NCLEX-RN | QB3 | Practice Exam #12 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. Which finding is consistent with PERNICIOUS ANEMIA?
- Strawberry tongue
- Currant Jelly stool
- Beefy red tongue
- Pale hypochromic RBC
2. Incident of prostate cancer is found to have been reduced on a population exposed in tolerable amount of sunlight. Which vitamin is associated with this phenomenon?
- Vitamin A
- Vitamin B
- Vitamin C
- Vitamin D
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3. A patient is having difficulty with cognitive abilities after a stroke. What part of the brain was MOST likely affected?
- Midbrain
- Cerebrum
- Medulla oblongata
- Cerebellum
4. Which of the following actions demonstrates the nurse's understanding about the newborn's thermoregulatory ability?
- Placing the newborn under a radiant warmer
- Suctioning with a bulb syringe.
- Obtaining an Apgar score.
- Inspecting the newborn's umbilical cord.
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5. The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply. 1. The child has symptoms of a cold. 2. The child had a previous anaphylactic reaction to the vaccine. 3. The mother reports that the child is having intermittent episodes of diarrhea. 4. The mother reports that the child has not had an appetite and has been fussy. 5. The child has a disorder that caused a severely deficient immune system. 6. The mother reports that the child has recently been exposed to an infectious disease.
- 1,3,5,6
- 2,4,5
- 2,5
- 1,2,3,4
6. To establish open and trusting relationship with a female client who has been hospitalized with severe anxiety, the nurse in charge should?
- Encourage the staff to have frequent interaction with the client
- Share an activity with the client
- Give client feedback about behavior
- Respect client's need for personal space
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7. A home care nurse makes a follow-up visit to a patient who recently suffered a cerebrovascular accident The patient is mobile and able to perform activities of daily living. However, the patient has not sleeping and has lost weight due to lack of appetite. The patient also feels overwhelmed with sadness. Which of the following is the most appropriate evaluation?
- Patient's progress is as expected and no further intervention is necessary
- Patient needs referral to a nutritionist
- Patient needs intervention for depression
- Patient needs sleeping medication
8. A client received burns to his entire back and left arm. Using the Rule of Nines, the nurse can calculate that he has sustained burns on what percentage of his body?
- 9%
- 18%
- 27%
- 36%
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9. Norma, a 42-year-old client with a diagnosis of chronic undifferentiated schizophrenia lives in a rooming house that has a weekly nursing clinic. She scratches while she tells the nurse she feels creatures eating away at her skin. Which of the following interventions should be done first?
- Talk about his hallucinations and fears
- Refer him for anticholinergic adverse reactions
- Assess for possible physical problems such as rash
- Call his physician to get his medication increased to control his psychosis
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10. The nurse would evaluate that the client understands his home care instructions after scleral buckling for a detached retina if he says his activity should include:
- Avoiding abrupt movements of the head
- Exercising the eye muscles each day
- Turning the entire head rather than just the eyes for sight
- Avoiding activities requiring good depth perception
11. The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply. 1. Easy bruising occurs. 2. Gum bleeding occurs. 3. It is a hereditary bleeding disorder. 4. Treatment and care are similar to that for hemophilia. 5. It is characterized by extremely high creatinine levels. 6. The disorder causes platelets to adhere to damaged endothelium.
- 1,2,3,4,5
- 1,2,3,4,6
- 2,3,4,5,6
- 1,3,5
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12. 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
13. Mr. Liberatore, age 76, is admitted to your unit He has a past medical history of hypertension, DM, hyperlipidemia. Recently he has had several episodes where he stops talking mid sentence and stares into space. Today the episode lasted for 15 minutes. The admission diagnosis is impending CVA. Q. Mr. Liberatore suffers a left sided CVA. He is right handed. The nurse should expect:
- left-sided paralysis
- visual loss
- no alterations in speech
- no impairment of bladder function
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14. Which of the following is not a sign of thromboembolism?
- Swelling
- Redness
- Coolness
- Edema
15. A child is scheduled for a myringotomy. What goal of this procedure will the nurse discuss with the parents?
- Promote drainage from the ear
- irrigate the Eustachian tube
- Correct a malformation in the inner ear
- Equalize pressure on the tympanic membrane
16. A client, age 36, with paranoid schizophrenia believes the room is bugged by the Central Intelligence Agency and that his roommate is a foreign spy. The client has never had a romantic relationship, has no contact with family members, and hasn't been employed in the last 14 years. Based on Erikson's theories, the nurse should recognize that this client is in which stage of psychosocial development?
- Autonomy versus shame and doubt
- Generativity versus stagnation
- Integrity versus despair
- Trust versus mistrust
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17. How often should an inactive patient's positions be changed?
- At least every 3 hours.
- At least every 2 hours.
- At least every 4 hours.
- At least once a shift.
18. Which of the following best describes parallel play between two toddlers?
- Sharing crayons to color separate pictures
- Playing a board game with a nurse
- Sitting near each other while playing with separate dolls
- Sharing their dolls with two different nurses
19. A trial for vaginal delivery after an earlier caesareans, would likely to be given to a gravida, who had:
- A First low transverse cesarean was for active herpes type 2 infections; vaginal culture at 39 weeks pregnancy was positive.
- First and second caesareans were for cephalopelvic disproportion.
- First caesarean through a classic incision as a result of severe fetal distress.
- First low transverse caesarean was for breech position. Fetus in this pregnancy is in a vertex presentation.
20. Colchicine is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this medication would be used with caution in which disorder?
- Myxedema
- Kidney disease
- Hypothyroidism
- Diabetes mellitus
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21. A 12-year-old child who has been diagnosed with insulin dependent mellitus (IDDM) since age 3.Comes to the clinic for a routine visit. The patient has begun to self-manage care with parental supervision. The patient injects 28 units of NPH insulin every morning and 8units at bedtime. The patient checks blood sugar 4 times every day. The patient's weight is stable and diet is unchanged. However, the patient reports several hypoglycemic reactions every week. The nurse knows the MOST likely cause is that:
- The patient is not eating the adequate number of calories reported
- The dosages of insulin may need to be decreased as the patient continues to grow
- There may be changes in exercise or stress levels or the beginning of a growth Spurt
- The patient may not be competent in techniques of drawing up and injecting insulin
22. When titrating an analgesic to manage pain, what is the priority goal?
- Administer smallest dose that provides relief with the fewest side effects.
- Titrate upward until the client is pain free.
- Titrate downwards to prevent toxicity
- Ensure that the drug is adequate to meet the clients subjective needs.
23. The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as:
- Atrial flutter
- A sinus rhythm
- Ventricular tachycardia
- Atrial fibrillation
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24. Nurse Michelle is assessing a 24 year old client with a diagnosis of hydatidiform mole. She is aware that one of the following is unassociated with this condition?
- Excessive fetal activity.
- Larger than normal uterus for gestational age.
- Vaginal bleeding.
- Elevated levels of human chorionic gonadotropin.
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25. A male client with diabetes mellitus is receiving insulin. Which statement correctly describes an insulin unit?
- It's a common measurement in the metric system.
- It's the basis for solids in the avoirdupois system.
- It's the smallest measurement in the apothecary system.
- It's a measure of effect not a standard measure of weight or quantity.
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26. A nurse assesses a clients serum electrolyte levels in the laboratory report. What electrolyte in intracellular fluid should the nurse consider most important?
- Sodium
- Calcium
- Chloride
- Potassium
27. When given postoperative discharge instruction to a patient who had abdominal surgery, all of the following regarding wound healing is true EXPECT
- Bathing to soak abdomen is preferred over showering
- A void tight belts and clothes with seams that may rub the wound
- Pain medication may affect ability to drive
- Irregular bowel habits can be expected
28. 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 goal of the therapy in phobia is:
- Change her lifestyle
- Ignore reaction producing situation
- Change her reaction towards anxiety
- Eliminate fear producing situation
29. Situation: Jimmy developed this goal for hospitalization. "To get a handle on my nervousness." The nurse is going to collaborate with him to reach his goal. Jimmy was admitted to the hospital because he called his therapist that he planned to asphyxiate himself with exhaust from his car but frightened instead. He realized he needed help. Q. The nurse is guided that Jimmy is aware of his concerns of the "here and now" when he crossed out which item from this "list of what to know"
- anxiety laden unconscious conflicts
- subjective idea of the range of mild to severe anxiety
- early signs of anxiety
- physiological indices of anxiety
30. Acute infection is:
- Infection may occur slowly and takes long time.
- is limited to the specific part of the body where micro-organisms remain,
- Infection appears suddenly or in short time.
- When microorganisms spread and damage different part of body.
31. A client with hepatitis C is scheduled for a liver biopsy. Which would the nurse include in the teaching plan for this client?
- The client should lie on the left side after the procedure.
- Cleansing enemas should be given the morning of the procedure.
- Blood coagulation studies might be done before the biopsy.
- The procedure is noninvasive and causes no pain.
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32. EPI is based on?
- Basic health services
- Scope of community affected
- Epidemiological situation
- Research studies
33. The nurse is providing medication instructions to an older client who is taking digoxin daily. The nurse explains to the client that decreased lean body mass and decreased glomerular filtration rate, which are age-related body changes, could place the client at risk for which complication with medication therapy?
- Decreased absorption of digoxin
- Increased risk for digoxin toxicity
- Decreased therapeutic effect of digoxin
- Increased risk for side effects related to digoxin
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34. A patient diagnosed with tuberculosis is prescribed isoniazid (isoniazid), Rifampin (Rifadin), pyrazinamide (Rifamate), ethambutol HCL (Myambuton), one month later the patient comes to the physician office with hepatitis. Which drug is the MOST likely cause?
- Ethambutol (Myambuton)
- Acetaminophen
- Izoniazid (Izoniazid)
- Pyrazinamide (Rifamate)
35. Defines health as the ability to maintain internal milieu. Illness according to him/her/them is the failure to maintain internal environment.
- Cannon
- Bernard
- Leddy and Pepper
- Roy
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36. A 33-year old female client came for consultation at the health center with the chief complaint of fever for a week. Accompanying symptoms were muscle pains and body malaise. A week after the start of fever, the client noted yellowish discoloration of his sclera. History showed that he waded in flood waters about 2 weeks before the onset of symptoms. Based on her history, which disease condition will you suspect?
- Hepatitis A
- Hepatitis B
- Tetanus
- Leptospirosis
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37. A client is admitted to the psychiatric hospital with a diagnosis of catatonic schizophrenia. During the physical examination, the client's arm remains outstretched after the nurse obtains the pulse and blood pressure, and the nurse must reposition the arm. This client is exhibiting:
- suggestibility
- negativity
- waxy flexibility.
- retardation
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38. Which of the following activities would Nurse Trish recommend to the client who becomes very anxious when thoughts of suicide occur?
- Using exercise bicycle
- Meditating
- Watching TV
- Reading comics
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39. Situation: Graciela 1 1/2 year old is admitted the hospital from the emergency room with a fracture of the left femur due to a Tall down a flight of stairs. Graciela is placed oh Bryant's traction. Q. While on Bryant's traction, which of these observations of Graciela and her traction apparatus would indicate a decrease in the effectiveness of her traction?
- Graciela's buttocks are resting on the bed
- The traction weights are hanging 10 inches above the floor
- Graciela's legs are suspended at a 90 degree angle to her trunk
- The traction ropes move freely through the pulley
40. The nurse is preparing to administer 100 ml potassium chloride solution. The prescriptions indicate that this should be infuse for 2 hours. The nurse should administer how many ml per hour?
- 10
- 25
- 50
- 100
41. The home care nurse is visiting a client who is in a body cast. While performing an assessment, the nurse plans to evaluate the psychosocial adjustment of the client to the cast. What is the most appropriate assessment for this client?
- The need for sensory stimulation
- The amount of home care support available
- The ability to perform activities of daily living
- The type of transportation available for followup care
42. Prior to initiating therapy with unfractionated heparin for a patient hospitalized with a deep vein thrombosis, the nurse should plan to:
- Weigh the patient
- Administer aspirin
- Limit fluid intake
- Undress the patient
43. She described the four conservation principle.
- Leininger
- Orlando
- Levin
- Parse
44. A dying male client gradually moves toward resolution of feelings regarding impending death. Basing care on the theory of Kubler-Ross, Nurse Trish plans to use nonverbal interventions when assessment reveals that the client is in the:
- Bargaining stage
- Anger stage
- Denial stage
- Acceptance stage
45. The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?
- Hamburger patty green beans French fries and iced tea
- Roast beef sandwich potato chips baked beans and cola
- Baked chicken fruit cup potato salad coleslaw yogurt and iced tea
- Fish sandwich gelatin with fruit and coffee
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46. Nurse Hazel is teaching a mother who plans to discontinue breast feeding after 5 months. The nurse should advise her to include which foods in her infant's diet?
- Skim milk and baby food.
- Whole milk and baby food.
- Iron-rich formula only.
- Iron-rich formula and baby food.
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47. Situation: Colorectal cancer can affect old and younger people. Surgical procedures and other modes of treatment are done to ensure quality of life. You are assigned in the Cancer institute to care of patients with this type of cancer. Q. To confirm his impression of colorectal cancer, Larry wiil require which diagnostic study?
- carcinoembryonic antigen
- proctosigmoidbscopy
- stool hematologic test
- abdominal computed tomography (CT) test
48. Which statement made by the nurse describes the inheritance pattern of autosomal recessive disorders?
- An affected newborn has unaffected parents.
- An affected newborn has one affected parent.
- Affected parents have a one in four chance of passing on the defective gene.
- Affected parents have unaffected children who are carriers.
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49. Nurse Michelle should know that the drainage is normal four (4) days after a sigmoid colostomy when the stool is:
- Green liquid
- Solid formed
- Loose, bloody
- Semiformed
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50. The nurse assists with a lumbar puncture on a child with suspected bacterial meningitis. If the diagnosis is correct the cerebrospinal fluid should have which of the following qualities?
- Pink viscous appearance
- Clear fluid appearance
- Turbid appearance
- Blood-tinged appearance