NCLEX-RN | QB2 | Practice Exam #7 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. Situation NURSES are involved in maintaining a safe and healthy environment. This is part of quality care managementQ. Which of the following term most precisely refer to an infection acquired in the hospital that was not present or incubating at the time of hospital admission?
- Secondary bloodstream infection
- Nosocomial infection
- Emerging infectious disease
- Primary bloodstream infection
2. 55-year-old client is admitted with an acute inferior-wall myocardial infarction. During the admission interview, he says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which of the following nursing diagnoses takes priority for this client?
- Ineffective tissue perfusion
- ineffective airway clearance
- Ineffective therapeutic regimen management
- Ineffective communication pattern
3. Hormonal effects of the antipsychotic medications include which of the following?
- Retrograde ejaculation and gynecomastia
- Dysmenorrhea and increased vaginal bleeding
- Polydipsia and dysmenorrhea
- Akinesia and dysphasia
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4. All of the following laboratory test results on a burned clients blood are present during the emergent phase. Which result should the nurse report to the physician immediately?
- Serum sodium elevated to 131 mmol/L (mEq/L)
- Serum potassium 7.5 mmol/L (mEq/L)
- Arterial pH is 7.32
- Hematocrit is 52%
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5. To minimize a toddler from scratching and picking at a healing skin graft site, the nurse should utilize?
- Hand mittens
- Mild sedatives
- Punishment for picking
- Distraction
6. The nurse is caring for a client with B-Thalassemia major. Which therapy is used to treat Thalassemia?
- IV fluids
- Frequent blood transfusions
- Oxygen therapy
- Iron therapy
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7. A patient presents to the office for a physical assessment The patient is found to be healthy and fit but occasionally drinks alcohol and has unprotected sex. What is the BEST nursing diagnosis?
- Health-seeking behavior
- knowledge deficit, high risk behavior
- Low self esteem
- Altered thought process
8. A 76 year-old woman present with facial drooping on the left side and muscle weakness of the left arm and leg after suffering a fall at home.Which type of paresis is most likely?
- Monoparesis
- Paraparesis
- Hemiparesis
- Quadri paresis
9. The nurse has performed discharge teaching to a client in need of a high-iron diet. The nurse recognizes that teaching has been effective when the client selects which meal plan?
- Hamburger French fries and orange juice
- Sliced veal spinach salad and whole-wheat roll
- Vegetable lasagna Caesar salad and toast
- Bacon lettuce and tomato sandwich; potato chips; and tea
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10. Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of
- Transformational leader
- Transactional leader
- Servant leader
- Charismatic leader
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11. Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?
- The adolescent gives away a DVD and a cherished autographed picture of a performer
- The adolescent runs out of the therapy group, swearing at the group leader, and to her room.
- The adolescent becomes angry while speaking on the telephone and slams down the receiver.
- The adolescent gets angry with her roommate when the roommate borrows the client's clothes without asking.
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12. Which of the following should the nurse do when a primipara who is lactating tells the nurse that she has sore nipples?
- Tell her to breast feed more frequently
- Administer a narcotic before breast feeding
- Encourage her to wear a nursing brassiere
- Use soap and water to clean the nipples
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13. A patient in a long-term care facility is in persistent vegetative state with a right contracture of the right arm and hand. What is the BEST goal over the next 90 days for this patient related to the nursing diagnosis of impaired mobility?
- Develop no further contractures
- Wear an arm and hand splint
- Have no pain related to the contractures
- None of the above
14. A child with iron deficiency complains of feeling tired all the times. The nursing diagnosis of fatigue is related to:
- A decreased ability of the blood to transparent oxygen to the tissues
- An increased paroxysmal abdominal pain and distension to the stomach
- A decreased anxiety level during hospitalization
- A decreased nutritional intake with malabsorption of nutrition
15. A therapy that focuses on here and now principle to promote self-acceptance?
- Gestalt therapy
- Cognitive therapy
- Behavior therapy
- Personality therapy
16. Situation: Basic knowledge on Intravenous solutions is necessary for care of clients with problems with fluids and electrolytes.Q. Which of the following is not true with regards to the informed consent?
- It should describe different treatment alternatives
- It should contain a thorough and detailed explanation of the procedure to be done
- It should describe the client's diagnosis
- It should given an explanation of the client's prognosis
17. To limit drug interactions, the nurse should advise the parent of chronically ill child to:
- Refer to the medications by the generic name
- Teach the child the name of all medications prescribed
- Give all medications one hour apart
- Get all prescriptions filled at the same pharmacy
18. Situation: Mrs. Cruz was admitted in the Medical Floor due to pyrosis, dyspepsia and difficulty of swallowing.Q. What diagnostic test would confirm the type of problem Mrs. Cruz have?
- barium enema
- barium swallow
- colonoscopy
- lower GI series
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19. Tympanic temperature is taken from John, A client who was brought recently into the ER due to frequent barking cough. The temperature reads 37.9 Degrees Celsius. As a nurse, you conclude that this temperature is:
- High
- Low
- At the low end of the normal range
- At the high end of the normal range
20. Nurse Tony should first discuss terminating the nurse-client relationship with a client during the:
- Termination phase when discharge plans are being made.
- Working phase when the client shows some progress.
- Orientation phase when a contract is established.
- Working phase when the client brings it up.
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21. A patient has hepatitis B (HBV) and is now a chronic carrier. In planning care, the nurse would explain an HBV carrier would MOST likely be at risk for developing a super infection with which other type of hepatitis?
- A
- C
- E
- D
22. When working with children who have been sexually abused by a family member it is important for the nurse to understand that these victims usually are overwhelmed with feelings of:
- Humiliation
- Confusion
- Self blame
- Hatred
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23. During a pelvic exam the nurse notes a purple-blue tinge of the cervix. The nurse documents this as which of the following?
- Braxton-Hicks sign
- Chadwicks sign
- Goodells sign
- McDonald's sign
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24. The initial assessment of a newborn reveals a chest circumference of 34cm and an abdominal circumference of 31cm. The chest is asymmetrical and breath sounds are diminished on the left side. The nurse should give priority to:
- Providing supplemental oxygen by a ventilated mask
- Performing auscultation of the abdomen for the presence of active bowel sounds
- Inserting a nasogastric tube to check for esophageal patency
- Positioning on the left side with head and chest elevated
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25. During a home visit a client with AIDS tells the nurse that he has been exposed to measles. Which action by the nurse is most appropriate?
- Administer an antibiotic.
- Contact the physician for an order for immune globulin.
- Administer an antiviral.
- Tell the client that he should remain in isolation for two weeks.
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26. A patient with chronic obstructive pulmonary disease (COPD) experiencing frequent dyspnea which of the following exercise would teach the patient how to BETTER control breathing?
- Lower side rib
- Segmental
- Pursed-lip
- Diaphragmatic
27. A client is scheduled for radical neck surgery and a total laryngectomy. During the preoperative teaching, the nurse should prepare the client for which of the following postoperative possibilities?
- Endotracheal intubation
- Insertion of laryngectomy tube
- Immediate speech therapy
- Gastrostomy tube
28. An 82 year-old woman with Alzheimer s disease had moved into a long-term care facility two weeks previously. Since then, the staff has found her wondering in the hallways in middle of the night. When approached, she is confused and frustrated, often forgetting where she is.Which intervention would most likely decrease the patient's confusion?
- Administer a sleeping sedative
- Provide full-time nursing care
- Place a nightlight in the room
- Provide a large meal before bed
29. Situation: Patricia Zeno is a client with history myasthenia gravis.Q. Clients with myasthenia gravis, Guillain-Barre Syndrome or amyotrophic sclerosis experience:
- Progressive deterioration until death
- Increased risk of respiratory complications
- Deficiencies of essential neurotransmitter
- Involuntary twitching of small muscle groups
30. Situation: Carbon Monoxide poisoning is said to be the 2nd leading cause of poison death. It is said to be the leading cause of inhalation poisoning. Mr. Edgardo was rushed to the hospital after being unconscious inside an enclosed parking lot Carbon monoxide poisoning is suspected.Q. Which of the following is a sign the nurse will expect to see on Mr. Edgardo?
- Cherry-red skin
- Pale skin
- Cyanotic
- Restlessness
31. A nurse assists a patient with Alzheimer s disease in teeth brushing. The patient indicates warning to complete the task alone, but is unable to get the toothpaste on the toothbrush. The nurse can MUST effectively help the patient by:
- Providing privacy to complete the task
- Completing task
- Providing hand-over-hand assistance with the task
- Telling the patient to brush the teeth today
32. Chris a 4-month old infant was brought by her mother to the health center because of cough. His respiratory rate is 42/minute. Using the Integrated Management of Child Illness (IMCl) guidelines of assessment, his breathing is considered as:
- Fast
- Slow
- Normal
- Insignificant
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33. When establishing an initial nurse-client relationship, Nurse Hazel should explore with the client the:
- Clients perception of the presenting problem.
- Occurrence of fantasies the client may experience.
- Details of any ritualistic acts carried out by the client
- Client's feelings when external; controls are instituted.
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34. While caring for a patient in the post-anesthesia care unit (PACU), a nurse observes the onset of rapid breathing cyanosis, and narrowing blood pressure. The nurse should plan to:
- Administer bolus glucose
- Suction the airway
- Turn the patient to the right side
- Administer intravenous fluids
35. Situation: Mr. Bald, 36 years old patient complaints of fatigue, weight loss, and low-grade fever. He also has pain his fingers, elbows, and ankles.Q. Systemic lupus erythematosus (SLE) primarily attacks which of the following tissues?
- Connective
- B. Heart
- Nerve
- Lung
36. A client has just undergone insertion of a central venous catheter at the bedside under ultrasound. The nurse would be sure to check which results before initiating the flow rate of the client's intravenous (IV) solution at 100 mL/hour?
- Serum osmolality
- Serum electrolyte levels
- Intake and output record
- Chest radiology results
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37. SITUATION: Marvin, A male patient diagnosed with colon cancer was newly put in colostomy.Q. While irrigating the client's colostomy, Marvin suddenly complains of severe cramping. Initially, the nurse would
- Stop the irrigation by clamping the tube
- Slow down the irrigation
- Tell the client that cramping will subside and is normal
- Notify the physician
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38. The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus (MRSA). Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
- The nurse leaves the stethoscope in the clients room for future use.
- The nurse cleans the stethoscope with alcohol and returns it to the exam room.
- The nurse uses the stethoscope to assess the blood pressure of other assigned clients.
- The nurse cleans the stethoscope with water dries it and returns it to the nurses station.
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39. A female client has an acute pancreatitis. Which of the following signs and symptoms the nurse would expect to see?
- Constipation
- Hypertension
- Ascites
- Jaundice
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40. Which set of vital signs would best indicate to the nurse that a client has an increase in intracranial pressure?
- BP 180/70 pulse 50 respirations 16 temperature 101°F
- BP 100/70 pulse 64 respirations 20 temperature 98.6°F
- BP 96/70 pulse 132 respirations 20 temperature 98.6°F
- BP 130/80 pulse 50 respirations 18 temperature 99.6°F
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41. The nurse provides discharge instructions to a client who is taking warfarin sodium. Which statement, by the client, reflects the need for further teaching?
- "I will avoid alcohol consumption."
- "I will take my pills every day at the same time.”
- "I have already called my family to pick up a MedicAlert bracelet."
- "I will take coated aspirin for my headaches because it will coat my stomach."
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42. A client with diabetes mellitus demonstrates acute anxiety when admitted to the hospital for the treatment of hyperglycemia. What is the appropriate intervention to decrease the client's anxiety?
- Administer a sedative.
- Convey empathy trust, and respect toward the client.
- Ignore the signs and symptoms of anxiety anticipating that they will soon disappear.
- Make sure that the client is familiar with the correct medical terms to promote understanding of what is happening.
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43. The nurse is performing an assessment on a pregnant client in the last trimester with a diagnosis of severe preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis?
- Enlargement of the breasts
- Complaints of feeling hot when the room is cool
- Periods of fetal movement followed by quiet periods
- Evidence of bleeding, such as in the gums, petechiae, and purpura
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44. Situation: Nursing care for the elderly.Q. An elderly confused client gets out of bed at night to go to the bathroom and tries to go to another bed when she returns. The MOST appropriate action the nurse would take is to:
- Assign client to a single room
- Leave a light on all night
- Remind client to call the nurse when she wants to get up
- put side rails on the bed
45. Which of the following statements is true about range of motion (ROM) exercises?
- Done just once a day
- Help prevent strokes and paralysis
- Require at least ten repetitions of each exercise
- Are often performed during ADLs such as bathing or dressing
46. A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem?
- Diarrhea
- Metabolic acidosis
- Metabolic alkalosis
- Hyperactive bowel sounds
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47. The nurse has given suggestions to a client with trigeminal neuralgia about strategies to minimize episodes of pain. The nurse determines that the client needs further teaching if the client makes which statement?
- "I will wash my face with cotton pads."
- "I'll have to start chewing on my unaffected side."
- "I should rinse my mouth if tooth-brushing is painful"
- "I'll try to eat my food either very warm or very cold."
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48. A resident who is lying in bed suddenly becomes short of breath. After calling for help, the nurse aide's next action should be to
- ask the resident to take deep breaths.
- take the resident's vital signs.
- raise the head of the bed.
- elevate the residents feet.
49. Deficiency of this mineral results in tetany, osteomalacia, osteoporosis and rickets.
- Vitamin D
- Iron
- Calcium
- Sodium
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50. The physician has ordered Coumadin (sodium warfarin) for a client with a history of clots. The nurse should tell the client to avoid which of the following vegetables?
- Lettuce
- Cauliflower
- Beets
- Carrots
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