NCLEX-PN Practice Exam #8 -> answers with explanation
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Practice Tests: NCLEX-PN Practice Exam #8 - 50 questions
All 50 questions are randomized each time you take the test, and do not appear in the same order here.
1. A nurse is giving shift report off to the oncoming LPN. Which of these is an inappropriate shift report?
- The nurse gives report to the oncoming LPN, checking a wound vac and dressing together.
- The nurse reports in SBAR format, noting that the patient was noncompliant with their diet during the shift.
- The nurse reports in the hallway, SBAR format, and alerts the oncoming LPN about how rude the patient was throughout the shift.
- The nurse reports at bedside with the oncoming LPN and discusses the patient's concerns after the chart has been reviewed.
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2. The nurse notices that a family is waiting at the nursing station desk for its loved one to be brought to the unit for admission during a change-of-shift report. The nurse should:
- request that the family wait for its loved one in the client's room and wait to resume the report until the family has left the desk area
- request that a nursing assistant bring coffee for the family while it waits at the desk and continue with the report
- request that the family have a seat in the station rather than stand while awaiting its loved one
- request that the family wait for its loved one in the Emergency Department waiting room
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3. The LPN on shift notices a patient come in to the clinic with bruises on his arm. The patient seems very afraid and doesn't speak much which concerns the nurse because these are signs of physical abuse. The nurse should:
- report the suspected abuse to one of the other nurses and work together on how to handle it
- ignore the bruises, as this is not why the patient is being treated and is not appropriate for the nurse to address
- report the findings to the appropriate authorities based on the state requirements and protocols
- use therapeutic communication to talk to the patient and attempt to get evidence of suspected abuse
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4. An LPN is talking with a patient scheduled to undergo a vasectomy in the next few minutes. He states, "I know I signed the form and all, but I'm not feeling so sure of this. It can be reversed pretty easily, right?" What is the LPN's best response?
- "Yes, vasectomies can be reversed, but I'm sure once you have it you won't regret it."
- "It sounds like you might be a little nervous. Don't worry, this is a pretty minor procedure, and the doctor doing it is the best we have. You're in great hands."
- "It's normal to feel a little nervous before a procedure like this one."
- "It sounds like you have a few more questions you'd like answered. Let me grab the doctor quickly so he can answer them for you."
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5. The ICU nurse caring for a client who has just been declared brain dead can expect to find evidence of the client's wishes regarding organ donation:
- on the driver's license of the client
- in the client's safety deposit box
- in the client's last will and testament
- on the client's insurance card
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6. To manage time most effectively, the nurse responds to which of the following stimuli first.
- the physician's loud verbal direction
- the nursing supervisor who is going to a meeting
- unit staff leaving on a break
- the care needs of the returning postoperative client just exiting the elevator
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7. An LPN is working on the care plan for a patient with diabetes mellitus. Which of these outcomes would be the most appropriate?
- The patient will maintain a blood glucose level within normallimits throughout my shift.
- The patient will maintain a blood glucose level within the normal range of 70-110 (per facility policy).
- The patient will maintain a blood glucose level within normalrange limits today.
- The patient will maintain a blood glucose level within the normal range of 70-110 (per facility policy) throughout my shift.
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8. A nurse working with a cardiac patient notes the use of an ethical principle during her care of the patient. Which of these is the best example of an ethical principle in nursing?
- Beneficence, as the nurse promoted the patient to be respected and involved in his or her care.
- Veracity, as the nurse followed through with any promises made to the patient during his or her care.
- Nonmaleficence, as the nurse did not cause harm to the patient.
- Fidelity, as the nurse maintained honesty with the patient during any education and care.
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9. Which isolation procedure will be followed for secretions and blood?
- Respiratory
- Standard Precautions
- Contact Isolation
- Droplet
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10. Someone who has received a recent tattoo should be screened for:
- tuberculosis
- herpes
- hepatitis
- syphilis
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11. A patient being treated for sickle cell disease has an order for pain medication. Morphine was ordered, but the nurse is having difficulty deciphering the dose. The nurse should:
- call the charge nurse to reach out to the ordering physician to verify the order including the correct medication, dose, route, and frequency
- call the physician to verbally verify the order including correct medication, dose, route, and frequency
- just go with his or her gut on what the typical dose is for this medication and administer to the patient so they do not have to wait on the physician
- ask the attending physician to come back to the unit and to help read what the order states regarding the correct medication, dose, route, and frequency
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12. People-related supervisory tasks include all of the following except:
- coaching
- encouraging
- target setting
- rewarding
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13. Issues addressed in ethics committees include all of the following except:
- nonpayment of bills
- euthanasia
- starting or stopping treatment
- use of feeding tubes
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14. The LPN on a Continuous Quality Improvement (CQI) team needs to work on ways to reduce medication errors. Which of these is the best approach for the nurse?
- Have an inservice to supervise staff members during medication administration to determine if further education needs to be given.
- Ensure the staff has been educated on the five rights of medication administration.
- Ensure that all staff members are educated on howto appropriately fill out an incident report if they make a medication error.
- Track the incident reports for repeating offenders and report findings to next chain in command.
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15. In a disaster situation, the nurse assessing a diabetic client on insulin assesses for all of the following except
- diabetic signs and symptoms
- nutritional status
- bleeding problems
- availability of insulin
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16. A client is diagnosed with HIV. Which of the following are antiviral drug classes used in the treatment of HIV/AIDS?
- nucleoside reverse transcriptase inhibitors
- protease inhibitors
- HIV fusion inhibitors
- all of the above.
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17. A child comes to the clinic with a skin rash. The maculopapular lesions are distributed around the mouth and have honey-colored drainage. The caregiver states that the rash is getting worse and seems to spread with the child's scratching. Which of the following advisory comments should be given?
- The history and presentation might indicate chickenpox, a highly contagious disease.
- The lesions might indicate a noncontagious infection that does not require isolation.
- The history and presentation might indicate an infectious illness called impetigo.
- The lesions are not contagious unless others have open wounds or lesions themselves.
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18. The client's lab culture report is negative for a suspected infection. A test that can correctly identify those who do not have a given disease is:
- specific
- sensitive
- negative culture
- marginal finding
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19. Several passengers aboard an airliner suddenly become weak and suffer breathing difficulty. The diagnosis is likely to be.
- outbreak of Asian flu
- Chemical exposure
- bacterial pneumonia
- allergic reaction
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20. The acts enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called:
- Good Samaritan laws
- HIPAA
- Patient Self-Determination Act (PSDA)
- OBRA
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21. An LPN works on an adult medical/surgical unit and has been pulled to work on the burn unit, which cares for patients of all ages. What should he do?
- He should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting.
- He should refuse to take the assignment, as caring for infant and child population is not within his scope of practice.
- He should take the assignment, but ask to be paired with a more experienced LPN.
- He should take the assignment, but make it clear he will only care for adult patients.
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22. A legal right to confidentiality of client information is waived when:
- a court system subpoenas information
- a family member requests health care information of a client
- a living will takes effect
- the client is declared incompetent by the legal system
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23. An LPN is having conflict with another nurse during her shift. She has tried to discuss the issues with the nurse with no resolution. What is the most appropriate way for the nurse to proceed?
- Report the conflict to the nurse manager of the unit.
- Report the conflict to the assigned charge nurse of the unit.
- Discuss the conflict with the other nurse to attempt resolution of issue.
- Report the conflict to the director of nursing over the unit.
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24. An example of a process standard on a med-surg unit is:
- a procedure for changing IV tubing.
- a policy for staffing.
- the job description of the CEO (chief executive officer).
- a procedure for checking waveforms on a client being treated on an intra-aortic balloon pump.
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26. Which of these patients should the LPN/LVN see first?
- a patient with a newly placed NG who is complaining of pain around the face and a plugged nose
- a patient in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm
- a patient newly diagnosed with Hepatitis A who reports stomach pain and itchy skin
- a post-op prostatectomy patient who complains of bladder spasms and blood in his foley bag
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27. The LPN needs to delegate a task to the nurse aide who is new to the unit. Which of these is the best option for the nurse to choose in proceeding?
- Delegate the task to the nurse aide, watch them perform the task without them seeing you, and follow up to ensure the task was done safely/ accurately.
- Delegate the task to the nurse aide, ensure understanding of the task, and supervise task being performed.
- Delegate the task to the nurse aide, confirm understanding, and follow up to ensure the task was safely/correctlydone.
- Delegate the task to the nurse aide, supervise if needed and check in after the task to see if help is needed.
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28. Which of these tasks would be inappropriate for an LPN to take?
- teaching a 24-year-old first-time mother how to properly care for her new baby
- adjustment of a 68-year-old patient's cervical traction as ordered by the attending doctor
- obtaining an occult blood sample from a 16-year-old patient with ulcerative colitis
- an assessment of a 36-year-old man newly admitted for chest pain
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29. Which of these would be an appropriate assignment for the LPN/LVN?
- a 20-year-old patient with Cystic Fibrosis who needs an early morning sputum sample collection
- an 84-year-old patient 2 days post-op after knee replacement surgery who needs help ambulating
- an 18-year-old femur fracture patient who is just returning to the floor from the recovery unit
- a 35-year-old patient who is suffering from an acute asthma attack
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30. An 85-year-old client is eligible for Medicare reimbursable home care services. Referral is contingent on meeting which of the following criteria?
- homebound status, requiring skilled therapy care
- immediate previous hospitalization for acute care
- age
- requirement of nursing and social work support
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31. Which of these is true regarding advance directives?
- An advanced directive is legally valid in every state, no matter which state it was created in.
- A physician must determine when a patient is unable to make medical decisions for himself.
- They must be reviewed and re-signed every 10 years in order to remain valid.
- They cannot be honored by EMTs (emergency medical technicians) unless signed by a doctor.
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32. Which of these scenarios would not be considered a violation of HIPAA laws?
- looking up only the address (not the medical portion) in the chart of a co-worker who just delivered a baby so you can surprise her with a gift
- discussing discharge plans with a patient in a multi-bed recovery room with the curtain drawn around the patient's bed
- looking up the medical information of a friend not in your care but who gave you permission
- checking on your spouse's medical record because you are listed as her power of attorney
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33. A client has experienced a CVA with right hemiparesis and is ready for discharge from the hospital to a long-term care facility for rehab. To provide optimal continuity of care, the nurse should do all of the following except:
- document current functional status
- have the physician phone a report to the receiving facility
- copy appropriate parts of the medical record for transport to the receiving facility
- phone a report to the facility
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34. Which direction given to the nursing assistant is most likely to accomplish the task of getting a urine specimen delivered to the lab immediately after collection?
- "Make it a stat delivery."
- "Please do it as soon as you can after break."
- "This client is delirious, and we're worried about a urinary sepsis."
- "Take this client to the bathroom now and collect a urine specimen from this voiding. Take the specimen to the lab immediately."
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35. In an emergency situation, the nurse determines whether a client has an airway obstruction. Which of the following does the nurse assess?
- ability to speak
- ability to hear
- oxygen saturation
- adventitious breath sounds
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36. The nurse should teach parents of small children that the most common type of first-degree burn is:
- scalding from hot bath water or spills
- contact with hot surfaces such as stoves and fireplaces
- contact with flammable liquids or gases resulting in flash burns
- sunburn from lack of protection and overexposure
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37. The nurse is teaching a client about erythema infectiosum. Which of the following factors are not correct?
- There is no rash.
- The disorder is uncommon in adults.
- There is no fever.
- There is sometimes a "slapped face" appearance.
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38. The role of the incident report in risk management is:
- liability protection
- to provide data for analysis by a risk manager to determine how future problems can be avoided
- to discipline staff for errors
- all of the above
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39. The nurse is teaching a teenage female about preventing the transmission of genital herpes. Which of the following statements should the nurse include?
- "Do not sit on toilet seats without protection."
- "Oral sex does not transmit the virus."
- "This infection can be transmitted via intercourse even when you do not feel ill."
- "Try to drink lots of fluids after sex to flush the reproductive tract."
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40. The vast majority of deaths resulting from unintentional poisoning occur in:
- infants
- toddlers
- teens
- adults
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41. A patient is refusing to stay in the hospital because he does not agree with his healthcare treatment plan. The nurse stops the patient from leaving due to concern for his health. Which of these legal charges could the nurse face?
- Invasion of privacy, as the nurse is getting involved in the patient's private decisions regarding healthcare.
- False imprisonment, as the nurse is not allowing the patient to leave as he has decided to.
- Malpractice, as the nurse is intentionally keeping the patient from making his own decisions, thus violating that nursing duty.
- Negligence, as the nurse ignored the patient's right to choose with regard to his healthcare.
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42. A client is told that his test is positive, but in fact, the client does not have the disease tested for. Which type of false report is this an example of?
- positive
- false positive
- negative
- false negative
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43. The nurse is teaching a client about the use of Rifampin for prophylaxis after an exposure to meningitis. What change in bodily functions should the nurse advise the client about?
- The client's urine might turn blue.
- The client remains infectious to others for 48 hours.
- The client's contact lenses might be stained orange.
- The client's skin might take on a crimson glow.
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44. The LPN notices a patient with poor gait and balance. She is currently being treated for hypertension, but the nurse is concerned. What should the nurse do?
- Speak with the attending physician about his concerns and request a referral for the patient to go to the hospital gym.
- Speak with the attending physician about his concerns and request a referral to physical therapy.
- Do nothing as this has nothing to do with why the patient was hospitalized.
- Add this issue to the nursing care plan and have daily gait/balance training as an intervention.
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45. Which of these would be the most appropriate way to document a patient's refusal of medication?
- "Subcutaneous Heparin injection was attempted to be given to the patient per the physician's order. Patient refused, stating, 'I do not want that injection.' Potential risks for refusing the medication were reviewed with the patient and patient verbalized understanding."
- "Pt stated she did not want the SQ heparin inj at this time. Risks of not taking this med were reviewed with the pt and pt verbalized understanding."
- "The patient refused the heparin injection when I tried to administer it. She yelled at me saying, 'I do not want that injection right now!' and told me to leave the room. I explained the risks of not taking the medication. She seemed very annoyed that I tried to give it at that time. I will attempt again later in my shift."
- "Heparin refused during shift. Risks reviewed."
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46. A nurse witnesses a patient sign the consent form for surgery with the surgeon. As the surgeon leaves, the patient starts to speak and then stops. The nurse asks if the patient has further questions and he says, "I don't want to bother the surgeon." The nurse should:
- acknowledge the patient's wish not to bother the surgeon and answer all of their questions, as appropriate
- acknowledge the patient's wish not to bother the surgeon and tell the patient to let you know if they change their mind
- go get the surgeon to answer all of the patient's questions
- answer any questions as appropriate as well as have the surgeon come back to answer any questions if needed
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47. Priorities to be considered intermediate are:
- the nonemergency, non-life-threatening needs of the client.
- those tasks that can be delegated to assistive personnel.
- those tasks that can be performed at the end of the shift.
- those task that can be performed at any time.
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48. The only time that an individual may receive medical care without giving informed consent is:
- when the durable power of attorney for health care is not available
- in an emergency, life-or-death situation
- when the physician is not available for discussion with the client
- when they (clients) are not able to speak for themselves
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49. A gastroenterologist should be consulted for clients suffering from:
- digestive system diseases
- urinary system diseases
- female reproductive system diseases
- nervous system diseases
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50. A case management clinical pathway for congestive heart failure might include all of the following except:
- physician follow-up appointments with transportation
- client education regarding medication use
- a nutritional consult for diet review and accommodation
- insurance review for reimbursement
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