Practice Tests: NCLEX-PN Practice Exam #20 - 50 questions
All 50 questions are randomized each time you take the test, and do not appear in the same order here.
1. A laboring patient is experiencing late decelerations. Which position should she be placed in?
- lithotomy
- semi-Fowler's
- left lateral
- right lateral
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2. Medical records indicate a patient has developed a condition of respiratory alkalosis. Which of the following clinical signs would not apply to a condition of respiratory alkalosis?
- Muscle tetany
- Syncope
- Numbness
- Anxiety
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3. As you are administering penicillin intravenously, you determine that the patient becomes hypotensive and with a bounding, rapid pulse rate. What is the first thing that you would do?
- Decrease the rate of the intravenous medication flow.
- Increase the rate of the intravenous medication flow.
- Call the doctor.
- Stop the intravenous flow.
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4. You are caring for a four-year-old female patient who was severely burned in a house fire. How would you determine the extent of this child's burns?
- By using the Lund and Browder chart.
- By using the Rule of Nines.
- By using the Rule of Tens.
- By using the Parkland Formula.
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5. The wound irrigation process cleanses the wound and:
- Reduces the potential of pain in the wound region or area.
- Stops the spread of infection by way of magnifying the "clean" area.
- Pushes extravasated blood from a hematoma into nearby healthy tissue.
- Allows for the introduction of medications in solution form.
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6. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient?
- Intravenous potassium supplementation
- Intravenous calcium supplementation
- Kidney dialysis
- Parenteral nutrition
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7. A nurse is reviewing a patient's current Lithium levels. Which of the following values is outside the therapeutic range?
- 1.0mEq/L
- 1.1 mEq/L
- 1.2 mEq/L
- 1.3 mEq/L
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8. During which stage of anesthesia is a patient most likely to experience involuntary motor activity?
- Stage I
- Stage II
- Stage III
- Stage VI
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9. A nurse is assessing a patient in the ICU. The patient has the following signs: weak pulse, quick respiration, acetone breath, and nausea. Which of the following conditions is most likely occurring?
- Hypoglycemic patient
- Hyperglycemic patient
- Cardiac arrest
- End-stage renal failure
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10. A nurse is performing a screening on a patient that has been casted recently on the left lower extremity. Which of the following statements should the nurse be most concerned about?
- The patient reports, "I didn't keep my extremity elevated like the doctor asked me to."
- The patient reports, "I have been having pain in my left calf."
- The patient reports, "My left leg has really been itching."
- The patient reports, "The arthritis in my wrists is flaring up, when I put weight on my crutches."
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11. Your client has a doctor's order that reads "advance diet as tolerated". This client has returned from the recovery room after an appendectomy and he states, "I am hungry". What would you offer this client to consume?
- Cheese and crackers
- Apple sauce
- Chicken broth
- A peanut butter sandwich
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12. Select the tactile sensation that is accurately paired with its description or procedure for testing:
- Fine motor coordination: The use of the fingers.
- Stereognosis: Equal hearing in both ears.
- Two-point discrimination: The nurse gently pricks the patient's skin.
- Gross motor function: The use of the lower limbs.
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13. When performing an abdominal assessment, what is the correct order of the tasks?
- inspect, palpate, auscultate, percuss
- inspect, palpate, percuss, auscultate
- inspect, auscultate, percuss, palpate
- inspect, percuss, palpate, auscultate
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14. What can help reduce a patient's anxiety and postsurgical pain?
- Preoperative teaching
- Preoperative checklist
- Psychological counseling
- Preoperative medication
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15. Select the stage of shock that is accurately paired with its characteristic:
- The initial stage of shock: Hyperventilation occurs and the blood pH rises.
- The compensatory stage of shock: Hypoxia occurs and lactic acid rises.
- The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens.
- The refractory stage of shock: Potassium ions leak out, sodium ions build up and metabolic acidosis increases.
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16. Your 54-year-old male HIV positive patient has just expired. How should you care for this deceased patient?
- Bathe the patient but it is no longer necessary to use standard precautions because the patient is deceased.
- Place the patient in a negative pressure isolated area of the morgue.
- Double shroud the patient to prevent the spread of infection.
- Bathe the patient using the same standard precautions you used when he was alive.
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17. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow?
- 38 gtts/min
- 42 gtts/min
- 50 gtts/min
- 40 gtts/min
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18. 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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19. The doctor has ordered 20cc an hour of normal saline intravenously for your pediatric patient. You will be using a pediatric intravenous tubing that delivers 60cc per drop. How many drops per minute will you administer using this pediatric intravenous set?
- 30 drops per minute
- 25 drops per minute
- 20 drops per minute
- 22 drops per minute
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20. A nurse is assigned to do pre-operative teaching on a blind patient who is scheduled for surgery the following morning. What teaching strategy would best fit the situation?
- Verbal teaching in short sessions throughout the day.
- Pre-operative booklet on the surgery in Braille.
- Provide a tape for the client.
- Have the blind patient's family member instruct the patient.
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21. You are caring for a patient who has no cognitive functioning but only basic human functions such opening the eyes and the sleep - wake cycle. What level of consciousness does this patient have?
- Obtunded
- A persistent vegetative state
- Locked in syndrome
- Brain death
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22. Which technique or method is used to determine whether or not the patient has an irregular pulse?
- Apical pulse
- Inspection
- Auscultation
- Percussion
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23. A nurse has been ordered to set-up Buck's traction on a patient's lower extremity due to a femur fracture. Which of the following applies to Buck's traction?
- A weight greater than 10 lbs. should be used.
- The line of pull is upward at an angle.
- The line of pull is straight.
- A weight greater than 20 lbs. should be used.
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24. Which of the following is a life threatening acute complication of diabetes mellitus?
- Neuropathy
- Hypoglycemia
- Retinopathy
- Impaired microcirculation
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25. Which is the proper hand position for performing chest vibration?
- cup the hands
- use the side of the hands
- flatten the hands
- spread the fingers of both hands
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26. A 13-year-old girl is admitted to the ER with lower right abdominal discomfort. Which the following measures should the admitting nursing take first?
- Administer Loritab to the patient for pain relief.
- Place the patient in right sidelying position for pressure relief.
- Start a Central Line.
- Provide pain reduction techniques without administering medication.
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27. A nurse is working in a pediatric clinic and a mother brings in her 13-month-old child who has Down Syndrome. The mother reports, "My child's muscles feel weak and he isn't moving well. My RN friend check his reflexes and she said they are diminished." Which of the following actions should the nurse take first?
- Contact the physician immediately
- Have the patient go to X-ray for a c-spine work-up.
- Start an IV on the patient
- Position the child's neck in a neutral position
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28. A cavity containing pus surrounded by inflamed tissue is:
- cellulitis
- an abscess
- extravasation
- an adhesion
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29. A nurse suspects a patient is developing Bell's Palsy. The nurse wants to test the function of cranial nerve VII. Which of the following would be the most appropriate testing procedures?
- Test the taste sensation over the back of the tongue and activation of the facial muscles.
- Test the taste sensation over the front of the tongue and activation of the facial muscles.
- Test the sensation of the facial muscles and sensation of the back of the tongue.
- Test the sensation of the facial muscles and sensation of the front of the tongue.
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30. Select the stage of viral hepatitis that is accurately paired with its characteristic(s).
- The prodromal stage: Jaundice begins.
- The icteric stage: Flu like symptoms occur.
- The preicteric stage: Elevated urine bilirubin levels.
- The posticteric stage: Jaundice and dark urine occurs.
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31. Which position will you place your patient in when they are demonstrating the signs and symptoms of hypovolemic shock?
- The Trendelenberg position
- The supine position
- The left lateral position
- The right lateral position
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32. When suctioning a client, what is the usual amount of time the nurse should spend for each suction pass?
- 2 seconds
- 10 seconds
- 20 seconds
- 30 seconds
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33. In managing nausea related to Morphine epidural analgesia, the nurse should administer:
- Indocin
- Codeine
- Motrin
- Compazine
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34. Which statement about adjuvant medications is true and accurate?
- Licensed practical nurses cannot administer adjuvant medications.
- Adjuvant medications are schedule 2 narcotics.
- Adjuvant medications are schedule 1 narcotics.
- Adjuvant medications can be purchased over the counter.
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35. Which nonpharmacological technique entails the use of electronic monitoring equipment while the patient controls basic bodily mechanisms?
- Meditation
- Visualization
- Biofeedback
- Chiropractic
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36. A nurse is reviewing a patient's serum glucose levels. Which of the following scenarios would indicate abnormal serum glucose values for a 30-year-old male?
- 70 mg/dl
- 55 mg/dl
- 110 mg/dl
- 100 mg/dl
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37. Select a myth or falsehood relating to pain, pain management and addiction.
- Addiction can be accurately predicted.
- Withdrawal, drug tolerance and physical dependence do not indicate addiction.
- Pain medications can be used with patients who have a substance abuse history.
- Addiction is signaled when the client employs deception and stockpiling.
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38. A nurse is caring for a 10-year-old boy who has just been diagnosed with a congenital heart defect. Which of the following clinical signs does not indicate CHF?
- Increased body weight
- Elevated heart rate
- Lower extremity edema
- Compulsive behavior
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39. A 32-year-old male with a complaint of dizziness has an order for Morphine via. IV. Which of the following should the nurse do first?
- Check the patient's chest x-ray results.
- Retake vitals including blood pressure.
- Perform a neurological screen on the patient.
- Request the physician on-call assess the patient.
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40. An episiotomy is:
- a surgical incision of the perineum to prevent tearing during delivery
- releasing the red plug from the cervix just before crowning occurs
- an incision in the abdomen with which the baby can be delivered through
- the severance of the umbilical cord between mother and child
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41. Which is an appropriate outcome for the nursing diagnosis of Body Image Disturbance for a client with anorexia nervosa?
- The client verbalizes knowledge of a maintenance diet.
- The client demonstrates assertiveness with family.
- The client verbalizes her body size accurately.
- The client demonstrates control of obsessive behaviors.
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42. In an obstetrical emergency, which of the following actions should the nurse perform first after the baby delivers?
- Place extra padding under the mother to absorb blood from the delivery.
- Cut the umbilical cord using sterile scissors.
- Suction the baby's mouth and nose.
- Wrap the baby in a clean blanket to preserve warmth.
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43. A nurse is caring for a patient who has recently been diagnosed with fibromyalgia and COPD. Which of the following tasks should the nurse delegate to a nursing assistant?
- Transferring the patient to the shower.
- Ambulating the patient for the first time.
- Taking the patient's breath sounds
- Educating the patient on monitoring fatigue
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44. Teaching about the need to avoid foods high in potassium is most important for which client?
- a client receiving diuretic therapy
- a client with an ileostomy
- a client with metabolic alkalosis
- a client with renal disease
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45. When caring for an infant during cardiac arrest, which pulse must be palpated to determine cardiac function?
- Carotid
- Brachial
- Pedal
- Radial
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46. All of the following should be performed when fetal heart monitoring indicates fetal distress except:
- increase maternal fluids
- administer oxygen
- decrease maternal fluids
- turn the mother
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47. The doctor has ordered 500 mg of a medication po once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient?
- 1 Tablet
- 2 Tablets
- 3 Tablets
- 4 Tablets
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48. Which fetal heart monitor pattern can indicate cord compression?
- variable decelerations
- early decelerations
- bradycardia
- tachycardia
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49. Which of the following is best for a client who has difficulty swallowing and chokes frequently?
- A liquid diet.
- Tilting the head back when swallowing.
- Tucking the chin in when swallowing.
- Following each bite with a drink of water.
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50. Your patient has been diagnosed with giant cell arteritis. What medication will this patient most likely be given?
- High doses of aspirin
- High doses of prednisone
- Methotrexate
- Albuterol
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