NCLEX-RN | QB2 | Practice Exam #49 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. The most critical factor for nurse Linda to determine during crisis intervention would be the client's:
- Available situational supports
- Willingness to restructure the personality
- Developmental theory
- Underlying unconscious conflict
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2. You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to LPN/LVN?
- Complete admission assessment.
- Set up oxygen and suction equipment.
- Place a padded tongue blade at bedside.
- Pad the side rails before patient arrives.
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3. Which of the following categories of medications would the nurse anticipate being included in the conservative management of a client with a herniated lumbar disk?
- Muscle relaxant
- Sedatives
- Tranquilizers
- Parenteral analgesics
4. A client's sputum smears for acid fast bacilli (AFB) are positive, and transmission-based airborne precautions are ordered. Nurse Kyle should instruct visitors to:
- limit contact with non-exposed family members
- Avoid contact with any objects present in the client's room
- Wear an Ultra-Filter mask when they are in the clients room
- Put on a gown and gloves before going into the clients room
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5. An adult patient has been taking a drug (Drug A) that is highly metabolized by the cytochrome p-450 system. He has been on this medication for 6 months. At this time, he is started on a second medication (Drug B) that is an inducer of the cytochrome p-450 system. You should monitor this patient for:
- Increased therapeutic effects of Drug A.
- Increased adverse effects of Drug B.
- Decreased therapeutic effects of Drug A.
- Decreased therapeutic effects of Drug B.
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6. Which of the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD)?
- Divalproex (depakote) and Lithium (lithobid)
- Chlordiazepoxide (Librium) and diazepam (valium)
- Fluvoxamine (Luvox) and clomipramine (anafranil)
- Benztropine [Cogentin) and diphenhydramine (benadryl)
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7. The nurse is performing discharge teaching on a client with ulcerative colitis who has been placed on a low-residue diet Which food would need to be eliminated from this clients diet?
- Roasted chicken
- Noodles
- Cooked broccoli
- Roast beef
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8. The nurse is caring for a client who is suicidal. When accompanying the client to the bathroom, the nurse should:
- give him privacy in the bathroom.
- allow him to shave.
- open the window and allow him to get some fresh air
- observe him.
9. A 34 year- old quadriplegia patient resides at home with his wife. In order to prevent contractures of all extremities, the community care nurse will instruct the patient's wife in performance of:
- Active range of motion exercises.
- Passive range of motion exercises.
- Active-assistive range of motion exercises.
- Resistive range of motion exercises.
10. The nurse is evaluating the client who was admitted eight hours ago for induction of labor. Which action should be taken first by the nurse?
- Instruct the client to push.
- Perform a vaginal exam.
- Turn off the Pitocin infusion.
- Place the client in a semi-Fowlers position.
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11. Standards of pain management dictate the nurses:
- Administer analgesic via injection whenever possible
- Avoid the use of the word "pain"
- Screen for pain at each encounter
- Discourage around-the clock dosage of analgesics
12. A 12 year old patient had a cast removed from the left leg after wearing it for 8 weeks. The patients wants to resume sports as soon as possible. In order to regain muscle strength lost while wearing the cast, the nurse will instruct the patient in the performance of:
- resistive range of motion exercise
- passive range of motion exercise
- Active assistive range of motion exercise
- Active range of motion exercise
13. 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
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14. The nurse is caring for a patient with magnesium toxicity. Which of the following clinical manifestation should the nurse anticipate?
- Paresthesia
- Decreased deep-tendon reflexes
- Cardiac palpitations
- Decreased cardiac output
15. When preparing a client for cesarean delivery, which of the following key concepts should be considered when implementing nursing care?
- Instruct the mother's support person to remain in the family lounge until after the delivery
- Arrange for a staff member of the anesthesia department to explain what to expect postoperatively
- Modify preoperative teaching to meet the needs of either a planned or emergency cesarean birth
- Explain the surgery expected outcome, and kind of anesthetics
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16. Which statement by the client indicates correct understanding of rehabilitation after burn injury?
- "I will never be fully recovered from the burn."
- "I am considered fully recovered when all the wounds are closed"
- "I will be fully recovered when I am able to perform all the activities I did before my injury"
- "I will be fully recovered when I achieve the highest possible level of functioning that I can?"
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17. Which of the following assessment would provide the best information about the clients physiologic response and the effectiveness of the medication prescribed specifically for alcohol withdrawal?
- Sleeping pattern
- Mental alertness
- Nutritional status
- Vital signs
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18. The best way of determining whether a patient has learned to instill ear medication properly is for the nurse to:
- Ask the patient if he/she has used ear drops before
- Have the patient repeat the nurse's instructions using her own words
- Demonstrate the procedure to the patient and encourage to ask questions
- Ask the patient to demonstrate the procedure
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19. A terminally ill cancer patient is scheduled for an NGT feeding today. How should you position the patient?
- Semi fowlers in bed
- Bring the client into a chair
- Slightly elevated right side lying position
- Supine in bed
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20. The most threatening complication of vomiting in clients with stroke is:
- Aspiration
- Dehydration
- Fluid and electrolyte imbalance
- Malnutrition
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21. Which nursing intervention ensures adequate ventilating exchange after surgery?
- Remove the airway only when client is fully conscious
- Assess for hypoventilation by auscultating the lungs
- Position client laterally with the neck extended
- Maintain humidified oxygen via nasal cannula
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22. Which route of administration is preferable for administration of daily analgesics (if all body systems are functional)?
- IV
- IM or subcutaneous
- Oral
- Transdermal
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23. The nurse is visiting the asthmatic patient at home to reinforce the importance of eliminating environmental allergens and to assess the patient's response to the environmental changes. This type of implementation is called:
- Supervision and coordination
- Discharge planning
- Monitoring and surveillance
- None.
24. A client has returned from having a bronchoscopy. Before offering the client sips of water the nurse should assess the clients:
- Blood pressure
- Pupilary response
- Gag reflex
- Pulse rate
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25. Which of the following actions should the nurse take to use a wide base support when assisting a client to get up in a chair?
- Bend at the waist and place arms under the clients arms and lift
- Face the client, bend knees and place hands on clients forearm and lift
- Spread his or her feet apart
- Tighten his or her pelvic muscles
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26. The nurse is planning the diet of a client who is recovering from acute pancreatitis. The nurse should select foods that are
- High in carbohydrate and protein
- Low in sodium but high fat
- High in protein and sodium
- Low in fat and low protein
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27. If the labor period lasts only for 3 hours, the nurse should suspect that the following conditions may occur: 1.Laceration of cervix. 2.Laceration of perineum. 3.Cranial hematoma in the fetus. 4.Fetal anoxia
- 1 and 2
- 2 and 4
- 2, 3 and 4
- 1, 2, 3 and 4
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28. The client with which of the following types of lung cancer has the best prognosis?
- Adenocarcinoma
- Oat cell
- Squamous cell
- Small cell
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29. The graduate nurse is assigned to care for the client on ventilator support pending organ donation. Which goal should receive priority?
- Maintaining the clients systolic blood pressure at 70mmHg or greater
- Maintaining the clients urinary output greater than 300cc per hour
- Maintaining the clients body temperature of greater than 33°F rectal
- Maintaining the clients hematocrit at less than 30%
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30. Which of the following nursing intervention would least likely be effective when dealing with a client with aggressive behavior?
- Approach him in a calm manner
- Provide opportunities to express feelings
- Maintain eye contact with the client
- Isolate the client from others
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31. Antiretroviral agents, such as AZT are used in the management of AIDS. Which of the following is not an action expected of these drugs?
- They prolong the life of the client with AIDS
- They reduce the risk of opportunistic infections
- They shorten the period of communicability of the disease
- They are able to bring about a cure of the disease condition
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32. A diagnosis of multiple sclerosis is often delayed because of the varied symptoms experienced by those affected with the disease. Which symptom is most common in those with multiple sclerosis?
- Resting tremors
- Double vision
- Flaccid paralysis
- Pill-rolling tremors
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33. A 45-year-old client, has no family history of breast cancer or other risk factors for this disease. Nurse Jane should instruct her to have mammogram how often?
- Twice per year
- Once per year
- Every 2 years
- Once, to establish baseline
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34. The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
- Increased pulse rate
- Increased urinary output
- Decreased diastolic blood pressure
- Increased pupil size
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35. 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. The most important component of neurologic assessment is:
- pupil reactivity
- vital sign assessment
- cranial nerve assessment
- level of consciousness/responsiveness
36. The wife of a client with COPD is worried about caring for her husband at home. Which statement by the nurse provides the most valid information?
- You should avoid emotional situations that increase his shortness of breathe.
- Help your husband arrange activities so that he does as little walking as possible.
- Arrange a schedule so your husband does all necessary activities before noon; then he can rest during the afternoon and evening
- Your husband will be no more short of breath when he walks but that will not hurt him.
37. When PROM occurs, which of the following provides evidence of the nurses understanding of the client's immediate needs?
- The chorion and amnion rupture 4 hours before the onset of labor
- PROM removes the fetus most effective defense against infection
- Nursing care is based on fetal viability and gestational age.
- PROM is associated with malpresentation and possibly incompetent cervix.
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38. A client is two days post-operative colon resection. After a coughing episode the clients wound eviscerates. Which nursing action is most appropriate?
- Reinsert the protruding organ and cover with 4-4s.
- Cover the wound with a sterile 4-4 and ABD dressing.
- Cover the wound with a sterile saline-soaked dressing.
- Apply an abdominal binder and manual pressure to the wound.
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39. A dopamine receptor agonist such as bromocriptine (Parlodel) relieves muscle rigidity caused by antipsychotic medication by:
- blocking dopamine receptors in the central nervous system (CNS).
- blocking acetylcholine in the CNS.
- activating norepinephrine in the CNS.
- activating dopamine receptors in the CNS.
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40. A client with chronic pain is being treated with opioid administration via epidural route. Which medication would it be most important to have available due to a possible complication of this pain relief procedure?
- Ketorolac (Toradol)
- Naloxone (Narcan)
- Diphenhydramine (Benadryl)
- Promethazine (Phenergan)
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41. Situation: Nurse Macarena is a Family Planning and Infertility Nurse Specialist and currently attends to FAMILY PLANNING CLIENTS AND INFERTILE COUPLES. The following conditions pertain to meeting the nursing needs of this particular population group. Administration of aminoglycosides to the older persons requires careful patient assessment because older people:
- are more sensitive to drugs
- have increased hepatic, renal and gastrointestinai function
- have increased sensory perception
- mobilize drugs more rapidly
42. Which of the following complications of bulimia nervosa is life threatening?
- Amenorrhea
- Bradycardia
- Electrolyte Imbalance
- Yellow skin
43. While caring for a patient in the post-anesthesia care unit (PACU), a nurse plans toKeep 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
44. The nurse caring for the child with a large meningomylocele is aware that the priority care for this client is to:
- Cover the defect with a moist sterile saline gauze.
- Place the infant in a supine position.
- Feed the infant slowly.
- Measure the intake and output.
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45. Family members are encouraging your client to tough it out rather than run the risk of becoming addicted to narcotics. The client is stoically abiding by the family's wishes. Priority nursing interventions for this client should target which dimension of pain?
- Sensory
- Affective
- Sociocultural
- Behavioral
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46. A child was recently diagnosed with spastic cerebral palsy. Which of the following statement by the parent would indicate to the nurse that parent understands teaching about illness?
- Full recovery is possible
- This illness should not progress
- Cerebral palsy is a hereditary disease
- Surgery can sometimes improve walking
47. A client with glomerulonephritis is placed on a low-sodium diet. Which of the following snacks is suitable for the client with sodium restriction?
- Peanut butter cookies
- Grilled cheese sandwich
- Cottage cheese and fruit
- Fresh peach
48. A client with paranoid personality disorder is admitted to a psychiatric facility. Which remark by the nurse would best establish rapport and encourage the client to confide in the nurse?
- "I get upset once in a while, too"
- "I know just how you feel. I a feel the same way in your situation."
- "I worry too, when I think people are talking about me.”
- "At times, it's normal not to trust anyone."
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49. 1 cup is equals to how many ounces?
- 8
- 80
- 800
- 8000
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50. 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 1MCL if the child is having 2 'h weeks ear discharges, how would you classify and treat the child: 1.Green. 2.Yellow. 3.Pink. 4.Red. 5.Dry the ear by wicking. 6.5 days antibiotic. 7.Urgent referral with first dose of antibiotic
- 4,7
- 2,5,6
- 1,5
- 2,5