NCLEX-RN | QB3 | Practice Exam #17 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. An illustration that shows how the members of an organization are connected:
- Flowchart
- Bar graph
- Organizational chart
- Line graph
2. As labor progresses satisfactorily, it would be appropriate to administer pain medication with cervical dilatation of:
- 4 cm.
- 3 cm.
- 5 cm.
- 7 cm.
3. The nurse is caring for a client with anorexia nervosa. Which behavior is characteristic of this disorder and reflects anxiety management?
- Engaging in immoral acts
- Always reinforcing self-approval
- Observing rigid rules and regulations
- Having the need always to make the right decision
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4. When assessing a female client who is receiving tricyclic antidepressant therapy, which of the following would alert the nurse to the possibility that the client is experiencing anticholinergic effects?
- Urine retention and blurred vision
- Respiratory depression and convulsion
- Delirium and Sedation
- Tremors and cardiac arrhythmias
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5. A patient who is 18-hour postoperative after an above-the knee amputation complaints of feeling like something is crawling under the dressing as well as increased pressure of the dressing . The nurse suspect haemorrhage. The patients vital signs remains within the normal range. What should the nurse do FIRST?
- Call the physician
- Place ice around the dressing
- Encourage patient to discuss fears
- Lower the temperature of the room
6. A four-year-old is admitted with acute leukemia. It will be most important to monitor the child for:
- Abdominal pain and anorexia
- Fatigue and bruising
- Bleeding and pallor
- Petechiae and mucosal ulcers
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7. Which of the following teaching method is effective in client who needs to be educated about self injection of insulin?
- Detailed explanation
- Demonstration
- Use of pamphlets
- Film showing
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8. Nurse Oliver is caring for a client with impaired mobility that occurred as a result of a stroke. The client has right sided arm and leg weakness. The nurse would suggest that the client use which of the following assistive devices that would provide the best stability for ambulating?
- Crutches
- Single straight-legged cane
- Quad cane
- Walker
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9. Situation: Rosanna 20 y/o unmarried patient believes that the toilet for the female patient in contaminated with AIDS virus and refuses to use it unless she flushes it three times and wipes the toilet seat the same number of times with antiseptic solution. Q. The fear of using "contaminated" toilet seat can be attributed to Rosanna's inability to:
- Adjust to a strange environment
- Express her anxiety
- Develop the sense of trust in other person
- Control unacceptable impulses or feelings
10. When creating an assignment for a team consisting of a registered nurse RN), 1 licensed practical nurse (LPN), and 2 unlicensed assistive personnel (UAP), which is the best client for the LPN?
- A client requiring frequent temperature checks
- A client requiring assistance with ambulation every 4 hours
- A client on a mechanical ventilator requiring frequent assessment and suctioning
- A client with a spinal cord injury requiring urinary catheterization every 6 hours
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11. The correct sequence for assessing the abdomen is:
- Tympanic percussion, measurement of abdominal girth, and inspection
- Assessment for distention, tenderness, and discoloration around the umbilicus.
- Percussions, palpation, and auscultation
- Auscultation, percussion, and palpation
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12. Situation: The question with regards to the OPERATING ROOM. Q. One of the hidden dangers in the OR is missing instruments. What is the appropriate approach to this happening?
- correct labeling
- "a place for everything and everything in its place"
- install a flush sterilizer in the OR
- increase instrument inventory
13. The nurse is reviewing the results of a sweat test taken from a child with cystic fibrosis. Which finding supports the clients diagnosis?
- A sweat potassium concentration less than 40mEq/L
- A sweat chloride concentration greater than 60mEq/L
- A sweat potassium concentration greater than 40mEq/L
- A sweat chloride concentration less than 40mEq/L
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14. The primary methods used to examine the skin, mucus membrane and hair are:
- Inspection and palpation
- Percussion and inspection
- Palpation and auscultation
- Auscultation and percussion
15. A client was hospitalized with major depression with suicidal ideation for 1 week. He is taking venlafaxine (Effexor), 75 mg three times a day, and is planning to return to work. The nurse asks the client if he is experiencing thoughts of self-harm. The client responds, "I hardly think about it anymore and wouldn't do anything to hurt myself." The nurse judges:
- The client to be decompensating and in need of being readmitted to the hospital.
- The client to need an adjustment or increase in his dose of antidepressant.
- The depression to be improving and the suicidal ideation to be lessening.
- The presence of suicidal ideation to warrant a telephone call to the client's physician
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16. A nurse is caring for an 8-year-old male with cystic fibrosis. Based on the nurse's understanding of the disease. What nursing intervention should the nurse expect to perform?
- Restrict sodium and fluid intake
- Give antidiarrheal medications
- Discourage coughing after postural drainage
- Administer pancreatic enzymes with each meal
17. A resident has diabetes. Which of the following is a common sign of a low blood sugar?
- Fever
- Shakiness
- Thirst
- Vomiting
18. Situation: Please continue responding as a professional nurse in varied health situations through the following questions. Q. When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do?
- Demonstrate how to assess her blood glucose
- Teach correct administration of subcutaneous bronchodilators
- Ensure she seeks treatment for any acute exacerbation
- Explain that she should avoid steroids during her pregnancy
19. Which biological used in EPI should not be stored in the freezer?
- Measles vaccine
- DPT
- OPV
- MMR
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20. Ms. Capone is newly-promoted to a patient care manager position. She updates her knowledge on the theories in management and leadership in order to become effective in her new role. She learns that some managers have low concern for services and high concern for staff. Which style of management refers to this?
- Organization Management
- Impoverished Management
- Country Club Management
- Team Management
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21. The nurse is preparing to suction the client with a tracheotomy. The nurse notes a previously used bottle of normal saline on the clients bedside table. There is no label to indicate the date or time of initial use. The nurse should:
- Lip the bottle and use a pack of sterile 4-4 for the dressing.
- Obtain a new bottle and label it with the date and time of first use.
- Ask the ward secretary when the solution was requested.
- Label the existing bottle with the current date and time.
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22. A client is scheduled to undergo an abdominal perineal resection with a permanent colostomy. Which of the following measures would be an anticipated part of the client's preoperative care?
- Keep the client NPO for 24 hrs before surgery
- Administer neomycin sulfate the evening before surgery
- Inform the client that total parenteral nutrition will likely be implemented after surgery
- Advise the client to limit physical activity
23. A severely immunocompromised female patient requires a blood transfusion. To prevent GVHD, the physician will order:
- Diphenhydramine hydrochloride (Benadryl).
- The transfusion to be administered slowly over several hours.
- Irradiation of the donor blood.
- Acetaminophen (Tylenol).
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24. What would be the long-term management goal for a patient with diabetes mellitus, type II?
- Quickly lower blood glucose level by administering insulin
- Achieve hypoglycemic state
- Maintain daily exercise
- Understand how to self-administer insulin
25. Situation: As the CPES is applicable for all professional nurse, the professional growth and development of Nurses with specialties shall be addressed by a Specialty Certification Council. The following questions apply to these special groups of nurses. Q. By force of law, therefore, the PRC-Board of Nursing released Resolution No. 14 Series of the entitled: "Adoption of a Nursing Specialty Certification Program and Creation of Nursing Specialty Certification Council." This rule-making power is called:
- Quasi-Judicial Power
- Regulatory Power
- Quasi/Legislative Power
- Executive/Promulgation Power
26. A patient classification system where patients minimal therapy and less frequent observation
- minimal care (category 1)
- moderate care (category 2)
- maximum care (category 3)
- intensive care (category 4)
27. A nursing care plan for a male client with bipolar I disorder should include:
- Providing a structured environment
- Designing activities that will require the client to maintain contact with reality
- Engaging the client in conversing about current affairs
- Touching the client provide assurance
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28. In Integrated Management of Childhood Illness, the nurse is aware that the severe conditions generally require urgent referral to a hospital. Which of the following severe conditions DOES NOT always require urgent referral to a hospital?
- Mastoiditis
- Severe dehydration
- Severe pneumonia
- Severe febrile disease
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29. Mr. Duffy is admitted to the CCU with a diagnosis of R/0 Ml. He presented in the ER with a typical description of pain associated with an Ml, and is now cold and clammy, pale and dyspneic. He has an IV of D5W running, and is complaining of chest pain. Oxygen therapy has not been started, and he is not on the monitor. He is frightened. Q. During the first three days that Mr. Duffy is in the CCU, a number of diagnostic blood tests are obtained. Which of the following patterns of cardiac enzyme elevation are most common following an MI?
- SGOT, CK, and LDH are all elevated immediately.
- SGOT rises 4-6 hours after infarction with CK and LDH rising slowly 24 hours later.
- CK peaks first (12-24 hours), followed by the SGOT (peaks in 24-36 hours) and then the LDH (peaks 3-4 days).
- CK peaks first and remains elevated for 1 to 2 weeks.
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30. The nurse is caring for a client following a modified radical mastectomy. Which assessment finding would indicate that the client is experiencing a complication related to this surgery?
- Sanguineous drainage in the Jackson-Pratt drain
- Pain at the incisional site
- Complaints of decreased sensation near the operative site
- Arm edema on the operative side
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31. Which of the following findings is associated with right-sided heart failure?
- Shortness of breath
- Nocturnal polyuria
- Daytime oliguria
- Crackles in the lungs
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32. On which of the following areas would the nurse expect to observe chloasma?
- Breast areola, and nipples
- Chest, neck, arms, and legs
- Abdomen, breast, and thighs
- Cheeks, forehead, and nose
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33. Which of the following is the primary goal for surgical resection of lung cancer?
- To remove the tumor and all surrounding tissue.
- To remove the tumor and as little surrounding tissue as possible.
- To remove all of the tumor and any collapsed alveoli in the same region.
- To remove as much as the tumor as possible, without removing any alveoli.
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34. SITUATION: Wide knowledge about the human ear, it's parts and it's functions will help a nurse assess and analyze changes in the adult client's health. Q. Ear drops are prescribed to an infant, The most appropriate method to administer the ear drops is
- Pull the pinna up and back and direct the solution towards the eardrum
- Pull the pinna down and back and direct the solution onto the wall of the canal
- Pull the pinna down and back and direct the solution towards the eardrum
- Pull the pinna up and back and direct the solution onto the wall of the canal
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35. Situation: A nurse is working with an aggressive client in the psychiatric unit Q. Which of the following is an accurate way of reporting and recording an incident?
- "When asked about his relationship with his father, client became anxious."
- "When asked about his relationship with his father, client clenched his jaw/teeth, made a fist and turned away from the nurse."
- "When asked about his relationship with his father, client was resistant to respond"
- "When asked about his relationship with his father, his anger was suppressed"
36. Which of the following causes of infertility in the female is primarily psychological in origin?
- Vaginismus
- Dyspareunia
- Endometriosis
- Impotence
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37. Situation: The physician has ordered 3 units of whole blood to be transfused to Wally following a repair of a dissecting aneurysm of the aorta. Q. In case Wally will experience an acute hemolytic reaction, what will be your PRIORITY intervention?
- A immediately stop the blood transfusion, infuse Dextrose 5% in Water and call the physician
- stop the blood transfusion and monitor the patient closely
- immediately stop the BT, infuse NSS, call the physician, notify the blood bank
- immediately stop the BT, notify the blood bank and administer antihistamines
38. A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Nursing care should include:
- Releasing the traction for five minutes each shift
- Loosening the pins if the client complains of headache
- Elevating the head of the bed 90°
- Performing sterile pin care as ordered
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39. The physician ordered, Magnesium Hydroxide cc Aluminum Hydroxide. What does cc means?
- without
- with
- one half
- With one half dose
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40. Which patient should be assigned to the traveling nurse, new to neurologic nursing care, who has been on the neurologic unit for 1 week?
- A 34-year-old patient newly diagnosed with multiple sclerosis (MS)
- A 68-year-old patient with chronic amyotrophic lateral sclerosis (ALS)
- A 56-year-old patient with Guillain-Barre syndrome (GBS) in respiratory distress
- A 25-year-old patient admitted with CA level spinal cord injury (SCI)
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41. Which of the following hormones stimulates the secretion of milk?
- Progesterone
- Prolactin
- Oxytocin
- Estrogen
42. Situation: Milo 16 y/o has been diagnosed to have AIDS, he worked as entertainer in a cruise ship: You are assigned in a private room of Milo. Which procedure should be of utmost importance:
- Alcohol wash
- Universal precaution
- Washing isolation
- Gloving technique
43. Which of the following cardiac conditions does a fourth heart sound (S4) indicate?
- Dilated aorta
- Normally functioning heart
- Decreased myocardial contractility
- Failure of the ventricle to eject all the blood during systole
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44. Nurse Rita is performing an otoscopic examination on a female client with a suspected diagnosis of mastoiditis. Nurse Rita would expect to note which of the following if this disorder is present?
- Transparent tympanic membrane
- Thick and immobile tympanic membrane
- Pearly colored tympanic membrane
- Mobile tympanic membrane
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45. A 65 year-old woman with a history of unstable angina and hypertension presents to the Emergency Department with a dull chest pain that she describes as similar to heartburn. The pain radiates down the left arm. She had taken sublingual nitroglycerin tablets without any relief. An electrocardiograph is performed and shows elevated S-T segments. The nurse is to administer a thrombolytic by intravenous infusion. Which factor places this candidate at high risk for bleeding?
- Unstable angina
- Hypertension
- Elevated S-T segments
- Age
46. Situation: Joanna Marie, a 40 year old client was diagnosed with breast cancer. Q. The nurse puts a folded towel under the left shoulder of the Client to be examined for clinical BSE. Why is this so?
- To make the left shoulder nearer to the hands of the clinician for palpation
- To make the pectoralis muscle prominent, toning the breast tissue for better palpation
- To put the breast in a more lateral position to better ease the palpation
- To balance and spread the breast tissue thus easing palpation
47. Situation: Mr Roberto's condition continues to worsen and the doctor suggested Kidney Transplantation. Q. Mr Roberto was readmitted to the hospital with acute graft rejection. Which of the following assessment finding would be expected?
- Hypotension
- Normal Body Temperature
- Decreased WBC
- Elevated BUN and Creatinine
48. Situation: As a nurse in the Oncology Unit, you have to be prepared to provide efficient and effective care to your patients. Q. Earliest sign of skin reaction to radiation therapy is:
- desquamation
- erythema
- atrophy
- pigmentation
49. The physician has scheduled a Whipple procedure for a client with pancreatic cancer. The nurse recognizes that the clients cancer is located in:
- The tail of the pancreas
- The head of the pancreas
- The body of the pancreas
- The entire pancreas
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50. In conducting a primary survey on a trauma patient, which of the following is considered one of the priority elements of the primary survey?
- Complete set of vital signs
- Palpation and auscultation of the abdomen
- Brief neurologic assessment
- Initiation of pulse oximetry
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