NCLEX-RN | QB2 | Practice Exam #6 (50 questions)

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

 

1. A client is hospitalized with an acute myocardial infarction. Which nursing diagnosis reflects an understanding of the cause of acute myocardial infarction?

• Decreased cardiac output related to damage to the myocardium
• Impaired tissue perfusion related to an occlusion in the coronary vessels
• Acute pain related to cardiac ischemia
• Ineffective breathing patterns related to decreased oxygen to the tissues

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2. Situation: Nurse Macarena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing needs of this particular population group. Which of the following factors is most important in determining the success of relationships used in delivering nursing care?

• Type of illness of the client
• Transference and countertransference
• Effective communication
• Personality of the participants

3. Which of these findings is an early sign of bladder cancer?

• Painless Hematuria
• Occasional Polyuria
• Nocturia
• Dysuria

4. A client with asthma has an order to begin an aminophylline IV infusion. Which piece of equipment is essential for the nurse to safely administer the medication?

• Large bore intravenous catheter
• IV inline filter
• IV infusion device
• Cover to prevent exposure of solution to light

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5. A 6-year-old patient has been diagnosed with acute rheumatic fever. Then nurse knows that the antibiotic of choice for this illness is:

• Bezathgine peniciliintMegaciilin)
• Amoxicillin (Amoxil)
• Erythromycin (Eryhrocin)
• Vancomycin (Vancocin)

6. A client is admitted to the labor and delivery unit in active labor. During examination the nurse notes a papular lesion on the perineum. Which initial action is most appropriate?

• Document the finding.
• Report the finding to the doctor
• Prepare the client for a C-section.
• Continue primary care as prescribed.

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7. A 21-year-old female is being discharged after a 2-day admission for pelvic inflammatory disease (PID). Which statement BEST identifies the patients understanding of follow-up care for PID?

• My sexual partner needs to be treated with antibiotics
• Its OK to resume sexual relation now
• "I need to inform any sexual partners I have had in the past 30 days that I had PID"
• "In order to prevent getting PID I need to continue to take birth control pills"

8. A nurse interviews a patient, recently admitted to long term care facility, to obtain information on the patient's health perception. The nurse encourages the patient to elaborate about this change. Which type of questioning would be MOST effective in this situation?

• Analytical
• Focused
• Closed
• Open-ended

9. Client has undergone lipper GI and Lower GI series. Which type of health assessment framework is used in this situation?

• Functional health framework
• Head to toe framework
• Body system framework
• Cephalocaudal framework

10. Nurse John is performing an assessment on a neonate. Which of the following findings is considered common in the healthy neonate?

• Simian crease
• Conjunctival hemorrhage
• Cystic hygroma
• Bulging fontanelle

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11. Situation: Larry was admitted at Manila Doctor s Hospital because of a second-degree burn wound.Q. Before debriding a second-degree burn wound in the left lower leg, the nurse should do which of the following?

• Apply Lindane (Kwell) to the affected area
• Medicate the client with narcotic analgesic
• Administer acyclovir (Zovirax) IV
• Apply a topical antimicrobial ointment

12. Situation: With the increasing documented cases of CANCER the best alternative to treatment still remains to be PREVENTION. The following conditions apply.Who among the following are recipients of the tertiary level of care for cancer cases?

• Those under early treatment
• Those under supportive care
• Those under early detection
• Those scheduled for surgery

13. A client who was exposed to hepatitis A is given gamma globulin to provide passive immunity which:

• Increases the production of short lived antibodies
• Provides antibodies that neutralize the antigen
• Accelerates antigen-antibody union at the hepatic sites
• Stimulates the lymphatic system to produce large number of antibodies

14. The nurse is caring for an infant admitted from the delivery room. Which finding should be reported?

• Acyanosis
• Acrocyanosis
• Halequin sign
• Absent femoral pulses

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15. Situation: Nurse Joanna works as an OB-Gyn Nurse and attends to several HIGH-RISK PREGNANCIES: Particularly women with preexisting or newly acquired illness. The following conditions applyBernadette is a 22-year old woman. Which condition would make her more prone than others to developing a Candida infection during pregnancy?

• Her husband plays golf 6 days a week
• She was over 35 when she became pregnant
• She usually drinks tomato juice for breakfast
• She has developed gestational diabetes

16. Following kidney transplantation, cyclosporine is prescribed for a client Which laboratory result would indicate an adverse effect from the use of this medication?

• Hemoglobin level of 14.0 g/dL (140 mmol/L)
• Creatinine level of 0.6 mg/dL (53 mcmol/L)
• Blood urea nitrogen level of 25 mg/dl_ (5.5 mmol/L)
• Fasting blood glucose level of 99 mg/dL (5.5 mmol/L)

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17. The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the clients history should be reported to the doctor?

• Diabetes
• Prinzmetals angina
• Cancer
• Cluster headaches

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18. A client is hospitalized with a diagnosis of chronic glomerulonephritis. The client mentions that she likes salty foods. The nurse should warn her to avoid foods containing sodium because:

• reducing sodium promotes urea nitrogen excretion
• reducing sodium improves her glomerular filtration rate
• reducing sodium increases potassium absorption
• reducing sodium decreases edema

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19. To prevent foot drop in a client with Bucks traction, the nurse should:

• Place pillows under the client's heels.
• Tuck the sheets into the foot of the bed
• Teach the client isometric exercises
• Ensure proper body positioning.

20. Situation: In your professional nursing role, it is essential to establish a meaningful nurse­ patient relationship.Q. The longest and the most productive phase of the NPR is:

• Termination phase
• Working phase
• Pre-orientation phase
• Orientation phase

21. A community health care nurse visits a patient who had cerebrovascular accident The patient is at risk for deficient volume due to voluntary reduction intake fluid intake to avoid the use of the bathroom. The nurse educates the patient on the importance of drinking fluids and maintaining hydration. Which of the following indicates the efficacy of the nursing intervention?

• Amber color urine
• Respiration of 35
• Tachycardia
• Moist mucous membrane

22. A client tells the nurse that he is having suicidal thoughts every day. In conferring with the treatment team, the nurse should make which of the following recommendations?

• A no-suicide contract
• Weekly outpatient therapy
• A second psychiatric opinion
• Intensive inpatient treatment

23. Which of the following Best describes the assessment step of the nursing process?

• Identifying nursing interventions as appropriate for short-term, intermediate, and long­ term goal attainment
• Assigning priorities to the nursing diagnosis
• Establishing goals or expected outcomes
• Obtaining a nursing history and complete a physical examination of the patient

24. A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment would be:

• Flank pain radiating in the groin
• Distention of the lower abdomen
• Perineal edema
• Urethral discharge

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25. Which of the following is TRUE in the stage of alarm of general adaptation syndrome?

• Results from the prolonged exposure to stress
• Levels or resistance is increased
• Characterized by adaptation
• Death can ensue

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26. The physician has ordered Stadol (butorphanol) for a post-operative client The nurse knows that the medication is having its intended effect if the client:

• Is asleep 30 minutes after the injection
• Asks for extra servings on his meal tray
• Has an increased urinary output
• States that he is feeling less nauseated

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27. Nurse Zeny is caring for a client in acute addisonian crisis. Which laboratory data would the nurse expect to find?

• Hyperkalemia
• Reduced blood urea nitrogen (BUN)
• Hypernatremia
• Hyperglycemia

28. The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?

• Twitching
• Hypoactive bowel sounds
• Negative Trousseau's sign
• Hypoactive deep tendon reflexes

29. In the delivery room, Mrs. Ellie Is 10 cm. dilated and the head is fast emerging. Her attending physician has not yet arrived. The initial action the nurse must take after the head emerges is:

• Support the head while the rest of the body is spontaneously delivered.
• Push down on the fundus to help expel the infant.
• Call the doctor STAT
• Deliver the shoulder by turning the presenting part to internal rotation.

30. Situation Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered that an A-V shunt was surgically created.Q. Rudy undergoes hemodialysis for the first time and was scared of disequilibrium syndrome. He asked you how this can be prevented. Your response is:

• maintain a conducive comfortable and cool environment
• maintain fluid and electrolyte balance
• initial hemodialysis shall be done for 30 minutes only so as not to rapidly remove the waste from the blood than from the brain
• maintain aseptic technique throughout the hemodialysis

31. Situation: For more than a month now, Cecilia is persistently feeling restless, worried and feeling as if something dreadful is going to happen. She fears being alone in places and situations where she thinks that no one might come to rescue her just in case something happens to her.Q. Cecilia's problem is that she always sees and thinks negative hence she is always fearful Phobia is a symptom described as:

• organic
• psychosomatic
• psychotic
• neurotic

32. The Causative agent of Tuberculosis is said to be:

• Mycobacterium Tuberculosis
• Hansens Bacilli
• Bacillus Anthracis
• Group A Beta Hemolytic Streptococcus

33. Superficial bladder cancer can be treated by direct instillation of the antineoplastic antibiotic agent mitomycin (Mutamycin). This process is termed:

• Intraventricular administration.
• Intravesical administration.
• Intravascular administration.
• Intrathecal administration.

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34. The nurse is teaching a patient who has just diagnosed with bacterial conjunctivitis, The nurse should that the MOST effective way to transmission of this to other people is by

• Putting on clean gloves before cleansing the eye
• Taking medication as prescribe
• Wearing a gauze eye patch
• Performing hand hygiene

35. A male client undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. Nurse Trish first response is to:

• Call the physician
• Place a saline-soaked sterile dressing on the wound.
• Take a blood pressure and pulse.
• Pull the dehiscence closed.

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36. The nurse is admitting a client with a suspected duodenal ulcer. The client will most likely report that his abdominal discomfort decreases when he:

• Avoids eating
• Rests in a recumbent position
• Eats a meal or snack
• Sits upright after eating

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37. A patient is brought to emergency room with a severe head injury. A craniotomy is performed to evacuate a blood clot Which of the following is a desired expected outcome 24 hours postoperatively?

• Gag reflux present
• Cerebral perfusion pressure, 68mm Hg
• Intracranial pressure, 21 mm Hg
• Decreased lacrimation

38. A toddler with otitis media has just completed antibiotic therapy. A recheck appointment should be made to:

• Determine whether the ear infection has affected her hearing.
• Make sure that she has taken all the antibiotic.
• Document that the infection has completely cleared.
• Obtain a new prescription in case the infection recurs.

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39. The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:

• That cannot be assessed
• That is in situ
• With increasing lymph node involvement
• With distant metastasis

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40. Roberto San Andres, A new nurse in the hospital is about to administer oxygen on patient with Respiratory distress. As his senior nurse, you should intervene if Roberto will:

• Uses venture mask in oxygen administration
• Put a non rebreather mask in the patient before opening the oxygen source
• Use a partial rebreather mask to deliver oxygen
• Check for the doctor's order for Oxygen administration

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41. A 26-year-old client is admitted to the psychiatric unit with acute onset of schizophrenia. His physician prescribes the phenothiazine chlorpromazine (Thorazine), 100 mg by mouth four times per day. Before administering the drug, the nurse reviews the client's medication history. Concomitant use of which drug is likely to increase the risk of extrapyramidal effects?

• guanethidine (Ismelin)
• droperidol (Inapsine)
• lithium carbonate (Lithonate)
• alcohol

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42. The nurse is caring for a client after a bronchoscopy and biopsy. Which finding, if noted in the client, should be reported immediately to the health care provider?

• Drycough
• Hematuria
• Bronchospasm
• Blood-streaked sputum

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43. 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

44. The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?

• "We need to encourage our child to drink fluids"
• "Coughing spells may be triggered by dust or smoke"
• "Vomiting may occur when our child has coughing episodes"
• "We need to maintain droplet precautions and a quiet environment for at least 2 weeks."

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45. The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. 1.Pathological fracture. 2.Urinalysis positive for nitrites. 3.Hemoglobin level of 15.5 g/dL (155 mmol/L). 4.Calcium level of 8.6 mg/dL (2.15 mmol/L). 5.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

• 1,2,5
• 1,4,5
• 1,2,3,4
• 3,4,5

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46. A 30 year-old woman has been prescribed albuterol PNR1 and prophylactic inhaled corticosteroids to be taken once per day. She has been taking the prophylactic as prescribed but has needed to use the albuterol more often than usual She has a chronic cough and often has air hunger.Which intervention is initially most appropriate?

• Refer for a chest X-ray
• Administer magnesium sulfate
• Assess peak flow measurement
• Perform arterial blood gas analysis

47. A 12 year-old patient had a cast removed from the left leg after wearing if for eight weeks. The patient wants to resume sports as soon as possible. In order to regain muscle strength lost while wearing cast, the nurse will instruct the patient in performance of:

• Resistive range of motion exercises to left leg
• Passive range of motion exercises to right leg
• Active-assistive range of motion exercises to the right leg
• Active range of motion exercises to both legs

48. The nurse is inserting a nasogastric (NG) tube into a patient as prescribed. The nurse has advanced the tube into the patient's posterior pharynx. The nurse should now ask the patient to.

• Hold the breath
• Stare upwards with the eyes towards the ceiling
• Perform the Valsalva maneuver
• Lower the chin towards the chest

49. Which of the following is normal newborn calorie intake?

• 110 to 130 calories per kg.
• 30 to 40 calories per lb of body weight.
• At least 2 ml per feeding
• 90 to 100 calories per kg

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50. The best method of evaluating the amount of peripheral edema is:

• Weighing the client daily
• Measuring the extremity
• Measuring the intake and output
• Checking for pitting

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NCLEX-RN | QB2 | Practice Exam #6 (50 questions)