NCLEX-RN | QB3 | Practice Exam #24 (50 questions)

All 50 questions are randomized each time you take the test, and do not appear in the same order.

1. A Patient with tuberculosis can transmit the disease to another individual Through:

• Air droplets
• Physical contact
• Hand to mouth exchange
• Blood and body fluids

2. In relation to submersion injuries, which task is most appropriate to delegate to an LPN/ LVN?

• Talk to a community group about water safety issues.
• Stabilize the cervical spine for an unconscious drowning victim.
• Remove wet clothing and cover the victim with a warm blanket.
• Monitor an asymptomatic near-drowning victim.

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3. SITUATION: Alfred, a 40 year old construction worker developed cough, night sweats and fever. He was brought to the nursing unit for diagnostic studies. He told the nurse he did not receive a BCG vaccine during childhood Q. The nurse performs a Mantoux Test. The nurse knows that Mantoux Test is also known as:

• PPD
• PDP
• PDD
• DPP

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4. Situation: Mastery of Psychotropic medications is necessary for the therapeutic improvement in the health of the psychiatric clients. Q. The nurse should expect that a client who cheeks the medication is a non-complaint patient. Knowing the non compliance is the single most important factor for exacerbation and rehospitalisation, the doctor ordered Prolixin [Fluphenazine Decanoate]. The nurse knows that is it given:

• Orally
• Sublingually
• IV
• IM

5. A nurse is caring for a postoperative patient who is on subcutaneous, low dose heparin. This medication is used to prevent:

• Deep vein thrombosis
• Congestive heart failure
• Paralytic Ileus
• Pneumonia

6. A nurse has just started total parenteral nutrition (TPN) as prescribed for a patient with severe dysphagia low prealbumin levels. In one to two hours, the nurse should anticipate assessing the patient's:

• Blood glucose level
• Weight
• Liver
• SpO2

7. Nurse Pauline is aware that Dementia unlike delirium is characterized by:

• Slurred speech
• Insidious onset
• Clouding of consciousness
• Sensory perceptual change

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8. Central venous access devices (CVADs) are frequently utilized to administer chemotherapy. What is a distinct advantage of using the CVAD for chemotherapeutic agent administration?

• CVADs are less expensive than a peripheral IV.
• Once a week administration is possible.
• Caustic agents in small veins can be avoided.
• The patient or his family can administer the drug at home.

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9. Situation: As a perioperative nurse, you are aware of the correct processing methods for preparing instruments and other devices for patient use to prevent infection. Q. To achieve sterilization using disinfectants, which of the following is used?

• Low level disinfectants immersion in 24 hours
• Intermediate level disinfectants immersion in 12 hours
• High level disinfectants immersion in 1 hour
• High level disinfectants immersion in 10 hours

10. A client is admitted to the psychiatric unit with a tentative diagnosis of psychosis. Her physician prescribes the phenothiazine thioridazine (Mellaril) 50 mg by mouth three times per day. Phenothiazines differ from central nervous system (CNS) depressants in their sedative effects by producing:

• deeper sleep than CNS depressants.
• greater sedation than CNS depressants.
• a calming effect from which the client is easily aroused.
• more prolonged sedative effects, making the client more difficult to arouse.

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11. For which common complication of myocardial infarction should the nurse monitor clients in the coronary care unit?

• Dysrhythmia
• Hypokalemia
• Anaphylactic shock
• Cardiac enlargement

12. Oral contraceptive pills are of different types. Which type is most appropriate for mothers who are breastfeeding?

• Estrogen only
• Progesterone only
• Mixed type-estrogen and progesterone
• 21-day pills mixed type

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13. Mrs Ahmed age 53, her pulse rate is found to be 52 per minute. Her heart rate could be described as:

• Tachypnea
• Tachycardia
• Bradypnea
• Bradycardia

14. Who developed the first theory of nursing?

• Hammurabi
• Alexander
• Fabiola
• Nightingale

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15. The nurse has a prescription to hang a 1000-mL intravenous (IV) bag of 5% dextrose in water with 20 mEq of potassium chloride. The nurse also needs to hang an IV infusion of piperacillin/ tazobactam. The client has one IV site. The nurse should plan to take which action first?

• Start a second IV site.
• Check compatibility of the medication and IV fluids.
• Mix the prepackaged piperacillin/tazobactam per agency policy.
• Prime the tubing with the IV solution, and backprime the medication.

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16. The client using a diaphragm should be instructed to:

• The client using a diaphragm should keep the diaphragm in a cool location.
• Keep the diaphragm in a cool location
• Have the diaphragm resized if she gains five pounds
• Have the diaphragm resized if she has any surgery

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17. A patient with diabetic retinopathy is experiencing an episode of unresolved hemorrhage in the eye. The nurse identifies the MOST likely procedure to benefit this patient would be:

• Enucleation
• Radial keratotomy
• Vitrectomy
• Peripheral Iridectomy

18. The nurse prepares to administer a phytonadione (vitamin K) injection to a newborn, and the mother asks the nurse why her infant needs the injection. What best response should the nurse provide?

• "Your newborn needs the medicine to develop immunity."
• "The medicine will protect your newborn from being jaundiced."
• "Newborns have sterile bowels, and the medicine promotes the growth of bacteria in the bowel.”
• "Newborns are deficient in vitamin K, and this injection prevents your newborn from bleeding."

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19. The nurse is caring for the client who had an above the knee amputation two (2) days ago. The residual limb was wrapped with an elastic compression bandage which has come off. The nurse immediately:

• Calls the physician
• Rewrap the stump with an elastic compression bandage
• Applies ice to the site
• Applies a dry sterile dressing and elevates it on a pillow

20. A patient is in the preoperative area to lumbar surgery. The patient reports anxiety about being intubated and expresses concern about waking up during the surgery. The nurse MUST discuss the patient’s concern with the:

• Anesthesia provider
• Surgeon
• Scrub nurse
• Charge nurse

21. A client has been receiving cyanocobalamine (Bl 2) injections for the past six weeks. Which laboratory finding indicates that the medication is having the desired effect?

• Neutrophil count of 60%
• Basophil count of 0.5%
• Monocyte count of 2%
• Reticulocyte count of 1%

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22. Situation: Nurse Gloria is the staff nurse assigned at the Emergency Department. During her shift, a patient was rushed - in the ED complaining of severe heartburn, vomiting and pain that radiates to the flank. The doctor suspects gastric ulcer. Q. What diagnostic test would yield good visualization of the ulcer crater?

• Endoscopy
• Gastroscopy
• Barium Swallow
• Histology

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23. Marco approached Nurse Trish asking for advice on how to deal with his alcohol addiction. Nurse Trish should tell the client that the only effective treatment for alcoholism is:

• Psychotherapy
• Alcoholics anonymous (A.A.)
• Total abstinence
• Aversion Therapy

24. A couple who wants to conceive but has been unsuccessful during the last 2 years has undergone many diagnostic procedures. When discussing the situation with the nurse, one partner states, "We know several friends in our age group and all of them have their own child already, Why can't we have one?". Which of the following would be the most pertinent nursing diagnosis for this couple?

• Fear related to the unknown.
• Pain related to numerous procedures.
• Ineffective family coping related to infertility.
• Self-esteem disturbance related to infertility.

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25. A nurse is preparing to insert a nasogastric tube into a client. The nurse places the client in which position for insertion:

• Right side
• Low Fowler's
• HighFowler's
• Supine with the head flat

26. These are characteristics of a mature person, except:

• practical and ambitious
• accountable and responsible for his actions
• feels comfortable with himself
• acknowledges strengths and weaknesses

27. Nurse caring for a patient receiving a transfusion assesses that the patient is wheezing and is complaining of back pain. After the nurse stops the transfusion, the nurse should:

• discontinue the IV.
• notify the charge nurse.
• administer heparin.
• raise the patient's head.

28. A client is scheduled for an ultrasound examination of the prostate. To describe the procedure to the client, the nurse should plan to relate that:

• The procedure is performed using a cystoscope
• A probe will be inserted into the rectum
• A flat disk is placed on the abdomen
• This procedure uses x-rays to produce a visual image

29. The home health nurse visits a client at home and determines that the client is dependent on drugs. During the assessment, which action should the nurse take to plan appropriate nursing care?

• Ask the client why he started taking illegal drugs.
• Ask the client about the amount of drug use and its effect.
• Ask the client how long he thought that he could take drugs without someone finding out.
• Not ask any questions for fear that the client is in denial and will throw the nurse out of the home.

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30. 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 therapy most effective for clients with phobia is:

• Hypnotherapy
• Group therapy
• Cognitive therapy
• Behavior therapy

31. The nursing intervention to relieve "morning sickness11 in a pregnant woman is by giving:

• Dry carbohydrate food like crackers
• Low sodium diet
• Intravenous infusion
• Antacid

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32. Which nurse should be assigned to care for the postpartal client with preeclampsia?

• The RN with two weeks of experience in postpartum
• The RN with three years of experience in labor and delivery
• The RN with 10 years of experience in surgery
• The RN with one year of experience in the neonatal intensive care unit

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33. The nurse is preparing to administer medication through a nasogastric tube that is connected to suction. To administer the medication, the nurse should take which action?

• Position the client supine to assist in medication absorption.
• Aspirate the nasogastric tube after medication administration to maintain patency.
• Clamp the nasogastric tube for 30 to 60 minutes following administration of the medication.
• Change the suction setting to low intermittent suction for 30 minutes after medication administration.

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34. A pregnant client in late pregnancy is complaining of groin pain that seems worse on the right side. Which of the following is the most likely cause of it?

• Beginning of labor.
• Bladder infection.
• Constipation.
• Tension on the round ligament

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35. Situation: You are working as a Pediatric Nurse in your own Child Health Nursing Clinic, the following cases pertain to ASSESSMENT AND CARE OF THE NEWBORN AT RISK conditions. Q. Theresa, a mother with a 2 year old daughter asks, "At what are can I be able to take the blood pressure of my daughter as a routine procedure since hypertension is common in the family?" Your answer to this is:

• At 2 years you may
• As early as 1 year old
• When she's 3 years old
• When she's 6 years old

36. A newborn in 38 weeks, the infant was cyanotic, what is the best position for him:

• Supine
• Prone
• Lateral
• None of the above.

37. The nurse has just administered ibuprofen to a child with a temperature of 102 °F (38.8 °C). The nurse should also take which action?

• Remove excess clothing and blankets from the child.
• Withhold oral fluids for 8 hours.
• Sponge the child with cold water
• Plan to administer salicylate in 4 hours.

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38. In health belief model, Individual perception matters. Which of the following is highly UNLIKELY to influence preventive behavior?

• Perceived susceptibility to an illness
• Perceived seriousness of an illness
• Perceived threat of an illness
• Perceived curability of an illness

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39. There are four catheter sizes available for use, which one of these should you use for Mr. Hamilton?

• Fr. 18
• Fr. 12
• Fr. 10
• Fr. 5

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40. To minimize confusion in the elderly hospitalized client the nurse should:

• Provide sensory stimulation by varying the daily routine.
• Keep the room brightly lit and the television on to provide orientation to time.
• Encourage visitors to limit visitation to phone calls to avoid overstimulation.
• Provide explanations in a calm caring manner to minimize anxiety.

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41. Situation: Camila, 25 years old, was reported to be gradually withdrawing and isolating herself from friends and family members. She became neglectful of her personal hygiene. She was observed to be talking irrelevantly and incoherently. She was diagnosed as schizophrenia Q. The past history of Camila would most probably reveal that her premorbid personality is:

• schizoid
• extrovert
• ambivert
• cycloid

42. Which of the following discharge planning instructions takes PRIORITY in patient with congestive heart failure?

• Maintaining a low cholesterol, low sodium and low potassium diet
• Recognizing signs andsymptoms that requireimmediate medicalattention
• The importance ofremaining physicallyactive
• The importance ofdrinking plenty of fluid

43. Which of the following nursing interventions promotes patient safety?

• Asses the patients ability to ambulate and transfer from a bed to a chair
• Demonstrate the signal system to the patient
• Check to see that the patient is wearing his identification band
• All of the above

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44. What statement by the client indicates the need for further discussion regarding the outcome of skin grafting (allografting) procedures?

• "For the first few days after surgery, the donor sites will be painful.”
• "Because the graft is my own skin, there is no chance it won't 'take'”
• "I will have some scarring in the area when the skin is removed for grafting”
• "Once all grafting is completed, my risk for infection is the same as it was before 1 was burned.”

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45. A resident is on a bladder retraining program. The nurse aide can expect the resident to:

• have a fluid intake restriction to prevent sudden urges to urinate.
• wear an incontinent brief in case of an accident.
• have an indwelling urinary catheter.
• have a schedule for toileting.

46. Remedios felt “EMPTY" She felt that she has already lost God's favor and love because of her sins. This is a type of what spiritual crisis?

• Spiritual Anger
• Spiritual Loss
• Spiritual Despair
• Spiritual Anxiety

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47. Situation: Tony, 11 years old, has 'kissing tonsils' and is scheduled for tonsillectomy and adenoidectomy or T and A. Q. The PACU nurse will maintain postoperative T and A client in what position?

• Supine with neck hyperextended and supported with pillow
• Prone with the head on pillow and tuned to the side
• Semi-Fowler's with neck flexed
• Reverse trendelenburg with extended neck

48. The nurse is assessing the abdomen. The nurse knows the best sequence to perform the assessment is:

• Inspection auscultation palpation
• Auscultation palpation inspection
• Inspection palpation auscultation
• Palpation inspection auscultation

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49. Situation: Care of clients with tracheotosmy is often a challenge to a beginning nurse. The following questions will test your knowledge on Tracheostomy and its related care. Q. Prior to the suctioning or removal of the inner cannula, the nurse knows that the client is prepared and positioned in:

• High fowlers
• Semi fowlers position
• Left side lying
• Sims

50. Which of the following is the most prominent feature of public health nursing?

• It involves providing home care to sick people who are not confined in the hospital
• Services are provided free of charge to people within the catchment area
• The public health nurse functions as part of a team providing a public health nursing service
• Public health nursing focuses on preventive, not curative services

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NCLEX-RN | QB3 | Practice Exam #24 (50 questions)