Practice Tests: NCLEX-PN Practice Exam #17 - 50 questions

All 50 questions are randomized each time you take the test, and do not appear in the same order here.

1. The PN enters the patient's room and finds the patient unresponsive and not breathing. The PN determines that the scene is safe. What step should the PN take next?

• Apply AED pads.
• Administer oxygen via an ambu-bag.
• Begin chest compressions.
• Activate the emergency response system.

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2. Which of the following blood pressure parameters indicates PIH? Elevation over a baseline of:

• 30 mmHg systolic and/or 15 mmHg diastolic
• 40 mmHg systolic and/or 20 mmHg diastolic
• 10 mmHg systolic and/or 5 mmHg diastolic
• 20 mmHg systolic and/or 20 mmHg diastolic

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3. The nurse should teach a client in the Emergency Department, who has suffered an ankle sprain, to:

• use cold applications to the sprain during the first 24-48 hours
• expect disability to decrease within the first 24 hours of injury
• expect pain to decrease within 3 hours after injury
• begin progressive passive and active range of motion exercises immediately

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4. Susie, a 35-year old gravida III para II at 23 weeks gestation, is seen in the Emergency Department with painless, bright red vaginal bleeding. Susie reports that she has been feeling tired and has noticed ankle swelling in the evening. Laboratory tests reveal a hemoglobin level of 11.5 g/dL. After evaluating the situation, the nurse determines that Susie is at risk for placenta previa, based on which of the following data?

• anemia
• edema
• painless vaginal bleeding
• fatigue

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5. Which of the following viruses is most likely to be acquired through casual contact with an infected individual?

• influenza virus
• herpes virus
• cytomegalovirus (CMV)
• human immunodeficiency virus (HIV)

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6. In alcoholics with anemia:

• pernicious anemia is more common than folic acid deficiency
• iron deficiency and folic acid deficiency can coexist
• the alcohol interferes with iron absorption
• oral vitamin replacement is contraindicated

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7. During surgery, it is found that a client with adenocarcinoma of the rectum has positive peritoneal lymph nodes. What is the next most likely site of metastasis?

• brain
• bone
• liver
• mediastinum

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8. Herbal therapy has several indications for use. Primarily, herbal therapy is:

• used to treat many common complaints and diseases.
• used to promote certain types of low-carb diets.
• used as an adjunct to medications.
• used to create a diet without salt and carbohydrates.

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9. What is pica?

• dependency on alcohol
• increased iron in the diet
• the sickle cell trait
• eating ice

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10. When discussing possible complications of pregnancy with a client, the nurse should explain that all of the following are symptoms of urinary tract infection (UTI). Which of the following is least indicative of UTI during pregnancy?

• low-back pain
• urinary frequency
• Gl distress
• malaise

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11. A nurse is caring for a client with an elevated cortisol level. The nurse can expect the client to exhibit symptoms of:

• urinary excess
• hyperpituitarism
• urinary deficit
• hyperthyroidism

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12. Neural tube defects in the fetus have been primarily associated with which deficiency in the mother?

• iron
• folic acid
• vitamin B12
• vitamin E

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13. Elderly persons with pernicious anemia should be instructed:

• to increase their dietary intake of foods high in B12
• that they do not need to return for follow-up for at least a month after initiation of treatment
• that oral B12 is safer and less expensive than parenteral replacement
• that diarrhea can be a transient side effect of B12 injections

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14. When caring for a client with a possible diagnosis of placenta previa, which of the following admission procedures should the nurse omit?

• perineal shave
• enema
• urine specimen collection
• blood specimen collection

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15. A nurse is caring for a client with an elevated urine osmolarity. The nurse should assess the client for:

• fluid volume excess.
• hyperkalemia.
• hypercalcemia.
• fluid volume deficit.

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16. The chemotherapeutic agent 5-fluorourcacil (5-FU) is ordered for a client as an adjunct measure to surgery. Which statement about chemotherapy is true?

• It is a local treatment affecting only tumor cells.
• It is a systemic treatment affecting both tumor and normal cells.
• It has not yet been proved an effective treatment for cancer.
• It is often the drug of choice because it causes few, if any, side effects.

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17. The best lab test to diagnose disseminated intravascular coagulation (DIC) is.

• platelet count
• protime (PT)
• partial thromboplastin time (PTT)
• D-dimer

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18. A client receiving drug therapy with furosemide and digitalis requires careful observation and care. In planning care for this client, the nurse should recognize thatelectrolyte imbalances is most likely to occur:

• hyperkalemia
• hypernatremia
• hypokalemia
• hypomagnesemia

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19. Which is the most common microorganism associated with gastritis?

• syphilis
• cytomegalovirus
• H. pylori
• mycobacterium

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20. In teaching bleeding precautions to a client with leukemia, the PN should include which of the following instructions?

• Use a soft toothbrush.
• Use dental floss daily.
• Hold pressure on any scrapes for 1-2 minutes.
• Use a triple-edged razor.

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21. When teaching a client about anti-retroviral therapy for human immunodeficiency virus (HIV), the PN should emphasize.

• when started, therapy must not be interrupted to prevent viral resistance
• when started, therapy must not be interrupted to prevent opportunistic infection
• therapy should be interrupted for one day each month to prevent toxicity
• therapy should be interrupted for one week every three months to prevent toxicity

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22. Which statement best describes electrolytes in intracellular and extracellular fluid?

• There is a greater concentration of sodium in extracellular fluid and potassium in intracellular fluid.
• There is an equal concentration of sodium and potassium in extracellular fluid.
• There is a greater concentration of potassium in extracellular fluid and sodium in intracellular fluid.
• There is an equal concentration of sodium and potassium between intracellular and extracellular fluid.

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23. Which of the following needs immediate medical attention and emergency intervention? The client who:

• complains of sharp pain upon taking a deep breath and excessive coughing
• exhibits yellow, productive sputum, lowgrade fever, and crackles
• has a shift of the trachea to the left, with no breath sounds on the right
• has asthma and complains of an inability to catch her breath after exercise

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24. A client with sickle cell disease is worried about passing the disease on to children. Which of the following statements by the PN is most appropriate for this client?

• "You should discuss this with your physician."
• "Sickle cell disease is genetically based and might be passed on to children."
• "Sickle cell disease is genetically based and is not passed on to children."
• "Sickle cell disease is caused by an infection and cannot be passed on to children."

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25. Which of the following procedures describes an opening between the colon and abdominal wall?

• ileostomy
• jejunostomy
• colostomy
• cecostomy

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26. When assessing a client with early impairment of oxygen perfusion, such as pulmonary embolus, the nurse should expect to find restlessness and symptoms:

• warm, dry skin
• bradychardia
• tachycardia
• eupnea

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27. Rachel is a 32-year-old woman seeking evaluation and treatment of major depressive symptoms. A major nursing priority during the assessment process includes which of the following?

• meaning of current stressors
• possibility of self-harm
• motivation to participate in treatment
• presence of alcohol or other drug use

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28. Which physiologic mechanism best describes the function of the sodium-potassium pump?

• active transport
• diffusion
• filtration
• osmosis

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29. A physician orders a serum creatinine for a hospitalized client. The nurse should explain to the client and his family that this test:

• is normal if the level is 4.0 to 5.5 mg/dl
• can be elevated with increased protein intake
• is a better indicator of renal function than the BUN
• reflects the fluid volume status of a person

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30. A female prostitute enters a clinic for treatment of a sexually transmitted disease. This disease is the most prevalent STD in the United States. The nurse can anticipate that the woman has:

• herpes
• chlamydia
• gonorrhea
• syphilis

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31. A client with jaundice has which skin color?

• pale
• ruddy
• yellow
• pink

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32. One of the major functions of the kidneys in maintaining normal fluid balance is:

• the manufacture of antidiuretic hormone
• the regulation of calcium and phosphate balance
• the regulation of the pH of the extracellular fluid
• the control of aldosterone levels

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33. The anemias most often associated with pregnancy are:

• folic acid and iron deficiency
• folic acid deficiency and thalassemia
• iron deficiency and thalassemia
• thalassemia and B12 deficiency

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34. The nurse should make _____ responses when questioned by a client about the role of leptin in the body.

• It increases food intake in clients, thereby promoting obesity.
• It assists in the regulation of steroids.
• It increases the total fat mass of people who are obese.
• It might decrease the total fat mass in the bodies of people who are obese.

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35. Which of the following should be included in a diet rich in iron?

• peaches, eggs, beef
• cereals, kale, cheese
• red beans, enriched breads, squash
• legumes, green beans, eggs

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36. A woman is in the active phase of labor. An external monitor has been applied, and a fetal heart deceleration of uniform shape is observed, beginning just as the contraction is under way and returning to the baseline at the end of the contraction. Which of the following nursing actions is most appropriate?

• Administer O2.
• Turn the client on her left side.
• Notify the physician.
• No action is necessary.

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37. Which of the following symptoms is most characteristic of a client with cancer of the lungs?

• exertional dyspnea
• persistent changing cough
• air hunger; dyspnea
• cough with night sweats

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38. The nurse should utilize data about which of the following to provide information about the nutritional status of a client being evaluated for malnutrition?

• triceps skinfold measurement
• fasting blood glucose level
• hemoglobin A1c level
• serum lipid profile results

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39. Laboratory tests reveal the following electrolyte values for Mr. Smith: Na 135 mEq/L, Ca 8.5 mg/dL, Cl 102 mEq/L, and K 2.0 mEq/L. Which of the following values should the nurse report to the physician because of its potential risk to the client?

• Ca
• K
• Na
• Cl

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40. What are the implications for a client with renal insufficiency who wants to start a low-carbohydrate (CHO) diet?

• As long as the client eats a minimum of 30g of CHO/day, there should be no problem.
• The client's clinical condition is a contraindication to starting a low CHO diet.
• Calcium supplements should be utilized to prevent the development of osteoporosis while on a low CHO diet.
• As long as the client eats foods that are high biologic protein sources, a low CHO diet can be followed.

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41. Alice came to the Emergency Department in the last week before her estimated date of confinement complaining of headaches, blurred vision, and vomiting. Suspecting PIH. With which of the following statements should the nurse best respond to Alice's complaints?

• "The physician will probably want to admit you for observation."
• "The physician will probably order bed rest at home."
• "These are really dangerous signs."
• "The physician will probably prescribe some medicine for you."

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42. Which type of hepatitis is transmitted via the fecal-oral route?

• A
• B
• C
• D

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43. A serious complication of a total hip replacement is displacement of the prosthesis. What is the primary sign of displacement?

• pain on movement and weight bearing
• hemorrhage
• affected leg appearing 1-2 inches longer
• edema in the area of the incision

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44. One day postoperative, the client complains of dyspnea, and his respiratory rate (RR) is 35, slightly labored, and there are no breath sounds in the lower-right base. The nurse should suspect:

• cor pulmonale
• atelectasis
• pulmonary embolus
• cardiac tamponade

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45. A female client complains to the nurse at the health department that she has fatigue, shortness of breath, and lightheadedness. Her history reveals no significant medical problems. She states that she is always on a fad diet without any vitamin supplements. Which tests should the nurse expect the client to have first?

• peptic ulcer studies
• complete blood count, including hematocrit and hemoglobin
• genetic testing
• hemoglobin electrophoresis

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46. Which of the following microorganisms is easily transmitted from client to client on the hands of health care workers?

• mycobacterium tuberculosis
• Clostridium tetani
• staphylococcus aureus
• human immunodeficiency virus

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47. A client had a colostomy done one day ago. Which of the following is an abnormal finding when assessing the stoma?

• mild edema
• minimal bleeding
• rose color
• dark red color

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48. Which of the following is true concerning human immunodeficiency virus (HIV)?

• HIV infection involves CD4 receptor protein on the surface of helper T-cells.
• The presence of circulating antibodies that neutralize HIV is evidence that the individual has immunity-HIV.
• HIV replication occurs extracellularly.
• DNA replication

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49. Nursing care for a client undergoing chemotherapy includes assessment for signs of bone marrow depression. Which finding accounts for some of the symptoms related to bone marrow depression?

• erythrocytosis
• leukocytosis
• polycythemia
• thrombocytopenia

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50. Nurses should understand the chain of infection because it refers to:

• the linkages between various forms of microorganisms.
• the sequence required for transmission of disease
• the clustering of bacteria in a specific pattern.
• increasing virulence patterns among species of microorganisms.

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NCLEX-PN Practice Exam #17 - 50 questions