NCLEX-RN | QB2 | Practice Exam #40 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. A client with schizoaffective disorder is exhibiting Parkinsonian symptoms. Which medication is responsible for the development of Parkinsonian symptoms?
- Zyprexa (olanzapine)
- Cogentin (benzatropine mesylate)
- Benadryl (diphenhydramine)
- Depakote (divalproex sodium)
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2. Katrina has an abnormal result on a Papanicolaou test. After admitting that she read her chart while the nurse was out of the room, Katrina asks what dysplasia means. Which definition should the nurse provide?
- Presence of completely undifferentiated tumor cells that don't resemble cells of the tissues of their origin.
- Increase in the number of normal cells in a normal arrangement in a tissue or an organ.
- Replacement of one type of fully differentiated cell by another in tissues where the second type normally isn't found.
- Alteration in the size, shape, and organization of differentiated cells.
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3. Ms. Caro learns that some leaders are transactional leaders. Which of the following does NOT characterize a transactional leader?
- Focuses on management tasks
- Is a caretaker
- Uses trade-offs to meet goals
- Inspires others with vision
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4. Myra, 21 year old nursing student has difficulty sleeping. She told Nurse Blake II really think a lot about my ex-boyfriend recently." Blake told Myra "And that causes you difficulty sleeping?" Which therapeutic technique is used in this situation?
- Reflecting
- Restating
- Exploring
- Seeking clarification
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5. A client is receiving Pyridium (phenazopyridine hydrochloride) for a urinary tract infection. The client should be taught that the medication may:
- Cause diarrhea
- Change the color of her urine
- Cause mental confusion
- Cause changes in taste
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6. A 52 yr-old married man with two adolescent children is beginning rehabilitation following a cerebrovascular accident As the nurse is planning the client's care, the nurse should recognize that his condition will affect: only himself
- only his wife and children
- him and his entire family
- no one, if he has complete recovery
- only himself
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7. A pregnant client tells the nurse that she is worried about having urinary frequency. What will be the most appropriate nursing response?
- "Try using Kegel (perineal) exercises and limiting fluids before bedtime. If you have frequency associated with fever, pain on voiding, or blood in the urine, call your doctor/ nurse-midwife.
- "Placental progesterone causes irritability of the bladder sphincter. Your symptoms will go away after the baby comes.”
- "Pregnant women urinate frequently to get rid of fetal wastes. Limit fluids to 1L/daily”
- "Frequency is due to bladder irritation from concentrate urine and is normal in pregnancy. Increase your daily fluid intake to 3L.”
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8. The nurse is caring for a client diagnosed with bulimia. The most appropriate initial goal for client diagnosed with bulimia is to:
- avoid shopping for large amounts of food.
- control eating impulses.
- identify anxiety-causing situations.
- eat only three meals per day.
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9. A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast Which statement by the parents indicates a need for further instruction?
- "The cast may feel warm as the cast dries"
- "I can use lotion or powder around the cast edges to relieve itching”
- "A small amount of white shoe polish can touch up a soiled white cast."
- "If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast"
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10. Rudolf is admitted for an overdose of amphetamines. When assessing the client, the nurse should expect to see:
- Tension and irritability
- Slow pulse
- Hypotension
- Constipation
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11. If a patients blood pressure is 150/96, his pulse pressure is:
- 54
- 96
- 150
- 246
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12. The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply. 1.Pallor. 2.Edema. 3.Anorexia. 4.Proteinuria. 5.Weight loss. 6.Decreased serum lipids
- 1,2,3,4
- 2,3,5
- 3,4,5
- 1,3,5,6
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13. Nurse Lynnette notices that a female client with obsessive-compulsive disorder washes her hands for long periods each day. How should the nurse respond to this compulsive behavior?
- By designating times during which the client can focus on the behavior.
- By urging the client to reduce the frequency of the behavior as rapidly as possible.
- By calling attention to or attempting to prevent the behavior.
- By discouraging the client from verbalizing anxieties.
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14. Which selection would provide the most calcium for the client who is four months pregnant?
- A granola bar
- A bran muffin
- A cup of yogurt
- A glass of fruit juice
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15. The nurse is planning to admit a pregnant client who is obese. In planning care for this client, which potential client needs should the nurse anticipate? Select all that apply. 1.Bed rest as a necessary preventive measure may be prescribed. 2.Routine administration of subcutaneous heparin may be prescribed. 3.An overbed lift may be necessary if the client requires a cesarean section. 4.Less frequent cleansing of a cesarean incision, if present, may be prescribed. 5.Thromboembolism stockings or sequential compression devices may be prescribed.
- 1,2,4
- 3,4,5
- 1,3,5
- 2,3,5
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16. When planning discharge teaching for the parent of an infant with respiratory problems , the nurse should EMPHASIZE
- Use of supplemental oxygen at night
- Frequent hand washing
- Sleeping in the supine position
- Rice-thickened formula during night-time feedings
17. Patient with fecal ileostomy in the lower left part of abdomen, the stool form will be:
- Mushy
- Solid
- Watery
- None of the above.
18. The client from the OR is transferred to the post-anesthesia care unit after surgical repair of abdominal aortic aneurysm. Which of the following assessment findings would indicate that the repair was successful?
- Urine output of 50 mL/hr.
- Presence of non-pitting, peripheral edema
- Clear sclera.
- Presence of carotid bruit
19. Situation: Michelle is a 6 year old preschooler. She was reported by her sister to have measles but she was at home because of fever, upper respiratory problem and white sports in her mouth.To render comfort measure is one of the priorities, which includes care of the skin, eyes, ears, mouth and nose. To clean the mouth, your antiseptic is in some form of which one below?
- Water
- Sulfur
- Alkaline
- Salt.
20. The home health psychiatric nurse visits a client with chronic schizophrenia who was recently discharged after a prolong stay in a state hospital The client lives in a boarding home, reports no family involvement, and has little social interaction. The nurse plan to refer the client to a day treatment program in order to help him with:
- Managing his hallucinations
- Medication teaching
- Social skills training
- Vocational training
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21. Among the following foods, which has the highest amount of potassium per serving?
- Cantaloupe
- Avocado
- Raisin
- Banana
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22. A doctor has ordered an intramuscular injection (IM) for a 6 month-old infant after her IV infiltrated. Because infant have under developed muscles, the nurse should not administer the injection into which muscle?
- Vastuslaterlis
- Rectus femoris
- Ventrogluteal
- Gluteus maximus
23. A nurse is evaluating a patient 5 days after a right total hip replacement. Which of the following goals is appropriate for the patient?
- Maintain hip abduction without dislocation
- Rest with legs elevate while sitting
- Tie shoes and put on undergarments without assistive devices
- Perform scissors-like leg exercise daily
24. Situation: Fiona is experiencing left sharp pain and occasional hematuria. She was advised to undergo 1VP by her physician.Q. The IVP reveals that Fiona has small renal calculus that can be passed out spontaneously. To increase the chance of passing the stones, you instructed her to force fluids and do which of the following?
- Balanced diet
- Ambulance more
- Strain all urine
- Bed rest
25. A 62-year-old patient has been treated for congestive heart failure and a Nursing diagnosis of fluid volume excess. After diuretic therapy and dietary Interventions, the patient has met all short-term goals. The nurse should:
- Revise the care plan with a diagnosis of risk for alteration in fluid balance
- Add a new diagnosed of risk of fluid volume deficit
- Discontinue the care plan as the diagnosis is resolved
- Continue the care plan as written
26. Situation: Lizbeth 20 year-old college student is brought to the hospital by her mother who states that for the past week her behavior has become very strange. She has become more and more withdrawn - Diagnosis: Schizophrenia Catatonic.Q. While Lizbeth remains in an unreasonable state, does not eat or drink, the nurse first priority id to assess her:
- Fluid intake and output
- Skin turgor
- Bowel elimination
- Vital signs such as T.P.R. and blood pressure
27. You will not give DPT 2 if the mother says that the infant had?
- Seizures a day after DPT1
- Fever for 3 days after DPT1
- Abscess formation after DPT1
- Local tenderness for 3 days after DPT1
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28. Which of the following statements reflects Kohlbergs theory of the moral development of the preschool-age child?
- Obeying adults is seen as correct behavior.
- Showing respect for parents is seen as important.
- Pleasing others is viewed as good behavior.
- Behavior is determined by consequences.
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29. Before a surgical procedure. Give the sequence on applying the protective items listed below. 1.Eye wear or goggles. 2.Cap. 3.Mask. 4.Gloves. 5.Gown
- 3,2,1,5,4
- 3,2,1,4,5
- 2,3,1,5,4
- 2,3,1,4,5
30. Nausea and vomiting are common adverse effects of radiation and chemotherapy. When should a nurse administer antiemetics?
- 30 minutes before the initiation of therapy.
- With the administration of therapy.
- Immediately after nausea begins.
- When therapy is completed.
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31. Situation: Mr. Gonzales was admitted to the hospital with ascites and jaundice. To rule out cirrhosis of the liver:Q. Which laboratory test indicates liver cirrhosis?
- Situation: Mr. Gonzales was admitted to the hospital with ascites and jaundice. To rule out cirrhosis of the liver:Q. Which laboratory test indicates liver cirrhosis?
- Decreased red blood cell count
- Elevated white blood cell count
- Elevated serum aminotransferase
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32. How long should the thermometer stay in the Clients Axilla?
- 3 minutes
- 4 minutes
- 7 minutes
- 10 minutes
33. Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration?
- Cardiac
- Gastrointestinal
- Musculoskeletal
- Pulmonary
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34. Certain substances increase the amount of urine produced. These include:
- Caffeine-containing drinks, such as coffee and cola.
- Beets
- Urinary analgesics
- Kaolin with pectin (Kaopectate)
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35. A 45 year-old woman presents to the clinic with urinary incontinence. Point-to-point testing, in which she must touch the tip of her nose with the doctor's index finger on command, reveals slowness and uncertainty. Alternate hand movement testing shows asymmetry slowness and increased concentration. Rhythmic, involuntary movements of the hands are noted at rest. During Romberg's test, the patient easily loses balance.Which type of urinary incontinence treatment is most appropriate?
- Bladder retraining and anti-cholinergic agents
- Timed voiding and biofeedback training
- Intermittent straight catheter and biofeedback
- Timed voiding and anti-cholinergic agents
36. A five-year-old is a family contact to the client with tuberculosis. Isoniazid (INH) has been prescribed for the client The nurse is aware that the length of time that the medication will be taken is:
- Six months
- Three months
- One year
- Two years
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37. One nursing intervention for patient with asthma is to facilitate removal of secretions. This can be done by:
- Encourage the patient to perform slow and shallow breathing
- Encourage the patient to increase fluid intake
- Encourage the patient to hyperventilate
- Encourage the patient to decrease
38. The most effective measure of controlling schistosomiasis is;
- casefinding and prompt treatment of cases
- provision of sanitary toilets
- environmental sanitation and environmental control
- practice of hygiene
39. 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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40. Rosana is in the second stage of Alzheimer s disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain?
- "Where is your pain located?"
- "Do you hurt? (pause) "Do you hurt?"
- "Can you describe your pain?"
- "Where do you hurt?"
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41. To check for wound hemorrhage after a client has had a surgery for the removal of a tumor in the neck, nurse grace should:
- Loosen an edge of the dressing and lift it to see the wound
- Observe the dressing at the back of the neck for the presence of blood
- Outline the blood as it appears on the dressing to observe any progression
- Press gently around the incision to express accumulated blood from the wound
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42. A 58-year-old man is going to have chemotherapy for lung cancer. He asks the nurse how the chemotherapeutic drugs will work. The most accurate explanation the nurse can give is which of the following?
- "Chemotherapy affects all rapidly dividing cells."
- "The molecular structure of the DNA is altered."
- "Cancer cells are susceptible to drug toxins."
- "Chemotherapy encourages cancer cells to divide."
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43. A client who's actively hallucinating is brought to the hospital by friends. They say that the client used either lysergic acid diethylamide (LSD) or angel dust (phencyclidine [PCP]) at a concert Which of the following common assessment findings indicates that the client may have ingested PCP?
- Dilated pupils
- Nystagmus
- Paranoia
- Altered mood
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44. As a young manager, she knows that conflict occurs in any organization. Which of the following statements regarding conflict is NOT true?
- Can be destructive if the level is too high
- Is not beneficial; hence it should be prevented at all times
- May result in poor performance
- May create leaders
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45. The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the health care provider's prescriptions and should question which prescription?
- Prepare the client for an ultrasound.
- Obtain equipment for a manual pelvic examination.
- Prepare to draw a hemoglobin and hematocrit blood sample.
- Obtain equipment for external electronic fetal heart rate monitoring.
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46. He emphasizes to the team that they need to put their efforts together towards the attainment of the goals of the program. Which of the following principles refers to this?
- Span of control
- Unity of direction
- Unity of command
- Command responsibility
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47. A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client's activated partial thromboplastin time (aPTT) is 65 seconds (65 seconds). The nurse anticipates that which action is needed?
- Discontinuing the heparin infusion
- Increasing the rate of the heparin infusion
- Decreasing the rate of the heparin infusion
- Leaving the rate of the heparin infusion as is
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48. Which of the following best explains why tricyclic antidepressants are used with caution in elderly patients?
- Central Nervous System effects
- Cardiovascular system effects
- Gastrointestinal system effects
- Serotonin syndrome effects
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49. Situation: A nurse is working with an aggressive client in the psychiatric unit.Q. Mrs. Dion was visiting her son at the Psychiatry Ward. Which of the following items will the nurse not allow to be brought inside the ward?
- String rosary bracelet
- Box of cake
- Bottle of coke
- Rubber shoes
50. To determine if the cause of infertility is a blockage of the fallopian tubes, the test to be done is:
- Huhner's test
- Rubin's test
- Postcoital test
- None of the above
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