NCLEX-RN | QB2 | Practice Exam #38 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. A prescribed amount of oxygen s needed for a patient with COPD to prevent:
- Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)
- Circulatory overload due to hypervolemia
- Respiratory excitement
- Inhibition of the respiratory hypoxic stimulus
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2. Situation: Mastery of Psychotropic medications is necessary for the therapeutic improvement in the health of the psychiatric clients.Q. Which of the following is an antidepressant?
- Serenace (Haloperidol)
- Valium (Diazepam)
- Tofranil (Imipramine HCI)
- Triiaton (Pherpenazine)
3. Nurse Maureen is talking to a male client, the client begins choking on his lunch. Hes coughing forcefully. The nurse should:
- Stand him up and perform the abdominal thrust maneuver from behind.
- Lay him down, straddle him, and perform the abdominal thrust maneuver.
- Leave him to get assistance
- Stay with him but not intervene at this time.
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4. Situation: Mr. Anthony Martinelli is a 54-year old truck driver. He is admitted for possible gastric ulcer, He is a heavy smoker.Q. Mr. Martinelli had an Hgb of 9.8. You would not find which of the following assessments in a patient with severe anemia?
- Pallor
- Cold sensitivity
- Fatigue
- Dyspnea only on exertion
5. Situation: Nursing care for the elderly.Q. In planning care for a patient with Parkinsons disease, which of these nursing diagnoses should have priority?
- potential for injury
- altered nutritional state
- ineffective coping
- altered mood state
6. Which of the following treatment is a suitable surgical intervention for a client with unstable angina?
- Echocardiogram
- Cardiac catheterization
- Nitroglycerin
- Percutaneous transluminal coronary angioplasty (PTCA)
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7. The home healthcare nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine and the nurse teaches the client about the medication. Which statement, by the client, indicates the need for further teaching?
- "Constipation and bloating might be a problem."
- "I'll continue to watch my diet and reduce my fats"
- "Walking a mile each day will help the whole process"
- "I'll continue my nicotinic acid from the health food store”
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8. The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?
- Macaroni and cheese
- Shrimp with rice
- Turkey breast
- Spaghetti with meat sauce
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9. SITUATION: Mr. Dela Isla, a client with early Dementia exhibits thought process disturbances.Q. The nurse is aware that in communicating with an elderly client, the nurse will:
- Lean and shout at the ear of the client
- Open mouth wide while talking to the client
- Use a low-pitched voice
- Use a medium-pitched voice
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10. The nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which action is most appropriate?
- Notify the health care provider of the findings.
- Reposition the mother and check the monitor for changes in the fetal tracing.
- Take the mother's vital signs and tell the mother that bed rest is required to conserve oxygen.
- Document the findings and tell the mother that the pattern on the monitor indicates fetal wellbeing.
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11. The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder?
- Increased calcium level
- Increased white blood cells
- Decreased blood urea nitrogen level
- Decreased number of plasma cells in the bone marrow
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12. Situation: Because severe burn can affect the person s totality it is important that you apply interventions focusing on the various dimensions of man. You also have to understand the rationale of the treatmentQ. Which topical antimicrobial is most frequently used in burn wound care?
- Neosporin
- Silver nitrate
- Silver sulfadiazine
- Sulfamylon
13. The nurse is browsing the chart of the patient and notes a normal serum lipase level. Which of the following is a normal serum lipase value?
- 10U/L
- 100 U/L
- 200 U/L
- 350 U/L
14. A client at 8 weeks gestation calls complaining of slight nausea in the morning hours. Which of the following client interventions should the nurse question?
- Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water
- Eating a few low-sodium crackers before getting out of bed
- Avoiding the intake of liquids in the morning hours
- Eating six small meals a day instead of thee large meals
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15. This type of healing occurs when there is a delayed surgical closure of infected wound:
- First intention
- Second intention
- Third intention
- Fourth intention
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16. After reviewing the Myrnas maternal history of magnesium sulfate during labor, which condition would nurse Richard anticipate as a potential problem in the neonate?
- Hypoglycemia
- Jitteriness
- Respiratory depression
- Tachycardia
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17. A client is discharged following hospitalization for congestive heart failure. The nurse teaching the family suggests they encourage the client to rest frequently in which of the following positions?
- High Fowlers
- Supine
- Left lateral
- Low Fowler's
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18. A first time mother of a three week-old breastfed baby brings the infant to the clinic and complains that her child has been forcefully vomiting after feeding. He was born at 40 weeks gestation, weighing 3.6 kilograms. He is constantly hungry and irritable. Examination reveals a swollen abdomen and a palpable mass in the middle upper right quadrant. What is the most likely health problem?
- Intussusception
- Pyloric stenosis
- Gastroeosophageal reflux
- Diaphragmatic hernia
19. Which position allow maximum chest expansion to the client:
- Prone.
- Semi folwer.
- Supine.
- Lateral
20. The nurse is teaching a client who is being started on imipramine about the medication. The nurse should inform the client to expect maximum desired effects at which time period following initiation of the medication?
- in 2 months
- In 2 to 3 weeks
- During the first week
- During the sixth week of administration
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21. A mother tells the nurse that her daughter has become quite a collector filling her room with Beanie babies dolls and stuffed animals. The nurse recognizes that the child is developing:
- Object permanence
- Post-conventional thinking
- Concrete operational thinking
- Pre-operational thinking
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22. On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease?
- Cracked lips
- Normal appearance
- Conjunctival hyperemia
- Desquamation of the skin
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23. Situation: Among common conditions found in children especially among poor communities are ear infection/problems. The following questions apply.An ear discharge that has been present for more than 14 days can be classified as:
- mastoiditis
- chronic ear infection
- acute ear infection
- complicated ear infection
24. Situation: Mrs. Leah has had confirmation of her pregnancy. She presents the emergency room with abdominal pain not yet diagnosed.Q. After a spontaneous abortion the nurse should observe the client for:
- Hemorrhage and infection
- Dehydration and hemorrhage
- Subinvolution and dehydration
- Signs of pregnancy-induced hypertension
25. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa?
- Infection
- Hemorrhage
- Chronic hypertension
- Disseminated intravascular coagulation
26. A patient sustains an amputation of the first and second digits in a chainsaw accident Which task should be delegated to the LPN/LVN?
- Gently cleanse the amputated digits with Betadine solution.
- Place the amputated digits directly into ice slurry.
- Wrap the amputated digits in sterile gauze moistened with saline.
- Store the amputated digits in a solution of sterile normal saline.
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27. A client arrives at a birthing center in active labor. Following examination, it is determined that her membranes are still intact and she is at a -2 station. The health care provider prepares to perform an amniotomy. What will the nurse relay to the client as the most likely outcomes of the amniotomy? Select all that apply. 1.Less pressure on her cervix. 2.Decreased number of contractions. 3.Increased efficiency of contractions. 4.The need for increased maternal blood pressure monitoring. 5.The need for frequent fetal heart rate monitoring to detect the presence of a prolapsed cord
- 1,2,3
- 3,4,5
- 3,5
- 1,2,5
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28. A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?
- High calorie high protein high fat
- High calorie high carbohydrate low protein
- High calorie low carbohydrate high fat
- High calorie high protein low fat
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29. A newborn is diagnosed with congenital syphilis. Classic signs of congenital syphilis are:
- Red papular rash desquamation white strawberry tongue
- Rhinitis maculopapular rash hepatosplenomegaly
- Red edematous cheeks maculopapular rash on the trunk and extremities
- Epicanthal folds low-set ears protruding tongue
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30. The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client Is taking fluoxetine. Which information would be Important for the nurse to obtain during this client visit regarding the side and adverse effects of the medication?
- Cardiovascular symptoms
- Gastrointestinal dysfunctions
- Problems with mouth dryness
- Problems with excessive sweating
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31. Which of the following is the priority focus of nursing practice with the current early postpartum discharge?
- Promoting comfort and restoration of health
- Exploring the emotional status of the family
- Facilitating safe and effective self-and newborn care
- Teaching about the importance of family planning
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32. In sympto-thermal method, the parameters being monitored to determine if the woman is fertile or infertile are:
- Temperature, cervical mucus, cervical consistency
- Release of ovum, temperature and vagina
- Temperature and wetness
- Temperature, endometrial secretion, mucus
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33. Situation: Nurses attitudes toward the pain influence the way they perceive and interact with clients in pain.Q. What symptom more distressing than pain, should the nurse monitor when giving opioids especially among elderly clients who are in pain?
- Forgetfulness
- Constipation
- Drowsiness
- Allergic reactions like pruritus
34. The postpartum nurse is taking the vital signs of a client who delivered a healthy newborn 4 hours ago. The nurse notes that the client's temperature is 100.2T. What is the priority nursing action?
- Document the findings.
- Retake the temperature in 15 minutes.
- Notify the health care provider (HCP).
- Increase hydration by encouraging oral fluids.
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35. Situation: Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications.Q. Fanny came in from PACU after pelvic surgery. As Fanny's nurse you know that the sign that would be indicative of a developing thrombophlebitis would be:
- tender, painful area on the leg
- pitting edema of the ankle
- a reddened area at the ankle
- pruritus on the calf and ankle
36. Which of the following is included in Orem's theory?
- Maintenance of a sufficient intake of air
- Self perception
- Love and belongingness
- Physiologic needs
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37. The condition in which the body temperature is above the average normal is called:
- Braaypnea
- Fever.
- Hypertension.
- Hypothermia.
38. A client with ovarian cancer is being treated with vincristine. The nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication?
- Diarrhea
- Hair loss
- Peripheral neuropathy
- Chest pain
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39. An older adult client wakes up at 2 o'clock in the morning and comes to the nurses station saying, "I am having difficulty in sleeping." What is the best nursing response to the client?
- "I'll give you a sleeping pill to help you get more sleep now."
- "Perhaps you a like to sit here at the nurses station for a while."
- "Would you like me to show you where the bathroom is?"
- "What woke you up?"
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40. Situation: Organ donation is a new form of treatment that provides multiple complication such as rejection.Q. In 1983, The FDA approved the first anti-rejection drug by the name of:
- Cyclosporine
- Prednisone
- Imuran
- Azathioprine
41. Situation: Julio seeks psychiatric counselling for his ritualistic behavior of counting his money as many as 10 times before leaving home.Q. An initial appropriate nursing diagnosis is:
- Impaired social interaction
- Ineffective individual coping
- Impaired Adjustment
- Anxiety Moderate
42. A 3-years-old has returned to the clinic 4 days after being diagnosed with gastroenteritis and dehydration. A parent reports that the vomiting has stopped, and the child is tolerating liquids, rice, apple sauce, and bananas. The diarrhea persists, but seems to be decreasing in volume. When evaluating for signs of dehydration, the nurse will assess the patient's skin turgor by:
- Grasping the skin over the abdomen with two fingers raising the skin with two fingers
- Grasping the skin over the forehead with two fingers and raising the skin with two fingers
- Holding the patient's mouth open and assessing the tongue for deep creases or Furrows
- Drawing two tubes of blood and running blood urea nitrogen (BUN) and creatinine (Cr).
43. The nurse is caring for a client with possible cervical cancer. What clinical data would the nurse most likely find in the clients history?
- Post-coital vaginal bleeding
- Nausea and vomiting
- Foul-smelling vaginal discharge
- Elevated temperature levels
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44. Which of the following nursing intervention is essential for the client who had pneumonectomy?
- Medicate for pain only when needed.
- Connect the chest tube to water-seal drainage.
- Notify the physician if the chest drainage exceeds l00mL/hr.
- Encourage deep breathing and coughing.
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45. A 22 year old client suffered from his first tonic-clonic seizure. Upon awakening the client asks the nurse, "What caused me to have a seizure? Which of the following would the nurse include in the primary cause of tonic clonic seizures in adults more the 20 years?
- Electrolyte imbalance
- Head trauma
- Epilepsy
- Congenital defect
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46. The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant?
- Diarrhea
- Projectile vomiting
- Regurgitation of feedings
- Foul-smelling ribbon-like stools
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47. The client with hyperparathyroidism is taking a lendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply. 1."I should take this medication with food." 2."I should take this medication at bedtime" 3."I should sit up for at least 30 minutes after taking this medication" 4."I should take this medication first thing in the morning on an empty stomach." 5."I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day."
- 3,4,5
- 2,3,4,5
- 1,2,3
- 3,4
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48. A 26-year-old male reports losing his sight in both eyes. Hes diagnosed as having a conversion disorder and is admitted to the psychiatric unit. Which nursing intervention would be most appropriate for this client?
- Not focusing on his blindness
- Providing self-care for him
- Telling him that his blindness isn't real
- Teaching eye exercises to strengthen his eyes
49. A 20-year-old female has a prescription for tetracycline. While teaching the client how to take her medicine the nurse learns that the client is also taking Ortho-Novum oral contraceptive pills. Which instructions should be included in the teaching plan?
- The oral contraceptives will decrease the effectiveness of the tetracycline.
- Nausea often results from taking oral contraceptives and antibiotics.
- Toxicity can result when taking these two medications together.
- Antibiotics can decrease the effectiveness of oral contraceptives so the client should use an alternate method of birth control.
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50. A female patient admitted for abdominal pain complains of generalized pain, nausea vomiting and constipation. Nursing assessment finds: temperature,38.60C (101.50F), heart rate-92; respiration rate-18; blood pressure level, 130/68mmHg. The patient has rebound tenderness and abdominal rigidity. In the past hour, her pain has localized on the right side. The nurse suspects:
- Intestinal obstruction
- Influenza
- Appendicitis
- Pyloric Stenosis