lOMoARcPSD|40206794
NCLEX-RN (WITH NGN) 2025-2026
EXIT EXAM QUESTION WITH CORRECT
ANSWERS & EXPERT CERTIFIED RATIONALES
bleeding from a minor cut, or bleeding from a cut that resumes after stopping for a
short time. Hemophiliacs do not bleed faster or more frequently. Instead, they bleed
longer due to a deficiency of clotting factor.
Clients are often aware of bleeding before clinical manifestation. Bleeding can be life-
threatening to these clients.
• Option A: Direct pressure to the nose stops the bleeding. Apply manual or
mechanical pressure if active bleeding is noted. If spontaneous or traumatic
bleeding is evident, monitor vital signs.
• Option B: If a pack is necessary, the nares are loosely packed. Controlling
bleeding is a nursing priority. Nasal packing should be avoided, because the
subsequent removal of the packing may precipitate further bleeding.
• Option D: Ice packs should be applied directly to the nose as well. Assess for
any signs of bruising and bleeding (note the
, 40206794
extent of bleeding). Assess for prolonged bleeding after minor injuries.
NCLEXRN-08-001
Question Tag: unilateral adrenalectomy
Question Category: Physiological Integrity
A client has had a unilateral adrenalectomy to remove a tumor. To prevent
complications, the most important measurement in the immediate postoperative
period for the nurse to take is:
• A. Blood pressure
• B. Temperature
• C. Output
• D. Specific gravity
Correct Answer: A. Blood pressure
Blood pressure is the best indicator of cardiovascular collapse in the client who has
had an adrenal gland removed. The remaining gland might have been suppressed
due to the tumor activity. Primary adrenal insufficiency occurs after bilateral
adrenalectomy. Signs and symptoms are volume depletion, hypotension,
hyponatremia, hyperkalemia, fever, abdominal pain. Patients are managed by
replacement therapy based on glucocorticoids (hydrocortisone or cortisone),
Downloaded by DOCMERIT DOCMERIT ()
, 40206794
mineralocorticoids (fludrocortisone) in cases of confirmed corticoids or aldosterone
deficiency, respectively.
• Option B: Temperature would be an indicator of infection. Patients in the
adrenal crisis typically present with profoundly impaired well-being,
hypotension, nausea and vomiting, and fever responding well to parenteral
hydrocortisone
administration. Infections are the major precipitating causes of adrenal crisis.
• Option C: Decreased output would be a clinical manifestation but would take
longer to occur than blood pressure changes. The clinician must be able to
work-up and manage patients with adrenal masses, both functional and non-
functional, to treat these patients with minimal morbidity. When planning for
adrenalectomy, considerations of hormonal changes and preoperative
preparation for these changes is as important and demands as much of the
surgeon’s attention as the technical aspects of the case.
• Option D: Specific gravity changes occur with other disorders. Adrenalectomy
has been shown to have a relatively low risk of postoperative complications,
with an overall rate of 3.6%.
Improved patient outcomes and decreased hospital costs have
been demonstrated when adrenalectomy is performed by a high-volume
adrenal surgeon (>/=6 adrenalectomies/year).
Downloaded by DOCMERIT DOCMERIT ()
, 40206794
NCLEXRN-08-002
Question Tag: Addison’s disease, glucocorticoids
Question Category: Physiological Integrity
A client with Addison’s disease has been admitted with a history of nausea and
vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol).
Which of the following interventions would the nurse implement?
• A. Daily weights
• B. Intake/output measurements
• C. Sodium and potassium levels monitored
• D. Glucometer readings as ordered
Correct Answer: D. Glucometer readings as ordered
IV glucocorticoids raise the glucose levels and often require coverage with insulin.
Cortisone and prednisone replace cortisol deficits, which
will promote sodium reabsorption. Fludrocortisone is a mineralocorticoid for
patients who require aldosterone replacement to promote sodium and water
replacement. Acute adrenal
insufficiency is a medical emergency requiring immediate fluid and corticosteroid
administration. If treated for adrenal crisis, the patient requires IV hydrocortisone
Downloaded by DOCMERIT DOCMERIT ()
NCLEX-RN (WITH NGN) 2025-2026
EXIT EXAM QUESTION WITH CORRECT
ANSWERS & EXPERT CERTIFIED RATIONALES
bleeding from a minor cut, or bleeding from a cut that resumes after stopping for a
short time. Hemophiliacs do not bleed faster or more frequently. Instead, they bleed
longer due to a deficiency of clotting factor.
Clients are often aware of bleeding before clinical manifestation. Bleeding can be life-
threatening to these clients.
• Option A: Direct pressure to the nose stops the bleeding. Apply manual or
mechanical pressure if active bleeding is noted. If spontaneous or traumatic
bleeding is evident, monitor vital signs.
• Option B: If a pack is necessary, the nares are loosely packed. Controlling
bleeding is a nursing priority. Nasal packing should be avoided, because the
subsequent removal of the packing may precipitate further bleeding.
• Option D: Ice packs should be applied directly to the nose as well. Assess for
any signs of bruising and bleeding (note the
, 40206794
extent of bleeding). Assess for prolonged bleeding after minor injuries.
NCLEXRN-08-001
Question Tag: unilateral adrenalectomy
Question Category: Physiological Integrity
A client has had a unilateral adrenalectomy to remove a tumor. To prevent
complications, the most important measurement in the immediate postoperative
period for the nurse to take is:
• A. Blood pressure
• B. Temperature
• C. Output
• D. Specific gravity
Correct Answer: A. Blood pressure
Blood pressure is the best indicator of cardiovascular collapse in the client who has
had an adrenal gland removed. The remaining gland might have been suppressed
due to the tumor activity. Primary adrenal insufficiency occurs after bilateral
adrenalectomy. Signs and symptoms are volume depletion, hypotension,
hyponatremia, hyperkalemia, fever, abdominal pain. Patients are managed by
replacement therapy based on glucocorticoids (hydrocortisone or cortisone),
Downloaded by DOCMERIT DOCMERIT ()
, 40206794
mineralocorticoids (fludrocortisone) in cases of confirmed corticoids or aldosterone
deficiency, respectively.
• Option B: Temperature would be an indicator of infection. Patients in the
adrenal crisis typically present with profoundly impaired well-being,
hypotension, nausea and vomiting, and fever responding well to parenteral
hydrocortisone
administration. Infections are the major precipitating causes of adrenal crisis.
• Option C: Decreased output would be a clinical manifestation but would take
longer to occur than blood pressure changes. The clinician must be able to
work-up and manage patients with adrenal masses, both functional and non-
functional, to treat these patients with minimal morbidity. When planning for
adrenalectomy, considerations of hormonal changes and preoperative
preparation for these changes is as important and demands as much of the
surgeon’s attention as the technical aspects of the case.
• Option D: Specific gravity changes occur with other disorders. Adrenalectomy
has been shown to have a relatively low risk of postoperative complications,
with an overall rate of 3.6%.
Improved patient outcomes and decreased hospital costs have
been demonstrated when adrenalectomy is performed by a high-volume
adrenal surgeon (>/=6 adrenalectomies/year).
Downloaded by DOCMERIT DOCMERIT ()
, 40206794
NCLEXRN-08-002
Question Tag: Addison’s disease, glucocorticoids
Question Category: Physiological Integrity
A client with Addison’s disease has been admitted with a history of nausea and
vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol).
Which of the following interventions would the nurse implement?
• A. Daily weights
• B. Intake/output measurements
• C. Sodium and potassium levels monitored
• D. Glucometer readings as ordered
Correct Answer: D. Glucometer readings as ordered
IV glucocorticoids raise the glucose levels and often require coverage with insulin.
Cortisone and prednisone replace cortisol deficits, which
will promote sodium reabsorption. Fludrocortisone is a mineralocorticoid for
patients who require aldosterone replacement to promote sodium and water
replacement. Acute adrenal
insufficiency is a medical emergency requiring immediate fluid and corticosteroid
administration. If treated for adrenal crisis, the patient requires IV hydrocortisone
Downloaded by DOCMERIT DOCMERIT ()
