NCLEX-RN | QB2 | Practice Exam #42 (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 reviewing the medication of a patient who is scheduled for a coronary artery bypass graft (CABG) in three days. Which of the following medications MUST be discontinued at least a week prior to surgery?
- Digoxin (Lanoxin)
- Furosemide (Lasix)
- Propranolol hydrochloride(inderal)
- Warfarin sodium (Coumadin)
2. He checks if his instruments meet the criteria for evaluation. Which of the following criteria refers to the consistency or the ability to yield the same response upon its repeated administration?
- Validity
- Reliability
- Sensitivity
- Objectivity
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3. Situation: Transurethral resection prostatectomy (TURP) is performed to Mr Recto, 60 years old, due to prostate enlargement Post operatively he has continuous irrigation (Cystoclysis). Q. After the removal of the three way catheter, the nurse should inform Mr. Recto that he can normally experience:
- Dribbling incontinence
- Polyuria
- Dysuria
- The drainage has stopped
4. When a resident is combative and trying to hit the nurse aide, it is important for the nurse aide to:
- show the resident that the nurse aide is in control.
- call for help to make sure there are witnesses.
- explain that if the resident is not calm a restraint may be applied.
- step back to protect self from harm while speaking in a calm manner.
5. A patient presents to the emergency room with complaints of eye and drainage. In planning for the examination of the patients complaints, which of the following instruction would the nurse MOST likely select?
- Sphygmomanometer
- Thermometer
- Ophthalmoscope
- Otoscope
6. Situation: In a disaster there must be a chain of command in place that defines the roles of each member of the response team. Within the health care group there are pre-assigned roles based on education, experience and training on disaster. Q. There are important principles that should guide the triage team in disaster management that you have to know if you were to volunteer as part of the triage team. The following principles should be observed in disaster triage, EXCEPT:
- any disaster plan should have resource available to triage at each facility and at the disaster site if possible
- make the most efficient use of available resources
- training on disaster is not important to the response in the event of a real disaster because each disaster is unique in itself
- do the greatest good for the greatest number of casualties
7. A client has cancer of the liver. The nurse should be most concerned about which nursing diagnosis?
- Alteration in nutrition
- Alteration in urinary elimination
- Alteration in skin integrity
- ineffective coping
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8. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
- Withholding oral intake after midnight
- Telling the client that no special preparation is needed
- Explaining that a small dose of radioactive isotope will be used
- Giving an oral suspension of glucose one hour before the test
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9. A client is admitted to the hospital with seizures. The client has jerking of the right arm and twitching of the face but is alert and aware of the seizure. This behavior is characteristic of which type of seizure?
- Absence
- Complex partial
- Simple partial
- Tonic-clonic
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10. A 2-month old infant was brought to the health center for immunization. During assessment the infant's temperature registered at 38.1 C. Which is the best course of action that you will take?
- Go on with the infants immunization
- Give paracetamol and wait for his fever to subside
- Refer the infant to the physician for further assessment
- Advise the infant's mother to bring him back for immunization when he is well
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11. Situation: It is the first day of clinical experience of nursing students at the Psychiatry Ward- During the orientation, the nurse emphasizes that the team members including nursing students are legally responsible to safeguard patient's records from loss or destruction or from people not authorized to bead it Q. The nurse must see to it that the written consent of mentally ill patients must be taken from:
- Doctor
- Social worker
- Parents or legal guardian
- Law enforcement authorities
12. Situation: A research study was under taken in order to identify and analyze a disabled boy's coping reaction pattern during stress. Q. The investigator also provided the nursing care of the subject The investigator is referred to as a/an.
- Participant-observer
- Observer researcher
- Caregiver
- Advocate
13. Mr Heywood is to remain in bed for the time being. Which position would the nurse find gives Mr. Heywood the most comfort?
- On his back with the head and knees elevated
- On his side with hips and legs straight
- On his abdomen with his head to the side
- On his back with his head and knees straight
14. The physician has ordered a paracentesis for a client with severe abdominal ascites. Before the procedure the nurse should:
- Provide the client with a urinal
- Prep the area by shaving the abdomen
- Encourage the client to drink extra fluids
- Request an ultrasound of the abdomen
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15. Situation: Elderly clients usually produce unusual signs when it comes to different diseases. The aging process is a complicated process and the nurse should understand that it is an inevitable fact and she must be prepared to care for the growing elderly population. Q. The most dependable sign of infection in the older patient is:
- change in mental status
- fever
- pain
- decreased breath sounds with crackles
16. The nurse is conducting health screening for osteoporosis. Which client is at greatest risk of developing this disorder?
- A 25-year-old woman who runs
- A 36-year-old man who has asthma
- A 70-year-old man who consumes excess alcohol
- A sedentary 65-year-old woman who smokes cigarettes
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17. A nurse is preparing an assessment of a patients nutritional status. Which of the following diagnostic test would be the best measure of the patient's recent nutritional status with a half-life of 2-3 days?
- Prealbumin
- Hemoglobin
- Albumin
- 24-urine creatinine
18. The client has an order for gentamycin to be administered. Which lab results should be reported to the doctor before beginning the medication?
- Hematocrit
- Creatinine
- White blood cell count
- Erythrocyte count
19. A mother brought her 10 month old infant for consultation because of fever which started 4 days prior to consultation. To determine malaria risk, what will you do?
- Do a tourniquet test
- Ask where the family resides
- Get a specimen for blood smear
- Ask if the fever is present everyday
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20. A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot Which action should the nurse take?
- Administer an analgesic.
- Release the skin traction.
- Apply ice to the extremity.
- Notify the health care provider (HCP).
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21. Lydia is scheduled for elective splenectomy. Before the clients goes to surgery, the nurse in charge final assessment would be:
- signed consent
- vital signs
- name band
- empty bladder
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22. A female patient has been advised that laboratory tests confirm herpes simplex virus (HSV), type 2. The nurse should teach the patient that a Papanicolaou test (Pap smear) is recommended:
- Every 6 months if symptoms persist despite treatment
- Every year even if asymptomatic
- Whenever symptoms recur
- Every 3 years if other Pap smears have been negative
23. The physician has ordered nitroglycerin buccal tablets for a client with stable angina. The nurse knows that nitroglycerin:
- Slows contractions of the heart
- Dilates coronary blood vessels
- Increases the ventricular fill time
- Strengthens contractions of the heart
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24. While conducting a class for expected mothers, the nurse explains the difference between true labor construction and false labor contraction by indicating that the labor contractions:
- Are located mainly in the abdomen and groin
- Have increasing intensity
- Occur with decreasing intervals
- Occur at regular intervals
25. The nurse is caring for a client receiving supplemental oxygen. The effectiveness of the oxygen therapy is best determined by:
- The rate of respirations
- The absence of cyanosis
- Arterial blood gases
- The level of consciousness
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26. The nurse is caring for a client with a colostomy. The client tells the nurse that he makes small pin holes in the drainage bag to help relieve gas. The nurse should teach him that this action:
- destroys the odor-proof seal
- wont affect the colostomy system
- is appropriate for relieving the gas in a colostomy system
- destroys the moisture barrier seal
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27. Among the following foods, which food should you emphasize giving on an Alcoholic client?
- Pork liver and organ meats, Pork
- Red meat, Eggs and Dairy products
- Green leafy vegetables, Yellow vegetables, Cantaloupe and Dairy products
- Chicken, Peanuts, Bananas, Wheat germs and yeasts
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28. After a laryngectomy the most important equipment to place at the clients bedside would be:
- Suction equipment
- Humidified oxygen
- A nonelectric call bell
- A cold-stream vaporizer
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29. A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen (BUN) level drops to which value?
- 3mg/dL(1,05mmol/L)
- 15mg/dL(5.25mmol/L)
- 29mg/dL(10.15mmol/L)
- 35mg/dL(12.25mmol/L)
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30. A 45 year-old patient has had difficulty sleeping and has lost ten kilograms despite having a large appetite on examination there is a palpable thyroid gland. Blood pressure: 108/58 mmHg. Heart rate: 116/min. Respiratory rate: 22/min. Body temperature: 38.0C oral. Height: 164. Weight: 50 kilograms. Which additional symptom is most likely?
- Heart palpitations.
- Depression.
- Anorexia.
- Paresthesia.
31. Infertility increases a clients risk of which of the following diseases?
- Diabetes mellitus.
- Nystagmus.
- Cholecystitis.
- Ovarian cancer.
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32. Nurse Bea should plan to assist a client with an obsessive-compulsive disorder to control the use of ritualistic behavior by:
- Providing repetitive activities that require little thought
- Attempting to reduce or limit situations that increase anxiety
- Getting the client involved with activities that will provide distraction
- Suggesting that the client perform menial tasks to expiate feelings of guilt
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33. A resident gets dressed and comes out of his room wearing shoes that are from two different pairs. The nurse aide should:
- tease the resident by complimenting the residents sense of style.
- ask if the resident realizes that the shoes do not match.
- remind the resident that the nurse aide can dress the resident.
- ask if the resident lost some of his shoes.
34. Cervical softening and uterine souffle are classified as which of the following?
- Diagnostic signs
- Presumptive signs
- Probable signs
- Positive signs
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35. A client is admitted to the emergency room with a gunshot wound to the right arm. After dressing the wound and administering the prescribed antibiotic the nurse should:
- Ask the client if he has any medication allergies.
- Check the clients immunization record.
- Apply a splint to immobilize the arm.
- Administer medication for pain.
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36. A client is admitted with a Ewings sarcoma. Which symptoms would be expected due to this tumors location?
- Hemiplegia
- Aphasia
- Nausea
- Bone pain
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37. A client with carcinoma of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH) as a complication of the cancer. The nurse 1.Radiation. 2.Chemotherapy. 3.Increased fluid intake. 4.Decreased oral sodium intake. 5.Serum sodium level determination. 6.Medication that is antagonistic to antidiuretic hormone.
- 1,2,5,6
- l,2,3,4
- 2,3,4,5,6
- 3,5,6
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38. For a client with Graves disease, which nursing intervention promotes comfort?
- Restricting intake of oral fluids
- Placing extra blankets on the client's bed
- Limiting intake of high-carbohydrate foods
- Maintaining room temperature in the low-normal range
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39. A 45 year-old patient has had difficulty sleeping and has lost ten kilograms despite having a large appetite on examination there is a palpable thyroid gland. Blood pressure: 108/58 mmHg. Heart rate: 116/min. Respiratory rate: 22/min. Body temperature: 38.0C oral. Height: 164. Weight: 50 kilograms. Which additional symptom is most likely?
- Heart palpitations.
- Depression.
- Anorexia.
- Paresthesia
40. A client is admitted with suspected Legionnaires disease. Which factor increases the risk of developing Legionnaires disease?
- Treatment of arthritis with steroids
- Foreign travel
- Eating fresh shellfish twice a week
- Doing volunteer work at the local hospital
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41. The client is admitted to the chemical dependence unit with an order for continuous observation. The nurse is aware that the doctor has ordered continuous observation because:
- Hallucinogenic drugs create both stimulant and depressant effects.
- Hallucinogenic drugs induce a state of altered perception.
- Hallucinogenic drugs produce severe respiratory depression.
- Hallucinogenic drugs induce rapid physical dependence.
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42. SITUATION: Mr. Ramos was barbecuing outdoors when the gas tank exploded. He sustained second degree and third degree burns of the anterior portion of BOTH arms, the upper half of his anterior trunk and the anterior and posterior portions of his left lower extremity. Which one of the following blood value determinations is most likely be useful to evaluate the adequacy of the fluid replacement?
- Creatinine levels
- Blood urea nitrogen
- Hematocrit level
- CO2 tension
43. Situation: Among common conditions found in children especially among poor communities are ear infection/problems. The following questions apply. Q. If the child has severe classification because of ear problem, what would be the best thing that you as the nurse can do?
- instruct mother when to return immediately
- refer urgently
- give an antibiotic for 5 days
- dry the ear by wicking
44. Anticipatory nausea and vomiting associated with chemotherapy occurs:
- Within the first 24 hours after chemotherapy
- 1-5 days after chemotherapy.
- Before chemotherapy administration.
- While chemotherapy is being administered.
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45. 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
46. The third period of infectious processes characterized by development of specific signs and symptoms
- Incubation period
- Prodromal period
- Illness period
- Convalescent period
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47. Tristan a 4 year old boy has suffered from full thickness burns of the face, chest and neck. What will be the priority nursing diagnosis?
- Ineffective airway clearance related to edema
- Impaired mobility related to pain
- Impaired urinary elimination related to fluid loss
- Risk for infection related to epidermal disruption
48. SITUATION: Devon, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Devon rushed at the scene. Q. As registered nurse, Devon knew that the first thing that he will do at the scene is:
- Stay with the person, Encourage her to remain still and Immobilize the leg while waiting for the ambulance.
- Leave the person for a few moments to call for help.
- Reduce the fracture manually.
- Move the person to a safer place.
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49. Rico with diabetes meilitus must learn how to seif-administer insulin. The physician has prescribed 10 U of 11-100 regular insulin and 35 U of 11-100 isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?
- "Inject insulin into healthy tissue with large blood vessels and nerves"
- "Rotate injection sites within the same anatomic region, not among different regions"
- "Administer insulin into areas of scar tissue or hypotrophy whenever possible."
- "Administer insulin into sites above muscles that you plan to exercise heavily later that day"
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50. The nurse is caring for a 20 lbs (9 kg) 6 month-old with a 3 day history of diarrhea, occasional vomiting and fever Peripheral intravenous therapy has been initiated, with 5% dextrose in 0.33% normal saline with 20 mEq of potassium per liter infusing at 35 ml/hr. Which finding should be reported to the health care provider immediately?
- 3 episodes of vomiting in 1 hour
- Periodic crying and irritability
- Vigorous sucking on a pacifier
- No measurable voiding in 4 hours
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