NCLEX-RN | QB2 | Practice Exam #8 (50 questions)

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

 

1. Situation: Ronald 23 years old was voluntarily admitted to the in-patient unit with a diagnosis of paranoid schizophrenia.Q. When communicating with the paranoid client, the main principle is to:

• Use logic and be persistent
• Provide an anxiety-free environment
• Express doubt and do not argue
• Encourage ventilation of anger

2. Which of the following are the most commonly assessed findings in cystitis?

• Frequency, urgency dehydration, nausea, chills, and flank pain
• Nocturia, frequency, urgency dysuria, hematuria, fever and suprapubic pain
• Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever
• High fever, chills, flank pain nausea, vomiting, dysuria, and frequency

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3. A nurse completes discharge instruction for patient who was admitted 5 days ago with pneumonia. Which statement by the patient would alert the nurse that more discharge teaching is needed?

• I need to gradually increase my activities
• I will not need the influenza or pneumonia vaccine
• I may experience fatigue and weakness for a prolonged time
• I need to have another chest x-ray in 4-6 weeks

4. While in skilled nursing facility, a client contracted scabies, which is diagnosed the day after discharge. The client is living at her daughter's home with six other persons. During her visit to the clinic, she asks a staff nurse, "What should my family do?" the most accurate response from the nurse is:

• "All family members will need to be treated.”
• "If someone develops symptoms, tell him to see a physician right away."
• "Just be careful not to share linens and towels with family members."
• "After you're treated, family members won't be at risk for contracting scabies."

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5. A client being treated for heart failure is administered intravenous bumetamde. Which outcome indicates that the medication has achieved the expected effect?

• Cough becomes productive of frothy pink sputum.
• Urine output increases from 10 mL/hour to greater than 50 ml hourly.
• The serum potassium level changes from 3.8 to 3.1 mEq/L(3.8 to 3.1 mmol/L).
• B-type natriuretic peptide (BNP) factor increases from 200 to 262 pg/mL(200 to 262 mg/L)

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6. Situation: As a nurse in the Oncology Unit, you have to be prepared to provide efficient and effective care to your patients.Q, Which of the following can be used on the irradiated skin during a course of radiation therapy?

• Adhesive tape
• Mineral oil
• Talcum powder
• Zinc oxide ointment

7. Ramon is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using?

• Withdrawal
• Logical thinking
• Repression
• Denial

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8. Zafiriukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication?

• Platelet count
• Neutrophil count
• Liver function tests
• Complete blood count

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9. The nurse is assessing for correct placement of a nasogastric tube. The nurse aspirates the stomach contents, checks the gastric pH, and notes a pH of 7.35. Based on this information, which action should the nurse take at this time?

• Retest the pH using another strip.
• Document that the nasogastric tube is in the correct place.
• Check for placement by auscultating for air injected into the tube.
• Call the health care provider to request a prescription for a chest radiograph.

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10. A client with emphysema has been receiving oxygen at 3L per minute by nasal cannula. The nurse knows that the goal of the clients oxygen therapy is achieved when the clients PaO2 reading is:

• 50-60mm Hg
• 70-80mm Hg
• 80-90mm Hg
• 90-98mm Hg

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11. A 32 year old female comes in for evaluation 14 days after an uncomplicated caesarean section . The patient is very anxious and complaining of sharp stabling pain in her chest .The patient has dyspnea , tachypnea , and hypoxemia .Which of the following postoperative complications is likely?

• Pulmonary embolism
• Atelectasis
• Pneumonia
• Aspiration

12. In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia the nurse should expect

• A rapid delivery
• Cervical effacement
• Infrequent contractions
• Progressive cervical dilation

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13. A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during social situation?

• Paranoia thoughts
• Emotional affect
• Independence need
• Aggressive behavior

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14. Nurse Derek is supervising a group of elderly clients in a residential home setting. The nurse knows that the elderly are at greater risk of developing sensory deprivation for what reason?

• Increased sensitivity to the side effects of medications.
• Decreased visual auditory and gustatory abilities.
• Isolation from their families and familiar surroundings.
• Decrease musculoskeletal function and mobility

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15. Situation: Ella is pregnant with her first baby. She went to the clinic for check-up.Q. According to Ella, her LMP is November 15, 2002. Using the Naegele's rule what is her EDC?

• August 22,2003
• July 22, 2003
• August 18, 2003
• February 22, 2003

16. Patricia a 20 year old college student with diabetes mellitus requests additional information about the advantages of using a pen like insulin delivery devices. The nurse explains that the advantages of these devices over syringes includes:

• Accurate dose delivery
• Shorter injection time
• Lower cost with reusable insulin cartridges
• Use of smaller gauge needle.

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17. The pathognomonic sign of measles is Koplik's spot You may see Koplik's spot by inspecting the:

• Nasa Mucosa
• Bucca mucosa
• Skin on the abdomen
• Skin on the antecubital surface

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18. Baby Reese is a 12 month old child. Nurse Oliver would anticipate how many teeth?

• 9
• 7
• 8
• 6

19. A client with schizophrenia who receives fluphenazine (Prolixin) develops pseudoparkinsonism and akinesia. What drug would the nurse administer to minimize extrapyramidal symptoms?

• benztropine (Cogentin)
• dantrolene (Dantrium)
• clonazepam (Klonopin)
• diazepam (Valium)

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20. A 7 year old boy with a fractured leg tells the nurse that he is bored. An appropriate intervention would be to

• Read a story and act out the part
• Watch a puppet show
• Watch television
• Listen to the radio

21. Nurse Trinity administered neutral protamine Hagedorn (NPH) insulin to a diabetic client at 7 a.m. At what time would the nurse expect the client to be most at risk for a hypoglycemic reaction?

• 10:00 am
• Noon
• 4:00 pm
• 10:00 pm

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22. The following are correct actions when taking radial pulse except:

• Put the palms downward
• Use the thumb to palpate the artery
• Use two or three fingers to palpate the pulse at the inner wrist
• Assess the pulse rate, rhythm, volume and bilateral quality

23. Situation: Anesthesia is used even during the Ancient times. In its evolution, modern marvels in the use of anesthesia enables the nurses to develop a more competitive approach in patient care.Q. Before the induction of spinal anesthesia, the client is placed in which of the following preferred position to widen the vertebral space:

• Quasi fetal position
• Prone position
• Flat on bed supine position
• Side Lying position affected side

24. Situation: You were on duty at the medical ward when Zeny came in for admission for tiredness, cold intolerance, constipation, and weight gain. Upon examination, the doctor's diagnosis was hypothyroidism.Q. Myxedema coma is a life threatening complication of long standing and untreated hypothyroidism with one of the following characteristics.

• Hyperglycemia
• hypothermia
• hyperthermia
• hypoglycemia

25. Prior to initiating therapy with unfractionated heparin for a patient hospitalized with a deep vein thrombosis, this treatment requires:

• Bed rest
• Aspirin therapy
• Fluid restrictions
• A high protein diet

26. A child has fluid volume deficit. The nurse per- forms an assessment and determines that the child is improving and the deficit is resolving if which finding is noted?

• The child has no tears.
• Urine specific gravity is 1.035.
• Capillary refill is less than 2 seconds.
• Urine output is less than 1 mL/kg/hour.

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27. 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. Ms. Baker has decided to have surgical correction of her stenosed valve at this time because her subjective complaints of dyspnea, hemoptysis, orthopnea, and paroxysmal nocturnal dyspnea have become unmanageable. These complaints are probably due to:

• thickening of the pericardium
• right heart failure
• pulmonary hypertension
• left ventricular hypertrophy

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28. Situation: The nurse engages the client in a. nurse-patient interaction.Q. The client has not been visited by relatives for months. He gives a, telephone number and requests the nurse to call. An appropriate action of the nurse would be:

• Inform the attending psychiatric about the request of the client
• Assist the client to bring his concern to the attention of the social worker
• "Here (gives her mobile phone). You may call this number now."
• Ask the client what is the purpose of contacting his relatives

29. The nurse is providing a health teaching to a group of parents regarding Chlamydia trachomatis. The nurse is correct in the statement, "Chlamydia trachomatis is not only an intracellular bacterium that causes neonatal conjunctivitis, but it also can cause:

• Discoloration of baby and adult teeth.
• Pneumonia in the newborn.
• Snuffles and rhagades in the newborn.
• Central hearing defects in infancy.

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30. The nurse is assisting the physician with removal of a central venous catheter. To facilitate removal the nurse should instruct the client to:

• Perform the Valsalva maneuver as the catheter is advanced
• Turn his head to the left side and hyperextend the neck
• Take slow deep breaths as the catheter is removed
• Turn his head to the right while maintaining a sniffing position

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31. Blake is working with a schizophrenic patient He noticed that the client is agitated, pacing back and forth, restless and experiencing Anxiety +3. Blake said "You appear restless" What therapeutic technique did Blake used?

• Offering general leads
• Seeking clarification
• Making observation
• Encouraging description of perception

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32. A client is hospitalized with fractures of the right femur and right humerus sustained in a motorcycle accident. Police suspect the client was intoxicated at the time of the accident Laboratory tests reveal a blood alcohol level of 0.2% (200 mg/dl). The client later admits to drinking heavily for years. During hospitalization, the client periodically complains of tingling and numbness in the hands and feet. The nurse realizes that these symptoms probably result from:

• acetate accumulation.
• thiamine deficiency.
• triglyceride buildup.
• a below-normal serum potassium level

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33. The nurse is preparing a client for discharge following the removal of a cataract The nurse should tell the client to:

• A decrease in systolic blood pressure during inspiration
• An increase in diastolic blood pressure during expiration
• An increase in systolic blood pressure during inspiration
• A decrease in diastolic blood pressure during expiration

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34. The nurse is aware that one of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility?

• Beta-adrenergic blockers
• Calcium channel blocker
• Diuretics
• Inotropic agents

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35. Mr. Duffy is admitted to the CCll with a diagnosis of R/O Ml. He presented in the ER with a typical description of pain associated with an Ml, and is now cold and clammy, pale and dyspneic. He has an IV of D5W running, and is complaining of chest pain. Oxygen therapy has not been started, and he is not on the monitor. He is frightened.Q. The point of maximal impulse (PMl) is an important landmark in the cardiac exam. Which statement best describes the location of the PMI in the healthy adult?

• Base of the heart, 5th intercostal space, 7-9 cm to the left of the midsternal line.
• Base of the heart, 7th intercostal space, 7-9 cm to the left of the midsternal line.
• Apex of the heart, intercostal space, 7-9 cm to the left of the midsternal line.

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36. A urine specimen for ketones should be removed from a clients retention catheter by:

• Disconnecting the catheter and draining it into a clean container
• Cleansing the drainage valve and removing it from the catheter bag
• Wiping the catheter with alcohol and draining it into a sterile test tube
• Using a sterile syringe to remove it from clamped, cleansed catheter

37. The client with cirrhosis of the liver is receiving Lactulose. The nurse is aware that the rationale for the order for Lactulose is:

• To lower the blood glucose level
• To lower the uric acid level
• To lower the ammonia level
• To lower the creatinine level

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38. In the Philippines, which specie of schistosoma is endemic in certain regions?

• S. mansoni
• S. japonicum
• S. malayensis
• S. haematobium

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39. Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy.Q. An oropharyngeal airway may:

• Not be used in a conscious patient.
• Cause airway obstruction.
• Prevent a patient from biting and occluding an ET tube.
• All of the above

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40. A client with myasthenia gravis ask the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:

• A genetic in the production acetylcholine
• A reduced amount of neurotransmitter acetylcholine
• A decreased number of functioning acetylcholine receptor sites
• An inhibition of the enzyme ACHE leaving the end plates folded

41. Situation: As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented.Q. Which among the following interventions should you consider as the highest priority when caring for June who has hemiparersis secondary to stroke?

• Place June on an upright lateral position
• Perform range of motion exercises
• Apply antiembolic stocking
• Use hand rolls or pillows for support

42. Francis who is addicted to cocaine withdraws from the drug. Nurse Ron should expect to observe:

• Hyperactivity
• Depression
• Suspicion
• Delirium

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43. During surgery, the nurse is assigned the following duties: setting up the sterile field, preparing sutures and ligatures assisting the surgeon during the procedure by anticipating the instruments and supplies that will be required and labeling tissue specimen obtained during surgery. The nurse MOST likely performing in what role?

• Circulating nurse
• Scrub Nurse
• RN first assistance
• Nurse anaesthetist

44. A nurse visits a patient at home who does not understand how to take a newly prescribed medication. The prescription reads: 5 ml PO TID p.c. meals. The nurse explains to the patient that the correct way to take the medication is:

• 1 teaspoon by mouth, 3 times a day before meals
• 1 teaspoon by mouth, 3 times a day after meals
• 1 tablespoon by mouth, 3 times a day before meals
• 1 tablespoon by mouth, 3 times a day after meals

45. Situation: Celina age 25, a ramp model, suddenly became blind after her boyfriend broke off with her. A thorough workup did not reveal any pathological findings.Q. The defense mechanism commonly used by these clients is:

• Projection
• Rationalization
• Repression
• Sublimation

46. 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 penicillin (Megacillin)
• Amoxicillin (Amoxil)
• Erythromycin (Eryhrocin)
• Vancomycin (Vancocin)

47. The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment which data would the nurse expect to obtain when asking the parent about the child's symptoms?

• Watery diarrhea
• Projectile vomiting
• Increased urine output
• Vomiting large amounts of bile

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48. The client has recently been diagnosed with diabetes. Which of the following indicates understanding of the management of diabetes?

• The client selects a balanced diet from the menu.
• The client can tell the nurse the normal blood glucose level.
• The client asks for brochures on the subject of diabetes.
• The client demonstrates correct insulin injection technique.

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49. Which action by the nurse indicates understanding of herpes zoster?

• The nurse covers the lesions with a sterile dressing.
• The nurse wears gloves when providing care.
• The nurse administers a prescribed antibiotic.
• The nurse administers oxygen.

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50. Situation: Jerome, a 37 years old man, was admitted to the hospital with periodic episode of manic behavior alternating with me depression. Diagnosis: Bipolar 1 disorder.Q. Initially one of the following activities would be appropriate for Jerome;

• Playing basketball
• Playing chess
• Gardening
• Writing

NCLEX-RN | QB2 | Practice Exam #8 (50 questions)