NCLEX-RN | QB3 | Practice Exam #31 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. The physician orders gr 10 of aspirin for a patient The equivalent dose in milligrams is:
- 0.6 mg
- 10 mg
- 60 mg
- 600 mg
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2. The following pain medications are ordered for a patient who had a right leg debridemen. Oxycodone 5 mg every 4 hours as needed and morphine 5 mg every 4 hours as needed. The nurse administered oxycodone 2 hours ago, but the patient report pain Rated 8 on a scale of 0 (no pain) to 10 (Severe pain) as the dressing change begins.Vital signs are: blood pressure level, 169/98 mmHg; heat rate, 112; Respiration rate 22; temperature 36.7 C (98.1 F).After evaluating the effectiveness of the pain Medication, what action should the nurse take?
- Administer additional oxycodone 5 mg
- Administer morphine 5 mg
- Change the dressing quickly
- Encourage deep breathing
3. Which of the following professionals can sign the birth certificate?
- Public health nurse
- Rural health midwife
- Municipal health officer
- Any of these health professionals
4. This is the essence of mental health:
- Self awareness
- Self actualization
- Self esteem
- Self worth
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5. If a young child has pneumonia when should the mother bring him back for follow up?
- After 2 days
- In the afternoon
- After 4 days
- After 5 days
6. The nurse is providing an educational session to new employees, and the topic is abuse of the older client. The nurse helps the employees to identify which client as most typically a victim of abuse?
- A man who has moderate hypertension
- A man who has newly diagnosed cataracts
- A woman who has advanced Parkinson's disease
- A woman who has early diagnosed Lyme disease
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7. A 67 year-old man was admitted to the hospital following a closed bone fracture. An intramedullary nail is inserted and the patient is placed in balanced skeletal traction. The following day, the patient becomes restless, drowsy and confused, he has difficulty breathing and appears very tired. Which additional sign or symptom would require immediate intervention?
- Anxiety
- Cold skin
- Constipation
- Petechiae on chest
8. A client who is positive for human immunodeficiency virus (HIV) delivers a newborn infant. The nurse provides instructions to help the client with care of her infant Which client statement indicates the need for further instruction?
- "I will be sure to wash my hands before and after bathroom use.”
- "I need to breast-feed, especially for the first 6 weeks postpartum.”
- "Support groups are available to assist me with understanding my diagnosis of HIV"
- "My newborn infant should be on antiviral medications for the first 6 weeks after delivery."
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9. Situation: Two children were brought to you. One with chest indrawing and the other had diarrhea. The following questions apply: Using Integrated Management and Childhood Illness (IMCI) approach, how would you classify the 1st child?
- Bronchopneumonia
- No pneumonia: cough or cold
- Severe pneumonia
- Pneumonia
10. In a CLOSED system, which of the following is true?
- Affected by matter
- A sole island in vast ocean
- Allows input
- Constantly affected by matter, energy, information
11. Situation: Patricia Zeno is a client with history myasthenia gravis. Q. Mrs. Zeno asks the nurse why the disease has occurred. The nurse bases the reply on the knowledge that there is:
- A genetic defect in the production of acetylcholine
- A reduced amount of neurotransmitter acetylcholine
- A decreased number of functioning acetylcholine receptor sites
- An inhibition of the enzyme Ache leaving the end plates folded.
12. When developing a teaching plan for a group of high school students about teenage pregnancy, the nurse would keep in mind which of the following?
- The incidence of teenage pregnancies is increasing.
- Most teenage pregnancies are planned.
- Denial of the pregnancy is common early on.
- The risk for complications during pregnancy is rare.
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13. The nurse is aware that the side effect of electroconvulsive therapy that a client may experience:
- Loss of appetite
- Postural hypotension
- Confusion for a time after treatment
- Complete loss of memory for a time
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14. A patient with acute Crohn's disease has been prescribed an elemental diet. The MOST likely rationale for this is to:
- Reset the bowel
- Improve nutrition
- Improve medication absorption
- Prepare for surgery
15. A child is diagnosed with asthma exacerbation. Which of the following nursing diagnoses should be the FIRST priority?
- In effective airway clearance related to broncho spasm and mucosal edema
- Fatigue related to hypoxia
- Anxiety related to illness and loss of control
- Deficient knowledge related to potential side effect of the medication
16. A client has undergone bone biopsy. Which nursing action should the nurse provide after the procedure?
- Administer analgesics via IM
- Monitor vital signs
- Monitor the site for bleeding, swelling and hematoma formation
- Keep area in neutral position
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17. Which nurse should not be assigned to care for the client with a radium implant for vaginal cancer?
- The LPN who is six months postpartum
- The RN who is pregnant
- The RN who is allergic to iodine
- The RN with a three-year-old at home
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18. Situation: You are fortunate to be chosen as part of the research team in the hospital. A review of the following IMPORTANT nursing concepts was made. Q. In Quantitative data, which of the following is described as the distance in the scoring units of the variable from the highest to the lower?
- Frequency
- Mean
- Median
- Range
19. What is the term used to describe an enlargement of the heart muscle?
- Cardiomegaly
- Cardiomyopathy
- Myocarditis
- Pericarditis
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20. Situation: Mrs. Lee has had confirmation of her pregnancy. She presents the emergency room with abdominal pain not yet diagnosed. Q. The most common type of ectopic pregnancy is tubal Within a few weeks after conception the tube may rupture suddenly, causing:
- Painless vaginal bleeding
- Intermittent abdominal contractions
- Continues dull, upper-quadrant abdominal pain
- Sudden knife-like, lower-quadrant abdominal pain
21. The mother of a one-year-old wants to know when she should begin toilet-training her child. The nurses response is based on the knowledge that sufficient sphincter control for toilet training is present by:
- 12-15 months of age
- 18-24 months of age
- 26-30 months of age
- 32-36 months of age
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22. Which information obtained from the mother of a child with cerebral palsy correlates to the diagnosis?
- She was born at 40 weeks gestation.
- She had meningitis when she was six months old.
- She had physiologic jaundice after delivery.
- She has frequent sore throats.
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23. A 38-year old patient's vital signs at 8 a.m. are axillary temperature 99.6 F (37.6 C); pulse rate, 88; respiratory rate, 30. Which findings should be reported?
- Respiratory rate only
- Temperature only
- Pulse rate and temperature
- Temperature and respiratory rate
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24. The nursing activity most likely to prevent the clogging of a nasogastric feeding tube is:
- Attaching the tubing to suction after each feeding
- Clamping the tubing after formula feeding
- Flushing the tubing with water and clamping it after each feeding
- Aspirate as much as possible from the tubing using a 50 ml syringe
25. Situation: In your professional nursing role, it is essential to establish a meaningful nurse patient relationship. Q. Preparation for termination of the nurse-patient relationship begins during the:
- Termination phase
- Working phase
- Pre-orientation phase
- Orientation phase
26. A client with anorexia nervosa is a member of a predischarge support group. The client verbalizes that she would like to buy some new clothes, but her finances are limited. Group members have brought some used clothes to the client to replace the client's old clothes. The client believes that the new clothes are much too tight and has reduced her calorie intake to 800 calories daily. How should the nurse evaluate this behavior?
- Normal behavior
- Evidence of the client's disturbed body image
- Regression as the client is moving toward the community
- Indicative of the client's ambivalence about hospital discharge
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27. Which of the following is an abnormal vital sign in postpartum?
- Pulse rate between 50-60/min
- BP diastolic increase from 80 to 95mm Hg
- BP systolic between 100-120mm Hg
- Respiratory rate of 16-20/min
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28. The nurse is planning care for the patient with celiac disease. In teaching about the diet the nurse should instruct the patient to avoid which of the following for breakfast?
- Puffed wheat
- Banana
- Puffed rice
- Cornflakes
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29. Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy. Q. On the morning of Mrs. Hogan's planned cholecystectomy she awakens with a pain in her right scapular area and thinks she slept in poor position. While doing the preop checklist you note that on her routine CB report her WBC is 15,000. Your responsibility at this point is:
- to notify the surgeon at once; this is an elevated WBC indicating an inflammatory reaction
- to record this finding in a prominent place on the preop checkiist and in your preop notes
- to call the laboratory for a STAT repeat WBC
- None. This is not an unusual finding
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30. A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which findings are noted on assessment? Select all that apply. 1.Proteinuria of 3+ 2. Respirations of 10 breaths/minute 3. Presence of deep tendon reflexes 4. Urine output of 20 mL in an hour 5. Serum magnesium level of 4 mEq/L (2 mmol/L)
- 1,4,5
- 2,3,4
- 1,3
- 2,4
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31. Which person is at greatest risk for developing Lymes disease?
- Computer programmer
- Elementary teacher
- Veterinarian
- Landscaper
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32. A child was admitted to the hospital three hours ago with a closed head injury. The child responds appropriately but sluggishly to stimuli, and drift in and out of sleep. Which of the following best describes this patients level of consciousness?
- Lethargic
- Obtunded
- Semi-comatose
- Comatose
33. Situation: Still in your self-managed Child Health Nursing Clinic, your encounter these cases pertaining to the CARE OF CHILDREN WITH PULMONARY AFFECTIONS. You were able to identify factors that lead to respiratory problems in the community where your health facility serves. Your primary role therefore in order to reduce morbidity due to pneumonia is to:
- Teach mothers how to recognize early signs and symptoms of pneumonia
- Make home visits to sick children
- Refer cases to hospitals
- Seek assistance and mobilize the BHWs to have a meeting with mothers
34. When should ambulation be initiated in the client who has sustained a major burn?
- When all full-thickness areas have been closed with skin grafts
- When the clients temperature has remained normal for 24 hours
- As soon as possible after wound debridement is complete
- As soon as possible after resolution of the fluid shift
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35. A client is in her third month of her first pregnancy. During the interview, she tells the nurse that she has several sex partners and is unsure of the identity of the baby's father. Which of the following nursing interventions is a priority?
- Counsel the woman to consent to HIV screening
- Perform tests for sexually transmitted diseases
- Discuss her high risk for cervical cancer
- Refer the client to a family planning clinic
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36. Florence nightingale is born on:
- France
- Britain
- U.S
- Italy
37. A study to compare the support system of patients with chronic illness and those with acute illness.
- Alcohol
- Caffeine
- Saw palmetto
- St. John’s wort
38. Kathleen is admitted to the psychiatric clinic for treatment of anorexia nervosa. To promote the client's physical health, the nurse should plan to:
- Severely restrict the client's physical activities.
- Weigh the client daily, after the evening meal.
- Monitor vital signs, serum electrolyte levels, and acid-base balance.
- Instruct the client to keep an accurate record of food and fluid intake.
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39. A female client who has a 28-day menstrual cycle asks the community health nurse when she get pregnant during her cycle. What will be the best nursing response?
- It is impossible to determine the fertile period reliably. So it is best to assume that a woman is always fertile.
- In a 28-day cycle, ovulation occurs at or about day 14. The egg lives for about 24 hours and the sperm live for about 72 hours. The fertile period would be approximately between day 11 and day 15.
- In a 28- day cycle, ovulation occurs at or about day 14. The egg lives for about 72 hours and the sperm live for about 24 hours. The fertile period would be approximately between day 13 and 17.
- In a 28-day cycle, ovulation occurs 8 days before the next period or at about day 20. The fertile period is between day 20 and the beginning of the next period.
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40. A client with bipolar disorder is discharged with a prescription for Depakote (divalproex sodium). The nurse should remind the client of the need for:
- Frequent dental visits
- Frequent lab work
- Additional fluids
- Additional sodium
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41. Situation: As a nurse you are expected to participate in initiating or participating in the conduct of research students to improve nursing practice. You to be updated on the latest trends and issues affected the profession and the best practices arrived at by the profession. Q. You would like to compare the support system of patient with chronic illness to those with acute illness. How will you best state your problem?
- A descriptive study to compare the support system of patients with chronic illness and those with acute illness in terms of demographic data and knowledge
- The effects of the types of support system of patients with chronic illness and those with acute illness
- A comparative analysis of the support system of patients with chronic illness and those with acute illness
- A study to compare the support system of patients with chronic illness and those with acute illness.
42. Which of these nursing actions will best promote independence for the client in skeletal traction?
- Instruct the client to call for an analgesic before pain becomes severe.
- Provide an overhead trapeze for client use
- Encourage leg exercise within the limits of traction
- Provide skin care to prevent skin breakdown.
43. The nurse is performing an initial assessment of a newborn Caucasian male delivered at 32 weeks gestation. The nurse can expect to find the presence of:
- Mongolian spots
- Scrotal rugae
- Head lag
- Polyhydramnios
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44. A nurse administers an intramuscular injection of vitamin K to a newborn. What is the purpose of the injection?
- Maintains the intestinal floral count
- Promotes proliferation of intestinal flora
- Stimulates vitamin K production in the baby
- Provides protection until intestinal flora is established
45. When caring for a male client with a 3-cm stage I pressure ulcer on the coccyx, which of the following actions can the nurse institute independently?
- Massaging the area with an astringent every 2 hours.
- Applying an antibiotic cream to the area three times per day
- Using normal saline solution to clean the ulcer and applying a protective dressing as necessary.
- Using a povidone-iodine wash on the ulceration three times per day.
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46. A patient with exacerbation of congestive heart failure has a nursing diagnosis of excess fluid volume. The nurse monitors fluids intake and output and administers furosemide, as ordered. Which of the following indicates the efficacy of the intervention?
- The patient has pitting edema
- The patient has shortness of breath
- The patient has a decrease in weight
- The patient has jugular vein distention
47. The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing?
- Flaccid paralysis of all extremities
- Adduction of the arms at the shoulders
- Rigid extension and pronation of the arms and legs
- Abnormal flexion of the upper extremities and extension and adduction of the lower extremities
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48. The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply. 1. "The ductus arteriosus allows blood to bypass the fetal lungs." 2. "One vein carries oxygenated blood from the placenta to the fetus.” 3. "The normal fetal heart tone range is 140 to 160 beats per minute in early pregnancy.” 4. “Two arteries carry deoxygenated blood and waste products away from the fetus to the placenta." 5. "Two veins carry blood that is high in carbon dioxide and other waste products away from the fetus to the placenta.”
- 1,2,4
- 2,3,4,5
- 1,3,5
- 2,3,5
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49. Which of the following statements best describes hyperemesis gravidarum?
- Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
- Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
- Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing maternal nutrients.
- Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding.
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50. A 13-year-old child is hospitalized for treatment of sickle cell crisis. The nurse finds the child is crying and does not answer the nurse when addressed. What should nurse do FIRST?
- Interview the parents about the child's pain tolerance and usual medication requirements
- Medicate the patient with the medication ordered for breakthrough pain as soon as possible, the resume the evaluation
- Ask the child to describe the pain, it is located, and to rate it on the Wong/baker pain scale.
- Tell the child to rest while and the nurse will return at another time for the evaluation