NCLEX-RN | QB3 | Practice Exam #44 (50 questions)

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

1. SITUATION: John Lloyd, a 27 basketball player sustained inhalation burn that required him to have tracheostomy due to massive upper airway edema. Q. Wilma knew that John Lloyd have an adequate respiratory condition if she notices that

• John Lloyd' respiratory rate is 18
• John Lloyd' Oxygen saturation is 91%
• There are frank blood suction from the tube
• There are moderate amount of tracheobronchial secretions

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2. Nurse Ronald is aware that the best tool for data gathering is?

• Interview schedule
• Questionnaire
• Use of laboratory data
• Observation

3. She finds out that some managers have benevolent-authoritative style of management. Which of the following behaviors will she exhibit most likely?

• Have condescending trust and confidence in their subordinates.
• Gives economic and ego awards.
• Communicates downward to staffs.
• Allows decision making among subordinates.

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4. The nurse in a labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. What is the first nursing action with this finding?

• Gently push the cord into the vagina,
• Place the client in Trendelenburg position.
• Find the closest telephone and page the health care provider stat.
• Call the delivery room to notify the staff that the client will be transported immediately.

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5. Which of the following is not true in implementing medical asepsis

• Wash hand before and after patient contact
• Keep soiled linens from touching the clothings
• Shake the linens to remove dust
• Practice good hygiene

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6. Situation: Respiration is one of the most important vital sign. This is usually the first Vital sign to be assessed more than anything for it is easily altered by the patient's consciousness. The nurse should be aware of the different changes and alteration in respiration. Q. Another name for an abnormal breath sound is:

• Adventurous breath sound
• Excursion
• Adventitious breath sound
• Dyspnea

7. The nurse manager is teaching the nursing staff about signs and symptoms related to hypercalcemia in a client with metastatic prostate cancer, and tells the staff that which is a late sign or symptom of this oncological emergency?

• Headache
• Dysphagia
• Constipation
• Electrocardiographic changes

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8. Situation: Survey and Statistics are important part of research that is necessary to explain the characteristics of the population. Q. In the value 80, 80,10,10, 25, 65,100, 200: What is the median?

• 71.25
• 22.5
• 10 and 25
• 72.5

9. A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse should assess for which manifestations of this complication?

• Warmth, redness, and pain in the left hand
• Ecchymosis and audible bruit over the fistula
• Edema and reddish discoloration of the left arm
• Pallor, diminished pulse, and pain in the left hand

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10. The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is:

• Decreased urinary output
• Hypersomnolence
• Absence of knee jerk reflex
• Decreased respiratory rate

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11. Mr. Duffy is admitted to the CCU with a diagnosis of R/O Ml. He presented in the ER with a typical description of pain associated with an Ml, and is now cold and clammy, pale and dyspneic. He has an IV of D5W running, and is complaining of chest pain. Oxygen therapy has not been started, and he is not on the monitor. He is frightened. Q. You know that all but one of the following may eventually result in uremia. Which option is not implicated?

• glomerular disease
• uncontrolled hypertension
• renal disease secondary to drugs, toxins, infections, or radiations
• all of the above

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12. A multigravida at 38 weeks' gestation is admitted with painless, bright red bleeding and mild contractions every 7 to 10 minutes. Which of the following assessments should be avoided?

• Maternal vital sign
• Fetal heart rate
• Contraction monitoring
• Cervical dilation

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13. A nurse is caring for a patient who had rhinoplasty 2-weeks ago. Which of the following is an expected outcome?

• Oral mucus membranes dry ,but pink and intact
• Face and nose free from swelling
• Able to make needs know, speech therapy started
• Demonstrate throat clearing while eating

14. Situation: The question with regards to the OPERATING ROOM. Q. Mr. TO. has undergone surgery for lyses of adhesions. He is transferred from Post Anesthesia Care Unit (PACU) to the Surgical floor, the nurse should obtain blood pressure, pulse and respiration every:

• 3 minutes
• 30 minutes
• 15 minutes
• 20 minutes

15. 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 I lost a baby at about 8 weeks" the nurse should record her obstetrical history as which of the following?

• G2 T2 P0 A0 L2
• G3 T1 P1 A0 L2
• G3 T2 P0 A0 L2
• G4 T1 PI A1 L2

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16. Which of the following is the correct interpretation of the ERROR OF PARALLAX

• If the eye level is higher than the level of the meniscus, it will cause a false high reading
• If the eye level is higher than the level of the meniscus, it will cause a false low reading
• If the eye level is lower than the level of the meniscus, it will cause a false low reading
• If the eye level is equal to that of the level of the upper meniscus, the reading is accurate

17. A contraindication for topical corticosteroid usage in a male patient with atopic dermatitis (eczema) is:

• Parasite infection.
• Viral infection.
• Bacterial infection.
• Spirochete infection.

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18. Situation: Survey and Statistics are important part of research that is necessary to explain the characteristics of the population. Q. According to the WHO statistics on the Homeless population around the world. Which of the following groups of people in the world disproportionately represents the homeless population?

• Hispanics
• Asians
• African Americans
• Caucasians

19. Situation: The nurse-patient relationship is a modality through which the nurse meets the client's needs. Q. The psychiatric nurse who is alert to both the physical and emotional needs of clients is working from the philosophical framework that states:

• All behavior is meaningful, communicating a message or a need
• Human beings are systems of interdependent and interrelated parts
• Each individual has the potential for growth and change in the direction of positive mental health
• There is a basic similarity among all human beings

20. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?

• Take the medication with milk.
• Report chest pain.
• Remain upright after taking for 30 minutes.
• Allow six weeks for optimal effects.

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21. Situation: Michelle is a 6 year oid preschooler. She was reported by her sister to have measles but she was at home because of fever, upper respiratory problem and white sports in her mouth. Method of prevention is to avoid exposure to an infection person. Nursing responsibility for rehabilitation of patient includes the provision of:

• Terminal disinfection
• Injection of gamma globulin
• Immunization
• Comfort measures

22. The nurse is preparing to care for a client who will be weaned from a cuffed tracheostomy tube. The nurse is planning to use a tracheostomy plug and plans to insert it into the opening in the outer cannula. Which nursing action is required before plugging the tube?

• Deflate the cuff on the tube.
• Place the inner cannula into the tube.
• Ensure that the client is able to speak.
• Ensure that the client is able to swallow.

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23. Situation: Brain tumor, whether malignant or benign, has serious management implications nurse, you should be able to understand the consequences of the disease and the treatment Q. Which of the following activities may increase intracranial pressure (ICP)?

• Raising the head of the bed
• Manual hyperventilation
• Use of osmotic Diuretics
• Valsalva's maneuver

24. Which statistic best reflects the nutritional status of a population?

• 1-4 year old age-specific mortality rate
• Proportionate mortality rate
• Infant mortality rate
• Swaroop's index

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25. The nurse educator is preparing to conduct a teaching session for the nursing staff regarding the theories of growth and development and plans to discuss Kohlberg's theory of moral development. What information should the nurse include in the session? Select all that apply. 1. Individuals move through all 6 stages in a sequential fashion. 2. Moral development progresses in relationship to cognitive development. 3. A person's ability to make moral judgments develops over a period of time. 4. The theory provides a framework for understanding how individuals determine a moral code to guide their behavior. 5. In stage 1 (punishment-obedience orientation), children are expected to reason as mature members of society. 6. In stage 2 (instrumental-relativist orientation), the child conforms to rules to obtain rewards or have favors returned.

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

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26. The nurse is making assignments for the day. The staff consists of an RN a novice RN an LPN and a nursing assistant Which client should be assigned to the RN?

• A client with peptic ulcer disease
• A client with skeletal traction for a fractured femur
• A client with an abdominal cholecystectomy
• A client with an esophageal tamponade

27. Which of the following groups of symptoms indicates a ruptured abdominal aortic aneurysm?

• Lower back pain, increased blood pressure, decreased re blood cell (RBC) count, increased white blood (WBC) count.
• Severe lower back pain, decreased blood pressure, decreased RBC count, increased WBC count.
• Severe lower back pain, decreased blood pressure, decreased RBC count, decreased RBC count, decreased WBC count.
• Intermittent lower back pain, decreased blood pressure, decreased RBC count, increased WBC count.

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28. SITUATION: John Smith was diagnosed with Acute Close Angle Glaucoma. He is being seen by Nurse Jet. Q. The Doctor orders pilocarpine. Nurse jet knows that the action of this drug is to

• Contract the Ciliary muscle
• Relax the Ciliary muscle
• Dilate the pupils
• Decrease production of Aqueous Humor

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29. Situation: Nurse Joanna works as an OB-Gyn Nurse and attends to several HIGH- RISK PREGNANCIES: Particularly women with preexisting or newly acquired illness. The following conditions apply Bernadette routinely takes acetylsalicylic acid (aspirin) for arthritis. Why should she limit or discontinue this toward the end of pregnancy?

• Aspirin can lead to deep vein thrombosis following birth.
• Newborns develop a red rash from salicylate toxicity
• Newborns develop withdrawal headaches from salicylates
• Salicylates can lead to increased maternal bleeding at childbirth

30. Which of the following statements by the parents of a child with school phobia would indicate the need for further teaching?

• "We'll keep him at home until phobia subsides"
• "We'll work with his teachers and counselors at school"
• "We'll try to encourage him to talk about his problem”
• "We'll discuss possible solutions with him and his counselor"

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31. It is the professionally desired norms against which a staff performance will be compared?

• Job descriptions
• Survey
• Flow chart
• Standards

32. The nurse is caring for a client who is recovering from a fractured femur. Which diet selection would be best for this client?

• Loaded baked potato fried chicken and tea
• Dressed cheeseburger French fries and a Diet Coke
• Tuna fish salad on sourdough bread potato chips and skim milk
• Mandarin orange salad broiled chicken and milk

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33. The nurse checks for hypocalcemia by placing a blood pressure cuff on a clients arm and inflating it After about 3 minutes the client develops carpopedal spasm. The nurse records this finding as a positive:

• Homan's sign
• Romberg sign
• Chvostek's skin
• Trousseau's sign

34. Human beings are the major reservoir of malaria. Which of the following strategies in malaria control is based on this fact?

• Stream seeding
• Stream clearing
• Destruction of breeding places
• Zooprophylaxis

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35. The client has been placed in the trendelenburg position. The nurse knows the effects of this position to the client include which of the following.

• increase blood flow to the feet
• decrease blood pressure
• increase pressure on the diaphragm
• decrease intracranial pressure

36. Which of the following is a NOT a correct statement of an Outcome criteria?

• Ambulates 30 feet with a cane before discharge
• Discusses fears and concerns regarding the surgical procedure
• Demonstrates proper coughing and breathing technique after a teaching session
• Reestablishes a normal pattern of elimination

37. Which of the following vital sign assessments that may indicate cardiogenic shock after myocardial infarction?

• BP - 80/60, Pulse - 110 irregular
• BP - 90/50, Pulse - 50 regular
• BP - 130/80, Pulse -100 regular
• BP - 180/100, Pulse - 90 irregular

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38. SITUATION: Wide knowledge about the human ear, it's parts and it's functions will help a nurse assess and analyze changes in the adult client's health. Q. Nurse Jenny is developing a plan of care for a patient with Menieres disease. What is the priority nursing intervention in the plan of care for this particular patient?

• Air, Breathing, Circulation
• Love and Belongingness
• Food, Diet and Nutrition
• Safety

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39. The client with dual diagnoses of major depression and alcohol abuse states, "I only drink when I can't sleep.” An initial outcome for this client is that the client will:

• Describe adaptive methods of coping to induce sleep.
• Verbalize negative effects of alcohol on the body.
• Describe dangerous effects when combining alcohol and antidepressant medication.
• Verbalize the desire to stop drinking alcohol

40. Upon assessment, the nurse got the following findings: 2 perineal pads highly saturated with blood within 2 hours post partum, PR= 80 bpm, fundus soft and boundaries not well defined. The appropriate nursing diagnosis is:

• Normal blood loss
• Blood volume deficiency
• Inadequate tissue perfusion related to hemorrhage
• Hemorrhage secondary to uterine atony

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41. If Ms. Drake tells the nurse her feet are cold; Which of the following nursing action would be best

• Apply a hot water bottle
• Use an electric heating pad
• Wrap them in a warm blanket
• Elevate her feet on a stool

42. The client with hyperemesis gravidarum is at risk for developing:

• Respiratory alkalosis without dehydration
• Metabolic acidosis with dehydration
• Respiratory acidosis without dehydration
• Metabolic alkalosis with dehydration

43. The four major concepts in nursing theory are the:

• Person, Environment, Nurse, Health
• Nurse, Person, Environment, Cure
• Promotive, Preventive, Curative, Rehabilitative
• Person, Environment, Nursing, Health

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44. When administrating an enema to an adult patient, how far should the nurse insert the tubing into the rectum?

• 2.2 to 4.4 cm (1 to 2 inches)
• 4.4 to 6.6 cm (2 to 3 inches)
• 6.6 to 8.8 cm (3 to 4 inches)
• 8.8 to 11 cm (4 to 5 inches)

45. A 60-year-old diabetic is taking glyburide (Diabeta) 1.25mg daily to treat Type II diabetes mellitus. Which statement indicates the need for further teaching?

• I will keep candy with me just in case my blood sugar drops.
• I need to stay out of the sun as much as possible.
• I often skip dinner because I don't feel hungry.
• I always wear my medical identification.

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46. The nurse is caring for an organ donor client with a severe head injury from an MVA. Which of the following is most important when caring for the organ donor client?

• Maintenance of the BP at 90mmHg or greater
• Maintenance of a normal temperature
• Keeping the hematocrit at less than 28%
• Ensuring a urinary output of at least 300mL/hr

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47. The client is having fetal heart rates of 100 to 110 beats per minute during the contractions. The first action the nurse should take is to:

• Apply an internal monitor
• Turn the client to her side
• Get the client up and walk her in the hall
• Move the client to the delivery room

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48. Currently, there is no way to prevent myelosuppression. However, there are medications available to elicit a more rapid bone marrow recovery. An example is:

• Epoetin alfa (Epogen, Procrit).
• Glucagon.
• Fenofibrate (Tricor).
• Lamotrigine (Lamictal).

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49. A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the HCP if the client is also taking which medication?

• Digoxin
• Phenytoin
• Vitamin A
• Furosemide

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50. A type of illness characterized by periods of remission and exacerbation

• Chronic
• Acute
• Sub acute
• Sub chronic

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NCLEX-RN | QB3 | Practice Exam #44 (50 questions)