NCLEX-RN | QB3 | Practice Exam #13 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. For a female client with suspected intracranial pressure (ICP), a most appropriate respiratory goal is:
- Maintain partial pressure of arterial oxygen (PaO2) above 80mmHg
- Promote elimination of carbon dioxide
- Lower the PH
- Prevent respiratory alkalosis
2. One day the mother of a young adult confides to nurse Frida that she is very troubled by he child's emotional illness. The nurse's most therapeutic initial response would be:
- "You may be able to lessen your feelings of guilt by seeking counseling"
- "It would be helpful if you become involved in volunteer work at this time"
- "I recognize it's hard to deal with this, but try to remember that this too shall pass"
- "Joining a support group of parents who are coping with this problem can be quite helpful."
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3. A 40 year-old woman presented with right hip pain. Palpation of the pelvic girdle is normal. An X-ray shows bone deformities, with osteolytic lesions and bone enlargement. The patient has not suffered any trauma and has been generally healthy. Which serum laboratory analysis would be most useful?
- Prothrombin time
- Alkaline phosphatase (if this high, calcium will be low and opposite)
- Acid phosphatase
- Parathyroid hormone
4. Situation: The mental health - psychiatric nurse functions in a variety of setting with different types of clients. Q. Lorelie upon discharge was referred to a volunteer group where she has learned to read patterns, cut out fabric and use a sewing machine to make simple outfits that will help her earn in the future. What type of activity therapy is this?
- Recreational therapy
- Art therapy
- Vocational therapy
- Educational therapy
5. According to Maslow, which of the following is TRUE about a self actualized person?
- Makes decision contrary to public opinion
- Do not predict events
- Self centered
- Maximum degree of self conflict
6. Which diet selection by a client with a decubitus ulcer would indicate a clear understanding of the proper diet for healing of the ulcer?
- Tossed salad milk and a slice of caramel cake
- Vegetable soup and crackers and a glass of iced tea
- Baked chicken breast broccoli wheat roll and an orange
- Hamburger French fries and corn on the cob
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7. In the summer months, a five year old girl present with a sore throat and a dry cough that has slowly become worse over the past three weeks, her body temperature is 38 c, on auscultation, there is a wheezing and shortness of breath. She lives in an overcrowded house with three brothers, parents and grandparents in a low-income neighborhood where she attend school. Which is the greatest risk factor?
- Resident in low-income neighborhood
- Attending School
- Exposure to pathogens in summer season
- Living crowded condition
8. A 22 year-old man presented to the Mental Health Clinic with a low-mood, a general loss of interest in activities and inability to experience pleasure. He admitted to suicidal thoughts and extreme lack of energy. He was prescribed a selective serotonin reuptake inhibitor to be taken daily. One month later, he presented to the clinic and reports feeling more energetic, but still has a low- mood. What is the patient's level of risk committing suicide at this time?
- Medium
- High
- Low
- None
9. Knowing that malnutrition is a frequent community health problem, you decided to conduct nutritional assessment. What population is particularly susceptible to protein energy malnutrition (PEM)?
- Pregnant women and the elderly
- Under 5 year old children
- 1-4 year old children
- School age children
10. The nurse is caring for a 12-year-old client with appendicitis. The clients mother is a Jehovahs Witness and refuses to sign the blood permit. What nursing action is most appropriate?
- Give the blood without permission.
- Encourage the mother to reconsider.
- Explain the consequences without treatment.
- Notify the physician of the mothers refusal.
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11. A female client undergoes yearly mammography. This is a type of what level of prevention?
- primary
- secondary
- tertiary
12. The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action?
- Take the medication with food.
- Increase fluid intake to 2000 to 3000 mL daily.
- Decrease sodium intake while taking the medication.
- Increase potassium intake while taking the
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13. A patient receiving chemotherapy developed some raised; red edematous wheals on the skin, which of the following care plan alter natives MOST likely need to occur before the treatment?
- Rein forced relaxation techniques
- Continue chemotherapy without change
- Continue with radiation therapy only
- Pre-medicate the patient with an antihistamine
14. Unused BCG should be discarded how many hours after reconstitution?
- At the end of the day
- 2
- 4
- 6
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15. A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:
- Her contractions are two minutes apart.
- She has back pain and a bloody discharge.
- She experiences abdominal pain and frequent urination.
- Her contractions are five minutes apart.
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16. A 3-years old child is seen at the pediatrician's office. The parents the child has had vomiting and diarrhea for the past 15 hours. The child's is lethargic with the following vital signs: temperature 37.20 C (99.0 F)t heart rate 145,respiration rate 25, and blood pressure level 95/55 mmHg. Which of the vital sign is abnormal?
- A 37.20 C (99.00 F)
- Heart rate 145
- Respiration rate 25
- Blood pressure level 95/55
17. A client with a diagnosis of addisonian crisis is being admitted to the intensive care unit. Which findings will the interprofessional health care team focus on? Select all that apply. 1. Hypotension 2. Leukocytosis 3. Hyperkalemia 4. Hypercalcemia 5. Hypernatremia
- 1,3,5
- 1,3
- 1,2,3
- 1,5
18. A patient is being evaluating due to onset of paleness, shortness of breath and sensations of heart palpitations. Which of the following component of complete blood count (CBC) should the nurse review to determine if the patient has anemia
- Leukocytes
- Platelets
- Erythrocytes
- Thrombocytes
19. Situation: Nurses are generalist, in order to cope up with the works demand you must have broad knowledge on anything. Nurse Joan was assigned in the medical ward. During the endorsement she found out that she was assigned to several patients of different case Q. Which of the following pathophysiological processes are involved in multiple sclerosis (MS)?
- Destruction of the brainstem and basal ganglia in the brain
- Degeneration of the nucleus pulposus, causing pressure on the spinal cord
- Chronic inflammation of rhizomes just outside the central nervous system
- Development of demyelination of the myelin sheath, interfering with the nerve
20. The tsunami in Thailand and Indonesia took thousands of people and change million lives. The people affected by the tsunami are saddened and do not know how to start all over again. What type of crisis is this?
- Situational
- Maturational
- Social
- Phenomenal
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21. 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. Jimmy initiates independence and takes an active part in his self care with the following EXCEPT:
- agreeing to contact the staff when he is anxious
- becoming aware of the conscious feeling
- assessing need for medication and medicating himself
- writing out a list of behaviors that he identifies as anxious
22. What is the first line for dysentery?
- Amoxicillin
- Tetracycline
- Cefalexin
- Cotrimoxazole
23. Which of the following is the MOST common type of cardiomyopathy in children and is treated with medications such as digoxin (Lanoxin) and warfarin (Coumadin)?
- Hypertrophic
- Dilated
- Restrictive
- Diastolic
24. Situation: Understanding different models of care is a necessary part of the nurse patient relationship. Q. A client with major depression is considering cognitive therapy. The client say to the nurse, "how does this treatment works?" The nurse responds by telling the client that:
- "This type of treatment helps you examine how your thoughts and feelings contribute to your difficulties"
- "This type of treatment helps you examine how your past life has contributed to your problems."
- "This type of treatment helps you confront your fears by exposing you to the feared objects abruptly."
- "This type of treatment will help you relax and develop new coping skills."
25. The nurse is making assignments for the day. The staff consists of an RN an LPN and a nursing assistant Which client could the nursing assistant care for?
- A client with Alzheimers disease
- A client with pneumonia
- A client with appendicitis
- A client with thrombophlebitis
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26. The most accurate time for measuring pulse rate is:
- 30 seconds.
- 15 seconds.
- 60 seconds.
- 45 seconds.
27. In planning home care for an immune-compromised child, the nurse instructs the parents to use cream or emollients to prevent or manage dry and cracked skin. A parent will BEST demonstrate understanding of the rationale for this be stating:
- Creams will prevent breaks in the skin and decrease the chance of infection
- Pleasantly scented creams will mask other less pleasant smells
- Micronutrients in the creams will help prevent malnutrition
- Creams will help prevent dehydration when my child does not drink enough
28. Situation: You are actively practicing nurse who just finished your Graduate Studies. You earned the value of Research and would like to utilize the knowledge and skills gained in the application of research to Nursing service. The following questions apply to research. Which of the following studies is based on quantitative research?
- A study examining the bereavement process in spouses of clients with terminal cancer
- A study exploring factors influencing weight control behavior
- A study measuring the effects of sleep deprivation on wound healing
- A study examining client's feelings before, during and after a bone marrow aspiration
29. The nurse is monitoring a client for the early signs and symptoms of dumping syndrome. Which findings indicate this occurrence?
- Sweating and pallor
- Bradycardia and indigestion
- Double vision and chest pain
- Abdominal cramping and pain
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30. Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?
- Playing video games
- Swimming
- Working crossword puzzles
- Playing slow-pitch softball
31. FHR can be auscultated with a fetoscope as early as which of the following?
- 5 weeks gestation
- 10 weeks gestation
- 15 weeks gestation
- 20 weeks gestation
32. A hospitalized client tells the nurse that an instructional directive is being prepared and that the lawyer will be bringing the document to the hospital today for witness signatures. The client asks the nurse for assistance in obtaining a witness to the will. Which is the most appropriate response to the client?
- "I will sign as a witness to your signature."
- "You will need to find a witness on your own.”
- "Whoever is available at the time will sign as a witness for you.”
- "I will call the nursing supervisor to seek assistance regarding your request."
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33. SITUATION: Wide knowledge about the human ear, it's parts and its functions will help a nurse assess and analyze changes in the adult client's health. Q. Following an ear surgery which statement if heard by Nurse Oca from the patient indicates a correct understanding of the post operative instructions?
- Activities are resumed within 5 days
- I will make sure that I will clean my hair and face to prevent infection
- I will use straw for drinking
- I should avoid air travel for a while
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34. Situation: The nurse is performing health education activities for Jane Segovia, a 30 years old Dentist with Insulin dependent diabetes Mellitus. Q. The nurse teaches Jane to know the difference between hypoglycaemia and ketoacidosis. Jane demonstrates understanding of the teaching by stating that glucose will be taken of which of the following symptoms develops?
- Heavy breathing
- Shakiness
- Blurred vision
- Foul breath odor
35. Parents of pediatric clients who undergo irradiation involving the central nervous system should be warned about postirradiation somnolence. When does this neurologic syndrome usually occur?
- Immediately
- Within 1 to 2 weeks
- Within 5 to 8 weeks
- Within 3 to 6 months
36. The nurse is assigned to check a clients continuous bladder irrigation. Which one of the following solution is normally used for continuous or intermittent bladder and catheter irrigations?
- Hydrogen peroxide
- Bacteriostatic water
- Sterile normal saline
- Plain water
37. Which client can best be assigned to the newly licensed nurse?
- The client receiving chemotherapy
- The client post-coronary bypass
- The client with a TURP
- The client with diverticulitis
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38. Situation: Ricky is a 12 year old-boy with Down's syndrome. He stands 5' and weight 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as support for his neck. X-ray of cervical spine showed "subluxation of Cl in relation to C2 with cord compression." He attends a school for special education. Q. The classroom teacher consults the school for guidance on how to take care of Ricky while inside the, classroom. The nurse considers as priority, Ricky's:
- Physiological needs
- Need for self-esteem
- Needs for safety and Security
- Needs for belonging
39. A four-year-old male is admitted to the unit with nephrotic syndrome. He is extremely edematous. To decrease the discomfort associated with scrotal edema the nurse should:
- Apply ice to the scrotum
- Elevate the scrotum on a small pillow
- Apply heat to the abdominal area
- Administer an analgesic
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40. This is a person or animal, who is without signs of illness but harbors pathogen within his body and can be transferred to another
- Environment
- Carrier
- Host
- Agent
41. Situation: Nurses hold a variety of roles when providing care to a perioperative patient. Q. It is also the nurse's function to determine when infection is developing in the surgical incision. The perioperative nurse should observe for what signs of impending infection?
- Localized heat and redness
- Serosanguinous exudates and skin blanching
- Separation of the incision
- Blood clots and scar tissue are visible
42. Situation: Records contain those, comprehensive descriptions of patient's health conditions and needs and at the same serve as evidences of every nurse's accountability in the, caregiving process. Nursing records normally differ from institution to, institution nonetheless they follow similar patterns of meeting needs for specifics, types of information. The following pertains to documentation/records management. These, are sheets/forms which provide an efficient and time saving way to record information that must be obtained repeatedly at regular and/or short intervals, of time. This does not replace the progress notes; instead this record of information on vital signs, intake and output, treatment, postoperative care, postpartum care, and diabetic regimen, etc., this is used whenever specific measurements or observations are needed to-be documented repeatedly. What is this?
- Nursing Kardex
- Graphic Flowsheets
- Discharge Summary
- Medicine and Treatment Record
43. A researcher that makes a generalization based on observations of an individuals behavior is said to be which type of reasoning:
- Inductive
- Logical
- Illogical
- Deductive
44. The nurse is teaching a client how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching?
- Withdraws the NPH insulin first
- Withdraws the regular insulin first
- Injects air into NPH insulin vial first
- Injects an amount of air equal to the desired dose of insulin into each vial
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45. The physician orders an IV solution of dextrose 5% in water at 100ml/hour. What would the flow rate be if the drop factor is 15 gtt = 1 ml?
- 5 gtt/minute
- 13 gtt/minute
- 25 gtt/minute
- 50 gtt/minute
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46. The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true of the collection of cultures for cytomegalovirus?
- Stool cultures are preferred for definitive diagnosis.
- Pregnant caregivers may obtain cultures.
- Collection of one specimen is sufficient.
- Accurate diagnosis depends on fresh specimens.
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47. The clinic nurse notes that the health care provider has documented a diagnosis of herpes zoster (shingles) in the client's chart Based on an understanding of the cause of this disorder, the nurse determines that this definitive diagnosis was made by which diagnostic test?
- Positive patch test
- Positive culture results
- Abnormal biopsy results
- Wood's light examination indicative of infection
48. Patient is planning to have an elective surgical procedure to repair an umbilical hernia. The patient is 68 years old. Weighs 136 kg (300 lbs.) Has diabetes mellitus. Which of the following approaches would be the MOST beneficial in order to reduce the patients surgical risk?
- Monitor blood glucose levels monthly
- Avoid fluid overload by restricting fluids
- Discourage any changes in routine before surgery
- Encourage weight reduction
49. SITUATION: Devon, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Devon rushed at the scene. Q. Devon suspects a hip fracture when he noticed that the old woman's leg is
- Lengthened, Abducted and Internally Rotated.
- Shortened, Abducted and Externally Rotated,
- Shortened, Adducted and Internally Rotated.
- Shortened, Adducted and Externally Rotated.
50. The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 19,500 mm3 (19.5 × 10^9/L). On the basis of this laboratory result, which intervention should the nurse include in the plan of care?
- Initiate bleeding precautions.
- Monitor closely for signs of infection.
- Monitor the temperature every 4 hours.
- Initiate protective isolation precautions.
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