NCLEX-RN | QB2 | Practice Exam #1 (50 questions)

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

1. Flumazenil (Romazicon) has been ordered for a client who has overdosed on oxazepam (Serax). Before administering the medication, the nurse should be prepared for which common adverse effect?

• Seizures
• Shivering
• Anxiety
• Chest pain

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2. The term used to describe blood in the urine.

• Glycosuria
• Hematuria
• Pyuria
• Albuminuria

3. The nurse is planning care for a client with adrenal insufficiency. The nurse should give priority to:

• Monitoring the client for signs of dehydration
• Promoting sleep and rest
• Providing high-calorie snacks
• Promoting a healthy body image

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4. Nitroglycerin is also available in ointment or paste form. Before applying nitroglycerin ointment, the nurse should:

• Cleanse the skin with alcohol where the ointment will be placed.
• Obtain the client's pulse rate and rhythm
• Remove the ointment previously applied
• Instruct the client to expect pain relief in the next 15 minutes

5. Parents of a toddler are dismayed when they learn that their child has Duchennes muscular dystrophy. Which statement describes the inheritance pattern of the disorder?

• An affected gene is located on one of the 21 pairs of autosomes.
• The disorder is caused by an over-replication of the X chromosome in males.
• The affected gene is located on the Y chromosome of the father.
• The affected gene is located on the X chromosome of the mother.

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6. Louis develops peritonitis and sepsis after surgical repair of ruptures diverticulum. The nurse in charge should expect an assessment of the client to reveal:

• Tachycardia
• Abdominal rigidity
• Bradycardia
• increased bowel sounds

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7. A nurse is taking care of a patient who underwent abdominal surgery 3 years ago. The patient has not been breaths deeply and refuses to get out of bed since the surgery due to pain. Also the patient complains of shortness of breath and the lung sounds are diminished upon auscultation. Vital signs are. Blood pressure level 120/70mm Hg, heart rate 22, temperature 36.40(97.6 F), O2 saturation 89%. Which of the following condition should the nurse suspect?

• Sepsis
• Atelectasis
• Congestive heart failure
• Emphysema

8. The physician has ordered a histoplasmosis test for the elderly client The nurse is aware that histoplasmosis is transmitted to humans by:

• Cats
• Turtles
• Birds
• Dogs

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9. An infant arrives in the emergency department not breathing and does have a pulse. When starting cardio pulmonary resuscitation (CPR), where is the correct place to assess for a pulse in this patient?

• Carotid
• Radial
• Brachial
• Temporal

10. Situation : Mang Felix, a 79 year old man who is brought to the Surgical Unit from PACU after a transurethral resection. You are assigned to receive him. You noted that he has a 3-way indwelling catheter for continuous fast dip bladder irrigation which is connected to a straight drainage.Q. Mang Felix informs you that he feels some discomfort on the hypogastric area and he has to void. What will be your most appropriate action?

• Remove his catheter then allow him to void his own
• Irrigate his catheter
• Tell him "Go ahead and void. You have an indwelling catheter"
• Assess color and rate of outflow, if there is a change refer to urologist for possible irrigation

11. When does the heart receives blood from the coronary artery?

• Systole
• Diastole
• When the valves opens
• When the valves closes

12. Before rigor mortis occurs, the nurse is responsible for:

• Providing a complete bath and dressing change
• Placing one pillow under the body's head and shoulders
• Removing the bodys clothing and wrapping the body in a shroud
• Allowing the body to relax normally

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13. Which of the following medications would the nurse expect the physician to order to reverse a dystonic reaction?

• prochlorperazine (Compazine)
• diphenhydramine (Benadryl)
• haloperidol (Haldol)
• midazolam (Versed)

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14. A health care provider s prescription reads levothyroxine, 150 mcg orally daily. The medication label reads levothyroxine, 0.1 mg/tablet. The nurse administers how many tablet(s) to the client?

• 2.5 tablets.
• 1 tablet.
• 3 tablets.
• 1.5 tablets.

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15. Situation : Mr. Reyes suffered head injuries in a motor vehicle accidentQ. Mr. Reyes has possible skull fracture. The nurse should:

• Observe him for signs of Brain injury
• Check for hemorrhaging from the oral cavity
• Elevate the foot of the bed if he develops symptoms of shock
• Observe for symptoms of decreased intracranial pressure and temperature

16. Situation : Two children were brought to you. One with chest indrawing and the other had diarrhea. The following questions apply:While on treatment, Nina 18 months old weighed 18 kgs and her temperature registered at 37 degrees C. Her mother says she developed cough 3 days ago. Nina has no general danger signs. She has 45 breaths/minute, no chest indrawing, no stridor. How would you classify Nina's manifestation.

• No pneumonia
• Severe pneumonia
• Pneumonia
• Bronchopneumonia

17. Isabel with a diagnosis of depression is started on imipramine (Tofranil), 75 mg by mouth at bedtime. The nurse should tell the client that:

• This medication may be habit forming and will be discontinued as soon as the client feels better.
• This medication has no serious adverse effects.
• The client should avoid eating such foods as aged cheeses, yogurt, and chicken livers while taking the medication.
• This medication may initially cause tiredness, which should become less bothersome overtime.

18. The nurse is preparing a list of home care instructions regarding stoma and laryngectomy care for a client with laryngeal cancer who had a laryngectomy. Which instructions should be included in the list? Select all that apply. 1.Restrict fluid intake. 2.Obtain a MedicAlert bracelet. 3.Keep the humidity in the home low. 4.Prevent debris from entering the stoma. 5.Avoid exposure to people with infections. 6.Avoid swimming and use care when showering.

• 1,2,3,4
• 2,4,6
• 1,3,5,6
• 2,4,5,6

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19. Sally Baker, a 40-year-old woman, is admitted to the hospital with an established diagnosis of mitral stenosis. She is scheduled for surgery to repair her mitral valve.Q. Of the four basic cell types of lung cancer listed below, which is always associated with smoking?

• adenocarcinoma
• squamous cell carcinoma (epidermoid)
• undifferentiated carcinoma
• bronchoalveolar carcinoma

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20. Nurse Mylene recognizes that the most important factor necessary for the establishment of trust in a critical care area is:

• Privacy
• Respect
• Empathy
• Presence

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21. Loretta, a newly admitted client was diagnosed with delirium and has history of hypertension and anxiety. She had been taking digoxin, furosemide (Lasix), and diazepam (Valium) for anxiety. This client's impairment may be related to which of the following conditions?

• Infection
• Metabolic acidosis
• Drug intoxication
• Hepatic encephalopathy

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22. While working in the ICU, you are assigned to care for a patient with a seizure disorder. Which of these nursing actions will you implement first if the patient has a seizure?

• Place the patient on a non-rebreather mask will the oxygen at 15 L/minute..
• Administer lorazepam (Ativan) 1 mg IV.
• Turn the patient to the side and protect airway.
• Assess level of consciousness during and immediately after the seizure.

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23. A diagnosis of Hodgkins disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of this dis- ease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease?

• Elevated vanillylmandelic acid urinary levels
• The presence of blast cells in the bone marrow
• The presence of Epstein-Barr virus in the blood
• The presence of Reed-Sternberg cells in the lymph nodes

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24. A client has been receiving Rheumatrex (methotrexate) for severe rheumatoid arthritis. The nurse should tell the client to avoid taking:

• Aspirin
• Multivitamins
• Omega 3 fish oils
• Acetaminophen

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25. Self governance, ability to choose or carry out decision without undue pressure or coercion from anyone:

• Veracity
• Autonomy
• Fidelity
• Beneficence

26. A client has a midpelvic contracture from a previous pelvic injury due to a motor vehicle accident as a teenager The nurse is aware that this could prevent a fetus from passing through or around which structure during childbirth?

• Symphysis pubis
• Sacral promontory
• Ischial spines
• Pubic arch

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27. The nurse is aware that clients with severe depression, possess which defense mechanism:

• Introjection
• Suppression
• Repression
• Projection

28. The physician orders the removal of an in-dwelling catheter the second post-operative day for a client with a prostatectomy. The client complains of pain and dribbling of urine the first time he voids. The nurse should tell the client that:

• Using warm compresses over the bladder will lessen the discomfort
• Perineal exercises will be started in a few days to help relieve his symptoms.
• if the symptoms dont improve the catheter will have to be reinserted.
• His complaints are common and will improve over the next few days.

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29. The child client has undergone hip surgery and is in a spica cast. Which of the following toy should be avoided to be in the child's bed?

• A toy gun.
• A stuffed animal.
• A ball.
• Legos.

30. When gathering evidence from a victim of rape the nurse should place the victims clothing in a:

• Plastic zip-lock bag
• Rubber tote
• Paper bag
• Padded manila envelope

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31. Which of the following assessment findings would lead the nurse to suspect Down syndrome in an infant?

• Small tongue
• Transverse palmar crease
• Large nose
• Restricted joint movement

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32. Situation: Clients with Bipolar disorder receives a very high nursing attention due to the increasing rate of suicide related to illness.Q. The client is taking a Tricyclic antidepressant Which of the following is an example of TCA?

• Paxil
• Zoloft
• Nardil
• Pamelor

33. The nurse is caring for a client with a fractured hip. The client is combative, confused, and trying to get out of bed. The nurse should:

• leave the client and get help
• obtain a physicians order to restrain the client
• read the facilitys policy on restraints
• order soft restraints from the storeroom

34. All of the following are common factors that invalidated examination or test results except:

• Inadequate specimen volume.
• Failure to send the specimen in a timely manner.
• Correct diet preparation.
• Insufficient bowel cleansing.

35. The nurse is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client's abdomen. After attachment of the electronic fetal monitor, what is the next nursing action?

• Identify the types of accelerations.
• Assess the baseline fetal heart rate.
• Determine the intensity of the contractions.
• Determine the frequency of the contractions.

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36. What other statistic may be used to determine attainment of longevity?

• Age-specific mortality rate
• Proportionate mortality rate
• Swaroops index
• Case fatality rate

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37. Which of the following is the screening test for dengue hemorrhagic fever?

• Complete blood count
• ELISA
• Rumpel-Leede test
• Sedimentation rate

38. A patient undergoing treatment for cancer with bone metastasis is experiencing severe pain. Which of the following treatment would the nurse MOST likely expect to improve the patient's pain control?

• Adjuvant radiation therapy
• Palliative radiation therapy
• Curative radiation therapy
• Radio surgery (stereotactic)

39. David, an adolescent boy was admitted for substance abuse and hallucinations. The client's mother asks Nurse Armando to talk with his husband when he arrives at the hospital. The mother says that she is afraid of what the father might say to the boy. The most appropriate nursing intervention would be to:

• Inform the mother that she and the father can work through this problem themselves.
• Refer the mother to the hospital social worker.
• Agree to talk with the mother and the father together.
• Suggest that the father and son work things out.

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40. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint maybe explained as:

• A normal occurrence in pregnancy because the fetus is using more oxygen.
• The fundus of the uterus is high pushing the diaphragm upwards.
• The woman is having anergic reaction to the pregnancy and its hormones.
• The woman maybe experiencing complication of pregnancy.

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41. The nurse is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan?

• Restrict visits with the family until the client begins to eat.
• Provide privacy during meals.
• Set up a strict eating plan for the client.
• Encourage the client to exercise, which will reduce her anxiety.

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42. All of the following are necessary household management in preventing the spread of Measles at home except:

• Boil foods that are not eaten by the patient
• Separate eating utensils of the patient from that of other members of the family
• Isolate the patient when symptoms start to appear
• Children should be watch out for complications of the disease

43. A patient has a history of severe, uncontrolled epistaxis. The patients blood pressure and platelet count are normal. To minimize the occurrence of bleeding episodes the nurse should teach the patient to.

• Sleep with the head elevated on at least two to three pillows
• Apply firm pressure to the nostrils four times a day
• Apply a water- soluble lubricant to the nasal septum twice daily
• Minimize the intake of caffeine and increase fluids intake

44. When the fetal head is at the level of the ischial spine, it is said that the station of the head is

• Station -1
• Station "0"
• Station +1
• Station +2

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45. The end product of protein digestion or the Building blocks of Protein is what we call:

• Nucleotides
• Fatty acids
• Glucose
• Amino Acids

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46. Situation: Nurses hold a variety of roles when providing care to a perioperative patient.Q. Which of the following nursing interventions is done when examining the incision wound and changing the dressing?

• Observe the dressing and type and odor of drainage if any
• Get patient's consent
• Wash hands
• Request the client to expose the incision wound

47. A client recently started on hemodialysis wants to know how the dialysis will take the place of his kidneys. The nurses response is based on the knowledge that hemodialysis works by:

• Passing water through a dialyzing membrane
• Eliminating plasma proteins from the blood
• Lowering the pH by removing nonvolatile acids
• Filtering waste through a dialyzing membrane

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48. Antonio with lung cancer develops Horner s syndrome when the tumor invades the ribs and affects the sympathetic nerve ganglia. When assessing for signs and symptoms of this syndrome, the nurse should note:

• miosis, partial eyelid ptosis, and anhidrosis on the affected side of the face.
• chest pain, dyspnea, cough, weight loss, and fever.
• arm and shoulder pain and atrophy of arm and hand muscles, both on the affected side.
• hoarseness and dysphagia.

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49. A patient arrives in the emergency room with burns over the upper trunk and arms. The nurse should obtain the patient's pulse at which of the following arterial location?

• Radial
• Carotid
• femoral
• Apical

50. A client with delusional thinking shows a lack of interest in eating at meal times. She states that she is unworthy of eating and that her children will die if she eats. Which nursing action would be most appropriate for this client?

• Telling the client that she may become sick and die unless she eats
• Paying special attention to the client's rituals and emotions associated with meals
• Restricting the client's access to food except at specified meal and snack times
• Encouraging the client to express her feelings at meal times

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NCLEX-RN QB2 | Practice Exam #2 (50 questions)