NCLEX-RN | QB3 | Practice Exam #7 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. During an evaluation at a community clinic, the patient completes the medical history. Which of the follow is NOT a risk factor for an acute myocardial infarction?
- Coronary artery disease
- Smoking
- Hemophilia
- Hyperlipidemia
2. A patient admitted to the hospital with acute cholecystitis, is scheduled for surgery in the morning and is NPO. At 8AM the patient develops a fever of 102.4 F (39.1 C).medication orders include acetaminophen 650 mg orally every four hours as needed. The nurse should:
- Give the medication as ordered by the physician
- Administer the ordered dose rectally
- Put moist cool cloths on the patient's fore head and axillae
- Notify the physician and request other orders
3. The nurse is conducting a dietary assessment on a client who is on a vegan diet. The nurse provides dietary teaching and should focus on foods high in which vitamin that may be lacking in a vegan diet?
- Vitamin A
- Vitamin B12
- Vitamin C
- Vitamin E
4. A community health nurse visits a patient who has suffered a stroke. The patient's spouse explains to the nurse that the patient chokes on foods at times. Which of the following referral ordered would the nurse anticipate needing for this patient?
- Speech therapist
- Dietician
- Physician therapist
- Neurologist
5. A pregnant client reports to a health care clinic, complaining of loss of appetite, weight loss, and fatigue. After assessment of the client, tuberculosis is suspected. A sputum culture is obtained and identifies Mycobacterium tuberculosis. Which instruction should the nurse include in the client's teaching plan?
- Therapeutic abortion is required.
- Isoniazid plus rifampin will be required for 9 months.
- She will have to stay at home until treatment is completed.
- Medication will not be started until after delivery of the fetus.
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6. An appropriate nursing intervention when caring for a postpartum mother with thrombophlebitis is:
- Encourage the mother to ambulate to relieve the pain in the leg
- Instruct the mother to apply elastic bondage from the foot going towards the knee to improve venous return flow
- Apply warm compress on the affected leg to relieve the pain
- Elevate the affected leg and keep the patient on bedrest
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7. Situation: Johnny, sought consultation to the hospital before Q. You asked questions as soon as she regained consciousness from thyroidectomy primarily to assess the evidence of:
- Death
- Mediastina shift
- Damage to the laryngeal nerve
- Hypocalcemia tetany
8. The nurse is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?
- Temperature of 100F
- Coolness and discoloration of the digits
- Complaints of pain
- Difficulty moving the digits
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9. At the age of 2 years, which of the following teeth have not been erupted?
- canine
- pre-molar
- molar
- incisor
10. The nurse has just received a report from the previous shift. Which of the following clients should the nurse visit first?
- A 50-year-old COPD client with a PCO2 of 50
- A 24-year-old admitted after an MVA complaining of shortness of breath
- A client with cancer requesting pain medication
- A one-day post-operative cholecystectomy with a temperature of 100F
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11. Marie, uses Benson's relaxation. How is it done?
- Systematically tensing muscle groups from top to bottom for 5 seconds, and then releasing them
- Concentrating on breathing without tensing the muscle, Letting go and repeating a word or sound after each exhalation
- Using a strong positive, feeling-rich statement about a desired change
- Exercise combined with meditation to foster relaxation and mental alacrity
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12. Situation: Nette, a nurse palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of her last menstrual period. Leopold's Maneuver is done. The obstetrician told mat she appears to be 20 weeks pregnant. Q. In doing Leopold's maneuver palpation which among the following is NOT considered a good preparation?
- The woman should lie in a supine position with her knees flexed slightly
- The hands of the nurse should be cold so that abdominal muscles would contract and tighten
- Be certain that your hands are warm (by washing them in warm water first if necessary)
- The woman empties her bladder before palpation
13. A child is treated for superficial (first-degree) thermal burns to the thigh. The child is in great discomfort and does not eat. Which of the following diagnosis should receive PRIORITY?
- Altered nutrition
- Impaired skin integrity
- Risk for infection
- Acute pain
14. The nurse is preparing a list of self-care instructions for a postpartum client who was diagnosed with mastitis. Which instructions should be included on the list? Select all that apply. 1. Wear a supportive bra. 2. Rest during the acute phase. 3. Maintain a fluid intake of at least 3000 mL/day. 4. Continue to breast-feed if the breasts are not too sore. 5. Take the prescribed antibiotics until the soreness subsides. 6. Avoid decompression of the breasts by breast-feeding or breast pump.
- 2,3,4,5
- 1,2,3,4
- 2,4,6
- 1,2,3,4 and 5.
15. When shaving a woman in preparation for cesarean section, the area to be shaved should be from _ to _
- Under breast to mid-thigh including the pubic area
- The umbilicus to the mid-thigh
- Xyphoid process to the pubic area
- Above the umbilicus to the pubic area
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16. A client with tuberculosis who has been on combined therapy with rifampin and isoniazid asks the nurse how long he will have to take medication. The nurse should tell the client:
- Medication is rarely needed after two weeks.
- He will need to take medication the rest of his life.
- The course of therapy is usually six months.
- He will be re-evaluated in one month to see if further medication is needed.
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17. Susie brought her 4 years old daughter to the RHU because of cough and colds. Following the IMCI assessment guide, which of the following is a danger sign that indicates the need for urgent referral to a hospital?
- Inability to drink
- High grade fever
- Signs of severe dehydration
- Cough for more than 30 days
18. A client with rheumatoid arthritis is beginning to develop flexion contractures of the knees. The nurse should tell the client to:
- Lie prone and let her feet hang over the mattress edge
- Lie supine with her feet rotated inward
- Lie on her right side and point her toes downward
- Lie on her left side and allow her feet to remain in a neutral position
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19. Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication?
- Tinnitus
- Diarrhea
- Constipation
- Decreased respirations
20. The nurse is reviewing a plan of care for a client with an internal radiation implant. Which intervention, if noted in the plan, indicates the need for revision of the plan?
- Wearing gloves when emptying the client’s bedpan
- Keeping all linens in the room until the implant is removed
- Wearing a lead apron when providing direct care to the client
- Placing the client in a semiprivate room at the end of the hallway
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21. A nurse is triaging in the emergency room when a client enters complaining of muscle cramps and a feeling of exhaustion after a running competition. Which of the following would the nurse suspect?
- Hypernatremia
- Hyponatremia
- Hyperkalemia
- Hypokalemia
22. A nurse is planning to assess the corneal reflex on unconscious client. Which of the following is the safest stimulus to touch the client's cornea?
- Cotton buds
- Sterile glove
- Sterile tongue depressor
- Wisp of cotton
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23. A1 year old child presents at the clinic one week after hospitalization for surgical repair of a fractured right femur. The patient is receiving pain medications every morning and evening. The best way to evaluate the effectiveness of the pain management plan is;
- To ask the child in simple terms about the comfort level of the past week
- By direct observation of the child's non-verbal behaviors during the visit
- To teach the child how to use wong/baker faces pain rating scale
- To interview the parent about behavior, moods, and sleep patterns over the past week
24. You are mentoring a student nurse in the intensive care unit (ICU) while caring for a patient with meningococcal meningitis. Which action by the student requires that you intervene immediately?
- The student enters the room without putting on a mask and gown.
- The student instructs the family that visits are restricted to 10 minutes,
- The student gives the patient a warm blanket when he says he feels cold.
- The student checks the patient's pupil response to light every 30 minutes.
25. A couple has been told that the male partner, who is healthy, is producing no sperm "because he has cystic fibrosis." Which of the following explanations is accurate in relation to this statement?
- Since the man is healthy he could not possibly have cystic fibrosis.
- Men with cystic fibrosis often have no epididymis.
- The expressivity of cystic fibrosis is variable.
- Cystic fibrosis is a respiratory illness having nothing to do with reproduction.
26. The nurse notes that the health care provider has documented a diagnosis of presbycusison a client's chart. Based on this information, what action should the nurse take?
- Speak loudly, but mumble or slur the words.
- Speak loudly and clearly while facing the client.
- Speak at normal tone and pitch, slowly and clearly.
- Speak loudly and directly into the client's affected ear.
27. Sally Baker, a 40-year-old woman, is admitted to the hospital with an established diagnosis of mitral stenosis. She is scheduled for surgery to repair her mitral valve. Q. Ms. Baker has decided to have surgical correction of her stenosed valve at this time because her subjective complaints of dyspnea, hemoptysis, orthopnea, and paroxysmal nocturnal dyspnea have become unmanageable. These complaints are probably due to:
- thickening of the pericardium
- right heart failure
- pulmonary hypertension
- left ventricular hypertrophy
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28. A patient presents at the clinic with weight loss and complains of trouble seeing at night. The nurse also observes numerous teeth with decay. Upon Learning that the patient has a vitamin deficiency, which of the following foods would the nurse MOST likely instruct the patient to add to diet?
- Cheese and breads
- Liver and rice
- Fish and rice
- Fruits and vegetables
29. A 25-year-old female presents to the emergency room with lethargy, decreased reflexes, hypoventilation, hypotension, and fixed and dilated pupils. A family member who is accompanying the patient has an empty bottle of diazepam(Valium) which the label states was recently refilled.The family member also indicates that the patient has a history of depression what intervention should the nurse expect to administer?
- Flumazenil or (activated charcoal)
- A tap water enema
- Magnesium sulphate to reduce the risk of seizure
- Nalaxazone
30. Myrna a pregnant client reports that her last menstrual cycle is July 11, her expected date of birth is:
- November 4
- November 11
- April 4
- April 18
31. Situation: If a child with diarrhea registers one sign in the pink row and one in the yellow; row in the IMCI Chart Q. Carlo has had diarrhea for 5 days. There is no blood in the stool, he is irritable. His eyes are sunken the nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the abdomen, it goes back slowly. How will you classify Carlo's illness?
- severe dehydration
- no dehydration
- some dehydration
- moderate dehydration
32. A male client with a history of cirrhosis and alcoholism is admitted with severe dyspnea resulted to ascites. The nurse should be aware that the ascites is most likely the result of increased...
- Pressure in the portal vein
- Production of serum albumin
- Secretion of bile salts
- Interstitial osmotic pressure
33. A nurse for a child with celiac disease (CD). The patient would have a permanent inability to tolerate:
- Protein
- Glutens
- Fruits
- Dairy
34. A patient had a craniotomy with resection of a nonmalignant neoplasm for the temporal lobe. The patient's vital signs are within the base line normal range. The nurse observes that the patient has developed bilateral periorbital edema. Which of the following actions would be appropriate for the nurse to take?
- Apply cold compresses to the patient's eyes
- Apply warm compresses to the patient's eyes
- Elevate the head of the patient's bed to 60 degrees
- Elevate the head of the patient's bed to 45 degrees
35. A nurse is evaluating the home of patient with left-sided paralysis. Which of the following observations would indicate that the patient is complying with home-based safety?
- The telephone is on a bedside table with is next to the head of the bed
- The bedside commode is on the left-side of the bed with the back of the commode facing the foot of the bed
- The walker has wheels on its back legs and has tennis balls on the front legs
- The stairs leading from the bedroom to the living area a handrail on the right-side of the stairway
36. When palpating the client's neck for lymphadenopathy, where should the nurse position himself?
- At the client's back
- At the client's right side
- At the clients left side
- In front of a sitting client
37. A nurse is teaching a prenatal class to a group of the first time mothers, each at different points in their gestation, which of the statement is TRUE regarding the management of fatigue?
- Rest flat on back, especially during the third trimester
- Exercise programs should focus on their training
- Frequent 15 minute to 30 minute rest periods are important
- Six hours of sleep a night is adequate
38. A client with a diagnosis of paranoid schizophrenia comments to the nurse, "How do I know what is really in those pills?" Which of the following is the best response?
- Say, "You know it's your medicine"
- Allow him to open the individual wrappers of the medication.
- Say, "Don't worry about what is in the pills. It's what is ordered ”
- Ignore the comment because it's probably a joke.
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39. During the immediate postoperative period, a patient reveals an oxygen saturation level of 91%. The nurse should:
- Position the patient on the left side
- Administer supplemental oxygen
- Continue to provide supportive care
- Lower the temperature of the room
40. The nurse visits a client at home. The client states, "I haven't slept at all the last couple of nights." Which response by the nurse demonstrates therapeutic communication?
- "Really?"
- "You're having difficulty sleeping?"
- "Sometimes I have trouble sleeping too.”
- "I see."
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41. In handwashing by medical asepsis, hands are held
- Above the elbow, The hands must always be above the waist
- Above the elbow, The hands are cleaner than the elbow
- Below the elbow, Medical asepsis do not require hands to be above the waist
- Below the elbow, Hands are dirtier than the lower arms
42. A client with antisocial personality disorder is trying to manipulate the healthcare team. Which of the following strategies is important for the staff to use?
- Focus on how to teach the client more effective behaviors for meeting basic needs.
- Help the client verbalize underlying feelings of hopelessness and learn coping skills.
- Remain calm and don't emotionally respond to the client's manipulative actions.
- Help the client eliminate the intense desire to have everything in life turn out perfectly.
43. If a patient develops a complication during a blood transfusion, the nurse first should be to:
- Stop the transfusion
- Notify the practitioner
- Administer an anti histamine
- Administer an anti-inflammatory medication
44. The client is admitted following repair of a fractured tibia and cast application. Which nursing assessment should be reported to the doctor?
- Pain beneath the cast
- Warm toes
- Pedal pulses weak and rapid
- Paresthesia of the toes
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45. After an Rh(-) mother has delivered her Rh (+) baby, the mother is given RhoGam. This is done in order to:
- Prevent the recurrence of Rh(+) baby in future pregnancies
- Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten when she delivered to her Rh(+) baby
- Ensure that future pregnancies will not lead to maternal illness
- To prevent the newborn from having problems of incompatibility when it breastfeeds
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46. When asking the parents about the onset of problems in young client with the diagnosis of schizophrenia, Nurse Linda would expect that they would relate the clients difficulties began in:
- Early childhood
- Late childhood
- Adolescence
- Puberty
47. Inadequate intake by the pregnant woman of which vitamin may cause neural tube defects?
- Niacin
- Riboflavin
- Folic Acid
- Thiamine
48. A nurse is preparing to obtain an arterial blood gas specimen from a client and plans to perform the Allen's test on the client After explaining the procedure to patient, what is the next step nurse need to do for performing the Alien's test?
- Ask the client to open and close the hand repeatedly.
- Assess the color of the extremity distal to the pressure point
- Release pressure from the ulnar artery
- Apply pressure over the ulnar and radial arteries.
49. Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy. Q. Mrs. Hogan returns to your clinical unit following discharge from the recovery room. Her vital signs are stable and her family is with her. Postoperative leg exercises should be initiated:
- after the physician writes the order
- after the family leaves
- if Mrs. Hogan will not be ambulated early
- stat
50. Situation: If a child with diarrhea registers one sign in the pink row and one in the yellow; row in the IMCI Chart. Q. The child with no dehydration needs home treatment Which of the following is not included the rules for home treatment in this case:
- continue feeding the child
- give oresol every 4 hours
- know when to return to the health center
- give the child extra fluids