Practice Tests: NCLEX-PN Practice Exam #19 - 50 questions
All 50 questions are randomized each time you take the test, and do not appear in the same order here.
1. A patient has suffered a left CVA and has developed severe hemiparesis resulting in a loss of mobility. The nurse notices on assessment that an area over the patient's left elbow appears as non-blanchable erythema and the skin is intact. The nurse should score the patient as having:
- stage I pressure ulcer
- stage II pressure ulcer
- stage III pressure ulcer
- stage IV pressure ulcer
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2. Your patient has been diagnosed with orchiditis. What information about this disorder should you inform the patient about?
- This disorder often occurs as the result of a streptococcus.
- This disorder can be symptomatically treated with ice.
- This disorder can be symptomatically treated with heat.
- This disorder is typically treated with surgery.
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3. A nurse is assessing a patient in the rehab unit at shift change. The patient has suffered a TBI 3 weeks ago. Which of the following is the most distinguishing characteristic of a neurological disturbance?
- LOC (level of consciousness)
- Short term memory
- + Babinski sign
- + Clonus sign
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4. A patient has a history of cardiac arrhythmia. A nurse has been ordered to give 2 units of blood to this patient. Which of the following actions should The nurse take?
- Prep the patient with pain medication.
- Notify the patient's family about the procedure via the telephone.
- Decrease the temperature of the blood to be given.
- Increase the temperature of the blood to be given.
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5. What intervention is the best to relieve constipation during pregnancy?
- Increasing the consumption of fruits and vegetables.
- Taking a mild over-the-counter laxative.
- Lying flat on back when sleeping.
- Reduction of iron intake by half or more.
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6. Select the stage of a pressure ulcer that is accurately pair with its characteristics.
- Stage I: Only slight blanching when pressure is applied to the skin.
- Stage II: The epidermis and part of the dermis is damaged or lost.
- Stage III: The wound has slough and eschar.
- Stage IV: The loss of skin usually exposes some fat.
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7. A patient has recently been prescribed (Norvasc). Which of the following side effect/s should the patient specifically watch out for?
- Hypotension and Angina
- Hypertension
- Lower extremity edema
- Peripheral sensory loss and SOB
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8. Which of the following arterial blood gas values indicates a patient may be experiencing a condition of metabolic acidosis?
- PaO2 (90%)
- Bicarbonate 159
- CO2 47 mm Hg
- pH 7.34
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9. A nurse has been ordered to administer Morphine to a patient. Which of the following effects is unrelated to Morphine's effects on the patient?
- Depressed function of the CNS
- Increased blood flow
- Decreased venous capacity
- Pain relief
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10. The protrusion of an internal organ through a wound or surgical incision is referred to as:
- serosanguineous
- dehiscence
- evisceration
- exuded
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11. Sutures and staples are typically removed following surgery within:
- 7 to 10 days if healing is considered adequate
- 10 to 14 days if healing is considered adequate
- 7 to 10 days if no further dressings are needed
- 10 to 14 days if no further dressings are needed
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12. A nurse is teaching a client about self-administration of Haldol 15 mg po hs. For which side effects must the client seek medical attention?
- SOB and fatigue
- restlessness and muscle spasms
- dry mouth
- diarrhea
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13. A nurse reviewed the arterial blood gas reading of a 25-year-old male: Bicarbonate ion - 25 mEq/l; PH-7.41; PaCO2 - 29 mmHg; PaO2 - 54 mmHg; FiO2 -22. The nurse should be able to conclude the patient is experiencing __________ conditions.
- metabolic acidosis
- respiratory acidosis
- metabolic alkalosis
- respiratory alkalosis
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14. Which of the following adverse effects have sometimes Tricyclics (Antidepressants) on patients that have a diagnosis of depression?
- Shortness of breath
- Fainting
- Large Intestine ulcers
- Distal muscular weakness
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15. A nurse is instructing a patient on the order of sensations with the application of an ice water bath for a swollen right ankle. Which of the following is the correct order of sensations experienced with an ice water bath?
- cold, burning, aching, and numbness
- burning, aching, cold, and numbness
- aching, cold, burning and numbness
- cold, aching, burning and numbness
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16. Which type of bum leads to the greatest degree of pain?
- A first degree burn
- A second degree burn
- A third degree burn
- A fourth degree burn
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17. A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS. Which of the following side effects should the patient specifically watch out for?
- Weakness and SOB
- Fever and anemia
- Hypertension and SOB
- Fever and hypertension
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18. A 27-year-old woman has delivered twins in the OB unit. The patient develops a condition of 5 centimeter diastasis recti abdominis. Which of the following statements is the most accurate when instructing the patient?
- Sit-ups are o.k. to do as long as you don't strain
- This condition leads to surgery in 80% of cases.
- Guarding the abdominal region is important at this time.
- Antibiotics are required for this condition in 70% of patients.
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19. A patient has just been prescribed Minipress to control hypertension. The nurse should instruct the patient to be observant of the following:
- Dizziness and light headed sensations
- Weight gain
- Sensory changes in the lower extremities
- Fatigue
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20. A nurse is reviewing a patient's medical record. The record indicates the patient has limited shoulder flexion on the left. Which plane of movement is limited?
- Horizontal
- Sagittal
- Frontal
- Vertical
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21. A patient has been admitted to the hospital with a HNP L4-5 segment diagnosis. After 24 hours the patient is able to ambulate with assistance with reduced muscle spasms. Which of the following medications was the most beneficial in changing the patient's mobility status?
- Mivacron
- Atropine
- Bethanechol
- Flexeril
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22. The charge nurse on a cardiac unit tells you a patient is exhibiting signs of right-sided heart failure. Which of the following would not indicate right-sided heart failure?
- Nausea
- Anorexia
- Rapid weight gain
- SOB (shortness of breath)
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23. A nurse assesses an 83-year-old female's venous ulcer for the second time that is located near the right medial malleolus. The wound is exhibiting purulent drainage and the patient has limited mobility in her home. Which of the options is the best course of action?
- Encourage warm water soaks to the right foot.
- Notify the case manager of the purulent drainage.
- Determine the patient's pulse in the right ankle.
- Recommend increased activity to reduce the purulent drainage.
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24. A patient has been ordered to get Tegretol for the first time. Which of the following side effects is not associated with Tegretol?
- Sore throat
- Vertigo
- Fever
- Shortness of breath
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25. A nurse is caring for a patient who has experienced burns to the right lower extremity. According to the Rule of Nines, which of the following percents most accurately describes the severity of the injury?
- 36%
- 27%
- 18%
- 9%
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26. Which of the following medications is not considered a neuromuscular blocker?
- Anectine
- Pavulon
- Pitressin
- Mivacron
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27. A patient has been ordered to get Klonapin for the first time. Which of the following side effects is not associated with Klonapin?
- Drowsiness
- Ataxia
- Salivation elevated
- Diplopia
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28. A 46-year-old has returned from a heart catheterization and wants to get up to start walking 3 hours after the procedure. The nurse should:
- tell the patient to remain with the leg straight for at least another hour and check the chart for activity orders
- allow the patient to begin limited ambulation with assistance
- recommend a physical therapy consultation for ambulation
- tell the patient to remain with leg straight for another 6 hours and check the chart for activity orders
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29. A twenty-one-year-old man suffered a concussion and the MD ordered a MRI. The patient asks, "Will they allow me to sit up during the MRI?" The correct response by the nurse should be:
- "I will have to talk to the doctor about letting you sit upright during the test."
- "You will be positioned in the reverse Trendelenburg position to maximize the view of the brain."
- "The radiologist will let you know."
- "You will have to lie down on your back during the test."
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30. Your long term care patient has chronic pain and at this point in time the patient needs increasing dosages to adequately control this pain. What is this patient most likely to be affected with?
- Drug addiction
- Drug interactions
- Drug side effects
- Drug tolerance
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31. A client is 36 hours post-op a TKR surgery. 270 cc's of sero-sanguinous accumulates in the surgical drains. What action should the nurse take?
- Notify the doctor
- Empty the drain
- Do nothing
- Remove the drain
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32. The patient should be sitting when deep breathing and coughing because this position:
- is physically more comfortable for the patient
- helps the patient to support their incision with a pillow
- loosens respiratory secretions
- allows the patient to observe their area and relax
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33. Which of the following is the best worded expected outcome?
- "The nurse will provide for adequate hydration"
- "The nurse will insure that the patient is safe"
- "The patient will cough and deep breath every two hours"
- "The patient will value health"
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34. A patient is complaining of severe chest pain during a stress test. Which of the following medications is the most appropriate to relieve this discomfort?
- Aspirin
- Diazoxide
- Procardia
- Mannitol
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35. A 62-year-old female is being seen on a home visit by a nurse. The patient reports she has been taking Premarin for years. Which of the following would indicate an over-dosage?
- Lower extremity edema
- Sensory changes in the upper extremities
- Increased occurrence of fractures
- Decreased peripheral blood flow
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36. A patient 3 hours post-op from a hysterectomy is complaining of intense pain at the incision site. When assessing the patient the nurse notes a BP of 169/93, pulse 145 bpm and regular. What action should the nurse take?
- Reassure patient that pain is normal following surgery.
- Administer pm Nifedipine and assess client's response.
- Administer pm Meperidine HCL and assess client's response.
- Recheck BP and pulse rate every 20 minutes for the next hour.
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37. A nurse is instructing a patient about the warning signs of (Digitalis) side effects. Which of the following side effects should the nurse tell the patient are sometimes associated with excessive levels of Digitalis?
- Seizures
- Muscle weakness
- Depression
- Anxiety
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38. A 28-year-old male has a diagnosis of AIDS. The patient has had a two-year history of AIDS. The most likely cognitive deficits include:
- Disorientation
- Sensory changes
- Inability to produce sound
- Hearing deficits
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39. You are caring for a patient with multiple-trauma. Of all of these injuries and conditions, it the most serious?
- a deviated trachea
- gross deformity of a lower extremity
- hematuria
- decreased bowel sounds
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40. A nurse is assessing a patient's breath sounds. The patient has had a pneumonectomy to the right lung performed 48 hours ago. Which of the following conditions most likely exists?
- Decreased breath sound volume
- Elevated tidal volume
- Elevated respiratory capacity
- Wheezing
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41. A nurse is caring for a patient in the step down unit. The patient has signs of increased intracranial pressure. Which of the following is not a sign of increased intracranial pressure?
- Bradycardia
- Increased pupil size bilaterally
- Change in LOC
- Vomiting
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42. A patient has experienced a severe third degree burn to the trunk in the last 36 hours. Which phase of burn management is the patient in?
- Shock phase
- Emergent phase
- Healing phase
- Wound proliferation phase
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43. A patient has recently been prescribed Lidocaine Hydrochloride. Which of the following symptoms may occur with over dosage?
- Memory loss and lack of appetite
- Confusion and fatigue
- Heightened reflexes
- Tinnitus and spasticity
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44. A nurse is reviewing a patient's arterial blood gas values: pH- 7.49; Bicarbonate ion 24 mEq/dl; PaCO2 - 31 mmHg; PaO2 - 52 mmHg; FiO2 - 22. Which of the following conditions apply under the following values?
- respiratory acidosis
- respiratory alkalosis
- metabolic acidosis
- metabolic alkalosis
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45. A nurse is reviewing a patient's ECG report. The patient exhibits a flat T wave, depressed ST segment and short QT interval. Which of the following medications can cause all of the above effects?
- Morphine
- Atropine
- Procardia
- Digitalis
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46. A patient has recently been diagnosed with symptomatic bradycardia. Which of the following medications is the most recognized for treatment of symptomatic bradycardia?
- Questran
- Digitalis
- Nitroglycerin
- Atropine
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47. A nurse is working in a pediatric clinic and a 25-year-old mother comes in with a 4 week-old baby. The mother is stress out about loss of sleep and the baby exhibits signs of colic. Which of the following techniques should the nurse teach the mother?
- Distraction of the infant with a red object
- Prone positioning techniques
- Tapping reflex techniques
- Neural warmth techniques
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48. A nurse is caring for a retired MD. The MD asks the question, "What type of cells create exocrine secretions?" The correct answer is:
- alpha cells
- beta cells
- acinar cells
- plasma cells
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49. A patient has recently been prescribed Albuterol. Which of the following changes are not associated with Albuterol?
- Tachycardia
- Hypertension
- Bronchodilation
- Sensory changes
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50. The recommended daily caloric intake for sedentary older men, active adult women and children is:
- 2400 calories
- 1600 calories
- 2800 calories
- 2000 calories
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