NCLEX-RN | QB2 | Practice Exam #12 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. The nurse is performing an assessment on a client with possible pernicious anemia. Which data would support this diagnosis?
- Complaints of numbness and tingling in the extremitiesComplaints of numbness and tingling in the extremities
- A weight loss of 10 pounds in two weeks
- A red beefy tongue
- A hemoglobin level of 12.0gm/dL
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2. A client has had a unilateral adrenalectomy to remove a tumor. The most important measurement in the immediate post-operative period for the nurse to take is:
- The blood pressure
- The temperature
- The urinary output
- The specific gravity of the urine
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3. Situation: Clients with Bipolar disorder receives a very high nursing attention due to the increasing rate of suicide related to illness.Q. A nurse is conducting a group therapy session and during the session. A client with mania consistently talks and dominates the group. The behaviour is disrupting the group interaction. The nurse would initially:
- Ask the client to leave the group session.
- Tell the client that she will not be allowed to attend any more group sessions.
- Tell the client that she needs to allow other client in a group time to talk.
- Ask another nurse to escort the client out of the group session.
4. Emily has gestational diabetes and it is usually managed by which of the following therapy?
- Diet
- Long-acting insulin
- Oral hypoglycemic
- Oral hypoglycemic drug and insulin
5. A nurse is assessing a child with cystic fibrosis. After thoroughly assessing respiratory status, the nurse should assess which of the following?
- Level of pain
- Skin turgor
- Genitourinary status, clarity of urine
- Nutritional status, characteristics of stool
6. While visiting a patient with a new colostomy, the home care nurse observes that the skin around the stoma site is red. Which intervention should the nurse do next?
- Apply pectin, gelatin or synthetic skin barrier around the stoma
- Apply triple antibiotic to the raw skin and leave it open to the air
- Instruct to empty the pouch as soon as stool is present
- Instruct to remove the bag and skin barrier after each stool
7. While caring for a patient in the post-anesthesia care unit (PACU), a nurse plans to Keep the patient warm. What is the MUST important reason for this action?
- To preserve nutritional stores
- To prevent cutaneous vessel dilation
- To decrease patient anxiety
- To lower risk of infection resulting from chill
8. Postpartum Period:The fundus of the uterus is expected to go down normally postpartally about __ cm per day.
- 1.0 cm
- 2.0 cm
- 2.5 cm
- 3.0 cm
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9. Which of the following is formal continuing education?
- Conference
- Enrollment in graduate school
- Refresher course
- Seminar
10. An adolescent client comes to the clinic 3 weeks after the birth of her first baby. She tells the nurse she is concerned because she has not returned to her pre-pregnant weight Which action should the nurse perform first?
- Review the client's weight pattern over the year
- Ask the mother to record her diet for the last 24 hours
- Encourage her to talk about her view of herself
- Give her several pamphlets on postpartum nutrition
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11. Situation: Mr. Reyes suffered head injuries in a motor vehicle accidentQ. Mr. Reyes is extremely confused. The nurse provide new information slowly and in small amounts because;
- Confusion or delirium can be a defense against further stress
- Destruction of brain cells has occurred, interrupting mental activity
- Teaching based on information progressing from the simple to the complex
- A minimum of information should be given, since he is unaware of surroundings
12. After administering inhaled corticosteroids to hospitalized child with asthama, the nurse plans to have the child rinse the mouth and gargle with water. The nurse knows the rationale for this action is prevention of:
- Tooth decay
- Oral candidiasis
- Dehydration
- Hypertrophy of the gums
13. A two-year-old is hospitalized with suspected intussusception. Which finding is associated with intussusception?
- Currant jelly stools
- Projectile vomiting
- Ribbonlikestools
- Palpable mass over the flank
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14. Nurse Monette recognizes that the focus of environmental (MILIEU) therapy is to:
- Manipulate the environment to bring about positive changes in behavior
- Allow the clients freedom to determine whether or not they wili be involved in activities
- Role play life events to meet individual needs
- Use natural remedies rather than drugs to control behavior
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15. A male client is admitted to the emergency department following an accident What are the first nursing actions of the nurse?
- Check respiration, circulation, neurological response.
- Align the spine, check pupils, and check for hemorrhage.
- Check respirations, stabilize spine, and check circulation.
- Assess level of consciousness and circulation.
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16. The nurse is preparing to care for a dying client, and several family members are at the client's bedside. Which therapeutic techniques should the nurse use when communicating with the family? Select all that apply. 1.Discourage reminiscing. 2.Make the decisions for the family. 3.Encourage expression of feelings, concerns, and fears. 4.Explain everything that is happening to all family members. 5.Touch and hold the client's or family member's hand if appropriate. 6.Be honest and let the client and family know they will not be abandoned by the nurse
- 1,2,3,4
- 2,4,5,6
- 3,5,6
- 2,3,4
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17. Situation: Vincent, age 26, who is caught in me raging conflict between his mother and his wife, complains of pains in his right leg that has progressed to the point of paralysis. After orthopedic consultation has shown no pathology, he is referred for a psychiatric consultation and is found to have a conversion disorder.Q. Vincent's conflict may be caused by which of the following stimuli?
- Hostile feelings towards his home
- Ambivalent feelings toward his wife
- Needs to be a dependent child and an independent adult
- Inadequate feelings in regard to assuming the role of husband
18. A female client with a fecal impaction frequently exhibits which clinical manifestation?
- Increased appetite
- Loss of urge to defecate
- Hard, brown, formed stools
- Liquid or semi-liquid stools
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19. Which statistic can give the most accurate reflection of the health status of a community?
- 1-4 year old age-specific mortality rate
- Infant mortality rate
- Swaroop's index
- Crude death rate
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20. Which of the following reacts to viruses and bacteria by increasing in number?
- Antigens
- Antibodies
- Rh factors
- Platelets
21. The nurse is caring for a client after a laryngectomy. The client is anxious with a respiratory rate of 32 and an oxygen saturation of 88. What should be the initial nursing action?
- Suction the client.
- increase the oxygen flow rate.
- Notify the physician.
- Recheck the O2 saturation reading.
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22. A six-month-old client is admitted with possible intussuception. Which question during the nursing history is least helpful in obtaining information regarding this diagnosis?
- Tell me about his pain.
- What does his vomit look like?
- Describe his usual diet.
- Have you noticed changes in his abdominal size?
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23. Who collects blood specimen?
- The nurse
- Medical technologist
- Physical therapist
- Physician
24. Situation: As a member of the health and nursing team you have a crucial role to play in ensuring that all the members participate actively is the various tasks agreed upon.Q. Part of your responsibility as a member of the diabetes core group is to get referrals from the various wards regarding diabetic patients needing diabetes education. Prior to discharge today 4 patients are referred to you. How would you start prioritizing your activities?
- Bring your diabetes teaching kit and start your session taking into consideration their distance from your office
- Contact the nurse-in-charge and find out from her the reason for the referral
- Determine their learning needs then prioritize
- involve the whole family in the teaching class
25. The physicians notes state that a client with cocaine addiction has formication. The nurse recognizes that the client has:
- Tactile hallucinations
- Irregular heart rate
- Paranoid delusions
- Methadone tolerance
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26. After a prostatectomy, a client complains of painful bladder spasms. To limit these spasms the nurse should:
- Administer a narcotic every 4 hours
- irrigate the foley catheter with 60 ml of normal saline
- Encourage the client not to contract his muscles as if he were voiding
- Advance the catheter to relieve the pressure against the prostatic fossa
27. What statement by the client recovering from cataract surgery would indicate to the nurse need for additional teaching?
- I'll call if I have a significant amount of pain.
- I'll continue to take my Metamucil for another week.
- I'll just do some laundry this afternoon instead of going to work.
- I'll take my acetazolamide (Diamox) drops with my other morning medications
28. A 51 -year-old female client tells the nurse in-charge that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client's lump is cancerous?
- Eversion of the right nipple and mobile mass
- Nonmobile mass with irregular edges
- Mobile mass that is soft and easily delineated
- Nonpalpable right axillary lymph nodes
29. Ronny told Blake I see dead people. Blake responded, You see dead people? This exchange is an example of what therapeutic communication technique?
- Reflecting
- Restating
- Exploring
- Seeking clarification
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30. According to DUNN, Overcrowding is what type of illness precursor?
- Heredity
- Social
- Behavioral
- Environmental
31. A client is admitted to the inpatient psychiatric unit He is unshaven, has body odor, and has spots on his shirt and pants. He moves slowly, gazes at the floor, and has a fiat affect The nurse's highest priority in assessing the client on admission would be to ask him:
- How he sleeps at night.
- If he is thinking about hurting himself.
- About recent stresses.
- How he feels about himself.
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32. A child comes in the clinic with several lesions to scalp. The round lesions have dandruff like scaling with hair loss. What is the most likely diagnosis?
- Impetigo
- Ringworm
- Ascariasis
- Amoebiasis
33. Situation: The mental health - psychiatric nurse functions in a variety of setting with different types of clients.Q. In a residential treatment home for adolescent girl's the clients were becoming increasingly tense and upset because of shortening of their recreation time. To die escalate possible anger and aggression among the clients it is BEST to play:
- religious music
- relaxation music
- dance music
- rock music
34. Arnold, a 19-year-old client with a mild concussion is discharged from the emergency department. Before discharge, he complains of a headache. When offered acetaminophen, his mother tells the nurse the headache is severe and she would like her son to have something stronger. Which of the following responses by the nurse is appropriate?
- "Your son had a mild concussion, acetaminophen is strong enough"
- "Aspirin is avoided because of the danger of Reye's syndrome in children or young adults"
- "Narcotics are avoided after a head injury because they may hide a worsening condition."
- "Stronger medications may lead to vomiting, which increases the intracranial pressure (ICP)"
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35. Which is a characteristic of person-to-person propagated epidemic?
- There are more cases of the disease than expected
- The disease must necessarily be transmitted through a vector
- The spread of the disease can be attributed to a common vehicle
- There is gradual build up of cases before we epidemic becomes easily noticeable
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36. Situation: In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with all these to safeguard the safety and quality to patient delivery outcome.Q. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered 'dirty cases'. When are these; procedures best scheduled?
- Last case
- In between cases
- According to availability of anesthesiologist
- According to the surgeon's preference
37. A six-month-old is being treated for thrush with Nystatin (mycostatin) oral suspension. The nurse should administer the medication by:
- Placing it in a small amount of applesauce
- Using a cotton-tipped swab
- Adding it to the infants formula
- Placing it in 2-3 oz. of water
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38. A child is admitted to the hospital with dehydration. The nurse should Give PRIORITYto which of the following nursing diagnoses?
- Anxiety related to hospitalization
- Fluid volume deficit related to vomiting
- Imbalance nutrition less than body requirements related diarrhea
- Risk for infection related to presence of invasive lines
39. What occurs during cardiogenic shock and result in inadequate tissue perfusion?
- Increased resistance of arterial vessels
- Decreased effectiveness of the heart as a pump
- Increased shunting of critical blood flow to heart
- Decreased capacity of the venous beds
40. A patient with a history of chronic obstructive pulmonary disease prepares for a colonoscopy with conserve sedation. Due to the patient's history the nurse should very cautious about administering.
- Antibiotics
- Sedation
- Oxygen
- Intravenous fluid
41. How should Nurse Michelle guide a child who is blind to walk to the playroom?
- Without touching the child, talk continuously as the child walks down the hall.
- Walk one step ahead, with the child's hand on the nurse's elbow.
- Walk slightly behind, gently guiding the child forward.
- Walk next to the child, holding the child's hand.
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42. A force within an individual that influences the strength of behavior?
- Motivation
- Envy
- Reward
- Self-esteem
43. A community health nurse is teaching healthful lifestyles to a group of senior citizens. The nurse knows that the leading cause of death in persons 65 and older is:
- Diabetes mellitus
- Chronic pulmonary disease
- Pneumonia
- Heart disease
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44. A woman is admitted to the psychiatric emergency department Her significant other reports that she has difficulty sleeping, has poor judgment, and is incoherent at times. The client's speech is rapid and loose. She reports being a special messenger from the Messiah. She has a history of depressed mood for which she has been taking an antidepressant. The nurse suspects which diagnosis?
- Schizophrenia
- Paranoid personality
- Bipolar illness
- Obsessive-compulsive disorder (OCD)
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45. Nurse Martan is preparing to administer a blood transfusion. Which action should the nurse take first?
- Arrange fortyping and cross matching of the clients blood.
- Compare the clients identification wristband with the tag on the unit of blood.
- Start an I.V. infusion of normal saline solution.
- Measure the client's vita; signs.
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46. What is characteristic symptom of hypoglycemia that should alert nurse to an early insulin reaction?
- Diaphoresis
- Drowsiness
- Severe thirst
- Coma
47. During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is necessary because?
- Anesthesia is administered during the procedure
- Decrease oxygen to the brain increases confusion and disorientation
- Grand mal seizure activity depresses respirations
- Muscle relaxations given to prevent injury during seizure activity depress respirations.
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48. The clinic nurse assesses the skin of a client with psoriasis after the client has used a new topical treatment for 2 months. The nurse identifies which characteristics as improvement in the manifestations of psoriasis? Select all that apply. 1.Presence of striae. 2.Palpable radial pulses. 3.Absence of any ecchymosison the extremities. 4.Thinner and decrease in number of reddish papules. 5.Scarce amount of silvery-white scaly patches on the arms
- 1,4
- 2,3,4,5
- 4,5
- 3,4
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49. A registered nurse who works in the preoperative area of the operating room notices that a client is scheduled for a partial mastectomy and axillary lymph node removal the following week. The nurse should make sure, that the client is well educated about her surgery by:
- taking with the nursing staff at the physician's office to find out what the client has been taught and her level of understanding
- making sure that the post-anesthesia recovery unit nurses know what to teach the patient before discharge
- providing all of the preoperative teaching before surgery
- having the post-operative nurses teach the patient because she'll be too anxious before surgery
50. An 83-year-old woman has several ecchymotic areas on her right arm. The bruises are probably caused by:
- increased capillary fragility and permeability
- increased blood supply to the skin
- self inflicted injury
- elder abuse