NCLEX-RN | QB3 | Practice Exam #27 (50 questions)

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

1. Situation: Baby Philip, a full term male child, is delivered by his mother who is RH negative. Q. Baby Philip is RH positive and his mother is RH negative. Baby Philip is to receive an exchange transfusion. The nurse know that he will receive RH-negative blood because:

• It is me same as die mother's blood
• It is neutral and will not react with his blood
• It eliminates the possibility of a transfusion reaction occurring
• His RBC's will not be destroyed by the maternal anti-RH antibodies

2. A 25 year-old female presented to the emergency room with lethargy, decreased reflexes, hypoventilation, hypotension, and fixed and dilated pupils. A family member who is accompanying the patient has an empty bottle of diazepam (Valium) which the label states was recently refilled. The family member also indicates that the patient has a history of depression. What intervention should the nurse expect to administer?

• Naloxone (Narcan)
• Activated charcoal
• Magnesium sulfate to reduce the risk of seizures
• A tap water enema

3. A nurse is assessing an infant diagnosed with failure to thrive. In addition to accurate anthropometric measurements, complete nutritional history, infant feeding ability, and head-to-toe assessment the nurse should asses which of the following:

• Parent-to-child interaction
• Number of sibling in the home
• Current sleep patterns
• Exposure to second hand smoke

4. The nursing assistant is assigned to give Ms. Bailey, who has had an abdominal hysterectomy, a sitz bath. She is instructed to use the special sitz bath tub. She asks the nurse why the regular bath tub cannot be used. The most correct reply is based on the fact that a regular bath tab:

• Is more slippery and is dangerous when used for surgical clients
• Cannot supply water that is of the desired temperature for this procedure
• Applies heat to the legs and alters the desired effect of heat directed to the pelvic region
• Cannot be kept as clean as a special sitz bath tub

5. The doctor has ordered a patient-controlled analgesia (PCA) pump for the client with chronic pain. The client asks the nurse if he can become overdosed with pain medication using this machine. The nurse demonstrates understanding of the PCA if she states:

• The machine will administer only the amount that you need to control your pain without any action from you.
• The machine has a locking device that prevents overdosing.
• The machine will administer one large dose every four hours to relieve your pain.
• The machine is set to deliver medication only if you need it.

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6. Situation: Infection can cause debilitating consequences when host resistance is compromised and virulence of microorganisms and environmental factors are favorable. Infection control is one important responsibility of the nurse to ensure quality of care. Q. A solution used to treat Pseudomonas would infection is:

• Dakin's solution
• Half-strength hydrogen peroxide
• Acetic acid
• Betadine

7. A 16-years old patient present to the clinic requesting birth control. With the diagnosis of health seeking behaviors, the BEST goals have the patient:

• Verbalizing understanding of safe sex practices and following safe sexual practices in all encounters
• Not engaging in sexual encounters until she is overlS years old and maintaining a healthy life style
• Recognizing the sign of pregnancy and the symptoms of sexually transmitted diseases
• Understanding safe sexual practices and use a condom to prevent pregnancy and sexually transmitted diseases

8. Which action is believed to be the most useful in preventing wound infections?

• Using sterile dressing supplies
• Performing careful hand hygiene
• Suggesting dietary supplements
• All of the above

9. SITUATION: Mr. Ramos was barbecuing outdoors when the gas tank exploded. He sustained second degree and third degree burns of the anterior portion of BOTH arms, the upper half of his anterior trunk and the anterior and posterior portions of his left lower extremity. The BEST initial management of burns that can be employed at the scene is generally which of the following:

• Pour cold water over the burned areas
• Apply clean dressing to the affected area
• Rinse the area with mild soap and water
• Apply tomato juice and ointment over the area

10. All of the following nursing interventions are correct when using the Z-track method of drug injection except:

• Prepare the injection site with alcohol
• Use a needle that's a least 1" long
• Aspirate for blood before injection
• Rub the site vigorously after the injection to promote absorption

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11. Situation: In your professional nursing role, it is essential to establish a meaningful nurse­ patient relationship. Q. A helping nurse patient relationship is characterized by which of the following?

• Recovery promoting
• Growth facilitating
• Mutual interaction
• Health enhancing

12. The client with acquired immunodeficiency syndrome is diagnosed with cutaneous Kaposi's sarcoma. Based on this diagnosis, the nurse understands that this has been confirmed by which finding?

• Swelling in the genital area
• Swelling in the lower extremities
• Positive punch biopsy of the cutaneous lesions
• Appearance of reddish-blue lesions noted on the skin

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13. The majority of the digestion processes take place in the:

• Mouth
• Small intestine
• Large intestine
• Stomach

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14. The registered nurse is conducting an in-service for colleagues on the subject of peptic ulcers. The nurse would be correct in identifying which of the following as a causative factor?

• N. gonorrhea
• H. influenza
• H. pylori
• E. coli

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15. 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. Elder clients are often at risk of having impaired skin integrity. One factor is that they often experience urinary incontinence. The elderly patient is at higher risk for urinary incontinence because of:

• increased glomerular filtration
• decrease elasticity of blood vessels
• decreased bladder capacity
• dilated urethra

16. A client with diabetes has an order for ultrasonography. Preparation for an ultrasound includes:

• Increasing fluid intake
• Limiting ambulation
• Administering an enema

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17. While caring for a patient with an ileostomy, the nurse would expect the ostomy tube located In Which Quadrant of the abdomen?

• Right lower
• Left lower
• Left upper
• Right upper

18. The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?

• Roast beef gelatin salad green beans and peach pie
• Chicken salad sandwich coleslaw French fries ice cream
• Egg salad on wheat bread carrot sticks lettuce salad raisin pie
• Pork chop creamed potatoes corn and coconut cake

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19. While caring for a patient in the post-anesthesia care unit (PACU) Who has developed Hypovolemic shock, a nurse should position the patient:

• Flat with legs elevated
• In Trendelenburg position
• With the head of the bed elevated 45 degrees
• Completely flat

20. Situation: Sexually Transmitted Diseases are important to identify during pregnancy because of their potential effect on the pregnancy, fetus, or newborn. The following questions pertain to STD's. What type of microorganism is the causative agent of syphilis?

• Spirochete
• Fungus
• Bacteria
• Protozoan

21. Situation: Mrs. Ethel Agustin 50 y/o, teacher is affected with myasthenia gravis. Q. In an effort to combat complications which might occur relatives should be taught:

• Checking cardiac rate
• Taking blood pressure reading
• Techniques of oxygen inhalation
• Administration of oxygen inhalation

22. Situation: The nurse is often met with the following situations when clients become angry and hostile. Q. To maintain a therapeutic eye contact and body posture while interacting with angry and aggressive individual, the nurse should:

• keep an eye contact while staring at the client
• keep his/her hands behind his/her back or in one's pocket
• fold his/her arms across his/her chest
• keep an "open" posture, e.g. Hands by sides but palms turned outwards

23. If a patient develops a complication during a blood transfusion, the nurse first should be to:

• Stop the transfusion
• Notify the practitioner
• Administer an antihistamine
• Administer an anti-inflammatory medication

24. An anesthetic agent which has side effects of confusion and suicidal tendencies;

• ether
• ketalar
• halothane
• sodium pentothal

25. The greatest danger of an uncorrected atrial fibrillation for a male patient will be which of the following:

• Pulmonary embolism
• Cardiac arrest
• Thrombus formation
• Myocardial infarction

26. May arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. She also tells the nurse that a home pregnancy test was positive but she began to have mild cramps and is now having moderate vaginal bleeding. During the physical examination of the client, the nurse notes that May has a dilated cervix. The nurse determines that May is experiencing which type of abortion?

• Inevitable
• Incomplete
• Threatened
• Septic

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27. A client with borderline personality disorder becomes angry when he is told that today's psychotherapy session with the nurse will be delayed 30 minutes because of an emergency. When the session finally begins, the client expresses anger. Which response by the nurse would be most helpful in dealing with the client's anger?

• "If it had been your emergency I would have made the other client wait."
• "I know it's frustrating to wait. I'm sorry this happened."
• "You had to wait. Can we talk about how this is making you feel right now?"
• "I really care about you and I'll never let this happen again."

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28. A client arrives at a birthing center in active labor. Following examination, it is determined that her membranes are still intact and she is at a -2 station. The health care provider prepares to perform an amniotomy. What will the nurse relay to the client as the most likely outcomes of the amniotomy? Select all that apply. 1. Less pressure on her cervix 2. Decreased number of contractions 3. Increased efficiency of contractions 4. The need for increased maternal blood pressure monitoring 5. The need for frequent fetal heart rate monitoring to detect the presence of a prolapsed cord

• 1,2,3
• 3,4,5
• 3,5
• 1,2,5

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29. Situation: A computer analyst, Mr. Ricardo J. Santos, 25 was brought to the hospital for diagnostic workup after he had experienced seizure in his office. Q. Mr. Santos is placed on seizure precaution. Which of the following would be contraindicated?

• Obtain his oral temperature
• Encourage to perform his own personal hygiene
• Allow him to wear his own clothing
• Encourage him to be out of bed.

30. Situation: The following questions refer to common clinical encounters experienced by an entry level nurse. The school nurse notices a child who is wearing old, dirty, poor-fitting clothes; is always hungry; has no lunch money; and is always tired. When the nurse asks the boy his tiredness, he talks of playing outside until midnight. The nurse will suspect that this child is:

• Being raised by a parent of low intelligence (IQ)
• An orphan
• A victim of child neglect
• The victim of poverty

31. Following an open-cholecystectomy, the nurse would instruct the patient to expect to resume normal activities in:

• 1 to 2 weeks
• 2 to 3 weeks
• 4 to 6 weeks
• 6 to 8 weeks

32. A client with Crohn's disease requires TPN to provide adequate nutrition. The nurse finds the TPN bag empty. What fluid would the nurse select to hang until another bag is prepared in the pharmacy?

• Lactated Ringers
• Normal saline
• D10W solution
• Normosol R

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33. A patient arrives in the emergency room with burns over the upper trunk and arms. The nurse should obtain the patient's pulse at which of the following arterial location?

• Radial
• Carotid
• femoral
• Apical

34. A home health nurse has entered a home to complete an admission assessment on a patient who has a methicillin-resistant Staphylococcus aureus (MRSA) urinary tract infection. The patient will receive intravenous anti-infective via a peripherally inserted central catheter (PICC) for 3 weeks. Which of the following actions should the nurse take FIRST?

• Shake the patient's hand
• Place the nursing supply bagon a clean, dry surface
• Obtain the patient's written consent for home health care
• Perform hand hygiene per the agency protocol

35. A client is admitted to the unit two hours after an injury with second-degree burns to the face trunk and head. The nurse would be most concerned with the client developing what?

• Hypovolemia
• Laryngeal edema
• Hypernatremia
• Hyperkalemia

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36. Situation: Sexually Transmitted Diseases are important to identify during pregnancy because of their potential effect on the pregnancy, fetus, or newborn. The following questions pertain to STD's. As a knowledgeable nurse, you know that the doctor may prescribe a certain medications for Ms. Reynald. What is the drug of choice for Reynald's infection?

• haloperidol
• miconazole
• benzathine penicillin
• metronidazole

37. During the postoperative period, a nurse is assigned to care for a morbidly obese patient with an abdominal incision. The nurse knows that this patient's weight increases the risk of:

• Left-sided heart failure
• Pressure sores of the coccyx
• Constipation and ileus
• Wound dehiscence

38. The nurse is assessing the heart sounds of a client with mitral stenosis following a history of rheumatic fever. To hear a mitral murmur the nurse should place the stethoscope at:

• The third intercostal space right of the sternum
• The third intercostal space left of the sternum
• The fourth intercostal space beneath the sternum
• The fourth intercostal space mid-clavicular line

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39. Situation: Miss Matias, found out that Mr. Carding, newly admitted patient, has terminal cancer and that his nurse has not yet informed him of the diagnosis. Q. The nurse, when dealing with the relatives of a dying patients must be sensitive to their emotional reactions. A family member who blames herself for the condition of the dying patient indicates that she:

• Has major issues
• is oversensitive
• Has neurotic tendencies
• Is potentially risk for suicide

40. Situation: The patient who is depressed will undergo electroconvulsive therapy. Q. Informed consent is necessary for the treatment for involuntary clients. When this cannot be obtained, permission may be taken from the:

• social worker
• doctor
• next of kin or guardian
• chief nurse

41. 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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42. Nurse Josie should instruct the client to eat which of the following foods to obtain the best supply of Vitamin B12?

• dairy products
• vegetables
• Grains
• Broccoli

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43. A child with rheumatic fever will be arriving to the nursing unit for admission. On admission assessment the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever?

• "Has the child complained of back pain?"
• "Has the child complained of headaches?"
• "Has the child had any nausea or vomiting?"
• "Did the child have a sore throat or fever within the last 2 months?"

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44. An infant who weighs 9 kg (19.8 lbs) requires 900ml of fluids per day for maintenance fluids. The inf ant typically consumes 120ml during each feeding. The infant must have how many feedings per day to meet the fluid maintenance needs?

• 4
• 8
• 10
• 12

45. Mr. Liberatore, age 76, is admitted to your unit He has a past medical history of hypertension, DM, hyperlipidemia. Recently he has had several episodes where he stops talking mid sentence and stares into space. Today the episode lasted for 15 minutes. The admission diagnosis is impending CVA. Q. Mr. Liberatore suffers a left sided CVA. He is right handed. The nurse should expect:

• left-sided paralysis
• visual loss
• no alterations in speech
• no impairment of bladder function

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46. After cardiac surgery, a patient has been prescribed low-sodium, low cholesterol diet. Which of the following menus is BEST?

• Salami, rye bread, sanerkrant
• Baked chicken thigh, iceberg lettuce, sliced tomatoes
• Pasta with canned tomato sauce, peas, wheat bread
• Bacon, lettuce and tomato sandwich with mayonnaise dressing

47. The nurse is monitoring the intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and should take which actions? Select all that apply. 1. Stop the infusion. 2. Notify the health care provider (HCP). 3. Prepare to apply ice or heat to the site. 4. Restart the IV at a distal part of the same vein. 5. Prepare to administer a prescribed antidote into the site. 6. Increase the flow rate of the solution to flush the skin and subcutaneous tissue.

• 1,2,3,4
• 1,2,3,5
• 2,3,4,5
• 1,2,3,6

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48. You are preparing a nursing care plan for the patient with SCI including the nursing diagnosis Impaired Physical Mobility and Self-Care Deficit. The patient tells you, "I don't know why we're doing all this. My life's over." What additional nursing diagnosis takes priority based on this statement?

• Risk for Injury related to altered mobility
• Imbalanced Nutrition, Less Than Body Requirements
• Impaired Adjustment to Spinal Cord Injury
• Poor Body Image related to immobilization

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49. Situation: Survey and Statistics are important part of research that is necessary to explain the characteristics of the population. Q. If the researcher implemented a new structured counselling program with a randomized group of subject and a routine counselling program with another randomized group of subject, the research is utilizing which design?

• Quasi experimental
• Experimental
• Comparative
• Methodological

50. One leadership theory states that "leaders are born and not made," which refers to which of the following theories?

• Trait
• Charismatic
• Great Man
• Situational

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NCLEX-RN | QB3 | Practice Exam #27 (50 questions)