NCLEX-RN | QB3 | Practice Exam #15 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. After the nurse has taught the client who is being discharged on lithium (Eskalith) about the drug, which of the following client statements would indicate that the teaching has been successful?
- "I need to restrict eating any foods that contain salt.”
- "If I forget a dose, I can double the dose the next time I take it.”
- "I'll call my doctor right away for any vomiting, severe hand tremors, or muscle weakness"
- "I should increase my fluid"
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2. Marco falls off his bicycle and injuries his ankle. Which of the following actions shows the initial response to the injury in the extrinsic pathway?
- Release of Calcium
- Release of tissue thromboplastin
- Conversion of factors XII to factor XIIa
- Conversion of factor VIII to factor VIIIa
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3. A client is admitted to the emergency department after being found unconscious. Her blood pressure is 82/50 mm Hg. She is 5' 4" (1.6 m) tall, weighs 79 lb (35.8 kg), and appears dehydrated and emaciated. After regaining consciousness, she reports that she has had trouble eating lately and can't remember what she ate in the last 24 hours. She also states that she has had amenorrhea for the past year. She is convinced she is fat and refuses food. The nurse suspects that she has:
- bulimia nervosa.
- anorexia nervosa.
- depression
- schizophrenia
4. A client is admitted for an CAT scan. The nurse should question the client regarding:
- Pregnancy
- A titanium hip replacement
- Allergies to antibiotics
- Inability to move his feet
5. 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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6. A client with a history of cardiac disease is due for a morning dose of furosemide. Which serum potassium level, if noted in the client's laboratory report, should be reported before administering the dose of furosemide?
- 3.2mEq/L(3.2mmol/L)
- 3.8mEq/L(3.8mmol/L)
- 4.2mEq/L(4.2mmol/L)
- 4.8mEq/L(4.8mmol/L)
7. Complications of wound healing include:
- Hematoma.
- Nausea.
- Hypertension.
- All of the above
8. The nurse is administering an intravenous dose of methocarbamol to a client with multiple sclerosis. For which adverse effect should the nurse monitor?
- Tachycardia
- Rapid pulse
- Bradycardia
- Hypertension
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9. A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the following may have contributed to her problem?
- Athletic activities.
- Vaccination history.
- Pet ownership.
- Genetic history.
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10. An elderly client is diagnosed with ovarian cancer. She has surgery followed by chemotherapy with a fluorouracil (Adrucil) IV. What should the nurse do if she notices crystals in the IV medication?
- Discard the solution and order a new bag.
- Warm the solution.
- Continue the infusion and document the finding.
- Discontinue the medication.
11. A client is brought to the hospital's emergency room by a friend, who states, "I guess he had some bad junk (heroin) today." In assessing the client, the nurse would likely find which of the following symptoms?
- Increased heart rate, dilated pupils, and fever.
- Tremulousness, impaired coordination, increased blood pressure, and ruddy complexion.
- Decreased respirations, constricted pupils, and pallor.
- Eye irritation, tinnitus, and irritation of nasal and oral mucosa.
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12. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown EXCEPT:
- Naegele's rule
- Quickening
- McDonald's rule
- Batholomew's rule of 4
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13. What is the maximum length of time a nurse should allow an IV bag of solution to infuse?
- 6 hours
- 12 hours
- 18 hours
- 24 hours
14. Situation: Nurse Anna is a new BSEN graduate and has just passed her Licensure Examination for Nurses in the Philippines. She has likewise been hired as a new Community Health Nurse in one of the Rural Health Units in their City, which of the following conditions may be acceptable TRUTHS applied to Community Health Nursing Practice. Q. Which of the following is the primary focus of community health nursing practice?
- Prevention of illness
- Rehabilitation back to health
- Promotion of health
- Cure of illness
15. Which of the following foods lowers the cardiac sphincter pressure?
- Roast beef, Steamed cauliflower and Rice
- Orange juice, Non fat milk, Dry crackers
- Decaffeinated coffee, Sky flakes crackers, Suman
- Coffee with coffee mate, Bacon and Egg
16. The drug of choice for schistosomiasis:
- Metrifonate
- Praziquante
- Hetrazan
- Quinidine Suifale
17. After seeking help at an outpatient mental health clinic. Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?
- Recommending a high-protein, low-fat diet.
- Giving sleep medication, as prescribed, to restore a normal sleep-wake cycle.
- Allowing the client time to heal.
- Exploring the meaning of the traumatic event with the client.
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18. Nurse Mandy is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client?
- The client lies still.
- The client asks questions.
- The client hears thumping sounds.
- The client wears a watch and wedding band.
19. Nurse Jonah is collecting a sputum specimen for culture and sensitivity testing from a client who has a productive cough. Nurse Jonah plans to implement which intervention to obtain the specimen?
- Ask the client to expectorate a small amount of sputum into the emesis basin.
- Ask the client to obtain the specimen after breakfast.
- Use a sterile plastic container for obtaining the specimen.
- Provide tissues for expectoration and obtaining the specimen.
20. Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates understanding of the nurses teaching?
- I must flush the tube with water after feedings and clamp the tube.
- I must check placement four times per day.
- I will report to the doctor any signs of indigestion.
- If my father is unable to swallow I will discontinue the feeding and call the clinic.
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21. A centrally located tumor would produce which of the following symptoms?
- Coughing
- Hemoptysis
- Pleuritic pain
- Shoulder pain
22. Situation: Nurse Macarena 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 nurse assessing newborn babies and infants during their hospital stay after birth will notice which of the following symptoms as a primary manifestation of Achalasia?
- Olive shaped mass on abdomen
- Failure to pass meconium during the first 24 to 48 hours after birth
- The skin turns yellow and then brown over the first 48 hours of life
- Effortless and non-projectile vomiting
23. Mrs. Santos is on her 5th pregnancy and has a history of abortion in the 4th pregnancy and the first pregnancy was a twin. She is considered to be:
- G4 P3
- G5 P3
- G5 P4
- G4 P4
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24. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/ minute.The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm?
- Sinus tachycardia
- Sinus bradycardia
- Sinus dysrhythmia
- Normal sinus rhythm
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25. An adult female client has a hemoglobin level of 10.8 g/dL (108 mmol/L). The nurse interprets that this result is most likely caused by which condition noted in the client's history?
- Dehydration
- Heart failure
- Iron deficiency anemia
- Chronic obstructive pulmonary disease
26. A client is diagnosed with Tuberculosis and respiratory isolation is initiated. This means that:
- Gloves are worn when handling the client's tissue, excretions, and linen.
- Both client and attending nurse must wear masks at all times.
- Nurse and visitors must wear masks until chemotherapy is begun. Client is instructed in cough and tissue techniques.
- Full isolation; that is, caps and gowns are required during the period of contagion.
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27. Which of the following is a function of epidemiology?
- Identifying the disease condition based on manifestations presented by a client
- Determining factors that contributed to the occurrence of pneumonia in a 3 year old
- Determining the efficacy of the antibiotic used in the treatment of the 3 year old client with pneumonia
- Evaluating the effectiveness of the implementation of the Integrated Management of Childhood Illness
28. The nurse is reviewing the laboratory results of a client with rheumatoid arthritis. Which of the following laboratory results should the nurse expect to find?
- Increased platelet count
- Elevated erythrocyte sedimentation rate (ESR)
- Electrolyte imbalance
- Altered blood urea nitrogen (BUN) and creatinine levels
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29. The nurse who is about to begin a blood transfusion knows that blood cells start to deteriorate after a certain period of time. The nurse takes which actions in order to prevent a complication of the blood transfusion as it relates to deterioration of blood cells? Select all that apply. 1. Checks the expiration date 2. Inspects for the presence of clots 3. Checks the blood group and type 4. Checks the blood identification number 5. Hangs the blood within the specified time frame per agency policy
- 1,2,3,4
- 3,4,5
- 1,3,5
- 1,5
30. During the nurse patient interaction, the nurse assesses the following to determine the patients coping strategy:
- how are you feeling right now?
- do you have anyone to take you home?
- what do you think will help you right now?
- How does your problem affect your life?
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31. Situation: Marie is 5 1/2 years old and described by the mother as bed wetting at night. Q. To help Marie who bed wets at night practice acceptable and appropriate behavior, it is important for the parents to be consistent with the following approaches EXCEPT:
- discipline with a king attitude
- matter of fact in handling the behavior
- sympathize for the child
- be loving yet firm
32. While evaluating the nutritional intake of a bedridden patient with multiple pressure sores, the nurse should make sure the patient INCREASES the intake of:
- Protein-rich foods
- Water Foods
- Rich in vitamin
- Fiber rich foods
33. What is the definitive test used to diagnose an abdominal aortic aneurysm?
- Abdominal X-ray
- Arteriogram
- CT scan
- Ultrasound
34. A client with hypertension has begun an aerobic exercise program. The nurse should tell the client that the recommended exercise regimen should begin slowly and build up to:
- 20-30 minutes three times a week
- 45 minutes two times a week
- One hour four times a week
- One hour two times a week
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35. When uterine rupture occurs, which of the following would be the priority?
- Limiting hypovolemic shock
- Obtaining blood specimens
- Instituting complete bed rest
- Inserting a urinary catheter
36. Situation: Mang Cardo, Age 72, is a widower with moderate Alzheimer's disease. Was brought to the home for the Aged by his married daughter. On admission, she says to the nurse, "I never thought this would happen to us. I really feel guilty about bringing him here, I can't bear to part with him." Q. The initial sign of Dementia is:
- Aphasia
- Forgetfulness
- Confusion
- Restlessness
37. Which is a preferable arm for BP taking?
- An arm with the most contraptions
- The left arm of the client with a CVA affecting the right brain
- The right arm
- The left arm
38. Mrs. Jane Gately has been dealing with uterine cancer for several months. Pain management is the primary focus of her current admission to your oncology unit Her vitasigns on admission are BP 110/64, pulse 78, respirations 18, and temperature 99.2 F. Morphine sulfate 6mg IV, q 4 hours, prn has been ordered. During your assessment after lunch, your findings are: BP 92/60, pulse 66, respirations 10, and temperature 98.8. Mrs. Gately is crying and tells you she is still experiencing severe pain. Your action should be to:
- give her the next ordered dose of MS.
- give her a back rub, put on some light music, and dim the lights in the room.
- report your findings to the MD, requesting an alternate medication order
- be obtained from the physician.
39. On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to:
- avoid all products containing alcohol.
- adhere to concomitant vitamin B therapy.
- return for monthly blood drug level monitoring.
- limit alcohol consumption to a moderate level.
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40. A female client is scheduled to receive a heart valve replacement with a porcine valve. Which of the following types of transplant is this?
- Allogeneic
- Autologous
- Syngeneic
- Xenogeneic
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41. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?
- Risk for infection
- Knowledge Deficit
- Anticipatory Grieving
- Pain
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42. The nurse is caring for a client with a cerebrovascular accident (CVA) who is complaining of being nauseated and is requesting an emesis basin. Which action would the nurse take first?
- Administer an ordered antiemetic.
- Obtain an ice bag and apply to the clients throat.
- Turn the client to one side.
- Notify the physician.
43. Paracentesis is best described as:
- The removal of fluid from the lung
- The removal of fluid or air from pleural cavity
- The removal of body fluid from the abdominal cavity
- The removal of secretion from the stomach
44. Mary asked Nurse Maureen about the incubation period of rabies. Which statement by the Nurse Maureen is appropriate?
- Incubation period is 6 months
- Incubation period is 1 week
- Incubation period is 1 month
- Incubation period varies depending on the site of the bite
45. A client is admitted to the psychiatric unit of a local hospital with chronic undifferentiated schizophrenia. During the next several days, the client is seen laughing, yelling, and talking to herself. This behavior is characteristic of:
- delusion
- looseness of association
- illusion
- hallucination
46. The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding?
- Frequent swallowing
- A decreased pulse rate
- Complaints of discomfort
- An elevation in blood pressure
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47. Estrogen antagonists are used to treat estrogen hormone-dependent cancer, such as breast carcinomA. Androgen antagonists block testosterone stimulation of androgen-dependent cancers. An example of an androgen-dependent cancer would be:
- Prostate cancer.
- Thyroid cancer,
- Renal carcinoma.
- Neuroblastoma.
48. What is the best course of action when there is a measles epidemic in a nearby municipality?
- Give measles vaccine to babies aged 6 to 3 months
- Give babies aged 6 to 11 months one dose of 100,000 ill of Retinol
- Instruct mother to keep their babies at home to prevent disease transmission
- Instruct mothers to feed their babies adequately to enhance their babies resistance
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49. A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly?
- Client reports not going to work for the past week.
- Client complains of not being able to "do anything" anymore.
- Client arrives at the clinic neat and appropriate in appearance.
- Client reports sleeping 12 hours per night and 3 to 4 hours during the day.
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50. A primigravida age 42 is six weeks pregnant. Based on the clients age her infant is at risk for:
- Down syndrome
- Respiratory distress syndrome
- Turners syndrome
- Pathological jaundice
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