NCLEX-PN Practice Exam #11 -> answers with explanation
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Practice Tests: NCLEX-PN Practice Exam #11 - 50 questions
All 50 questions are randomized each time you take the test, and do not appear in the same order here.
1. Which of these patients is affected with a healthcare acquired infection?
- A 18-year-old male patient who developed an intravenous line infection two days after insertion.
- A 72-year-old male patient who is at risk for infection secondary to AIDS/HIV.
- A 67-year-old female patient who was admitted with a urinary tract infection.
- A 5-year-old pediatric patient who develops the measles rash 3 days after admission.
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2. In evaluating the lab work of a client in a hepatic coma, which of the following lab tests is most important?
- blood urea nitrogen
- serum calcium
- serum ammonia
- serum creatinine
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3. To remove hard contact lenses from an unresponsive client, the nurse should:
- gently irrigate the eye with an irrigating solution from the inner canthus outward
- grasp the lens with a gentle pinching motion
- don sterile gloves before attempting the procedure
- ensure that the lens is centered on the cornea before gently manipulating the lids to release the lens
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5. Select the type of skeletal fracture that is correctly paired with its description:
- A complete fracture: The fractured bone penetrates through the skin to the skin surface.
- A pathological fracture: A fracture that results from some physical trauma.
- A greenstick fracture: This bends but does not fracture the bone.
- An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament
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6. You will be reinforcing teaching and instructing the patient. Which basic principle of teaching should you follow?
- Sequence the instruction from the least complex to the most complex.
- Assume that the patient knows little or nothing about the topic.
- Tell the patient to call their significant other so you can instruct them.
- Use medically oriented terms so the patient will be able to speak with the doctor.
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7. Which of the following is an appropriate nursing goal for a client at risk for nutritional problems?
- provide oxygen
- promote healthy nutritional practices
- treat complications of malnutrition
- increase weight
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8. Major competencies for the nurse giving end-of-life care include:
- demonstrating respect and compassion, and applying knowledge and skills in care of the family and the client.
- assessing and intervening to support total management of the family and client.
- setting goals, expectations, and dynamic changes to care for the client.
- keeping all sad news away from the family and client.
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9. Which healthcare associated infection is the greatest risk for patients?
- Pneumonia
- Catheter related infections
- Intravenous line infections
- C difficile
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10. Which of the following is a vector of infection?
- A contaminated ball
- A contaminated thermometer
- An infected person
- An infectious fly
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11. A 4-year-old client is unable to go to sleep at night in the hospital. Which nursing intervention best promotes sleep for the child?
- turning out the room light and closing the door
- tiring the child during the evening with play exercises
- identifying the child's home bedtime rituals and following them
- encouraging visitation by friends during the evening
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12. The nurse is transferring a client from a wheelchair to the bed. Which is the correct procedure?
- Pull the client toward you, and pivot him on the unaffected limb.
- Pull the client toward you, and pivot him on the affected limb.
- Push the client toward the bed, and pivot him on the affected limb.
- Stand the client on both legs, and push him toward the bed.
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13. Which of the following foods should be avoided by clients who are prone to develop heartburn as a result of gastroesophgeal reflux disease (GERD)?
- lettuce
- eggs
- chocolate
- butterscotch
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14. To ensure proper immobilization and increase client comfort when using a rigid splint:
- place the client on a stretcher before splinting
- place the client on a long spine board before splinting
- pad the spaces between the body part and the splint
- ensure that the splint conforms to the body curves
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15. A client turns her ankle. She is diagnosed as having a pulled ligament. This should be documented as a:
- sprain
- strain
- subluxation
- distoration
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16. Which is considered an internal disaster?
- A patient fall.
- The massive spread of pneumonia.
- A computer hacking episode.
- Unexpected staff absences due to illness.
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17. The goals of palliative care include all of the following except:
- giving clients with life-threatening illnesses the best quality of life possible
- taking care of the whole person - body, mind, spirit, heart, and soul
- no interventions are needed because the client is near death
- support of needs of the family and client
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18. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Facebook. This nurse was fired because the nurse has.
- violated the law
- acted in a negligent manner
- not completed the proper documentation
- violated an ethical principle
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19. A client with an ileus is placed on intestinal tube suction. Which of the following electrolytes is lost with intestinal suction?
- calcium
- magnesium
- potassium
- sodium chloride
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20. A client is complaining of difficulty walking secondary to a mass in the foot. The nurse should document this finding as.
- plantar fasciitis
- hallux valgus
- hammertoe
- Morton's neuroma
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21. A client with major head trauma is receiving bolus enteral feeding. The most important nursing order for this client is:
- measure intake and output
- check albumin level
- monitor glucose levels
- increase enteral feeding
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22. Pulling is easier than pushing. So pulling a client rather than pushing him or her has which of the following advantages?
- reduces workload
- decreases opposition from gravity
- maintains stability
- prevents muscle strain
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23. Your 32-year-old female patient has erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, fever, cardiac problems and skin nodules. What disorder would you most likely suspect based on these signs and symptoms?
- Leukemia
- Histoplasmosis
- Pneumocystis jirovec
- Rheumatoid arthritis
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24. Select the method of special precautions that is accurately paired with the personal protective equipment that is minimally required in order to prevent the spread of infection.
- Contact precautions: Gowns, gloves and mask.
- Droplet precautions: Face mask.
- Airborne transmission precautions: Negative pressure room.
- Contact precautions: Gloves.
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25. Who should document care?
- The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff.
- The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care.
- All staff members should document all of the care that they have provided.
- All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it.
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26. Which skin disorder most closely resembles and mimics dandruff?
- Lice infestation
- Scabies
- Dematitis
- Acne vulgaris
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27. What is the single most important thing that nurses do in order to prevent the spread of infection?
- Applying standard precautions.
- Using personal protective equipment.
- Adhering to the principles of asepsis.
- Handwashing.
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28. A client who is immobilized secondary to traction is complaining of constipation. Which of the following medications should the nurse expect to be ordered?
- Advil
- Anasaid
- Clinocil
- Colace
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29. Hazards of improper splinting include:
- aggravation of a bone or joint injury
- reduced distal circulation
- delay in transport of a client with a lifethreatening injury
- all of the above
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30. Ms. Petty is having difficulty falling asleep. Which of the following measures promote sleep?
- exercising vigorously for 20 minutes each night beginning at 9:30 p.m.
- taking a cool shower and drinking a hot cup of tea
- watching TV nightly until midnight
- getting a back rub and drinking a glass of warm milk
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31. Which legal document will most likely contain the patient's decision to not get cardiopulmonary resuscitation?
- Healthcare surrogacy
- Healthcare proxy
- Advance directives
- Durable power of attorney
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32. To remove a client's gown when she has an intravenous line, the nurse should:
- temporarily disconnect the intravenous tubing at a point close to the client and thread it through the gown
- cut the gown with scissors
- thread the bag and tubing through the gown sleeve, keeping the line intact
- temporarily disconnect the tubing from the intravenous container and thread it through the gown
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33. Assessment of a client with a cast should include.
- capillary refill, warm toes, no discomfort
- posterior tibial pulses, warm toes
- moist skin essential, pain threshold
- discomfort of the metacarpals
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34. Clumsiness, difficulty running, climbing, and riding a bicycle are some of the earliest signs and symptoms of.
- duchennes's muscular dystrophy
- osteomyelitis
- talipes or clubfoot
- septic joint, suppurative arthritis
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35. You are preparing a sterile field for an operating room surgical procedure. When should you stop the preparation of this sterile field?
- When you have placed a sterile item only 1 inch and not 2 inches from the edge of the sterile field.
- When you have completely finished the field. You cannot stop the set up until it is all done.
- When you have accidentally poured a sterile liquid into a container that was on the sterile field.
- When you turn your upper body only away from the field because the surgeon calls your name.
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36. Nurses caring for clients who have cancer and are taking opioids need to assess for all of the following except.
- tolerance
- constipation
- sedation
- addiction
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37. The method of splinting is always dictated by:
- location of the injury and whether it is open or closed
- the severity of the client's condition and the priority decision
- the number of available rescuers and the type of splints
- all of the above
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38. A client is having problems with her ankles. To assess her ankles' ROM, which ROM exercises should the nurse have her perform?
- flexion, extension, hyperextension
- flexion, extension, abduction, adduction
- external rotation, internal rotation
- extension, flexion, inversion, eversion
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39. A client with dumping syndrome should while a client with GERD should:
- sit up 1 hour after meals; lie flat 30 minutes after meals
- lie down 1 hour after eating; sit up at least 30 minutes after eating
- sit up after meals; sit up after meals
- lie down after meals; lie down after meals
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40. Wilms' tumor is a form of:
- renal cancer
- liver cancer
- basal cell carcinoma
- brain cancer
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41. When making an occupied bed, it is important for the nurse to:
- keep the bed in the low position
- use a bath blanket or top sheet for warmth and privacy
- constantly keep side rails raised on both sides
- move back and forth from one side to the other when adjusting the linens
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42. What is a major difference between a problem oriented medical record and a source oriented medical record?
- The problem oriented medical system has a centralized part of the chart for interdisciplinary progress notes and the source oriented medical record has separate areas for each profession's progress notes.
- The problem oriented medical system consists of narrative progress notes and the source oriented medical record uses SOAP.
- The source oriented medical system uses charting by exception and the source oriented medical record system does not.
- D. The source oriented medical system has a centralized part of the chart for interdisciplinary progress notes and the problem oriented medical record has separate areas for each profession's progress notes.
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43. Assessment of the client with an arteriovenous fistula for hemodialysis should include:
- inspection for visible pulsation
- palpation of thrill
- percussion for dullness
- auscultation of blood pressure
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44. In teaching clients with Buck's Traction, the major areas of importance should be:
- nutrition, ROM exercises
- ROM exercises, transportation
- nutrition, elimination, comfort, safety
- elimination, safety, isotonic exercises
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45. A client has a nasogastric (NG) tube in place following abdominal surgery. The purpose of this tube immediately following surgery is to:
- simplify medication administration
- measure accurate input and output
- prevent accumulation of fluids and gas
- facilitate collection of specimens
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46. Which patient is exercising their right to autonomy in the context of patient rights?
- An unemancipated 16-year-old who chooses to not have an intravenous line.
- An 86-year-old female who remains independent in terms of the activities of daily living.
- A 32-year-old who does not need the help of the nurse to bathe and groom themselves.
- A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful.
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47. Your client is adversely affected with fever, night sweats, occult hematuria, tenderness of the spleen and Osier's nodes. What disorder would you most likely suspect?
- Tuberculosis
- AIDS/HIV
- Pericarditis
- Endocarditis
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48. Idiopathic thrombocytopenia purpura is:
- highly similar to disseminated intravascular coagulation (DIC)
- caused by the over production of platelets
- a bleeding disorder that is characterized with too few platelets
- treated with immune system boosting medications
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49. The 24-hour day-night cycle is known as:
- circadian rhythm
- infradium rhythm
- ultradian rhythm
- non-REM rhythm
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50. Following a classic cholecystectomy resection for multiple stones, the PACU nurse observes a serosanguious drainage on the dressing. The most appropriate intervention is to:
- notify the physician of the drainage
- change the dressing
- reinforce the dressing
- apply an abdominal binder
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