NCLEX-RN | QB3 | Practice Exam #33 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. Because an infant has a meningomyelocele in the lumbosacral area, the infant should be observed for early symptoms of hydrocephalus, which include
- Overriding of cranial bones
- A soft flat anterior fontanel
- An increase in head circumference
- Prominent scalp veins
2. Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?
- Faster growing cells are less susceptible to chemotherapy.
- Non-dividing cells are more susceptible to chemotherapy
- Faster growing cells are more susceptible to chemotherapy
- Slower growing cells are more susceptible to chemotherapy.
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3. The second stage of labor begins with and ends with ?
- Begins with full dilatation of cervix and ends with delivery of placenta
- Begins with true labor pains and ends with delivery of baby
- Begins with complete dilatation and effacement of cervix and ends with delivery of baby
- Begins with passage of show and ends with full dilatation and effacement of cervix
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4. A one month old boy present with the head tilted towards the left side and the chin rotated to the right side. There is a palpable mass of soft tissue on the right side of the neck near the clavicle:
- Passive muscle stretching
- Surgical release of the muscle
- Surgical removal of the mass
- It's a normal mass in infants
5. The classification of CANCER according to its etiology Is best described as: 1. Nosocomial 2. Idiopathic 3. Neoplastic 4. Traumatic 5. Congenital 6. Degenrative
- 5 and 2
- 2 and 3
- 3 and 4
- 3 and 6
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6. 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. Which of the following statements does not apply to critically ill patients?
- Gender
- All have been hospitalized previously
- Are physically unstable
- Most have chronic illness.
7. Danny who is diagnosed with bipolar disorder and acute mania, states the nurse, "Where is my daughter? I love Louis. Rain, rain go away. Dogs eat dirt.” The nurse interprets these statements as indicating which of the following?
- Echolalia
- Neologism
- Clang associations
- Flight of ideas
8. The nurse is assigned to care for a child client admitted in the pediatrics unit. The client is receiving digoxin. Which of the following questions will be asked by the nurse to the parents of the child in order to assess the client's risk for digoxin toxicity?
- "Has he been exposed to any childhood communicable diseases in the past 2-3 weeks?"
- "Has he been taking diuretics at home?"
- "Do any of his brothers and sisters have history of cardiac problems?"
- "Has he been going to school regularly?"
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9. Which of the following lab results would be unexpected in a client with chronic renal failure?
- Serum potassium 6.0 mEq/L
- Serum creatinine 9 mg/dL
- BUN 15mg/dL
- Serum phosphate 5.2 mg/dL
10. The neonatal circulation differs from the fetal circulation because:
- The fetal lungs are non-functioning as an organ and most of the blood in the fetal circulation is mixed blood.
- The blood at the left atrium of the fetal heart is shunted to the right atrium to facilitate its passage to the lungs
- The blood in left side of the fetal heart contains oxygenated blood while the blood in the right side contains unoxygenated blood.
- None of the above
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11. What should the nurse do to assess the neurovascular status of an extremity casted from the ankle to the thigh?
- Palpate the femoral artery.
- Assess for a positive Homan sign.
- Compress and release the clients toenails.
- Instruct the client to flex and extend the knee.
12. Which of the following is TRUE about temperature?
- The highest temperature usually occurs later in a day, around 8 PM to 12 M.N.
- The lowest temperature is usually in the Afternoon, Around 12 RM
- Thyroxin decreases body temperature
- Elderly people are risk for hyperthermia due to the absence of fats, Decreased thermoregulatory control and sedentary lifestyle.
13. Immediately before expulsion, which of the following cardinal movements occur?
- Descent
- Flexion
- Extension
- External rotation
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14. Situation: Salome, 80 year old widow, has been observed to be irritable, demanding and speaking louder than usual. She would prefer to be alone and take her meals by herself, minimized receiving visitors at home and no longer bothers to answer telephone calls because of deterioration of her hearing. ‘She was brought by her daughter to, the Geriatic clinic for assessment and treatment Q. A nursing diagnosis for Salome is:
- sensory deprivation
- social isolation
- cognitive impairment
- ego despair
15. Nurse Katrina prepares an older-adult client for sleep, actions are taken to help reduce the likelihood of a fall during the night. Targeting the most frequent cause of falls, the nurse should:
- Offer the client assistance to the bathroom
- Move the bedside table closer to the client's bed
- Encourage the client to take an available sedative
- Assist the client to telephone the spouse to say "goodnight"
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16. The nurse is providing medication instructions to a parent Which statement by the parent indicates a need for further instruction?
- "I should cuddle my child after giving the medication."
- "I can give my child a frozen juice bar after he swallows the medication ”
- "I should mix the medication in the baby food and give it when I feed my child"
- "if my child does not like the taste of the medicine, I should encourage him to pinch his nose and drink the medication through a straw."
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17. 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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18. While performing a pre-operative assessment on a pt having arthroscopy of the right knee, a nurse examine the right leg for baseline assessment. The nurse should include all the following EXCEPT:
- Position and length of the leg
- Bilateral pulse
- Bony prominence of ankles and feet
- Rotation of patella
19. The physician orders a platelet count to be performed on Mrs. Smith after breakfast. The nurse is responsible for:
- Instructing the patient about this diagnostic test
- Writing the order for this test
- Giving the patient breakfast
- All of the above
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20. A nine year-old child has been diagnosed with external otitis. In addition to assessing severity of symptoms and need for pain relief, the nurse should assess:
- The hearing of the child
- The tympanic temperature
- Speech and language development
- Ear hygiene and the need for earplugs
21. A client rings the call light and complains of pain at the site of an intravenous (IV) infusion. The nurse assesses the site and determines that phlebitis has developed. The nurse should take which actions in the care of this client? Select all that apply. 1. Remove the IV catheter at that site. 2. Apply warm moist packs to the site. 3. Notify the health care provider (HCP). 4. Start a new IVline in a proximal portion of the same vein. 5. Document the occurrence, actions taken, and the client's response.
- 1,2,3,4,5
- 2,3,4,5
- 1,2,3,5
- 2,4,5
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22. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic effect based on which results?
- Prothrombin time of 12.5 seconds
- Activated partial thromboplastin time of 60 seconds
- Activated partial thromboplastin time of 28 seconds
- Activated partial thromboplastin time longer than 120 seconds
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23. Situation: As a Nurse, you have specific responsibilities as professional. You have to demonstrate specific competencies. Q. You are caring for Vincent who has just been transferred to the private room. He is anxious because he fears he won't be monitored as closely as he was in the Coronary Care Unit. How can you allay his fear?
- Move his bed to a room far from nurse's station to reduce
- Assign the same nurse to him when possible
- Allow Vincent uninterrupted period of time
- Limit Vincent's visitors to coincide with CCU policies
24. The nurse is assisting a patient to ambulate in the hall. The patient a history of coronary artery disease(CAD), and had coronary artery bypass graft surgery(CABG) 3 days ago, the patient reports chest pain rated 3 on a scale of 0 (no pain)to 10 (severe pain) the nurse should FIRST:
- Determine how long it has since the patient's last dose of aspirin
- Obtain a chair for the patient so sit down
- Assess the patient's radial pulse
- Ask the patient to take several slow, deep breaths
25. Situation: The patient who is depressed will undergo electroconvulsive therapy. Q. Which of the following is a possible side effect which you will discuss with the patient?
- hemorrhage within the brain
- robot-like body stiffness
- encephalitis
- confusion, disorientation and short term memory loss
26. Situation: Johnny, sought consultation to the hospital before Q. The BMR is based on the measurement that:
- Obstructing his vision
- Amount of oxygen consumption under resting condition over a measured period of time
- Amount of oxygen consumption under stressed condition over a measured period of time
- Ratio of respiration to pulse rate over a measured period of time
27. The LPN/LVN asks the registered nurse why oxytocin (Pitocin), 10 units (IV or IM) must be given to a client after birth fo the fetus. The nurse is correct to explain that oxytocin:
- Minimizes discomfort from "afterpains.”
- Suppresses lactation.
- Promotes lactation.
- Maintains uterine tone.
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28. A breast-feeding mother of an infant with lactose intolerance asks the nurse about dietary measures. What foods should the nurse tell the mother are acceptable to consume while breast-feeding? Select all that apply. 1.1% milk 2. Egg yolk 3. Dried beans 4. Hard cheeses 5. Green leafy vegetables
- 2,3,4
- 1,2,3,4,5
- 2,3,5
- 1,4,5
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29. The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of a ruptured ectopic pregnancy?
- Painless vaginal bleeding
- Abdominal cramping
- Throbbing pain in the upper quadrant
- Sudden stabbing pain in the lower quadrant
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30. A client with a history of phenylketonuria (PKU) is seen in the local family planning clinic. While completing the intake history the nurse provides information for a healthy pregnancy. Which statement indicates that the client needs further teaching?
- I can use artificial sweeteners to keep me from gaining too much weight when I get pregnant.
- I need to go back on a low-phenylalanine diet before I get pregnant.
- Fresh fruits and raw vegetables will make good between-meal snacks for me.
- My baby could be mentally retarded if I dont stick to a diet eliminating phenylalanine.
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31. Francis tells the nurse that her coworkers are sabotaging the computer When the nurse asks questions, the client becomes argumentative. This behavior shows personality traits associated with which of the following personality disorder?
- Antisocial
- Histrionic
- Paranoid
- Schizotypal
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32. To help prevent the spread of germs between patients, nurse aides should:
- wear gloves when touching residents.
- hold supplies and linens away from their uniforms.
- wash hands for at least two minutes after each resident contact
- warn residents that holding hands spreads germs.
33. A home care nurse visits a diabetic patient who was started on insulin injection, upon examination, the nurse observes small lumps and dents on the right upper arm where the patient has injected insulin. What is the BEST nursing intervention?
- Refer the patient to dermatologist for diabetic cellulitis
- instruct the patient to rotate the sites of injection
34. The client presents to the emergency room with a bulls eye rash. Which question would be most appropriate for the nurse to ask the client?
- Have you found any ticks on your body?
- Have you had any nausea in the last 24 hours?
- Have you been outside the country in the last six months?
- Have you had any fever for the past few days?
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35. Situation: You are working as a Pediatric Nurse in your own Child Health Nursing Clinic, the following cases pertain to ASSESSMENT AND CARE OF THE NEWBORN AT RISK conditions. Baby John was given a drug at birth to reverse the effects of a narcotic given to his mother in labor. What drug is commonly used for this?
- Naloxone (Narcan)
- Morphine Sulfate
- Sodium Chloride
- Penicillin G
36. A school-age child with type 1 diabetes mellitus has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do?
- Eat twice the amount normally eaten at lunchtime.
- Take half the amount of prescribed insulin on practice days.
- Take the prescribed insulin at noontime rather than in the morning.
- Eat a small box of raisins or drink a cup of orange juice before soccer practice.
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37. The nurse is caring for a patient who had a total proctocolectomy 24 hours ago due to a malignant neoplasm in the rectum. The patient continues to receive intravenous fluids and has started a clear liquid diet. The nurse understands that the patient is at INCREASED risk for which of the following postoperative complications?
- Dissemination intravascular coagulopathy (DIC)
- Atelectasis
- Syndrome of inappropriate anti-diuretics hormone(SIADH)
- Hypokalemia
38. The patient who had a stroke needs to be fed. What instruction should you give to the nursing assistant who will feed the patient?
- Position the patient sitting up in bed before you feed her.
- Check the patient's gag and swallowing reflexes.
- Feed the patient quickly because there are three more waiting.
- Suction the patient's secretions between bites of food.
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39. For a client with anorexia nervosa, the nurse plans to include the parents in therapy sessions along with the client. What fact should the nurse remember to be typical of parents of clients with anorexia nervosa?
- They tend to overprotect their children.
- They usually have a history of substance abuse.
- They maintain emotional distance from their children.
- They alternate between loving and rejecting their children.
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40. Ms.Clark has hyperthyroidism and is scheduled for a thyroidectomy. The physician has ordered Lugol's solution for the client. The nurse understands that the primary reason for giving Lugol's solution preoperatively is to:
- decrease the risk of agranulocytosis postoperatively.
- prevent tetany while the client is under general anesthesia.
- reduce the size and vascularity of the thyroid and prevent hemorrhage.
- potentiate the effect of the other preoperative medication so less medicine can be given while the client is under anesthesia.
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41. A client is recovering from abdominal surgery and has a large abdominal wound. The nurse should encourage the client to eat which food item that is naturally high in vitamin C to promote wound healing?
- Milk
- Oranges
- Bananas
- Chicken
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42. According to information provided in the accompanying graphic. A descending colon would be expected to produce:
- Fluid feces
- Mushy faces
- Semi-solid faces
- Solid faces
43. A nurse is assigned to care for a patient with an ileostomy. The nurse would expect the ostomy discharge to be:
- Fluid mushy
- Mushy
- Liquid
- Solid
44. A urinalysis is best evaluated for accurate result if specimen is analyzed within:
- 1 hour of collection or refrigerated until analyzed
- 1 hour of collection or left at room temperature
- 2 hours of collection
- 4 hours of collection
45. Which of the following is a correct nursing action when collecting urine specimen from a client with an Indwelling catheter?
- Collect urine specimen from the drainage bag
- Detach catheter from the connecting tube and draw the specimen from the port
- Use sterile syringe to aspirate urine specimen from the drainage port
- Insert the syringe straight to the port to allow self sealing of the port
46. Which of the following is a primary nursing intervention necessary for all patients with a Foley Catheter in place?
- Maintain the drainage tubing and collection bag level with the patients bladder
- Irrigate the patient with 1% Neosporin solution three times a daily
- Clamp the catheter for 1 hour every 4 hours to maintain the bladder's elasticity
- Maintain the drainage tubing and collection bag below bladder level to facilitate drainage by gravity
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47. Situation: Still in your self-managed Child Health Nursing Clinic, your encounter these cases pertaining to the CARE OF CHILDREN WITH PULMONARY AFFECTIONS. Q. In responding to the care concerns of children with severe disease, referral to the hospital of the essence especially if the child manifests which of the following?
- Wheezing
- Stopped bleeding
- Fast breathing
- Difficulty to awaken
48. Pain in orthopedic cases may not be mainly due to the surgery There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse?
- Explain all the possible interventions that may cause the client to worry
- Establish trusting relationship by giving his medication on time
- Stay with the client during pain episodes
- Promote client's sense of control and participation in control by listening to his concerns
49. Situation: You are actively practicing nurse who has just finished your graduate studies. You learned the value of research and would like to utilize the knowledge and skills gained in the application of research to the nursing service. The following questions apply to research. Q. A supposition or system of ideas that is proposed to explain a given phenomenon best defines:
- Paradigm
- Concept
- A theory
- A conceptual framework
50. When discussing dietary choices with a patient who is on heparin therapy the nurse should teach the patient that which of the following foods may increase clotting time?
- Grape fruit
- Oranges
- Bananas
- Red grapes