101.8 F (38.7
vc vc vc vc vc vc vc vc vc vc vc vc
C) postoperatively is higher than the low grade that is to be expected and should raise concern. Some p
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ain during repositioning and following physical therapy is to be expected and can be managed with anal
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
gesics. A small amount of bloody drainage on the surgical dressing is a result of normal healing.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
,QUESTION 3 vc
A nurse cares for a patient who has a nasogastric tube attached to low suction because of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
a suspected bowel obstruction. Which of the following arterial blood gas results might b
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e expected in this patient?
vc vc vc vc
A. pH 7.52, PCO2 54 mm Hg.
vc vc vc vc vc vc
B. pH 7.42, PCO2 40 mm Hg.
vc vc vc vc vc vc
C. pH 7.25, PCO2 25 mm Hg.
vc vc vc vc vc vc
D. pH 7.38, PCO2 36 mm Hg.
vc vc vc vc vc vc
ANSWER
Answer: A A patient on nasogastric suction is at risk of metabolic alkalosis as a result of loss of hydrochl
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
oric acid in gastric fluid. Of the answers given, only answer A (pH 7.52, PCO2 54 mm Hg) represents alk
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
alosis. Answer B is a normal blood gas. Answer C represents respiratory acidosis. Answer D is borderlin
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e normal with slightly low PCO2.
vc vc vc vc vc
QUESTION 4 vc
The healthcare provider is caring for a patient who has septic shock. Which of these sho
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uld the healthcare provider administer to the patient first? a.) Antibiotics to treat the un
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
derlying infection. b.) Corticosteroids to reduce inflammation. c.) IV fluids to increase int
vc vc vc vc vc vc vc vc vc vc vc vc
ravascular volume. d.) Vasopressors to increase blood pressure. vc vc vc vc vc vc vc
ANSWER
c.) IV fluids to increase intravascular volume. Rationale: Circulation and perfusion are addressed first so
vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
IV fluids will be started immediately. After blood cultures are obtained, broad-
c vc vc vc vc vc vc vc vc vc vc vc
spectrum antibiotics should be administered without delay. Vasopressors are administered if the patient
vc vc vc vc vc vc vc vc vc vc vc vc
is not responding to the fluid challenge. Corticosteroids may be considered to address the inflammatory
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
-induced vasodilation and capillary leakage vc vc vc vc
QUESTION 5 vc
Which of the following assessment findings is an early indication of hypovolemic shock?
vc vc vc vc vc vc vc vc vc vc vc vc vc
a.) Diminished bowel sounds b.) Increased urinary output c.) Tachycardia d.) Hypertensi
vc vc vc vc vc vc vc vc vc vc vc
on
ANSWER
c.) Tachycardia Rationale: Tachycardia is an early symptom as the body compensates for a declining blo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
od pressure the heart rate increases to circulate the blood faster to prevent tissue hypoxia.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 6 vc
When compensatory mechanisms for hypovolemic shock are activated, the nurse would
vc vc vc vc vc vc vc vc vc vc vc
expect which two patient findings to normalize? a.) Intensity of peripheral pulses and bo
vc vc vc vc vc vc vc vc vc vc vc vc vc
, dy temperature. b.) Peripheral pulses and heart rate (HR). c.) Metabolic alkalosis and ox
vc vc vc vc vc vc vc vc vc vc vc vc vc
ygen saturation. d.) Cardiac output (CO) and blood pressure (BP).
vc vc vc vc vc vc vc vc vc
ANSWER
d.) Cardiac output (CO) and blood pressure (BP).
vc vc vc vc vc vc vc
QUESTION 7 vc
A client is progressing into the third stage of shock. The nurse will expect this client to d
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
emonstrate: Choose all that apply: a.) Intractable circulatory failure. b.) Neuroendocrine
vc vc vc vc vc vc vc vc vc vc vc
responses. c.) Demonstrating MODS. d.) Buildup of metabolic wastes. e.) Profound hypote
vc vc vc vc vc vc vc vc vc vc vc
nsion. f.) Increase in lactic acidosis.
vc vc vc vc vc
ANSWER
c.) Demonstrating MODS. d.) Buildup of metabolic wastes.
vc vc vc vc vc vc vc
QUESTION 8 vc
A client has been diagnosed with sepsis. The nurse will most likely find which of the follo
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
wing when assessing this client: Select all that apply: a.) Rapid shallow respirations. b.) S
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
evere hypotension. c.) Mental status changes. d.) Elevated temperature. e.) Lactic acidosi
vc vc vc vc vc vc vc vc vc vc vc
s. f.) Oliguria.
vc vc
ANSWER
a.) Rapid shallow respirations. d.) Elevated temperature.
vc vc vc vc vc vc
QUESTION 9 vc
Dobutamine (Dobutrex) is used to treat a client experiencing cardiogenic shock. Nursing
vc vc vc vc vc vc vc vc vc vc vc vc
intervention includes: a.) Monitoring for fluid overload. b.) Monitoring for cardiac dysrh
vc vc vc vc vc vc vc vc vc vc vc
ythmias. c.) Monitoring respiratory status. d.) Monitoring for hypotension.
vc vc vc vc vc vc vc vc
ANSWER
b.) Monitoring for cardiac dysrhythmias. Rationale: Dobutamine is beneficial in cases where shock is cau
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
sed by heart failure. The drug increases contractility, and has the potential to cause dysrhythmias.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 10 vc
A patient with massive trauma and possible spinal cord injury is admitted to the ED. The
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc v
nurse suspects that the patient may be experiencing neurogenic shock in addition to hyp
c vc vc vc vc vc vc vc vc vc vc vc vc vc
ovolemic shock, based on the finding of a.) cool, clammy skin. b.) shortness of breath. c.)
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
heart rate of 48 beats/min d.) BP of 82/40 mm Hg.
vc vc vc vc vc vc vc vc vc vc
ANSWER
