NCLEX-RN | QB3 | Practice Exam #30 (50 questions)

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

1. The nurse is analyzing the laboratory studies on a client receiving dantrolene. Which laboratory test would identify an adverse effect associated with the administration of this medication?

• Platelet count
• Creatinine level
• Liver function tests
• Blood urea nitrogen level

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2. Nurse Mae tells one of the staff, "I don't have time to discuss the matter with you now. See me in my office later" when the latter asks if they can talk about an issue. Which of the following conflict resolution strategies did she use?

• Smoothing
• Compromise
• Avoidance
• Restriction

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3. The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately?

• Reinforce the dressing.
• Notify the health care provider (HCP).
• Document the findings and continue to monitor.
• Circle the area of drainage and continue to monitor.

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4. Some drugs are excreted into bile and delivered to the intestines. Prior to elimination from the body, the drug may be absorbed. This process is known as:

• Hepatic clearance.
• Enterohepatic cycling.
• First-pass effect.

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5. Situation: Based on studies of nurses working in special units like the intensive care unit and coronary care unit it is important for nurses to gather as much information to be able to address their needs for nursing care. Q. Families of critically ill patients desire which of the following needs to be met first by the nurse?

• Majority need extensive rehabilitation
• Emotional support
• Updated information on the client's status
• Spiritual counselling

6. A client with diagnosis of type 2 diabetes has been ordered a course of prednisone for her severe arthritic pain. An expected change that requires close monitoring by the nurse is;

• Increased blood glucose level
• Increased platelet aggregation
• Increased creatinine clearance
• Increased ketone level in urine

7. A nurse is applying a dressing to a client’s surgical wound using sterile technique. While engaging in this activity, the nurse accidentally places a moist sterile gauze pad on the cloth sterile field. What physical principle is applicable for causing the sterile field to become contaminated?

• Dialysis
• Osmosis
• Diffusion
• Capillarity

8. Mr. Jessie Ray, a newly admitted patient, has a seizure disorder which is being treated with medication. Which of the following drugs would the nurse question if ordered for him?

• Phenobarbital, 150 mg hs
• Amitriptylene (Elavil), 10 mg QID.
• Valproic acid (Depakote), 150 mg BID
• Phenytoin (Dilantin), 100 mg TID

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9. Situation: Ms. J.K. is a 24-year old woman admitted to the neurosurgery floor 2 days following a hypophysectomy f or a pituitary tumor. She is alert, oriented, and eager to return to her job as an executive to the hospital director. She is alert, oriented and eager to return to her job as an executive assistant to the hospital director. She calls the nurse to her room to express her concern about the frequency of urination she is experiencing, as well as the feeling of weakness that began this morning. Q. The most likely cause of her chief complaint this morning is

• A decrease in postoperative stress causing polyuria
• The onset of diabetes mellitus, an unusual complication
• An expected result of the removal of the pituitary gland
• A frequent complication of the hypophysectomy

10. Which hereditary disease is most closely linked to aneurysm?

• Cystic fibrosis
• Lupus erythematosus
• Marfan's syndrome
• Myocardial infarction

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11. Situation: Please respond as a professional nurse in the other health situations through the following question. After a vaginal examination, the nurse determines that the client's fetus is in an occiput posterior position. The nurse would anticipate that the client will have:

• A precipitous birth
• Intense back pain
• Frequent leg cramps
• Nausea and vomiting

12. A female client arrives at the emergency department with chest and stomach pain and a report of black tarry stool for several months. Which of the following order should the nurse Oliver anticipate?

• Cardiac monitor, oxygen, creatine kinase and lactate dehydrogenase levels
• Prothrombin time, partial thromboplastin time, fibrinogen and fibrin split product values.
• Electrocardiogram, complete blood count, testing for occult blood, comprehensive serum metabolic panel.
• Electroencephalogram, alkaline phosphatase and aspartate aminotransferase levels, basic serum metabolic panel

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13. The client is admitted from the emergency room with multiple injuries sustained from an auto accident. His doctor prescribes a histamine blocker. The nurse is aware that the reason for this order is to:

• Treat general discomfort
• Correct electrolyte imbalances
• Prevent stress ulcers
• Treat nausea

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14. Situation: One important toot a community health nurse uses in the conduct of his/her activities is the CHN Bag. Which of the following BEST DESCRIBES the use of this vital facility for our practice? The Community/Public Health Bag is:

• a requirement for home visits
• an essential and indispensable equipment of the community health nurse
• contains basic medications and articles used by the community health nurse
• D a tool used by the Community health nurse is rendering effective nursing procedure

15. Mr. Barry Heywood, a construction worker, has been experiencing periodic bouts of low back pain. Now, in addition to the pain that radiates into his buttocks, he has some numbness and tingling in his legs. The physician suspects that Mr. Heywood has a herniated intervertebral disk in the lumbar spine. While assessing the disk to indicate that the pain is increased when:

• Eating
• Sneezing
• Resting
• Urinating

16. Situation: Primary Health Care (PHC) is defined by the WHO as essential health care made universally accessible to individuals, families and communities. The WHO held a meeting in this place where Primary health Care was discussed. What is this place?

• Alma Ata
• Russia
• Vienna
• Geneva

17. According to Leavell and Clark's ecologic model, All of this are factors that affects health and illness except:

• Reservoir
• Agent
• Environment
• Host

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18. Calcium gluconate is being administered to a client with pregnancy induced hypertension (PIH), A nursing action that must be initiated as the plan of care throughout injection of the drug is:

• Ventilator assistance
• CVP readings
• EKG tracings
• Continuous CPR

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19. Which nursing diagnosis takes priority for newly diagnosed patient with a left-sided stroke?

• Risk for impaired swallowing related to absent gag reflex
• Risk for impaired skin integrity related to immobility
• Risk for infection related to invasive line placement
• Risk for impaired speech related to left side stroke

20. A patient classification system where patients need close attention and complete care in most activities and requires frequent and complex treatments and medications:

• Minimal Care (category 1)
• Moderate Care (category 2)
• Maximum Care (category 3)
• Intensive Care (category 4)

21. Situation: Rudy was diagnosed to have chronic renal failure. Hemodialysis is ordered that an A-V shunt was surgically created. Q. Which of the following action would be of highest priority with regards to the external shunt?

• Avoid taking BP or blood sample from the arm with shunt
• Instruct the client not to exercise the arm with the shunt
• Heparinize the shunt daily
• Change dressing of the shunt daily

22. The inflammation of the Lips, Palate and Tongue is associated in the deficiency of this vitamin:

• Vitamin B1
• Vitamin B2
• Vitamin B3
• Vitamin B6

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23. A client receiving parenteral nutrition (PN) complains of a headache. The nurse notes that the client has an increased blood pressure, bounding pulse,jugular vein distention, and crackles bilaterally. The nurse determines that the client is experiencing which complication of PN therapy?

• Sepsis
• Air embolism
• Hypervolemia
• Hyperglycemia

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24. Situation: The following questions refer to common clinical encounters experienced by an entry level nurse. Which of the following indicates the type(s) of acute renal failure?

• Four types: hemorrhagic with and without clotting, and nonhemorrhagic with and without clotting
• One type: Acute
• Three types: Prerenal, intrarenal, postrenal
• Two types: Acute and subacute

25. From the 33rd week of gestation till full term, a healthy mother should have prenatal check up every:

• week
• 2 weeks
• 3 weeks
• 4 weeks

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26. When counseling a patient who is starting to take MAO (monoamine oxidase) inhibitors such as Nardil for depression, it is essential that they be warned not to eat foods containing tyramine, such as:

• Roquefort, Cheddar, or Camembert cheese.
• grape juice, orange juice, or raisins.
• onions, garlic, or scallions.
• ground beef, turkey, or pork.

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27. What regulates HOMEOSTASIS according to the theory of Walter Cannon?

• Positive feedback
• Negative feedback
• Buffer system
• Various mechanisms

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28. Situation: Blood transfusion was ordered for Andre after an episode of severe bleeding. Q. Before blood transfusion, The nurse priority is to assess Andre for which of the following?

• Clotting time
• Vital Signs
• Sodium
• Weight

29. The number of cases of Dengue fever usually increases towards the end of the rainy season. This pattern of occurrence of Dengue fever is best described as;

• Epidemic occurrence
• Cyclical variation
• Sporadic occurrence
• Secular occurrence

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30. The nurse is caring for a client with suspected endometrial cancer. Which symptom is associated with endometrial cancer?

• Frothy vaginal discharge
• Thick white vaginal discharge
• Purulent vaginal discharge
• Watery vaginal discharge

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31. Situation: Nanette was rushed to the hospital due to burns. Witnesses told the emergency team that Nanette fell asleep while she is holding her cigarette thus, burning the bed sheets and herself. 2nd and 3rd degree burns are on the face, neck, anterior and posterior trunk as well as the anterior of the left leg and the whole right arm was burned. First degree burns are located on the anterior portion of the right leg and the anterior portion of the right and left arm. Nanette is a 110 lbs female client. Q. IV fluid that is commonly used in clients with dehydration, diarrhea and burns is:

• Lactated Ringers
• D5NSS
• Normal Saline Solution
• NSS Plus potassium

32. The primary power involved in labor and delivery is:

• Bearing down ability of mother
• Cervical effacement and dilatation
• Uterine contraction
• Valsalva technique

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33. Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which laboratory test results should the nurse report? Select all that apply. 1. Platelets 35,000 mm3 (35A109/L) 2. Sodium 150 mEq/L (150 mmol/L) 3. Potassium 5.0 mEq/L (5.0 mmol/L) 4. Segmented neutrophils 40% (0.40) 5. Serum creatinine, 1 mg/dL (88.3 pmol/L) 6. White blood cells, 3000 mm3 (3.0 x 10⁹/L)

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

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34. A client with pneumocystis jiroveci pneumonia is receiving intravenous Pentam (pentamidine). While administering the medication the nurse should give priority to checking the clients:

• Deep tendon reflexes
• Blood pressure
• Urine output
• Tissue turgor

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35. Marjorie has just given birth at 42 weeks gestation. When the nurse assessing the neonate, which physical finding is expected?

• A sleepy, lethargic baby
• Lanugo covering the body
• Desquamation of the epidermis
• Vernix caseosa covering the body

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36. The normal dilatation of the cervix during the first stage of labor in a nullipara is:

• 1.2 cm/hr
• 1.5 cm/hr
• 1.8 cm/hr
• 2.0 cm/hr

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37. Patient came to emergency with laceration in the left arm, what the first intervention for this patient:

• Elevate the right arm and put ice
• Give analgesic in the wound
• Do pressure on the wound
• None of the above.

38. Situation: Elderly clients usually produce unusual signs when it comes to different diseases. The ageing process is a complicated process and the nurse should understand that it is an inevitable fact and she must be prepared to care for the growing elderly population. Q. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:

• dementia
• a visual problem
• functional decline
• drug toxicity

39. The five-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms the nurse should teach the mother to:

• Place tape on the childs perianal area before putting the child to bed.
• Scrape the skin with a piece of cardboard and bring it to the clinic.
• Obtain a stool specimen in the afternoon.
• Bring a hair sample to the clinic for evaluation.

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40. The parents of a child with cystic fibrosis ask what determines the prognosis of the disease. The nurse knows that the greatest determinant of the prognosis is:

• The degree of pulmonary involvement
• The ability to maintain an ideal weight
• The secretion of lipase by the pancreas
• The regulation of sodium and chloride excretion

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41. During lunch in the dining room, a resident begins yelling and throws a spoon at the nurse aide. The best response by the nurse aide is to:

• remain calm and ask what is upsetting the resident.
• begin removing all the other residents from the dining room.
• scold the resident and ask the resident to leave the dining room immediately.
• remove the resident's plate, fork, knife, and cup so there is nothing else to throw.

42. Situation: Consider the following hypothesis: "The Job turnover rate and job dissatisfaction levels of graduate nurses who have worked less than 2 years is higher than for those graduate nurses who have worked for more than 2 years." Q. A systematic, objective, process of analyzing phenomena importance to nursing is termed as:

• Nursing research
• Research
• Scientific research
• Research process

43. Which of the following statements is NOT true about performance appraisal?

• Informing the staff about the specific impressions of their work help improve their performance.
• A verbal appraisal is an acceptable substitute for a written report
• Patients are the best source of information regarding personnel appraisal.
• The outcome of performance appraisal rests primarily with the staff.

44. 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. Preparation of the client for occult blood examination is:

• Fluid intake limited only to 1 liter/day
• NPO for 12 hours prior to obtaining of specimen
• Increase fluid intake
• Meatless diet for 48 hours prior to obtaining of specimen

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45. In caring for a dying client, you should perform which of the following activities:

• Do not resuscitate
• Assist client to perform ADL
• Encourage to exercise
• Assist client towards a peaceful death

46. The appropriate nutrition for Bipolar I disorder, in manic phase is:

• Low fat low sodium
• Low calorie, high fat
• Finger foods, high in calorie
• Small frequent feedings

47. What clinical finding indicates to a nurse that a client may have hypokalemia?

• Edema
• Muscle spasms
• Kussmaul breathing
• Abdominal distention

48. When performing Weber's test, Nurse Roseau expects that this client will hear:

• On unaffected side
• Longer through bone than air conduction
• On affected side by bone conduction
• By neither bone or air conduction

49. A client calls the nurse regarding an accident that just occurred during which an unknown chemical was splashed in his eyes. What is the most important for the nurse to tell the client to do immediately?

• Rinse the eye with large amount of water or saline solution
• Put a pad soaked in the sterile saline solution over the eye
• Go to the closest emergency room
• Have a co-worker visually checks the eye for a foreign body

50. The nurse is instructing the client to perform a testicular self-examination. The nurse tells the client:

• To examine the testicles while lying down.
• The best time for the examination is after a shower
• To gently feel the testicle with one finger to feel for a growth
• That testicular examination should be done at least every 6 months.

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NCLEX-RN | QB3 | Practice Exam #30 (50 questions)