NCLEX-RN | QB3 | Practice Exam #29 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. The nursing manager decides to form a committee to address the issue of violence against ED personnel. Which combination of employees is best suited to fulfill this assignment?
- ED physicians and charge nurses
- Experienced RNs and experienced paramedics
- RNs, LPN/LVNs, and nursing assistants
- At least one representative from each group of ED personnel
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2. The nurse performing an assessment on a client who has been receiving long-term steroid therapy would expect to find:
- Jaundice
- Flank pain
- Bulging eyes
- Central obesity
3. A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac stepdown unit (CSU). While giving report to the CSU nurse, the CCU nurse says, "His pulmonary artery wedge pressures have been in the high normal range/' The CSU nurse should be especially observant for:
- hypertension
- high urine output
- dry mucous membranes
- pulmonary crackles
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4. Situation: It is common that client ask the nurse personal questions. Q. When the nurse is asked a personal question, which of these reactions indicate a need her to introspect?
- The client is simply curious
- His/her right to privacy is being intruded
- The client knows no other way to begin a conversation
- Some patients are 1ike children in seeking recognition from the nurse
5. A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework?
- Behavioral framework
- Cognitive framework
- Interpersonal framework
- Psychodynamic framework
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6. The client is taking risperidone (Risperdal) to treat the positive and negative symptoms of schizophrenia. Which of the following negative symptoms will improve?
- Abnormal thought form.
- Hallucinations and delusions.
- Bizarre behaviour.
- Asocial behaviour and anergia.
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7. Situation: In a disaster there must be a chain of command in place that defines the roles of each member of the response team. Within the health care group there are pre-assigned roles based on education, experience and training on disaster. Q. As a nurse to which of the following groups are you best prepared to join?
- Treatment group
- Triage group
- Morgue management
- Transport group
8. Which of the following assessment findings would the nurse expect if the client develops DVT?
- Midcalf pain, tenderness and redness along the vein
- Chills, fever, malaise, occurring 2 weeks after delivery.
- Muscle pain the presence of Homans sign, and swelling in the affected limb.
- Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery.
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9. Which of the following statements about chest X-ray is false?
- No contradictions exist for this test
- Before the procedure, the patient should remove all jewelry, metallic objects, and buttons above the waist
- signed consent is not required
- Eating, drinking, and medications are allowed before this test
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10. The nurse is assessing a 48-year-old client who has come to the physician's office for his annual physical exam. One of the first physical signs of aging is:
- Accepting limitations while developing assets.
- Increasing loss of muscle tone.
- Failing eyesight, especially close vision.
- Having more frequent aches and pains.
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11. It is important for the nurse to teach the client that metformin (Glucophage):
- May cause nocturia
- Should be taken at night
- Should be taken with meals
- May increase the effects of aspirin
12. A client has been diagnosed with lung cancer and requires a wedge resection. How much of the lung is removed?
- One entire lung
- A lobe of the lung
- A small, localized area near the surface of the lung.
- A segment of the lung, including a bronchiole and its alveoli.
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13. The nurse is performing an assessment of an elderly client with a total hip repair Based on this assessment the nurse decides to medicate the client with an analgesic. Which finding most likely prompted the nurse to decide to administer the analgesic?
- The clients blood pressure is 130/86.
- The client is unable to concentrate.
- The clients pupils are dilated.
- The client grimaces during care.
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14. A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take?
- Call security for assistance and prepare to sedate the client.
- Tell the client to calm down and ask him if he would like to play cards.
- Tell the client that if he continues his behavior he will be punished.
- Leave the client alone until he calms down.
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15. To monitor clients registered in long-term regimens, such as the Multi-Drug Therapy, which component will be most useful?
- Tally report
- Output report
- Target/client list
- Individual health record
16. Nurse Ron is assisting with transferring a client from the operating room table to a stretcher. To provide safety to the client, the nurse should:
- Uncovers the client completely before transferring to the stretcher.
- Secures the client safety belts after transferring to the stretcher
- Moves the client rapidly from the table to the stretcher
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17. It refers to the manner of walking:
- Gait
- Range of motion
- Flexion and extension
- Hopping
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18. Which information is most important for the nurse Trinity to include in a teaching plan for a male schizophrenic client taking clozapine (Clozaril)?
- Monthly blood tests will be necessary.
- Report a sore throat or fever to the physician immediately.
- Blood pressure must be monitored for hypertension.
- Stop the medication when symptoms subside.
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19. The mechanisms involved in fetal delivery is
- Descent, extension, flexion, external rotation
- Descent, flexion, internal rotation, extension, external rotation
- Flexion, internal rotation, external rotation, extension
- Internal rotation, extension, external rotation, flexion
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20. Myra said "I saw my dead grandmother here at my bedside a while ago." Blake responded "Really? That is hard to believe. How do you feel about it?" What technique did Blake used?
- Disproving
- Disagreeing
- Voicing Doubt
- Presenting Reality
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21. Which of the following nursing interventions has the highest priority for the client scheduled for an intravenous pyelogram?
- Providing the client with a favorite meal for dinner
- Asking if the client has allergies to shellfish
- Encouraging fluids the evening before the test
- Telling the client what to expect during the test
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22. A group of symptoms that sums up or constitute a disease
- Syndrome
- Symptoms
- Signs
- Etiology
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23. A four year old boy presented with a firm and non- tender mass that his mother had discovered in the right upper abdominal quadrant He was admitted to the hospital and underwent complete surgical excision of a renal tumor that had extended beyond the kidney. The child was then scheduled for radiation and chemotherapy treatment Which stage was the tumor?
- I
- II
- III
- IV
24. Nurse Mickey is administering dexamethasome (Decadron) for the early management of a client's cerebral edema. This treatment is effective because:
- Acts as hyperosmotic diuretic
- Increases tissue resistance to infection
- Reduces the inflammatory response of tissues
- Decreases the information of cerebrospinal fluid
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25. What number 18 indicate, regarding body mass index scale (BMI):
- Underweight
- Morbidly obese
- Malnourished
- Normal
26. The nurse is formulating a plan of care to a client with a somatoform disorder. The nurse needs to have knowledge of which psychodynamic principle?
- The symptoms of a somatoform disorder are an attempt to adjust to painful life situations or to cope with conflicting sexual, aggressive, or dependent feelings.
- The major fundamental mechanism is regression.
- The client's symptoms are imaginary and the suffering is faked.
- An extensive, prolonged study of the symptoms will be reassuring to the client, who seeks sympathy, attention and love.
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27. Situation: Two children were brought to you. One with chest indrawing and the other had diarrhea. The following questions apply: A child with diarrhea is observed for the following EXCEPT:
- how long the child has diarrhea
- skin petechiae
- presence of blood in the stool
- signs of dehydration
28. Nurse Joel is providing information to a community group about violence in the family. Which statement by a group member would indicate a need to provide additional information?
- "Abuse occurs more in low-income families"
- "Abuser Are often jealous or self-centered"
- "Abuser use fear and intimidation"
- "Abuser usually have poor self-esteem"
29. Situation: Nurse Lorena 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. Lilia's cousin on the other hand, knowing nurse Lorena's specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?
- Donor sperm are introduced vaginally into the uterus or cervix
- Donor sperm are injected intra-abdominally into each ovary
- Artificial sperm are injected vaginally to test tubal patency
- The husband's sperm is administered intravenously weekly
30. Nurse Sandy observes that there is blood coming from the client's ear after head injury. Nurse Sandy should:
- Turn the client to the unaffected side
- Cleanse the client's ear with sterile gauze
- Test the drainage from the client's ear with Dextrostix
- Place sterile cotton loosely in the external ear of the client
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31. The charge nurse is formulating a discharge teaching plan for a client with mild preeclampsia. The nurse should give priority to:
- Teaching the client to report a nosebleed
- Instructing the client to maintain strict bed rest
- Telling the client to notify the doctor of pedal edema
- Advising the client to avoid sodium sources in the diet
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32. The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL (0.45 mmol/L). Which condition most likely caused this serum phosphorus level?
- Malnutrition
- Renal insufficiency
- Hypoparathyroidism
- Tumor lysis syndrome
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33. 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 doctor orders MAFENIDE for application over the bum area. The nurse understands that one disadvantage of this drug is that:
- It causes lactic acidosis
- It must be constantly applied
- It has minimal eschar penetration
- It is bacteriostatic
34. A staff nurse is precepting a new graduate nurse and the new graduate is assigned to care for a client with chronic pain. Which statement, if made by the new graduate nurse, indicates the need for further teaching regarding pain management?
- "I will be sure to ask my client what his pain level is on a scale of 0 to 10.”
- "I know that I should follow up after giving medication to make sure it is effective."
- "I know that pain in the older client might manifest as sleep disturbances or depression"
- "I will be sure to cue in to any indicators that the client may be exaggerating their pain"
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35. A client with disorganized type schizophrenia has been hospitalized for the past 2 years on a unit for chronic mentally ill clients. The client's behavior is labile and fluctuates from childishness and incoherence to loud yelling to slow but appropriate interaction. The client needs assistance with all activities of daily living. Which behavior is characteristic of disorganized type schizophrenia?
- Extreme social impairment
- Suspicious delusions
- Waxy flexibility
- Elevated affect
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36. Which of the following nursing interventions is considered the most effective form or universal precautions?
- Cap all used needles before removing them from their syringes
- Discard all used uncapped needles and syringes in an impenetrable protective container
- Wear gloves when administering IM injections
- Follow enteric precautions
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37. Which of the following behavior is not a sign or a symptom of Anxiety?
- Frequent hand movement
- Somatization
- The client asks a question
- The client is acting out
38. Situation: Nurses hold a variety of roles when providing care to a perioperative patient. Q. As a perioperative nurse, how can you best meet the safety need of the client after administering preoperative narcotic?
- Put side rails up and ask client not to get out of bed
- Send the client to ORD with the family
- Allow client to get up to go to the comfort room
- Obtain consent form
39. A pregnant client is receiving oxytocin (Pitocin) for induction of labor A condition that warrant the nurse in-charge to discontinue J.V. infusion of Pitocin is:
- Contractions every 1 % minutes lasting 70-80 seconds.
- Maternal temperature 101.2
- Early decelerations in the fetal heart rate.
- Fetal heart rate baseline 140-160 bpm.
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40. Which of the following complications of an abdominal aortic repair is indicated by detection of a hematoma in the perineal area?
- Hernia
- Stage 1 pressure ulcer
- Retroperitoneal rupture at the repair site
- Rapid expansion of the aneurysm
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41. A 32 year old female comes in for evaluation 14 days after an uncomplicated caesarean section. The patient is very anxious and complaining of sharp stabling pain in her chest .The patient has dyspnea, tachypnea, and hypoxemia .Which of the following postoperative complications is likely?
- Pulmonary embolism
- Atelectasis
- Pneumonia
- Aspiration
42. A client arrives at the emergency department following a burn injury that occurred in the basement at home, and an inhalation injury is suspected. What would the nurse anticipate to be prescribed for the client?
- 100% oxygen via an aerosol mask
- Oxygen via nasal cannula at 6 L/minute
- Oxygen via nasal cannula at 15 L/minute
- 100% oxygen via a tight-fitting, nonrebreather face mask
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43. Joy's stream of consciousness is occupied exclusively with thoughts of her father's death. Nurse Ronald should plan to help Joy through this stage of grieving, which is known as:
- Shock and disbelief
- Developing awareness
- Resolving the loss
- Restitution
44. The nurse is conducting an interview of an older client and is concerned about the possibility of benign prostatic hyperplasia (BPH). Which are characteristics of this disorder? Select all that apply. 1. Nocturia 2. Incontinence 3. Enlarged prostate 4. Nocturnal emissions 5. Decreased desire for sexual intercourse
- 1,3,5
- 1,2,3
- 1,3,4,5
- 1,2,3,4,5
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45. Situation: Still in your self-managed Child Health Nursing Clinic, your encounter these cases pertaining to the CARE OF CHILDREN WITH PULMONARY AFFECTIONS. Q. Which of the following is the most important responsibility of a nurse in the prevention of necessary deaths from pneumonia and other severe diseases?
- Giving of antibiotics
- Taking of the temperature of the sick child
- Provision of Careful Assessment
- Weighing of the sick child
46. Situation: The infant and child mortality rate in the low to middle income countries is ten times higher than industrialized countries. In response to this the WHO and UNICEF launched protocol Integrated Management of Childhood Illness to reduce the morbidity and mortality against childhood illnesses. The child with no dehydration needs home treatment. Which of the following is not included in the rules for home treatment in this case?
- Forced fluids
- When to return
- Give Vitamin A supplement
- Feeding more
47. Marie brought her 10 month old infant for consultation because of fever, started 4 days prior to consultation. In determining malaria risk, what will you do?
- Perform a tourniquet test.
- Ask where the family resides.
- Get a specimen for blood smear.
- Ask if the fever is present everyday.
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48. An elderly client is admitted to the nursing home setting. The client is occasionally confused and her gait is often unsteady. Which of the following actions, if taken by the nurse, is most appropriate?
- Ask the woman's family to provide personal items such as photos or mementos.
- Select a room with a bed by the door so the woman can look down the hall,
- Suggest the woman eat her meals in the room with her roommate.
- Encourage the woman to ambulate in the halls twice a day.
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49. The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action?
- Hold the next dose of insulin.
- Come to the clinic immediately.
- Encourage the child to drink liquids.
- Administer an additional dose of regular insulin.
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50. Situation: Mrs. Diaz is assigned in the female surgical ward. While on duty, an 15 year oid client, married, was admitted for CS. The informed consent for the operation has to be obtained. Q. Which of the following should the nurse remember when a doctor requests them to administer anesthesia?
- The nurse has the right to refuse it, if the doctor's order is unlawful
- Doctor's order should always be written
- The nurse may render medical procedure if the doctor supervises him
- The staff nurse can be accused of insubordination if she does not follow the doctor's order