NCLEX-PN Practice Exam #5 -> answers with explanation
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Practice Tests: NCLEX-PN Practice Exam #5 - 50 questions
All 50 questions are randomized each time you take the test, and do not appear in the same order here.
1. The nurse is caring for a dying client who has persistently requested that the nurse "help her to die and be in peace." According to the Code of Ethics for Nurses, the nurse should:
- Ask the client whether she has signed the advance directives document.
- Tell the client that he or she will ask another nurse to care for her.
- Instruct the client that only a physician can legally assist a suicide.
- Try to make the client as comfortable as possible, but refuse to assist in death.
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2. Using cliches in therapeutic communication leads the client toward:
- viewing the nurse as human
- accepting himself as human
- self-disclosing
- feeling discounted
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3. A client is having psychological counseling for problems communicating with his mother. Which model of stress is the most useful in reference to this stressor?
- Adaptation Model
- Stimulus-Based Model
- Transaction-Based Model
- Selye's Model of Stress
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4. An effective intervention for a client diagnosed with Obsessive-Compulsive Disorder is:
- discussing the repetitive action
- insisting the client not perform the repetitive act
- informing the client that the act is not necessary
- encouraging daily exercise
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5. The nurse who was not promoted then went to the utility room and slammed several cupboard doors while looking for Kleenex. This behavior exemplifies:
- displacement
- sublimation
- conversion
- reaction formation
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6. Which of the following describes the stages of domestic violence in an intimate relationship?
- happiness, crisis, angry outburst, intervention
- honeymoon period, escalation of stress, outburst, reconciliation
- acting out and making up
- peace and calm, angry outburst, peace and calm, denial
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7. A client tells the nurse that his wife's nagging really gets on his nerves. He asks the nurse to talk with her about her nagging during their family session tomorrow afternoon. Which of the following responses is the most therapeutic for the client?
- "Tell me more specifically about her complaints."
- "Can you think why she might nag you so much?"
- "I'll help you think about how to bring this up yourself tomorrow afternoon."
- "Why do you want me to initiate this in tomorrow's session rather than you?"
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8. An adolescent female reports being raped at a party where alcohol was served. The client admits to drinking alcohol before being raped by an acquaintance. The nurse should:
- inform the client that because she is underage, she is at fault for attending a party where alcohol was served
- ask the client if anyone witnessed the event because the client was intoxicated and might not remember correctly
- inform the client that it was not her fault, and support the client through the physical examination
- question whether the woman had consensual sex and now just feels guilty
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9. A client who recently lost 50 pounds just received news that she is pregnant. A possible nursing diagnosis is:
- Actual Chronic Low Self-Esteem (related to obesity)
- Potential Chronic Low Self-Esteem (related to obesity)
- Actual Situational Low Self-Esteem (related to fear of weight regain and pregnancy)
- Potential Situational Low Self-Esteem (related to fear of weight regain and pregnancy)
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10. What significant event occurs in the orientation phase of a nurse-client relationship?
- establishment of roles
- identification of transference phenomenon
- placement of the client within the client's family structure
- client agreement that the nurse has the authority in the relationship
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11. A female having her first child is experiencing crisis event.
- situational
- maturational
- adventitious
- reactive
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12. The nurse is caring for a client who is dying. While assessing the client for signs of impending death, the nurse observes the client for:
- elevated blood pressure
- Cheyne-Stokes respiration
- elevated pulse rate
- decreased temperature
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13. In the United States, several definitions of death are currently being used. The definition that uses apnea testing and pupillary responses to light is termed:
- whole brain death
- heart-lung death
- circulatory death
- higher brain death
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14. An 8-year-old Asian child is being examined during a school screening. The nurse notices small bruises on the anterior and posterior ribs. The nurse should ask the child:
- if the family practices coining.
- who hit him.
- if the child has fallen.
- how long the abuse has been occurring.
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15. Two staff nurses were considered for promotion to head nurse. The promotion is announced via a memo on the unit bulletin board. When the nurse who was not promoted first read the memo and learned that the other nurse had received the promotion, she left the room in tears. This behavior is an example of:
- conversion
- regression
- introjection
- rationalization
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16. A client recently lost a child due to poisoning. The client tells the nurse, "I don't want to make any new friends right now." This is an example ofindicator of stress.
- emotional behavioral indicator
- spiritual indicator
- sociocultural indicator
- intellectual indicator
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17. The nurse observes bilateral bruises on the arms of an elderly client in a long-term care facility. Which of the following questions should the nurse ask this client?
- "How did you get those bruises?"
- "Did someone grab you by your arms?"
- "Do you fall often?"
- "What did you bump against?"
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18. A hospitalized client has just been informed that he has terminal cancer. He says to the nurse, "There must be some mistake in the diagnosis." The nurse determines that the client is demonstrating:
- denial
- anger
- bargaining
- acceptance
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19. A client is admitted with a diagnosis of Multiple Drug Use. The nurse should plan care based on knowledge that:
- multiple drug use is very uncommon
- people might use more than one drug to enhance the effect or relieve withdrawal symptoms
- alcohol and barbiturates used together are not dangerous because one is a stimulant and the other is a depressant
- assessment and intervention are easier with multiple drug use because of the synergistic effect
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20. A man reports his wife is constantly cleaning. The activity has interfered with the family life. Friends have stopped visiting because she makes them uncomfortable. He states he has awakened in the middle of the night and found her cleaning. The nurse should consult with the couple and recommend the husband help with therapy by:
- telling his wife to stop cleaning whenever he notices her actions.
- making a baseline record of the time the wife spends cleaning.
- decreasing the stimuli in the home.
- helping his wife with the cleaning.
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21. During the work phase of the nurse-client relationship, the client says to her primary nurse, "You think that I could walk if I wanted to, don't you?" What is the best response by the nurse?
- "Yes, if you really wanted to, you could."
- "Tell me why you're concerned about what I think."
- "Do you think you could walk if you wanted to?"
- "I think you're unable to walk now, whatever the cause."
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22. Which activity is best employed to perform Milieu therapy?
- Investigating the client's view of the world.
- Promoting socialization skills.
- Focusing on inappropriate behavior.
- Providing repetitive ordinary experiences on a daily basis.
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23. Support systems during the grieving process include all of the following except.
- a despondent friend
- a nurse
- a social worker
- a family member
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24. The nurse suspects an elderly client has been the victim of abuse. The client denies abuse and declines assistance. The nurse's next action should be to:
- do nothing; the client has the right to refuse treatment
- report the incident to the police
- arrange an appointment with the client's next of kin
- educate the client about available services
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25. The three major sequential maturational crises for females include.
- puberty, pregnancy and menopause
- death of a spouse, menopause, and childbirth
- rape, divorce, and menarche
- dating, engagement, and separation
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26. Nursing considerations when caring for African-American clients include that:
- families are generally distant and unsupportive
- special hair, skin, and nail care might be required
- fad diets are a cultural norm
- clients are generally future-oriented
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27. A client is assessed by the nurse as experiencing a crisis. The nurse plans to:
- allow the client to work through independent problem-solving.
- complete an in-depth evaluation of stressors and responses to the situation.
- focus on immediate stress reduction.
- recommend ongoing therapy.
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28. A client goes to the mental health center for difficulty concentrating, insomnia, and nightmares. The client reports being raped as a child. The nurse should assess the client for further signs of:
- general anxiety disorder
- schizophrenia
- post-traumatic stress disorder
- bipolar disorder
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29. When caring for a Native-American family, which of the following the nurse needs to consider?
- The family consists solely of the parents and children.
- Native Americans tend to be future oriented.
- Some Native Americans use herbs and psychologic treatment of illnesses.
- Health care is usually prescribed by a medicine man (shaman).
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30. The three universal spiritual needs include all of the following except.
- meaning and purpose
- love and relatedness
- forgiveness
- God's permission
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31. Support-system enhancement includes all of the following except:
- determining the barriers to using support systems
- discussing ways to help with others who are concerned
- exploring life problems of the support-team members
- involving spouse, family, and friends in the care and planning
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32. When questioning an elder about suspected abuse, the nurse should keep the questions.
- nonjudgmental
- probing
- confrontational
- indirect
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33. What is the reason for a contract between nurse and client?
- Contracts state the roles the participants take.
- Contracts are indicative of the feeling tone established between participants.
- Contracts are binding and prevent either party from ending the relationship prematurely.
- Contracts spell out the participation and responsibilities of both parties.
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34. A corporate executive works 60-80 hours a week. The client is experiencing some physical signs of stress. The nurse teaches the client biofeedback techniques. This is an example of health-promotion interventions:
- structure
- relaxation technique
- time management
- regular exercise
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35. Which of the following attitudes is essential in a nurse who assists clients during crises?
- viewing crisis intervention as the first step in solving bigger problems
- wanting to help clients solve all problems identified
- taking an active role in guiding the process
- feeling that work requires identification with all of a client's problems
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36. After group therapy, the female victim of intimate partner violence confides to the nurse that she does not feel in any immediate danger. Which of the following statements about victims of domestic violence is true?
- Victims of domestic violence are often the best predictors of their risk of harm.
- Victims of domestic violence often overestimate their safety risk.
- Victims of domestic violence are typically in a state of denial.
- Victims of domestic violence know that keeping peace with their partner is the best method of preventing another attack.
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37. A couple from the Philippines living in the United States is expecting their first child. In providing culturally competent care, the nurse must first:
- review their own cultural beliefs and biases
- respectfully request that the couple utilize only medically approved health care providers
- realize that the clients have to learn their new country's accepted medical practices
- study family dynamics to understand the male and female gender roles in the clients' culture
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38. The most effective nursing strategy to assist a client in recognizing and using personal strength includes:
- encouraging the client's self-identification of strengths
- promoting the client's active external thinking
- listening to the client and providing advice as needed
- assisting the client in maintaining an external locus of control
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39. A successful resolution of the nursing diagnosis Negative Self-Concept (related to unrealistic self-expectations) is when the client can.
- report a positive self-concept
- identify negative thoughts
- recognize positive thoughts
- give one positive cue with each negative cue
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40. Social support systems include of the following except:
- call-in help lines
- emotional assistance provided by others
- community support groups
- use of coping skills and verbalization for anger management
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41. Which of the following coping mechanisms protects an individual from anxiety?
- denial and fantasy
- rationalization and suppression
- regression and displacement
- reaction formation and projection
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42. A 32-year-old female frequently comes to her primary care provider with vague complaints of headache, abdominal pain, and trouble sleeping. In the past, the physician has dutifully prescribed medication, but little else. Which of the following comments by the nurse to the physician is appropriate?
- "Often women who are victims of domestic violence suffer vague symptoms such as abdominal pain."
- "Often women become offended if asked about their safety in relationships."
- "It is mandatory that all women be questioned about domestic violence."
- "How would you feel to know that her partner is beating her and you didn't ask?"
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43. In performing a psychosocial assessment, the nurse begins by asking questions that encourage the client to describe problematic behaviors and situations. The next step is to elicit the client's:
- feelings about what has been described
- thoughts about what has been described
- possible solutions to the problem
- intent in sharing the description
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44. The nurse is working with families who have been displaced by a fire in an apartment complex. What is the priority intervention during the initial assessment?
- Provide a liaison to meet housing needs.
- Attentively listen when clients describe their feelings.
- Offer nurturing support for clients who are confused by the events.
- Provide structure for clients exhibiting moderate to severe anxiety.
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45. Appropriate nursing strategies to assist a client in maintaining a sense of self include:
- using the client's first name when addressing the client
- treating the client with dignity
- explaining procedures only if the client is attentive
- discouraging the use of personal items
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46. Which of the following statements is correct regarding rape?
- Most rapes are reported.
- Legally, a woman can be raped by her spouse.
- Prosecution and conviction for rape is easy.
- The most common location of rape is the victim's own home.
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47. When discussing the patterns of use of alcohol and other drugs, which piece of information should the nurse include?
- Lifetime prevalence and intensity of alcohol use is greater in women than men.
- Hispanics and African Americans have higher levels of alcohol use than Caucasians.
- Overuse of alcohol and other drugs increases into the mid-20s, then levels off and decreases with age.
- Heavy use is more common in higher socioeconomic groups because they can afford to buy the drugs.
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48. A nurse is teaching a group of clients with a diagnosis of Schizophrenia who are nearing discharge from a residential care facility. An essential topic to include is:
- pathophysiology of the disease and expected symptoms
- how to recognize and manage symptoms of relapse
- the need to take extra medication when feeling stressed
- the importance of contact with follow-up care daily
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49. Incidences of child abuse appear to be higher in the African-American community and might be explained by:
- the increased number of African Americans viewing violence on television.
- more single-parent households in African-American communities.
- stricter child-rearing practices in African-American households.
- a higher occurrence of rage in African Americans.
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50. The nurse can best communicate to a client that he or she has been listening by.
- restating the main feeling or thought the client has expressed
- making a judgment about the client's problem
- offering a leading question such as, "And then what happened?"
- saying, "I understand what you're saying."
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