Practice Tests: NCLEX-PN Practice Exam #18 - 50 questions

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

 

1. While the PN is removing the third of seven sutures in a patient's surgical incision, the PN notices a gap in between the skin where this suture was. Which of these are the most appropriate next steps?

• Approximate the edges, apply a butterfly strip, and proceed with removing the most distal suture.
• Approximate the edges, apply a butterfly strip, and notify the physician.
• Remove the most proximal suture, and observe for further wound gaping.
• Approximate the edges, apply a butterfly strip, and proceed with removing the most proximal suture.

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2. Which of these is not an early indicator of increased intracranial pressure?

• widening pulse pressure
• Cushing's reflex
• Cheyne-Stokes respirations
• decorticate posture

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3. A 21-year-old college student has just learned that she contracted genital herpes from her sexual partner. After completing the initial history and assessment, the nurse has data concerning areas pertinent to the disease. The data is likely to include all but which of the following?

• voiding patterns
• characteristics of lesions
• vaginal discharge
• prior history of varicella

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4. A 93-year-old female with a history of Alzheimer's Disease gets admitted to an Alzheimer's unit. The patient has exhibited signs of increased confusion and limited stability with gait. Moreover, the patient is refusing to use a w/c. Which of the following is the most appropriate course of action for the nurse?

• Recommend the patient remain in her room at all times.
• Recommend family members bring pictures to the patient's room.
• Recommend a speech therapy consult to the doctor.
• Recommend the patient attempt to walk pushing the w/c for safety.

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5. A client who has a known history of cardiac problems and is still smoking enters the clinic complaining of sudden onset of sharp, stabbing pain that intensifies with a deep breath. The pain is occurring on only one side and can be isolated upon general assessment. The nurse concludes that this description is most likely caused by:

• pleurisy
• pleural effusion
• atelectasis
• tuberculosis

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6. When assessing a client in the Emergency Department whose membranes have ruptured, the nurse notes that the fluid is a greenish color. What is the cause of this greenish coloration?

• blood
• meconium
• hydramnios
• caput

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7. The PN is caring for a patient undergoing peritoneal dialysis, and the output seems low. What should the PN do first?

• Stop the peritoneal dialysis and notify the physician.
• Check the patient's blood glucose level.
• Remove and replace the peritoneal dialysis catheter.
• Turn the patient side-to-side.

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8. Which of these is not a potential side effect of peritoneal dialysis?

• weight loss
• hyperglycemia
• hernia
• infection

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9. Ten-year-old Monica is admitted to the hospital with a medical diagnosis of Rheumatic Fever. She relates a history of "a sore throat about a month ago." Bed rest with bathroom privileges is prescribed. Which of the following nursing assessments should be given the highest priority when assessing Monica's condition?

• her response to being hospitalized
• the presence of a macular rash on her trunk
• her cardiac status
• the presence of polyarthritis and pain in her joints

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10. A person using over-the-counter nasal decongestant drops who reports unrelieved and worsening nasal congestion should be instructed to:

• switch to a stronger dose of the medication
• discontinue the medication for a few weeks
• continue taking the same medication, but use it more frequently
• use a combination of medications for better relief

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11. Which of the following statements should the nurse use to best describe a very low-calorie diet (VLCD) to a client?

• "This diet can be used when there is close medical supervision."
• "This is a long-term treatment measure that assists obese people who can't lose weight."
• "The VLCD consists of solid food items that are pureed to facilitate digestion and absorption."
• "A VLCD contains very little protein."

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12. A nurse is instructing a person who had a left CVA and right lower extremity hemiparesis to use a quad cane. Which of the following is the most appropriate gait sequence?

• Place the cane in the patient's left upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence.
• Place the cane in the patient's left upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence.
• Place the cane in the patient's right upper extremity, encourage cane, then right lower extremity, then left upper extremity gait sequence
• Place the cane in the patient's right upper extremity, encourage cane, then left lower extremity, then right upper extremity gait sequence.

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13. A client has been admitted in septic shock. Her nursing care plan includes the diagnosis High Risk for Injury (related to clotting disorder). Based on this diagnosis, all the following are appropriate entries in the nursing care plan except:

• obtain an order for a stool softener
• administer packed RBCs, if ordered
• encourage the client to rinse her mouth with mouthwash and scrub her teeth with an oral sponge
• dress venipuncture sites immediately to prevent infection

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14. The PN enters the room of a patient who is having a tonic-clonic seizure. What is the first action the nurse should take?

• Place a tongue depressor in between the patient's teeth.
• Secure the airway.
• Elevate the head of the bed.
• Prepare Lorazepam for administration.

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15. While the PN is bathing a patient with a chest tube, the tube is accidentally pulled out. What is the first priority for the PN?

• Attempt to re-insert the chest tube.
• Obtain a sterile dressing for the chest tube site.
• Discard the contaminated chest tube.
• Provide the patient with supplemental oxygen.

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16. The PN is caring for a patient with an open wound with a significant amount of drainage. What would the most appropriate dressing choice be for this wound?

• dry-to-wet dressing
• wet-to-dry dressing
• alginate dressing
• hydrocolloid dressing

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17. With a breech presentation, the nurse must be particularly alert for:

• quickening
• ophthalmia neonatorum
• pica
• prolapsed umbilical cord

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18. The PN walks into the patient's room and observes the patient having an asthma attack. What would be the best position for this patient?

• lying flat with arms crossed over chest
• sitting up, bent forward, arms resting
• left lateral Sims position
• standing with arms at side

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19. The nurse is caring for a patient who has a peripheral IV in her hand and a PICC line in the opposite arm. Which of these medications would be appropriate to administer in the peripheral IV?

• Erythromycin
• Tetracycline
• Vancomycin
• Cefazolin

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20. A nurse teaching a patient with COPD pulmonary exercises should:

• teach pursed-lip breathing techniques
• encourage repetitive heavy lifting exercises that will increase strength
• limit exercises based on respiratory acidosis
• take breaks every 10-20 minutes with exercises

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21. A nurse is teaching a client newly diagnosed with Emphysema about the disease process. Which of the following statements best explains the problems associated with emphysema and could be adapted for use in the nurse's discussion with the client?

• Hyperactivity of the medium-sized bronchi caused by an inflammatory response leads to wheezing and tightness in the chest.
• Larger than normal air spaces and loss of elastic recoil cause air to be trapped in the lung and collapse airways.
• Vasodilation, congestion, and mucosal edema cause a chronic cough and sputum production.
• Chloride is not being transported properly, producing excess absorption of water and sodium, and thick viscous mucus.

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22. The PN is reinforcing education with a patient being discharged with an Albuterol inhaler. The medication prescription orders the patient to take two puffs from the inhaler every 4-6 hours as needed. How long should the PN instruct the patient to wait between taking the first and second puff?

• 30 seconds
• 1 minute
• 1 hour
• 15 seconds

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23. Which of these is not a sign of early hyperglycemia?

• polyphagia
• polyketonia
• polyuria
• polydipsia

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24. Which of the following foods needs to avoid a client with urinary tract calculi?

• lettuce
• cheese
• apples
• broccoli

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25. A diet high in fiber content can help an individual to:

• lose body weight fast
• reduce diabetic ketoacidosis
• lower cholesterol
• reduce the need for folate

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26. The PN is caring for a quadriplegic patient, and the patient begins to experience autonomic dysreflexia. What is the most appropriate action for the PN to take?

• Check the patient's urinary catheter.
• Administer nitroglycerin sublingually.
• Notify the physician.
• Elevate the head of the bed as high as possible.

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27. Which of the following is not a primary function of the kidneys?

• blood pressure control
• vitamin D activation
• erythropoietin production
• reabsorbing waste products

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28. Which of these is not an appropriate treatment for maternal hypotension after epidural anesthesia?

• Stop the Pitocin infusion.
• Administer oxygen.
• Slow or hold IV fluids.
• Turn the patient on the left side.

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29. The PN is caring for a patient in early labor lying supine in bed. The patient states that she is feeling light-headed and nauseous, and the patient's blood pressure is lower than baseline. What is the most appropriate action?

• Administer oxygen.
• Elevate the foot of the bed.
• Ask the patient to lie on the left side.
• Continue to monitor the patient as labor progresses.

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30. Broccoli, oranges, dark greens, and dark yellow vegetables can be eaten to:

• supplement vitamin pills
• balance body molecules
• cure many diseases
• help improve body defenses

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31. The PN examines a patient's EKG strip and notices an absence of p-waves and the presence of sawtooth waves. Which of these is the most likely rhythm?

• atrial flutter
• bradycardia
• ventricular tachycardia
• atrial fibrillation

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32. A nurse is working in an outpatient orthopedic clinic. During the patient's history the patient reports, "I tore 3 of my 4 Rotator cuff muscles in the past." Which of the following muscles cannot be considered as possibly being torn?

• Teres minor
• Teres major
• Supraspinatus
• Infraspinatus

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33. A client receives a cervical intracavitary radium implant as part of her therapy. A common side effect of a cervical implant is:

• creamy, pink-tinged vaginal drainage
• stomatitis
• constipation
• xerostomia

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34. The nurse can promote relief of muscle pain, spasms, and tension by:

• having the client continue his activities as usual
• immobilizing the client
• applying heat, cold, pressure, or vibration to the painful area
• giving as much pain medication as needed to ease the muscle

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35. The best nursing diagnosis for a client with newly diagnosed Diabetes Mellitus is:

• Impaired Skin Integrity
• Knowledge Deficit: New Diabetes Diagnosis
• Alteration in Nutrition: More than Body Requirements
• Fluid Volume Deficit

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36. Light therapy can be effective for:

• overcoming weight problems
• helping with allergies
• use in alternative medical treatments
• working with sleep patterns

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37. A patient that has delivered an 8.2 lb. baby boy 3 days ago via c-section, reports white patches on her breast that aren't going away. Which of the following medications may be necessary?

• Nystatin
• Atropine
• Amoxil
• Loritab

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38. Which type of exercises might be prescribed to strengthen the pelvic floor muscles of a client with urinary incontinence?

• Kegel
• resistance
• passive
• stretching

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39. The PN is caring for a patient in recovery who has had an open laparotomy. The patient has a coughing fit, and the PN notices the sutures have torn and a small loop of bowel has protruded from the incision. Which of these actions would be the least appropriate?

• The PN should maintain light pressure on the area.
• The PN should monitor the patient for shock.
• The PN should gently guide the loop of bowel back into the abdominal cavity.
• The PN should dampen a sterile towel and place it over the wound.

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40. Which of the following diseases places a client at risk for developing cirrhosis?

• type I diabetes
• alcoholism
• leukemia
• glaucoma

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41. Which of the following nursing diagnoses is most appropriate for the client experiencing acute pancreatitis?

• Confusion
• Latex Allergy
• Acute Pain
• Constipation

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42. The PN is caring for a patient that had an open laparotomy 6 hours ago. The patient complains about coughing and a scratchy throat from being intubated. What would be the most important item to make sure the patient has at the bedside?

• an incentive spirometer
• a pillow
• ice chips
• throat lozenges

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43. The PN is caring for a client with diabetes insipidus. The nurse can expect the lab work to show:

• elevated urine osmolarity and elevated serum osmolarity
• decreased urine osmolarity and decreased serum osmolarity
• elevated urine osmolarity and decreased serum osmolarity
• decreased urine osmolarity and elevated serum osmolarity

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44. The LPN is caring for a postoperative patient who had an open appendectomy. Where would he look to check the incision site?

• the right lower quadrant
• the left upper quadrant
• the right upper quadrant
• the left lower quadrant

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45. The PN is preparing a patient who has undergone cataract surgery on the right eye for discharge. Which of these statements indicates that the patient understands his or her post-surgical instructions?

• "I need to sleep on my right side."
• "I need to sleep flat on my back."
• "I need to sleep on my left side."
• "I can sleep in any position I find comfortable."

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46. A client admitted to the medical nursing unit has classic symptoms of tuberculosis (TB) and tests positive on the purified protein derivative (PPD) skin test. Several months later, the nurse who cared for the client also tests positive on an annual TB skin test for work. The most likely course of treatment if the chest X-ray (CXR) is negative is to.

• repeat a TB skin test in six months
• treat the nurse with an anti-infective agent for six months
• monitor for signs and symptoms within the next year
• follow up in one year at the next annual physical with CXR only

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47. Appropriate care for a client with neutropenia includes:

• plenty of fresh fruits and vegetables
• a semi-private room
• wearing a mask when out of the room
• routine hand washing

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49. If a client is suffering from thyroid storm, the PN can expect to find on assessment:

• tachycardia and hyperthermia
• bradycardia and hypothermia
• a large goiter
• a calm, quiet client

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50. A patient that has TB can be taken off restrictions after _______ parameters have been met.

• negative culture results
• after 30 days of isolation
• normal body temperature for 48 hours
• non-productive cough for 72 hours

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NCLEX-PN Practice Exam #18 - 50 questions