NCLEX-RN | QB3 | Practice Exam #35 (50 questions)

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

1. Nurse assistant attending a nursing conference hears that one of her clients has hydrocele. She asks the nurse how this condition is treated. The most common response is:

• Usually the problem requires more medical or surgical intervention
• Surgery may be necessary to correct the problem
• Wearing a scrotal support usually corrects the problem
• Drug therapy usually helps control the collection of fluid

2. Where is the Tail of Spence located ?

• Upper outer quadrant
• Lower outer quadrant
• Left outer quadrant
• Right outer quadrant

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3. Terry with mania is skipping up and down the hallway practically running into other clients. Which of the following activities would the nurse in charge expect to include in Terry's plan of care?

• Watching TV
• Cleaning dayroom tables
• Leading group activity
• Reading a book

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4. Which of the following provides the richest source of Iron per area of their meat?

• Pork meat
• Lean red meat
• Pork liver
• Green mongo

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5. A client is receiving aminophylline IV. The nurse monitors the theophylline blood level and assesses that the level is within therapeutic range at which of the following levels?

• 5ug/mL
• 8ug/mL
• 15ug/mL
• 25ug/mL

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6. Situation: Some equipments and materials in our hospital are color coded, this is to increase the safety and proficiency of rendering patients care. Q. For pediatric patients, the spinal set is coded with color:

• Red
• Pink
• Yellow
• Blue

7. Situation: Concerted work efforts among members of the surgical team is essential to the success of the surgical procedure. Q. Surgery schedules are communicated to the OR usually a day prior to the procedure by the nurse of the floor or ward where the patient is confined. For orthopedic cases, what department is usually informed to be present in the OR?

• Rehabilitation department
• Laboratory department
• Maintenance department
• Radiology department

8. A primary concern when giving heparin subcutaneously to prevent bleeding is:

• Don't make massage on the injection site
• To make massage on the injection site
• Use the smallest gauge needle that is appropriate
• Use Z technique

9. For which clinical indicator should the nurse monitor a child with chronic hypoxia?

• Clubbing of fingers
• Slow, irregular respirations
• Subcutaneous hemorrhages
• Decreased red blood cell count

10. Which is not a clear liquid diet?

• Hard candy
• Gelatin
• Coffee with Coffee mate
• Bouillon

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11. Amikacin is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the health care provider (HCP) immediately if which occurs?

• Nausea
• Lethargy
• Hearing loss
• Muscle aches

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12. The emergency department nurse is assessing a client who has sustained a blunt injury to the chest wall. Which finding indicates the presence of a pneumothorax in this client?

• A low respiratory rate
• Diminished breath sounds
• The presence of a barrel chest
• A sucking sound at the site of injury

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13. The nurse is performing an assessment on a 10-year-old child suspected to have Hodgkin's disease. Which assessment findings are specifically characteristic of this disease? Select all that apply. 1. Abdominal pain 2. Fever and malaise 3. Anorexia and weight loss 4. Painful, enlarged inguinal lymph nodes 5. Painless, firm, and movable adenopathy in the cervical area

• 1,3,5
• 1,2,4,5
• 2,4
• 1,5

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14. While caring for a client with a newly applied plaster of Paris cast, the nurse makes note of all the following conditions. Which assessment finding requires immediate notification of the physician?

• Moderate pain, as reported by the client
• Report, by client, the heat is being felt under the cast
• Presence of slight edema of the toes of the casted foot
• Onset of paralysis in the toes of the casted foot

15. Situation: Nurse Minette is an independent nurse practitioner following-up referred clients in their respective homes. Here she handles a case of POSTPARTUM MOTHER AND FAMILY focusing on HOME CARE. Leah is developing constipation from being on bed rest. What measures would you suggest she take to help prevent this?

• Eat more frequent small meals instead of three large one daily
• Walk for at least half an hour daily to stimulate peristalsis
• Drink more milk, increased calcium intake prevents constipation
• Drink eight full glasses of fluid such as water daily

16. Situation: Ricky is a 12 year old-boy with Down's syndrome. He stands 5' and weight 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as support for his neck. X - ray of cervical spine showed "subluxation of Cl in relation to C2 with cord compression" He attends a school for special education. Q. All of the following activities are appropriate for Ricky EXCEPT:

• Working with clay
• Competitive sports
• Preparing and cooking simple menu
• Card and table games

17. Rh isoimmunization in a pregnant client develops during which of the following conditions?

• Rh-positive maternal blood crosses into fetal blood, stimulating fetal antibodies.
• Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies.
• Rh-negative fetal blood crosses into maternal blood, stimulating maternal antibodies.
• Rh-negative maternal blood crosses into fetal blood, stimulating fetal antibodies.

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18. The first manifestation of inflammation is:

• Redness on the affected area
• Swelling of the affected area
• Pain, which causes guarding of the area
• Increase heat due to transient vasodilation

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19. Serotonin release stimulates vomiting following chemotherapy. Therefore, serotonin antagonists are effective in preventing and treating nausea and vomiting related to chemotherapy. An example of an effective serotonin antagonist antiemetic is:

• ondansetron (Zofran).
• fluoxetine (Prozac).
• paroxetine (Paxil).
• sertraline (Zoloft).

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20. A newborn weighed seven pounds at birth. At six months of age the infant could be expected to weigh:

• 14 pounds
• 18 pounds
• 25 pounds
• 30 pounds

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21. When taking an obstetrical history on a pregnant client who states, "I had a son born at 38 weeks gestation, a daughter born at 30 weeks gestation and 1 lost a baby at about 8 weeks,"the nurse should record her obstetrical history as which of the following?

• G2 T2 P0 AO L2
• G3 T1 P1 AO L2
• G3 T2 P0 AO L2
• G4 T1 P1 A1 L2

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22. A client comes into the E.R. with acute shortness of breath and a cough that produces pink, frothy sputum. Admission assessment reveals crackles and wheezes, a BP of 85/46, a HR of 122 BPM, and a respiratory rate of 38 breaths/minute. The client's medical history included DM, HTN, and heart failure. Which of the following disorders should the nurse suspect?

• Pneumonia
• Pneumothorax
• Pulmonary edema
• Pulmonary embolism

23. A community health nurse is implementing an adult immunization program in the neighborhood. Which of the following would MOST likely be a universally recommended adult vaccination and dose frequency general population?

• Tetanus-diphtheria toxoid every 20 years
• Pneumococcal vaccination every 2 years
• Influenza vaccination every year
• One time typhoid vaccine followed by boosters every 5 years

24. A 77-year-old male client is admitted with a diagnosis of dehydration and change in mental status. He's being hydrated with L.V. fluids. When the nurse takes his vital signs, she notes he has a fever of 103T (39.4’C) a cough producing yellow sputum and pleuritic chest pain. The nurse suspects this client may have which of the following conditions?

• Adult respiratory distress syndrome (ARDS)
• Myocardial infarction (MI)
• Pneumonia
• Tuberculosis

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25. When an unexpected death occurs in the ED, which of the following tasks is most appropriate to delegate to the nursing assistant?

• Escort the family to a place of privacy.
• Go with the organ donor specialist to talk to the family.
• Assist with postmortem care. .
• Assist the family to collect belongings.

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26. Situation: You are assigned to take care of a group of patients across the lifespan. Pain in the elder persons require careful assessment because they:

• Experienced reduce sensory perception
• Have increased sensory perception
• Are expected to experience chronic pain
• Have decreased pain threshold

27. Situation: You are actively practicing nurse who just finished your Graduate Studies. You earned the value of Research and would like to utilize the knowledge and skills gained in the application of research to 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:

• a paradigm
• a concept
• a theory
• a conceptual framework

28. Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical history for which disorder in which the medication should be used with caution?

• Osteoarthritis
• Hypothyroidism
• Diabetes mellitus
• Polycystic disease

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29. Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder when discrepancies exist between what the client states and what actually exist?

• Rationalization
• Supportive confrontation
• Limit setting
• Consistency

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30. You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of a severe headache with photophobia and has a temperature of 102.60F orally. Which collaborative intervention must be accomplished first?

• Administer codeine 15 mg orally for the patient's headache.
• Infuse ceftriaxone (Rocephin) 2000 mg IV to treat the infection.
• Give acetaminophen (Tylenol) 650 mg orally to reduce the fever.
• Give furosemide (Lasix) 40 mg IV to decrease intracranial pressure.

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31. Situation: Mrs. Damian an immediate post op cholecystectomy and choledocholithotomy patient, complained of severe pain at the wound site. Q. Which of the following statement on pain is true?

• Culture and pain are not associated
• Pain accomplished acute illness
• Patient's reaction to pain varies
• Pain produces the same reaction such as groaning and moaning

32. A patient finds their 2-weeks-old infant unresponsive. The infant is limp, cyanotic and pale. There is no respiration, while the skin is cold to the touch. The parent begins resuscitation, and the infant is transferred to the hospital where the infant expires. The MOST likely diagnosis is:

• Sudden infant death syndrome
• Apparent life-threatening event
• Apnea of infancy
• Apnea of unknown origin

33. Refers to a person or animal, known or believed to have been exposed to a disease.

• Carrier
• Contact
• Agent
• Host

34. The nursery nurse is putting erythromycin ointment in the newborn's eyes to prevent infection. She places it in the following area of the eye:

• under the eyelid
• on the cornea.
• in the lower conjunctival sac
• by the optic disc.

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35. What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention?

• High-fowler's
• Raised 10 degrees
• Raised 30 degrees
• Supine position

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36. A nurse is caring for a client with a myocardial infarction. The nurse recognizes that the most common complication in the client following a myocardial infarction is:

• Right ventricular hypertrophy
• Cardiac dysrhythmia
• Left ventricular hypertrophy
• Hyperkalemia

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37. The nurse is performing an assessment on an older adult client Which assessment data would indicate a potential complication associated with the skin?

• Crusting
• Wrinkling
• Deepening of expression lines
• Thinning and loss of elasticity in the skin

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38. The nurse is assessing a client hospitalized with a duodenal ulcer Which finding should be reported to the doctor immediately?

• BP 82/60 pulse 120
• Pulse 68 respirations 24
• BP 110/88 pulse 56
• Pulse 82 respirations 16

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39. A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement made by the client indicates a need for further instruction?

• "I will watch for the evidence of the passage of tissue."
• "I will maintain strict bed rest throughout the remainder of the pregnancy."
• "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad."
• "I will avoid sexual intercourse until the bleed- ing has stopped, and for 2 weeks following the last evidence of bleeding.”

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40. What would be the primary goal of therapy for a client with pulmonary edema and heart failure?

• Enhance comfort
• Increase cardiac output
• Improve respiratory status
• Peripheral edema decreased

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41. The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client's white blood cell count was which value?

• 2000mm3
• 5800mm3
• 8400mm3
• 11,500mm3

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42. When a patient in the terminal stages of lung cancer begins to exhibit loss of consciousness, a major nursing priority is to:

• Protect the patient from injury
• Insert an airway
• Elevate the head of the bed
• Withdraw all pain medications

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43. The nurse in the mental health unit plans to use which therapeutic communication techniques when communicating with a client? Select all that apply. 1. Restating 2. Listening 3. Asking the client "Why?" 4. Maintaining neutral responses 5. Providing acknowledgment and feedback 6. Giving advice and approval or disapproval

• 1,2,3,4
• 1,2,4,5
• 2,3,4
• 1,3,5

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44. A client with non-Hodgkin's lymphoma is receiving daunorubicin Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication?

• Fever
• Sores in the mouth and throat
• Complaints of nausea and vomiting
• Crackles on auscultation of the lungs

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45. The client with cirrhosis is scheduled for a pericentesis, Which instruction should be given to the client before the exam?

• You will need to lay flat during the exam.
• You need to empty your bladder before the procedure.
• You will be asleep during the procedure
• The doctor will inject a medication to treat your illness during the procedure

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46. A pneumonectomy is a surgical procedure sometimes indicated for treatment of non-small- cell lung cancer. A pneumonectomy involves removal of:

• An entire lung field
• A small, wedge-shaped lung surface
• One lobe of a lung
• One or more segments of a lung lobe

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47. The clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse should provide which instruction to the parent?

• The hepatitis B vaccine will not be given to the child.
• The inactivated influenza vaccine will be given yearly.
• The varicella vaccine will be given before 6 months of age.
• A Western blot test needs to be performed and the results evaluated before immunizations.

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48. Which instruction take priority in reducing anxiety related to Surgical procedure and post operative exercise

• Risk of infection after surgery
• Advanced directives and what it means
• Pre operative laboratory result and what to expect on it
• None of the above.

49. Situation: it is the first day of clinical experience of nursing students at the Psychiatry Ward. During the orientation, the nurse emphasizes that the team members including nursing students are legally responsible to safeguard patient's records from loss or destruction or from people not authorized to bead it Q. It is unethical to tell one's friends and family member's data bout patients because doing so is violation of patients' rights to:

• Informed consent
• Confidentiality
• Least restrictive environment
• Civil liberty

50. A nursing is caring for a 3-weeks-old infant who was just admitted to the hospital Which of the following nursing interventions does NOT support this infants basic emotional and social needs?

• Provide for continual contact between parents and infant
• Activity involve parents in caring for the infant
• Keep the infant's environment quiet dim, and free of sensory stimulation
• Foster infant-sibling relationship as appropriate

 

NCLEX-RN | QB3 | Practice Exam #35 (50 questions)