NCLEX-RN | QB2 | Practice Exam #17 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. SITUATION: Mr. Bond, a client with early Dementia exhibits thought process disturbances.Q. The nurse will assess a loss of ability in which of the following areas?
- Balance
- Judgment
- Speech
- Endurance
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2. A client is admitted with acute adrenal crisis. During the intake assessment the nurse can expect to find that the client has:
- Low blood pressure
- A slow regular pulse
- Warm flushed skin
- Increased urination
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3. The chemotherapeutic DNA alkylating agents such as nitrogen mustards are effective because they:
- Cross-link DNA strands with covalent bonds between alkyl groups on the drug and guanine bases on DNA.
- Have few, if any side effects.
- Are used to treat multiple types of cancer.
- Are cell cycle-specific agents.
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4. A woman who delivered normally per vagina is expected to void within hours after delivery.
- 3 hrs
- 4 hrs
- 6-8 hrs
- 12-24 hours
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5. When teaching a group of adolescents about male hormone production, which of the following would the nurse include as being produced by the Leydig cells?
- Follicle-stimulating hormone
- Testosterone
- Leuteinizing hormone
- Gonadotropin releasing hormone
6. In his theory of learning as a BEHAVIORISM, he stated that transfer of knowledge occurs if a new situation closely resembles an old one.
- Bloom
- Lewin
- Thorndike
- Skinner
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7. Which of the following pediatric clients is at greatest risk for latex allergy?
- The child with a myelomeningocele
- The child with epispadias
- The child with coxa plana
- The child with rheumatic fever
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8. 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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9. Dr. Marquez orders serum electrolytes. To determine the effect of persistent vomiting, Nurse Trish should be most concerned with monitoring the:
- Chloride and sodium levels
- Phosphate and calcium levels
- Protein and magnesium levels
- Sulfate and bicarbonate levels
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10. The nurse is assessing a client who is 6 hours postpartum after delivering a full-term healthy newborn. The client complains to the nurse of feelings of faintness and dizziness. Which nursing action is most appropriate?
- Raise the head of the client's bed.
- Obtain hemoglobin and hematocrit levels.
- Instruct the client to request help when getting out of bed.
- Inform the nursery room nurse to avoid bringing the newborn to the client until the clients symptoms have subsided.
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11. The home health nurse is visiting a 15-year-old with sickle cell disease. Which information obtained on the visit would cause the most concern? The client:
- Likes to play baseball
- Drinks several carbonated drinks per day
- Has two sisters with sickle cell trait
- Is taking Tylenol to control pain
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12. While reviewing the chart of a client with a history of hepatitis B the nurse finds a serologic marker of HB8 AG. The nurse recognizes that the client:
- Has chronic hepatitis B
- Has recovered from hepatitis B infection
- Has immunity to infection with hepatitis C
- Has no chance of spreading the infection to others
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13. A nurse is assessing a pregnant client during the third trimester. What clinical finding is an expected response to the pregnancy?
- Tachycardia
- Dyspnea at rest
- Progressive dependent edema
- Shortness of breath on exertion
14. A nurse is providing care to a patient with a new skin graft on left leg. The patient is upset and the nurse notes copious red drainage oozing around the dressing. The nurse should immediately:
- Lift the dressing to assess the area
- Ask if the patient is having any pain
- Apply firm pressure for 10 to 15 minutes
- Assess the apical pulse
15. Term to describe the reactivation and recurrence of pronounced symptoms of a disease
- Remission
- Emission
- Exacerbation
- Sub acute
16. Situation: Developing countries such as the Philippines suffer from high infant and child mortality rates. Thus, as a management to the existing problem, the WHO and UNICEF launched the IMCI. An ear discharge that has been present for less than 14 days can be classified as:
- Complicated ear infection
- Acute ear infection
- Chronic ear infection
- Mastoiditis
17. A slipknot is used when securing a restraint so that
- the restraint cannot be removed by the resident.
- the restraint can be removed quickly when needed.
- body alignment is maintained while wearing the restraint.
- it can be easily observed whether the restraint is applied correctly.
18. The nurse is conducting a session about the principles of first aid and is discussing the interventions for a snakebite to an extremity. The nurse should inform those attending the session that the first priority intervention in the event of this occurrence is which action?
- Immobilize the affected extremity
- Remove jewelry and constricting clothing from the victim.
- Place the extremity in a position so that it is below the level of the heart.
- Move the victim to a safe area away from the snake and encourage the victim to rest.
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19. A client is about to undergo a lumbar puncture. The nurse describes to the client that which position will be used during the procedure?
- Side-lying with a pillow under the hip
- Prone with a pillow under the abdomen
- Prone in slight Trendelenburg position
- Side-lying with the legs pulled up and the head bent down onto the chest
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20. The normal respiration of a newborn immediately after birth is characterized as:
- Shallow and irregular with short periods of apnea lasting not longer than 15 seconds, 30-60 breaths per minute.
- 20-40 breaths per minute, abdominal breathing with active use of intercostals muscles.
- 30-60 breaths per minute with apnea lasting more than 15 seconds, abdominal breathing
- 30-50 breaths per minute, active use of abdominal and intercostal muscles
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21. When involved in prenatal teaching, a nurse should inform clients that there is an increase in vaginal secretions during pregnancy called leukorrhea. What causes this increase?
- Metabolic rate
- Production of estrogen
- Secretion from the Bartholin glands
- Supply of sodium chloride to the vaginal cell
22. The nurse is aware that the following solutions is routinely used to flush an IV device before and after the administration of blood to a patient is:
- 0.9 percent sodium chloride
- 5 percent dextrose in water solution
- Sterile water
- Heparin sodium
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23. 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. During the first three days that Mr. Duffy is in the CCU, a number of diagnostic blood tests are obtained. Which of the following patterns of cardiac enzyme elevation are most common following an MI?
- SGOT, CK, and LDH are all elevated immediately.
- SGOT rises 4-6 hours after infarction with CK and LDH rising slowly 24 hours later.
- CK peaks first (12-24 hours), followed by the SGOT (peaks in 24-36 hours) and then the LDH (peaks 3-4 days).
- CK peaks first and remains elevated for 1 to 2 weeks.
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24. Situation: Breast cancer is the 2nd most common type of cancer after lung cancer and 99% of which, occurs in women. Survival rate is 98% if this is detected early and treated promptly. Carmen is a 53 year old patient in the high risk group for breast cancer was recently diagnosed with Breast Cancer.Q. Protective factors for the development of breast cancer includes which of the following EXCEPT:
- Exercise
- Prophylactic Tamoxifen
- Breast Feeding
- Alcohol intake
25. Which of the following roommates would be best for the client newly admitted with gastric resection?
- A client with Crohn disease
- A client with pneumonia
- A client with gastritis
- A client with phlebitis
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26. The nurse is instructing a client with hypertension on the importance of choosing foods low in sodium. The nurse should teach the client to limit intake of which food?
- Apples
- Bananas
- Smoked sausage
- Steamed vegetables
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27. Situation As a nurse, you should be aware and prepared of the different roles you play.Q. A one-day postoperative abdominal surgery client has been complaining of severe throbbing abdominal pain described as 9 in a 1-10 pain rating. Your assessment reveals bowel sounds on all quadrants and the dressing is dry and intact What nursing intervention would you take?
- Medicate client as prescribed
- Encourage client to do imagery
- Encourage deep breathing and turning
- Call surgeon stat
28. After gastroscopy, an adaptation that indicates major complication would be:
- Nausea and vomiting
- Abdominal distention
- Increased GI motility
- Difficulty in swallowing
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29. A client is admitted to the inpatient adolescent unit after being arrested for attempting to sell cocaine to an undercover police officer. The nurse plans to write a behavioral contract To best promote compliance, the contract should be written:
- abstractly
- by the client alone.
- jointly by the client and nurse.
- jointly by the physician and nurse.
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30. During the postpartum period, a client tells a nurse she is having leg cramps. Which foods should the nurse encourage the client to eat?
- Liver and raisins
- Cheese and broccoli
- Eggs and lean meats
- Whole wheat breads and cereals
31. A neurological consult has been ordered for a pediatric client with suspected absence seizures. The client with absence seizures can be expected to have:
- Short abrupt muscle contractions
- Quick severe bilateral jerking movements
- Abrupt loss of muscle tone
- Brief lapse in consciousness
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32. The nurse working in the emergency department realizes that it would be contraindicated to induce vomiting if someone had ingested which of the following?
- Ibuprofen
- Aspirin
- Vitamins
- Gasoline
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33. In this mother's class, the nurse discusses about: specific needs during pregnancy and lactation, She states that the daily servings required for the carbohydrates group are:
- 4 servings
- 6 servings
- 2 servings
- 3 servings
34. Nurse Evangeline teaches an elderly client how to use a standard aluminum walker. Which of the following behaviors, if demonstrated by the client, indicates that the nurse's teaching was effective?
- The client slowly pushes the walker forward 12 inches, then takes small steps forward while leaning on the walker.
- The client lifts the walker, moves it forward 10 inches, and then takes several small steps forward.
- The client supports his weight on the walker while advancing it forward, then takes small steps while balancing on the walker
- The client slides the walker 18 inches forward, then takes small steps while holding onto the walker for balance.
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35. When assessing a lesion diagnosed as basal cell carcinoma, the nurse most likely expects to note which findings? Select all that apply. 1.An irregularly shaped lesion. 2.A small papule with a dry rough scale. 3.A firm, nodular lesion topped with crust. 4.A pearly papule with a central crater and a waxy border. 5.Location in the bald spot atop the head that is exposed to outdoor sunlight
- 4,5
- 1,2,3
- 3,4,5
- 1,3,5
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36. A Patient presents at the clinic with weight loss and complains of trouble seeing at night. The nurse also observes numerous teeth with decay. Upon Learning that the patient has a vitamin deficiency which of the following foods would the nurse MOST likely instruct the patient to add to diet?
- Cheese and breads
- Liver and rice
- Fish and rice
- Fruits and vegetables
37. A nurse aide is asked to change a urinary drainage bag attached to an indwelling urinary catheter The nurse aide has never done this before. The best response by the nurse aide is to
- change the indwelling catheter at the same time.
- ask another nurse aide to change the urinary drainage bag.
- change the bag asking for help only if the nurse aide has problems.
- ask a nurse to watch the nurse aide change the bag since it is the first time.
38. A clients vision is tested with a Snellen chart The results of the tests are documented as 20/60. What action should the nurse implement based on this finding?
- Provide the client with materials on legal blindness.
- Instruct the client that he or she may need glasses when driving.
- Inform the client of where he or she can purchase a white cane with a red tip.
- Inform the client that it is best to sit near the back of the room when attending lectures.
39. A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia?
- It can develop into ventricularnbriNation at anytime.
- It is almost impossible to convert to a normal rhythm.
- It is uncomfortable for the client, giving a sense of impending doom.
- It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia.
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40. The angle of the syringe and needle for intramuscular injections is:
- 90 degrees
- 45 degrees
- 15 degrees
- 10 degrees
41. The nurse is performing an assessment on an older client who is having difficulty sleeping at night Which statement by the client indicates the need for further teaching regarding measures to improve sleep?
- "I swim 3 times a week"
- "I have stopped smoking cigars."
- "I drink hot chocolate before bedtime."
- "I read for 40 minutes before bedtime."
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42. Which is the best nursing intervention regarding complementary and alternative medicine?
- Advising the client about "good" versus "bad" therapies
- Discouraging the client from using any alternative therapies
- Educating the client about therapies that he or she is using or is interested in using
- Identifying herbal remedies that the client should request from the health care provider
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43. A patient had right knee surgery and is being transferred to the post anesthesia care unit, which of the following information is ESSENTIAL to discuss
- Pre-operative weakness of the lower extremities
- Anxiety related to inherited risk factors of surgery
- Fear related to body image disturbances
- Allergy to aspirin based products
44. When caring for the child with autistic disorder the nurse should:
- Take the child to the playroom to be with peers.
- Assign a consistent caregiver.
- Place the child in a ward with other children.
- Assign several staff members to provide care.
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45. A 24 year-old man was admitted to the hospital after receiving a closed head injury in a motor vehicle accident He had a Glasgow Coma Score of 6 on admission and was being mechanically ventilated. The nurse observes the intracranial pressure has slowly and steadily increased over the past hour. What is the most appropriate initial nursing action?
- Administer mannitol
- Administer Phenobarbital
- Increase respiratory rate
- Reposition while maintaining neck alignment
46. Which of the following is the most critical intervention needed for a client with myxedema coma?
- Administering an oral dose of levothyroxine (Synthroid)
- Warming the client with a warming blanket
- Measuring and recording accurate intake and output
- Maintaining a patent airway
47. SITUATION: A 45 year old male construction worker was admitted to a tertiary hospital for incessant vomiting. Assessment disclosed: weak rapid pulse, acute weight loss of 0.5kg, furrows in his tongue, slow flattening of the skin was noted when the nurse released her pinch. Temperature: 35.8 C , BUN Creatinine ratio: 10 :1, He also complains for postural hypotension. There was no infection.Q. Approximately how much fluid is lost in acute weight loss of 0.5kg?
- 50 ml
- 750 ml
- 500 ml
- 75 ml
48. A health care provider prescribes laboratory studies for an infant of a woman positive for human immunodeficiency virus (HIV). The nurse anticipates that which laboratory study will be prescribed for the infant?
- Chest x-ray
- Western blot
- CD4+ cell count
- p24 antigen assay
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49. The nurse is aware that a common mode of transmission of Clostridium difficile is:
- Use of unsterile surgical equipment
- Contamination with sputum
- Through the urinary catheter
- Contamination with stool
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50. Situation: As a nurse researcher you must have a very good understanding of the common terms of concept used in research.Q. Which of the following usually refers to the independent variables in doing research?
- Result
- Cause
- Output
- Effect