NCLEX-RN | QB3 | Practice Exam #2 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. The physician asks the nurse to position a client for a vaginal examination. Which of the following position is normally used for this type of examination?
- Lithotomy position
- Sim's position
- Dorsal recumbent position
- Left lateral position
2. The client is admitted following cast application for a fractured ulna. Which finding should be reported to the doctor?
- Pain at the site
- Warm fingers
- Pulses rapid
- Paresthesia of the fingers
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3. Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy. Q. Atropine:
- Is always given for a heart rate less than 60 bpm.
- Cannot be given via ET tube.
- Has a maximum total dosage of 0.03-0.04 mg/kg IV in the setting of cardiac arrest.
- When given IV should always be given slowly.
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4. Situation: Mr. Roberto was long diagnosed with chronic renal failure. You are his nurse and the following question assesses your knowledge in the different fluid and electrolyte imbalances that are associated with chronic renal failure. Q. The main indicator of the need for hemodialysis is:
- Ascites
- Acidosis
- Hypertension
- Hyperkalemia
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5. A client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition?
- Intestinal obstruction
- Peptic ulcer with melena
- Diverticulitis with perforation
- Vomiting following cancer chemotherapy
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6. During the admission assessment on a client with chronic bilateral glaucoma, which statement by the client would the nurse anticipate since it is associated with this problem?
- "I have constant blurred vision."
- "I can't see on my left side."
- "I have to turn my head to see my room"
- "I have specks floating in my eyes"
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7. A patient has been transferred to the medical unit following a parathyroidectomy.Surgery was performed under general anesthesia and the patients diet my advance as tolerated. The patient requests a sip of apple juice. The nurse should FIRST assess the patient's:
- Skin turgor
- Cough reflex
- Lung sounds
- Bowel sounds
8. A client begins to experience alcoholic hallucinosis. What is the best nursing intervention at this time?
- Keeping the client restrained in bed
- Checking the clients blood pressure every 15 minutes and offering juices
- Providing a quiet environment and administering medication as needed and prescribed
- Restraining the client and measuring blood pressure every 30 minutes
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9. Defined health as a dynamic state in the life cycle, and Illness as interference in the life cycle.
- Henderson
- Rogers
- Roy
- King
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10. The nurse is preparing a client with an axillo-popliteal bypass graft for discharge. The client should be taught to avoid:
- Using a recliner to rest
- Resting in supine position
- Sitting in a straight chair
- Sleeping in right Sims position
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11. In a recumbent, immobilized patient, lung ventilation can become altered, leading to such respiratory complications as:
- Respiratory acidosis, atelectasis, and hypostatic pneumonia
- Apneustic breathing, atypical pneumonia and respiratory alkalosis
- Cheyne-Stokes respirations and spontaneous pneumothorax
- Kussmaul's respirations and hypoventilation
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12. An elderly patient with a long history of diabetes mellitus comes in for a routine check-up. Which of the following nursing diagnosis would the nurse anticipate?
- Risk for impaired skin integrity related to decreases sensation and circulation
- Excess fluid volume related to disease process
- Risk for injury to decrease gastric mobility and stress response
- Eficient fluids volume related to diarrhea and loss of fluids and electrolytes
13. Situation: You are assigned to take care of a group of patients across the lifespan. The nurse assessing newborn babies and infants during their hospital stay notice which of the following symptoms as a primary manifestation of Hirschsprung's disorder?
- A fine rash over the trunk
- Failure to pass meconium during the first 24 hours after birth
- The skin turns yellow and then brown over the first 24 hours to 46 hours after birth.
- High grade fever.
14. A nurse instructs a community education class on breast health. Which statement BEST described understanding of the appropriate age to start screening mammograms is a woman of average risk?
- At menopause
- At 65-years-old
- At the cessation of breastfeeding
- At 40-years-old
15. For the client who is using oral contraceptives, the nurse informs the client about the need to take the pill at the same time each day to accomplish which of the following?
- Decrease the incidence of nausea
- Maintain hormonal levels
- Reduce side effects
- Prevent drug interactions
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16. Which medications have been found to help reduce or eliminate panic attacks?
- Antidepressants
- Anticholinergics
- Antipsychotics
- Mood stabilizers
17. A client has been admitted with chest trauma after a motor vehicle crash and has undergone subsequent intubation. The nurse checks the client when the high-pressure alarm on the ventilator sounds, and notes that the client has absence of breath sounds in the right upper lobe of the lung. The nurse immediately assesses for other signs of which condition?
- Right pneumothorax
- Pulmonary embolism
- Displaced endotracheal tube
- Acute respiratory distress syndrome
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18. A patient has pacemaker implanted. Which of the following interventions is appropriate for the nursing diagnosis of risk for injury?
- Have patient avoid exposure to magnetic resonance imaging(MRI)
- Observe incision site for redness, purulent drainage,
- Offer back rubs to promote relaxation
- Instruct patient in dorsiflexion exercises of ankles
19. A nurse is assessing to care for a child with a seizure disorder. The nurse observes the child becomes stiff and lose consciousness, following by jerking movements for 1 minute after which the child becomes very sleepy, which of the following types of seizures occurred?
- Absence (petit mal)
- Generalized (tonic-clonic)
- Partial Psychomotor(temporal lobe)
- Status epilepticus
20. The nurse is caring for a client with rheumatoid arthritis. The nurse knows that the clients symptoms will be most improved by:
- Taking a warm shower upon awakening
- Applying ice packs to the joints
- Taking two aspirin before going to bed
- Going for an early morning walk
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21. A client in her third trimester tells the nurse, "I'm constipated all the time!" Which of the following should the nurse recommend?
- Daily enemas
- Laxatives
- Increased fiber intake
- Decreased fluid intake
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22. When assessing a premorbid personality characteristics of a client with a major depression, it would be unusual for the nurse to find that this client demonstrated:
- Rigidity
- Stubbornness
- Diverse interest
- Over meticulousness
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23. During vaginal examination of Janna who is in labor, the presenting part is at station plus two. Nurse, correctly interprets it as:
- Presenting part is 2 cm above the plane of the ischial spines.
- Biparietal diameter is at the level of the ischial spines.
- Presenting part in 2 cm below the plane of the ischial spines.
- Biparietal diameter is 2 cm above the ischial spines.
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24. Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? Select all that apply. 1. Maintain the child in a semiprivate room. 2. Reduce exposure to environmental organisms. 3. Use strict aseptic technique for all procedures. 4. Ensure that anyone entering the child's room wears a mask. 5. Apply firm pressure to a needle-stick area for at least 10 minutes.
- 1,2,3,4,5
- 2,3,4
- 1,2,5
- 1,2,4,5
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25. Which of the following is responsible for the rhythm and quality of breathing?
- Medulla oblongata
- Carotid bodies
- Aortic bodies
- Pons
26. Situation: The nurse is often met with the following situations when clients become angry and hostile. Q. During the pre-interaction phase of the N-P relationship/the nurse recognizes this normal INITIAL reaction to an assaultive or potentially assaultive person.
- To remain and cope with the incident
- Display empathy towards the patient
- To call for help from the other members of the team
- To stay and fight or run away
27. Nurse Perry is aware that language development in autistic child resembles:
- Scanning speech
- Speech lag
- Shuttering
- Echolalia
28. Which of the following signs will require a mother to seek immediate medical attention?
- When the first fetal movement is felt
- No fetal movement is felt on the 6th month
- Mild uterine contraction
- Slight dyspnea on the last month of gestation
29. Maureen, a primigravida client, age 20, has just completed a difficult, forceps- assisted delivery of twins. Her labor was unusually long and required oxytocin (Pitocin) augmentation. The nurse who's caring for her should stay alert for:
- Uterine inversion
- Uterine atony
- Uterine involution
- Uterine discomfort
30. A child in the postictal state of a seizure should show which of the following signs or symptoms?
- Feeling sleepy or exhausted
- Stiffness over entire body
- Verbalizes having an aura
- Eyes fixed in one position
31. Nurse Jolina must see to it that the written consent of mentally ill patients must be taken
- Priest
- Family lawyer
- Parents/legal guardians
- Nurse
32. Situation: Mr Ramos is a 60 year old male client admitted to the hospital with the diagnosis of pneumonia. He complains of pain when coughing. Q. What action should the nurse take in assisting Mr. Ramos in doing deep breathing and coughing exercise?
- Recognize that the patient is too sick to cough at this time
- Splint the patients chest while he coughs
- Turn Mr Ramos to the unaffected side and ask him to cough
- Encourage her to cough and then give her pain medication as ordered
33. The nurse is caring for the client who is going to have an arthogram using a contrast medium. Which of the following assessments by the nurse are of highest priority?
- Allergy to iodine or shellfish
- Ability of the client to remain still during the procedure
- Whether the client has any remaining questions about the procedure
- Whether the client wishes to void before the procedure
34. Situation: Nurse Lorena 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. The Dators are a couple undergoing testing for infertility. Infertility is said to exist when:
- a woman has no uterus
- a woman has no children
- a couple has been trying to conceive for 1 year
- a couple has wanted a child for 6 months
35. The nurse is preparing to test the visual acuity of a client, using a Snellen chart. Which identifies the accurate procedure for this visual acuity test?
- The right eye is tested, followed by the left eye, and then both eyes are tested.
- Both eyes are assessed together, followed by an assessment of the right eye and then the left eye.
- The client is asked to stand at a distance of 40 feet (12 meters) from the chart and to read the largest line on the chart.
- The client is asked to stand at a distance of 40 feet (12 meters) from the chart and to read the line that can be read 200 feet (60 meters) away by an individual with unimpaired vision.
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36. Prior to administration of an albuterol nebulizer, the nurse should help the patient assume what position?
- Sitting and leaning forward
- Feet elevated above level of heart
- High fowler's
- Standing
37. While monitoring a client for the development of disseminated intravascular coagulation (DIC), the nurse should take note of what assessment parameters?
- Platelet count prothrombin time, and partial thromboplastin time
- Platelet count blood glucose levels, and white blood cell (WBC) count
- Thrombin time, calcium levels, and potassium levels
- Fibrinogen level, WBC, and platelet count
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38. For the first 72 hours after thyroidectomy surgery the nurse would assess the client for Chvostek's sign and Trousseau's sign because they indicate which of the following?
- hypocalcemia
- hypercalcemia
- hypokalemia
- Hyperkalemia
39. Situation: Nurse Minette is an independent nurse practitioner following-up referred clients in their respective homes. Here she handles a case of POSTPARTUM MOTHER AND FAMILY focusing on HOME CARE. Q. Leah is developing constipation from being on bed rest. What measures would you suggest she take to help prevent this?
- Eat more frequent small meals instead of three large one daily
- Walk for at least half an hour daily to stimulate peristalsis
- Drink more milk, increased calcium intake prevents constipation
- Drink eight full glasses of fluid such as water daily
40. The nurse is reviewing the lab reports on several clients. Which one should be reported to the physician immediately?
- A serum creatinine of 5.2mg/dL in a client with chronic renal failure
- A positive C reactive protein in a client with rheumatic fever
- A hematocrit of 52% in a client with gastroenteritis
- A white cell count of 2200cu/mm in a client taking Dilantin (phenytoin)
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41. The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care provider's (HCP's) prescriptions and should contact the HCP to question which prescription?
- Obtain daily weight.
- Provide clear liquid intake.
- Nasotracheal suction as needed.
- Maintain a patent intravenous line.
42. A client with a history of lung disease is at risk for developing respiratory acidosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder?
- Bradycardia and hyperactivity
- Decreased respiratory rate and depth
- Headache, restlessness, and confusion
- Bradypnea, dizziness, and paresthesias
43. A client who has had abdominal surgery complains of feeling as though “something gave way" in the incisional site. The nurse removes the dressing and notes the presence of a loop of bowel protruding through the incision. Which interventions should the nurse take? Select all that apply. 1. Contact the surgeon. 2. Instruct the client to remain quiet 3. Prepare the client for wound closure. 4. Document the findings and actions taken. 5. Place a sterile saline dressing and ice packs over the wound. 6. Place the client in a supine position without a pillow under the head.
- 2,3,5 and 6 only.
- 1,2,3 and 4 only.
- 2,3,4 and 6 only.
- 1,2,3,4 and 5.
44. Which client is at risk for the development of a sodium level at 130 mEq/L (130 mmol/L)?
- The client who is taking diuretics
- The client with hyperaldosteronism
- The client with Cushing's syndrome
- The client who is taking corticosteroids
45. An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time?
- Prone position
- On the stomach
- Left lateral position
- Right lateral position
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46. The nurse is monitoring a client diagnosed with acromegaly who was treated with transsphenoidal hypophysectomy and is recovering in the intensive care unit. Which findings should alert the nurse to the presence of a possible postoperative complication? Select all that apply. 1. Anxiety 2. Leukocytosis 3. Chvostek's sign 4. Urinary output of 800 mL/hour 5. Clear drainage on nasal dripper pad
- 1,3,5
- 2,4,5
- 2,3,5
- 1,2,3
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47. Situation: Mr. Roberto was long diagnosed with chronic renal failure. You are his nurse and the following question assesses your knowledge in the different fluid and electrolyte imbalances that are associated with chronic renal failure. Q. To gain access to the vein and artery, an AV shunt was used for Mr. Roberto. The most serious problem with regards to the AV shunt is:
- Septicemia
- Clot formation
- Exsanguination
- Vessel sclerosis
48. The charge nurse is assigning staff for the day. Staff consists of an RN an LPN and a certified nursing assistant. Which client assignment should be given to the nursing assistant?
- Exploratory laparotomy with a colon resection the previous shift
- Client with a stroke who has been hospitalized for two days
- A client with metastatic cancer on PCA morphine
- A new admission with diverticulitis
49. A patient with gastro esophageal reflux disease (GERD) is to start taking prescribed omeprazole (prilosec). The nurse would istruct the patient to take the medication:
- 30 to 60 minutes before meal
- 90 to 120 minutes before meal
- With apple sauce
- With milk
50. Situation: Consider the following hypothesis: "The Job turnover rate and job dissatisfaction levels of graduate nurses who have worked less than 2 years is higher than for those graduate nurses who have worked for more than 2 years" Q. After the researcher has determined and read relevant literature, she has to:
- Write down the review
- Organized the relevant literature
- Analyze potential literature
- Integrate the review of literature