NCLEX-RN | QB3 | Practice Exam #3 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. Situation: John Mark is a 21 year old male client who was rushed following an automobile accident. He is very anxious, dyspneic and in severe pain. Q. JM's chest tube is said to be functioning correctly when which of the following is observed?
- Continuous bubbling in the water seal chamber
- Fluctuation in the water seal chamber
- Suction tubing attached to the wall unit
- Vesicular breath sounds heard in all lung fields
2. Situation: Mastery of Psychotropic medications is necessary for the therapeutic improvement in the health of the psychiatric clients. Q. Which of the following class of antidepressant is the least sedating?
- Neuroleptics
- SSRI
- MAOI
- TCA
3. The nurse manager is planning the clinical assignments for the day. Which staff members cannot be assigned to care for a client with herpes zoster? Select all that apply. 1. The nurse who never had roseola 2. The nurse who never had mumps 3. The nurse who never had chickenpox 4. The nurse who never had German measles 5. The nurse who never received the varicellazoster vaccine
- 3,4,5
- 1,3,4,5
- 3,5
- 1,2,3
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4. Situation: Burn is cause by transfer of heat source to the body. It can be thermal, electrical radiation or chemical. Q. During the Acute Phase of the burn injury, which of the following is a priority?
- Wound healing
- Reconstructive surgery
- Emotional support
- Fluid resuscitation
5. Situation: Amanda is suffering from chronic arteriosclerosis Brain syndrome she fell while getting out of the bed one morning and was brought to the hospital, and she was diagnosed to have cerebrovascular thrombosis thus transferred to a nursing home. Q. Which behavior results from organic psychoses?
- Memory deficit
- Disorientation
- Impaired Judgement
- Inappropriate affect
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6. Mosquito-borne diseases are prevented mostly with the use of mosquito control measures. Which of the following is NOT appropriate for malaria control?
- Use of chemically treated mosquito nets
- Seeding of breeding places with larva-eating fish
- Destruction of breeding places of the mosquito vector
- Use of mosquito-repelling soaps, such as those with basil or citronella
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7. Home health nurse visits a patient with chronic obstructive pulmonary disease (COPD) using home oxygen at 2 liters per minute. The patient reports periods of shortness of breath and inquires about increasing the oxygen to 4 liters/minute. The nurse explains that increasing the supplemental oxygen will:
- Increased activity tolerance
- Suppress the hypoxic drive
- Alleviate the shortness of breath
- Prevent lung infection
8. A patient hospitalized with tuberculosis (TB) has a productive cough and hemoptysis. Which of the following types of isolation room would be the BEST choice for the patient?
- Reverse isolation
- Standard isolation
- Positive-pressure
- Negative-pressure
9. When caring for a client with esophageal varices, the nurse knows that bleeding in this disorder usually stems from:
- esophageal perforation
- pulmonary hypertension
- portal hypertension
- peptic ulcers
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10. Situation: During surgical operation, it is inevitable to utilize sutures. The nurse should know the basic principles in suturing as well as knowledge in selecting sutures and caring for clients with sutures. Q. If the suture is performed on the client's face. The nurse will reinforce the teaching that the client should return when for suture removal?
- After 7 days
- After 3 to 4 Days
- After 10 days
- The next day
11. A client is scheduled for discharge and will be taking phenobarbital for an extended period. The nurse would place highest priority on teaching the client which point that directly relates to client safety?
- Take the medication only with meals.
- Take the medication at the same time each day.
- Use a dose container to help prevent missed doses.
- Avoid drinking alcohol while taking this medication.
12. The primary cause of pain in inflammation is:
- Release of pain mediators
- Injury to the nerve endings
- Compression of the local nerve endings by the edema fluids
- Circulation is lessen, Supply of oxygen is insufficient
13. A 52-years-old is admitted to the nursing unit from the physician's office with a diagnosis of acute cholecystitis. Physician orders on admission include: monitor vital sign every 4 hours; IV of ringer's lactate 125ml per hour; 1500 calorie, low-fat liquid diet, morphine sulfate 2mg IV every 2 hours as needed for pain, notify physician for sudden increase in frequency or intensity of pain, promethazine12.5 mg IV every 4 hours as needed for nausea or vomiting. Which of the following should the nurse plan to do FIRST?
- Remove any high-foods from the patient's room
- Notify the dietitian of the diet order
- Obtain venous access and start Ringer's lactate infusion
- Obtain an emesis basin and clean linens for the be side
14. A 72 year-old woman who is alert and oriented has been hospitalized with atrial fibrillation. Since admission four days ago, she has been receiving digoxin intravenous injection. Today is the first day the digoxin injection will be discontinued and she will change to oral tablets. Although she acknowledges the medication benefits, she refuses to take it as it makes her feel nauseous. What is the most appropriate nursing action?
- Continue administering by intravenous push
- Withhold medication and notify the physician
- Withhold medication and file an incident report
- Provide it in liquid from mixed into a drink
15. It is day 17 of a woman's menstrual cycle. She is complaining of breast tenderness and pain in her lower left quadrant. The woman states that her cycle is usually 31 days long. Which of the following is an appropriate reply by the nurse?
- "You are probably ovulating”
- "Your hormone levels should be checked."
- "You will probably menstruate early."
- "Your breast changes are a worrisome sign"
16. Which of the following signs indicates the need for sputum examination for AFB?
- Hematemesis
- Fever for 1 week
- Cough for 3 weeks
- Chest pain for 1 week
17. A client being treated with sodium warfarin (Coumadin) has a Protime of 120 seconds. Which intervention would be most important to include in the nursing care plan?
- Assess for signs of abnormal bleeding.
- Anticipate an increase in the Coumadin dosage,
- Instruct the client regarding the drug therapy.
- Increase the frequency of neurological assessments.
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18. A hospitalized child develops exanthema (rash) that covers the trunk and extremities. The nurse reviews the child's health history and notes that the child was exposed to varicella 2 weeks ago. Which nursing intervention is most appropriate to implement?
- Immediately admit the client to any available bed.
- Place the child in a private room on strict isolation.
- Assess the progression of the exanthema and report it to the health care provider.
- Allow the child to play in the playroom until the health care provider can be contacted
19. Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy. Q. Endotracheal intubation:
- Can be attempted for up to 2 minutes before you need to stop and ventilate the patient.
- Reduces the risk of aspiration of gastric contents.
- Should be performed with the neck flexed forward making the chin touch the chest.
- Should be performed after a patient is found to be not breathing and two breaths have been given but before checking for a pulse.
20. Nurse John is aware that a serious effect of inhaling cocaine is?
- Deterioration of nasal septum
- Acute fluid and electrolyte imbalances
- Extra pyramidal tract symptoms
- Esophageal varices
21. The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide and metformin. The nurse should provide which instructions to the client? Select all that apply. 1. Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes. 5. Muscle pain is an expected effect of metformin and may be treated with acetaminophen. 6. Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide.
- 1,2,4
- 2,3,5
- 1,2,3,4
- 1,3,4
22. The nurse calls together an inter disciplinary team with members from medicine, social services, the clergy, and nutritional services to care for a patient with a terminal illness. Which of the following types of care would the team MOST likely is providing?
- Palliative
- Curative
- Respite
- Preventive
23. 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. At the emergency room, the nurse assessed the extent of the burn on the patient's body. Based on the rules of nine. Which of the following is the BEST estimate of the burn?
- 0.36
- 0.45
- 0.27
- 0.54
24. A nurse is preparing to mix and administer chemotherapy. What equipment would be unnecessary to obtain?
- Surgical gloves
- Luer lock fitting IV tubing
- Surgical hat cover
- Disposable long-sleeve gown
25. The nurse is preparing a client for cataract surgery. The nurse is aware that the procedure will use:
- Mydriatics to facilitate removal
- Miotic medications such as Timoptic
- A laser to smooth and reshape the lens
- Silicone oil injections into the eyeball
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26. After a cystectomy and formation of an ileal conduit, the nurse provides instruction regarding prevention of leakage of the pouch and backflow of the urine. The nurse is correct to include in the instruction to empty the urine pouch:
- Every 3-4 hours.
- Every hour.
- Twice a day.
- Once before bedtime.
27. When admitting a client with a fractured extremity, the nurse would focus the assessment on which of the following first?
- The area proximal to the fracture
- The actual fracture site
- The area distal to the fracture
- The opposite extremity for baseline comparison
28. Which of the following drugs is the antidote for magnesium toxicity?
- Rho (D) immune globulin (RhoGAM)
- Hydralazine (Apresoline)
- Naloxone (Narcan)
- Calcium gluconate (Kalcinate)
29. Which of the following classifications applies to monozygotic twins for whom the cleavage of the fertilized ovum occurs more than 13 days after fertilization?
- conjoined twins
- diamniotic dichorionic twins
- diamniotic monochorionic twin
- monoamniotic monochorionic twins
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30. Situation: Francis, age 46 is admitted to the hospital with diagnosis of Chronic Lymphocytic Leukemia. Q. The treatment for patients with leukemia is bone marrow transplantation. Which statement about bone marrow transplantation is not correct?
- The patient is under local anesthesia during the procedure
- The aspirated bone marrow is mixed with heparin
- The aspiration site is the posterior or anterior iliac crest.
- The recipient receives cyclophosphamide (Cytoxan) for 4 consecutive days before the procedure
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31. A client is hospitalized with a diagnosis of chronic renal failure. An arteriovenous fistula was created in his left arm for hemodialysis. When preparing the client for discharge, the nurse should reinforce which dietary instruction?
- "Be sure to eat meat at every meal”
- "Monitor your fruit intake and eat plenty of bananas.”
- "Restrict your salt intake”
- "Drink plenty of fluids”
32. Situation: Sterilization is the process of removing ALL living microorganism. To be free of ALL living microorganism is sterility. Q. If a nurse will sterilize a heat and moisture labile instruments, it is according to AORN recommendation to use which of the following method of sterilization?
- Autoclaving
- Ethylene oxide gas
- Flash sterilizer
- Alcohol immersion
33. Situation: The nurse is performing health education activities for Jane Segovia, a 30 years old Dentist with Insulin dependent diabetes Mellitus. Q. Jane administered regular insulin at 7 A.M. and the nurse should instruct Jane to avoid exercising at around:
- 9 to 11 A.M.
- After 8 hours
- Between 8 A.M. to 9 A.M.
- In the afternoon, after taking lunch.
34. When a client has a lobectomy, what fills the space where the lobe was?
- The space stays empty.
- The surgeon fills the space with gel
- The lung space fulls up with serous fluid
- The remaining lobe or lobes overexpand to fill the space.
35. According to Bloom, there are 3 domains in learning. Which of these domains is responsible for the ability of Donya Delilah to inject insulin?
- Cognitive
- Affective
- Psychomotor
- Motivative
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36. Situation: Cancer of the prostate is the leading cancer in Men other than skin cancer. The following questions will assess your knowledge and theoretical foundation in dealing with clients with prostate cancer. Q. At the initial sign and symptoms of prostate cancer, before diagnosis, the physician can perform a screening test to detect a characteristic “STONY HARD" prostate and nodules at the prostate area using:
- Cystoscopy
- PSA
- DRE
- MRI
37. The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernigs sign is charted if the nurse notes:
- Pain on flexion of the hip and knee
- Nuchal rigidity on flexion of the neck
- Pain when the head is turned to the left side
- Dizziness when changing positions
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38. Situation: Rose seeks psychiatric consultation because of intense fear of flying in an airplane which has greatly affected her chances of success in her job. Q. The fear and anxiety related to phobia is said to be abruptly decreased when the patient exposed to what is feared through:
- Guided imagery
- Systematic desensitization
- Flooding
- Hypnotherapy
39. Francis with anemia has been admitted to the medical-surgical unit. Which assessment findings are characteristic of iron-deficiency anemia?
- Nights sweats, weight loss, and diarrhea
- Dyspnea, tachycardia, and pallor
- Nausea, vomiting, and anorexia
- Itching, rash, and jaundice
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40. SITUATION: A 65 year old woman was admitted for Parkinson's Disease. The charge nurse is going to make an initial assessment. Q. One day, the patient complained of difficulty in walking. Your response would be
- You will need a cane for support
- Walk erect with eyes on horizon
- I'll get you a wheelchair
- Don't force yourself to walk
41. The physician has ordered DDAVP (desmopressin acetate) for a client with diabetes insipidus. Which finding indicates that the medication is having its intended effect?
- The clients appetite has improved.
- The clients morning blood sugar was 120mg/dL
- The clients urinary output has decreased.
- The clients activity level has increased.
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42. The nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac monitor as a result of the laboratory value? Select all that apply. 1. ST depression 2. Prominent U wave 3. Tall peaked T waves 4. Prolonged ST segment 5. Widened QRS complexes
- 3,5
- 2,3
- 1,2,3,4
- 2,4,5
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43. The nurse is explaining the appropriate methods for measuring an accurate temperature to an unlicensed assistive personnel (UAP). Which method, if noted by the UAP as being an appropriate method, indicates the need for further teaching?
- Taking a rectal temperature for a client who has undergone nasal surgery
- Taking an oral temperature for a client with a cough and nasal congestion
- Taking an axillary temperature for a client who has just consumed hot coffee
- Taking a temporal temperature on the neck behind the ear for a client who is diaphoretic
44. A client is diagnosed with post-traumatic stress disorder following a rape by an unknown assailant. The nurse should give priority to:
- Providing a supportive environment
- Controlling the clients feelings of anger
- Discussing the details of the attack
- Administering a hypnotic for sleep
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45. The correct procedure for auscultating the client's abdomen for bowel sounds would include:
- Palpating the abdomen first to determine correct stethoscope placement
- Encouraging the client to cough to stimulate movement of fluid and air through the abdomen
- Placing the client on the left side to aid auscultation
- Listening for 5minutes in all four quadrants to confirm absence of bowel sound
46. The nurse judges correctly that a client is experiencing an adverse effect from amitriptyline hydrochloride (Elavil) when the client demonstrates:
- An elevated blood glucose level.
- Insomnia.
- Hypertension.
- Urinary retention.
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47. Which of the following represents a significant risk immediately after surgery for repair of aortic aneurysm?
- Potential wound infection
- Potential ineffective coping
- Potential electrolyte balance
- Potential alteration in renal perfusion
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48. A client with cancer of the pancreas has undergone a Whipple procedure. The nurse is aware that during the Whipple procedure the doctor will remove the:
- Head of the pancreas
- Proximal third section of the small intestines
- Stomach and duodenum
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49. Situation: You are working as a Pediatric Nurse in your own Child Health Nursing Clinic, the following cases pertain to ASSESSMENT AND CARE OF THE NEWBORN AT RISK conditions. Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a newborn?
- Keeping infants in a warm arid dark environment
- Administration of a cardiovascular stimulant
- Gentle exercise to stop muscle breakdown
- Early feeding to speed passage of meconium
50. The nurse is caring for a client with leukemia who has received the drug (daunorubicin) Cerubidine. Which of the following common side effects would cause the most concern?
- Nausea
- Vomiting
- Cardiotoxicity
- Alopecia