NCLEX-RN | QB3 | Practice Exam #26 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. A client whose husband just left her has a recurrence of anorexia nervosa. The nurse caring for her realizes that this exacerbation of anorexia nervosa results from the client's effort to:
- manipulate her husband.
- gain control of one part of her life.
- commit suicide.
- live up to her mother's expectations.
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2. A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription?
- Obtains a weight
- Takes the temperature
- Takes the blood pressure
- Checks the amount of urine output
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3. Situation: Clients with Bipolar disorder receives a very high nursing attention due to the increasing rate of suicide related to illness. Q. The nurse is planning activities for a client who has bipolar disorder, which aggressive social behaviour. Which of the following activities would be most appropriate for this client?
- Ping Pong
- Linen Delivery
- Chess
- Basketball
4. The nurse is performing an initial assessment on a newborn infant When assessing the infant's head, the nurse notes that the ears are low-set. Which nursing action is most appropriate?
- Document the findings.
- Arrange for hearing testing.
- Notify the health care provider.
- Cover the ears with gauze pads.
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5. During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is necessary because?
- Anesthesia is administered during the procedure
- Decrease oxygen to the brain increases confusion and disorientation
- Grand mal seizure activity depresses respirations
- Muscle relaxations given to prevent injury during seizure activity depress respirations.
6. Which of the following classes of medications maximizes cardiac performance in clients with heat failure by increasing ventricular contractility?
- Beta-adrenergic blockers
- Calcium channel blockers
- Diuretics
- Inotropic agents
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7. Which of the following is not a good source of iron?
- Butter
- Pechay
- Grains
- Beef
8. A client is hospitalized with hepatitis A. Which of the clients regular medications is contraindicated due to the current illness?
- Prilosec (omeprazole)
- Synthroid (levothyroxine)
- Premarin (conjugated estrogens)
- Lipitor (atorvastatin)
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9. A client has undergone gastrectomy. Nurse Jovy is aware that the best position for the client is:
- Left side lying
- Low fowler's
- Prone
- Supine
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10. A urinary tract infection is a potential danger with an indwelling catheter Nurse Gina can best plan to avoid this complication by:
- Assessing urine specific gravity
- Maintaining the ordered hydration
- Collecting a weekly urine specimen
- Emptying the drainage bag frequently
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11. A client with a head injury has an intracranial pressure (ICP) monitor in place. Cerebral perfusion pressure calculations are ordered. If the clients ICP is 22 and the mean pressure reading is 70 what is the clients cerebral perfusion pressure?
- "92"
- "72"
- "58"
- "48"
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12. Following an injury in which Ms. Leona Elkins while climbing stairs, she experiencing immediate swelling of her ankle and pain on movement Her physician has sent her to the hospital for x-ray. Which on of the following nursing measures would be most helpful for relieving the swelling while preparing to obtain the x-ray of Ms. Elkin's lower leg?
- Dangle the foot
- Elevate the foot
- Exercise the foot
- Immobilize the foot
13. What best describes nurses as a care provider?
- Determine client's need
- Provide direct nursing care
- Help client recognize and cope with stressful psychological situation
- Works in combined effort with all those involved in patients care
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14. The nurse is assessing the motor and sensory function of an unconscious client. The nurse should use which technique to test the client's peripheral response to pain?
- Sternal rub
- Nail bed pressure
- Pressure on the orbital rim
- Squeezing of the sternocleidomastoid muscle
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15. A client who has Alzheimer's disease is told by the nurse to brush his teeth. He shouts angrily, "Tomato soup!" Which of these comments by the nurse would be appropriate?
- Here's your toothbrush. First get your toothpaste, then wet your brush.”
- “I don't understand what you mean by "tomato soup.”
- "You seem upset"
- "I'll brush your teeth for you"
16. Which of the following should Nurse Cherry do first in taking care of a male client with rabies?
- Encourage the patient to take a bath
- Cover IV bottle with brown paper bag
- Place the patient near the comfort room
- Place the patient near the door
17. The PCS gave new guidelines including leaflets to educate cancer patients. As a nurse, When using materials like this, what is your responsibility?
- Read it for the patient
- Give it for the patient to read himself
- Let the family member read the material for the patient
- Read it yourself then, Have the client read the material
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18. After the nurse has administered a heparin injection. The patient is observed rubbing the area. The nurse should instruct the patient to not rub the area, as it may:
- Increase the risk of bleeding.
- Prevent proper absorption of the medication.
- Cause increased pain.
- Result in tissue death.
19. Situation: Nurse's attitudes toward the pain influence the way they perceive and interact with clients in pain. Q. You are the nurse in the pain clinic where you have client who has difficulty specify the location of pain. How can you assist such client?
- The pain is vague
- By charting-it hurts all over
- Identifying the absence and presence of pain
- Ask the client to point to the painful are by just one finger.
20. A client with myasthenia gravis has become increasingly weaker. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis?
- No change in the condition
- Complaints of muscle spasms
- An improvement of the weakness
- A temporary worsening of the condition
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21. The nurse asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed about administration of the eye medication?
- "I will flush the eyes after instilling the ointment."
- "I will clean the newborn's eyes before instilling ointment.”
- "I need to administer the eye ointment within 1 hour after delivery."
- "I will instill the eye ointment into each of the newborn's conjunctival sacs"
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22. Which of the following information, when voiced by the mother, would indicate to the nurse that she understands home care instructions following the administration of a diphtheria, tetanus, and pertussis injection?
- Measures to reduce fever
- Need for dietary restrictions
- Reasons for subsequent rash
- Measures to control subsequent diarrhea
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23. The mother notices a cheese-like substances in a neonate forehead. She asked the nurse if it can be removed. The appropriate response is:
- a soft towel and a baby oil can be used to remove the substance
- an alcohol and gauze can removed it
- it is a protected substance, leave It alone there
- baby lotion can be used to remove it
24. The nurse has given the client instructions about crutch safety. Which statement indicates that the client understands the instructions? Select all that apply. 1. "I should not use someone else's crutches.” 2. "1 need to remove any scatter rugs at home." 3. "I can use crutch tips even when they are wet." 4. "I need to have spare crutches and tips available." 5. "When I'm using the crutches, my arms need to be completely straight.”
- 2,3,5
- 1,2,3,4,5
- 2,3,4
- 1,2,4
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25. Kenneth, 25 year old diagnosed with HIV felt that he had not lived up with God's expectation. He fears that in the course of his illness, God will be punitive and not be supportive. What kind of spiritual crisis is Kenneth experiencing? 1. Spiritual Pain 2. Spiritual Anxiety 3. Spiritual Guilt 4. Spiritual Despair
- 1,2
- 2,3
- 3,4
- 1,4
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26. Which is true regarding the administration of antacids?
- Antacids should be administered without regard to mealtimes.
- Antacids should be administered with each meal and snack of the day.
- Antacids should not be administered with other medications.
- Antacids should be administered with all other medications for maximal absorption.
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27. A nurse interview a patient, recently admitted to long term care facility, to obtain information on the patients health perception. The nurse encourages the patient to elaborate about this change. Which type of questioning would be MOST effective in this situation?
- Analytical
- Focused
- Closed
- Open-ended
28. Situation: A "disaster" is a large-scale emergency—even a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybody's business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency program and activities for all four emergency phases (mitigation, preparedness, response, and recovery), for all type of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector. Q. During the disaster you see a victim with a green tag, you know that the person:
- has injuries that are significant and require medical care but can wait hours will threat to life or limb
- indicates injuries that are extensive and chances of survival are unlikely even with definitive care
- has injuries that are minor and treatment can be delayed from hours to days
29. Considered as the most accessible and convenient method for temperature taking is:
- Oral
- Rectal
- Tympanic
- Axillary
30. A client in labor is transported to the delivery room and prepared for a cesarean delivery. After the client is transferred to the delivery room table, the nurse should place the client in which position?
- Supine position with a wedge under the right hip
- Trendelenburg's position with the legs in stirrups
- Prone position with the legs separated and elevated
- Semi-Fowler's position with a pillow under the knees
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31. Situation: Susan is a patient in the clinic where you work. She is inquiring about pregnancy. On examination, Susan has been found of having a cystoceie. A cystocele is:
- A sebaceous cyst arising from the vulvar fold.
- Protrusion of intestines into the vagina
- Prolapse of the uterus into the vagina
- Herniation of the bladder into the vaginal walk
32. A mastectomy patient has developed lymph edema of the left arm. The nurse should teach the patient that the BEST position for the arm is:
- Immobilized across the chest
- Dependent
- Elevated
- In traction
33. During the assessment phase of a preoperative interview, the patient reports feeling nervous. The patient conveys to the nurse that a parent died in surgery due to malignant hyperthermia. To whom would this information be MOST pertinent?
- Post-anesthesia care unit(PACU) nurse
- Scrub nurse
- Anesthesia team
- Charge nurse
34. Some institutions will not infuse a fat emulsion, such as Intralipid, into central venous access devices (CVAD) because:
- Lipid residue may accumulate in the CVAD and occlude the catheter.
- If the catheter clogs, there is no treatment other than removal and replacement.
- Lipids are necessary only in the most extreme cases to prevent essential fatty acid (EFA) deficiency.
- Fat emulsions are very caustic.
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35. A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session?
- You will be sitting for the examination procedure.
- Portions of the procedure will cause pain or discomfort.
- You will be asleep during the procedure.
- You will not be able to drink fluids for 24 hours following the study.
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36. A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which medication?
- Diuretics
- Antibiotics
- Antilipemics
- Decongestants
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37. A client diagnosed with conductive hearing loss asks the nurse to explain the cause of the hearing problem. The nurse plans to explain to the client that this condition is caused by which problem?
- A defect in the cochlea
- A defect in cranial nerve VIII
- A physical obstruction to the transmission of sound waves
- A defect in the sensory fibers that lead to the cerebral cortex
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38. The public health conducts a study on the factors contributing to the high morality rate due to heart diseases in the municipality where she works. Which branch of epidemiology does the nurse practice in this situation?
- Descriptive
- Analytical
- Therapeutic
- Evaluation
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39. A client with lung cancer is admitted in the nursing care unit. The husband wants to know the condition of his wife. How should the nurse respond to the husband?
- Find out what information he already has.
- Suggest that he discuss it with his wife.
- Refer him to the doctor.
- Refer him to the nurse in charge.
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40. In infants and children, the side effects of first generation over-the-counter (OTC) antihistamines, such as diphenhydramine (Benadryl) and hydroxyzine (Atarax) include:
- Reye's syndrome.
- Cholinergic effects.
- Paradoxical CNS stimulation.
- Nausea and diarrhea.
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41. A patient has a 6-year history of inflammatory bowel disease that is resistant to medical therapy. The patient can BEST decreased the like hood of the disease progressing to:
- Consuming only elemental foods
- Stopping smoking
- Using effective birth control
- Avoiding over heating
42. A 57 year-old male client has hemoglobin of 10 mg/dl and a hematocrit of 32%. What would be the most appropriate follow-up by the home care nurse?
- Ask the client if he has noticed any bleeding or dark stools
- Tell the client to call 911 and go to the emergency department immediately
- Schedule a repeat Hemoglobin and Hematocrit in 1 month
- Tell the client to schedule an appointment with a hematologist
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43. The nurse observes a group of toddlers at daycare. Which of the following play situations exhibits the characteristics of parallel play?
- Lindie and Laura sharing clay to make cookies
- Nick and Matt playing beside each other with trucks
- Adrienne working a puzzle with Meredith and Ryan
- Ashley playing with a busy box while sitting in her crib
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44. 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. When teaching the client, with Meniere's disease, which of the following instructions would a nurse give about vertigo.
- Report dizziness at once
- Drive in daylight hours only
- Get up slowly, turning the entire body
- Change your position using the log roll technique
45. Situation: Jolina is an 18 year old beginning college student. Her mother observed that she is having problems relating with her friends. She is undecided about her future. She has lost insight, lost interest in anything and complained and complained of constant tiredness. Q. Jolina is out on antidepressant drugs. These drugs act on the brain chemistry, therefore they would be useful in which type of depression?
- exogenous depression
- neurotic depression
- endogenous depression
- psychotic depression
46. Family members are encouraging your client to "tough it out" rather than run the risk of becoming addicted to narcotics. The client is stoically abiding by the family's wishes. Priority nursing interventions for this client should target which dimension of pain?
- Sensory
- Affective
- Sociocultural
- Behavioral
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47. A resident has an indwelling urinary catheter. While making rounds, the nurse aide notices that there is no urine in the drainage bag. The nurse aide should first:
- ask the resident to try urinating.
- offer the resident fluid to drink.
- check for kinksin the tubing.
- obtain a new urinary drainage bag.
48. Situation: Please continue responding as a professional nurse in varied health situations through the following questions. 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
49. What should a nurse consider when trying to promote affective learning in a client with a newly diagnosed disease?
- Client’s past experiences
- Client’s personal resources
- Stress of the total situation
- Type of onset of the disease
50. ASA (aspirin) is being administered to a client The nurse understands that the most common mechanism of action for non narcotic analgesic is their ability to:
- Inhibit prostaglandin synthesis
- After pain perception in the cerebellum
- Directly affect the central nervous system
- Target the pain-producing effect of kinins