NCLEX-RN | QB3 | Practice Exam #46 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. Which question should the nurse ask the parents of a child suspected of having glomerulonephritis?
- "Did your child fall off a bike onto the handlebars?"
- "Has the child had persistent nausea and vomiting?"
- "Has the child been itching or had a rash anytime in the last week?"
- "Has the child had a sore throat or a throat infection in the last few weeks?"
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2. A newly admitted client has sickle cell crisis. He is complaining of pain in his feet and hands. The nurses assessment findings include a pulse oximetry of 92. Assuming that all the following interventions are ordered which should be done first?
- Adjust the room temperature
- Give a bolus of IV fluids
- Start O2
- Administer meperidine (Demerol) 75mg IV push
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3. Situation: A computer analyst, Mr. Ricardo J. Santos, 25 was brought to the hospital for diagnostic workup after he had experienced seizure in his office. Q.Just as nurse was entering the room, the patient who was sitting on his chair begins to have a seizure. Which of the following must the nurse do first?
- Ease the patient to the floor
- Lift the patient and put him on the bed
- Insert a padded tongue depressor between his jaws
- Restrain patient's body movement
4. Situation: Adam, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 OF. Q. The doctor ordered for a complete blood count. After the test, Nurse Ray received the result from the laboratory. Which laboratory values will confirm the diagnosis of appendicitis?
- RBC 5.5 x 106/mm3
- Hct 44 %
- WBC 13,000/mm3
- Hgb 15g/dL
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5. The nurse is teaching a client about adequate hand hygiene. What component of hand washing should the nurse include that is most important for removing microorganisms?
- Soap
- Time
- Water
- Friction
6. Which of the following medical conditions is commonly found in clients with bulimia nervosa?
- Allergies
- Cancer
- Diabetes mellitus
- Hepatitis A
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7. Following eruption of the primary teeth the mother can promote chewing by giving the toddler:
- Pieces of hot dog
- Carrot sticks
- Pieces of cereal
- Raisins
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8. Which of the following is one of the advantages of the newer antipsychotic medication risperidone (Risperdal)?
- The absence of anticholinergic effects
- A lower incidence of extrapyramidal effects
- Photosensitivity and sedation
- No incidence of neuroleptic malignant syndrome
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9. Indirect transmission of infection includes:
- Vehicle born transmission.
- Vector borne transmission.
- A only correct.
- A and B are correct.
10. A client admitted voluntarily for treatment of an anxiety disorder demands to be released from the hospital. Which action should the nurse take initiaily?
- Call the client's family to arrange for transportation.
- Attempt to persuade the client to stay "for only a few more days."
- Tell the client that leaving would likely result in an involuntary commitment.
- Contact the clients health care provider (HCP).
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11. A 6-year-old patient has presented to the clinic with fever, malaise and anorexia. The patient was treated 2 weeks ago for a streptococcal infection of the throat The nurse should expect the physician to order what test?
- Electrocardiogram
- Jones test
- Spinal tap
- Heart biopsy
12. Which instruction would not be included in the discharge teaching of the client receiving Thorazine (chlorpromazine)?
- You will need to wear protective clothing or a sunscreen when you are outside.
- You will need to avoid eating aged cheese.
- You should carry hard candy with you to decrease dryness of the mouth.
- You should report a sore throat immediately.
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13. Situation: Care of clients with tracheotosmy is often a challenge to a beginning nurse. The following questions will test your knowledge on Tracheostomy and its related care. Q. You know that when rendering tracheostomy care, the priority consideration is always to keep the airway patent and also to prevent infection at the site. The nurse knows the technique used in rendering Tracheostomy care is:
- Clean
- Disinfected
- Sterile
- Medical
14. The nurse is caring for a client who had an above the knee amputation. The client refuses to look at the stump. When the nurse attempts to speak with the client about his surgery, he tells the nurse that he doesn't wish to discuss it. The client also refuses to have his family visit. The nursing diagnosis that best describes the client's problem is:
- Hopelessness
- Powerlessness
- Disturbed body image
- Fear
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15. Situation: Nurses are generalist, in order to cope up with the works demand you must have broad knowledge on anything. Nurse Joan was assigned in the medical ward. During the endorsement she found out that she was assigned to several patients of different case Q. Which of the following statements best describes the Parkinson's Disease?
- Loss of myelin sheath surrounding peripheral nerves
- Degeneration of the substantia nigra; depleting dopamine
- Bleeding into the brain stem, resulting in meter dysfunction
- An autoimmune disorder that destroys acetylcholine receptors
16. When a person is admitted to the nursing home, the nurse aide should expect that the resident will
- have problems related to incontinence.
- require a lot of assistance with personal care.
- experience a sense of loss related to the life change.
- adjust more quickly if admitted directly from the hospital.
17. On a routine visit to the physician, a client with chronic arterial occlusive disease reports stopping smoking after 34 years. To relieve symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, the nurse should recommend which additional measure?
- Taking daily walks.
- Engaging in anaerobic exercise.
- Reducing daily fat intake to less than 45% of total calories
- Avoiding foods that increase levels of high density lipoproteins (HDLs)
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18. Which laboratory test would be the least effective in making the diagnosis of a myocardial infarction?
- AST
- Troponin
- CK-MB
- Myoglobin
19. A 35-year-oid male was knifed in the street fight, admitted through the ER, and is now in the ICU. An assessment of his condition reveals the following symptoms: respirations shallow and rapid, CVP 15 cm H2O, BP 90 mm Hg systolic, skin cold and pale, urinary output 30 mL/hr for the last 2 hours. Analyzing these symptoms, the nurse will base a nursing diagnosis on the conclusion that the client has which of the following conditions?
- Hypovolemic shock
- Cardiac tamponade
- Wound dehiscence
- Atelectasis
20. The nurse arrives at work and is told to report (float) to the intensive care unit (ICU) for the day because the ICU is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the ICU. The nurse should take which best action?
- Refuse to float to the ICU based on lack of unit orientation.
- Clarify with the team leader to make a safe ICU client assignment.
- Ask the nursing supervisor to review the hospital policy on floating.
- Submit a written protest to nursing administration, and then call the hospital lawyer.
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21. The physician has inserted an esophageal balloon tamponade in a client with bleeding esophageal varices. The nurse should maintain the esophageal balloon at a pressure of:
- 5-10mmHg
- 10-15mmHg
- 15-20mmHg
- 20-25mmHg
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22. The nurse is assigning staff for the day. Which client should be assigned to the nursing assistant?
- A five-month-oId with bronchiolitis
- A 10-year-old two-day post-appendectomy
- A two-year-old with periorbital cellulitis
- A one-year-old with a fractured tibia
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23. Nurse Irish is aware that Ritalin is the drug of choice for a child with ADHD. The side effects of the following may be noted by the nurse:
- Increased attention span and concentration
- Increase in appetite
- Sleepiness and lethargy
- Bradycardia and diarrhea
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24. A client with antisocial personality disorder is beginning to practice several socially acceptable behaviors in the group setting. Which of the following outcomes will result from this change?
- Fewer panic attacks
- Acceptance of reality
- Improved self-esteem
- decreased physical symptoms
25. Situation: Concerted work efforts among members of the surgical team is essential to the success of the surgical procedure. Q. In massive blood loss, prompt replacement of compatible blood is crucial. What department needs to be alerted to coordinate closely with the patient's family for immediate blood component therapy?
- Security Division
- Chaplaincy
- Social Service Section
- Pathology department
26. 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. During the first 48 hours, Burn victims is observed for metabolic acidosis resulting from loss of bicarbonate ions that arises from:
- Potassium loss
- Calcium loss
- Sodium loss
- Magnesium loss
27. Which of the following conditions is most commonly responsible for myocardial infarction?
- Aneurysm
- Heart failure
- Coronary artery thrombosis
- Renal failure
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28. The nurse is preparing a client for mammography. To prepare the client for a mammogram the nurse should tell the client:
- To restrict her fat intake for one week before the test
- To omit creams powders or deodorants before the exam
- That mammography replaces the need for self-breast exams
- That mammography requires a higher dose of radiation than x-rays
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29. The nurse is evaluating the clients pulmonary artery pressure. The nurse is aware that this test evaluates:
- Pressure in the left ventricle
- The systolic diastolic and mean pressure of the pulmonary artery
- The pressure in the pulmonary veins
- The pressure in the right ventricle
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30. The group at greatest risk for unmet needs is:
- the very young and the very old
- all age groups
- the poor and the very rich
- the adult and the aged
31. Which activity is suitable for a client who suffered an uncomplicated myocardial infarction (MI) two days ago?
- Sitting in the bedside chair for 15 minutes three times a day
- Remaining on strict bed rest with bedside commode privileges
- Ambulating in the room and hall as tolerated
- Sitting on the bedside for five minutes three times a day with assistance
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32. Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a compound found in which of the following foods?
- Figs and cream cheese
- Fruits and yellow vegetables
- Aged cheese and Chianti wine
- Green leafy vegetables
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33. When assessing a laboring client the nurse finds a prolapsed cord. The nurse should:
- Attempt to replace the cord.
- Place the client on her left side.
- Elevate the clients hips.
- Cover the cord with a dry sterile gauze.
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34. The nurse is preparing to change the parenteral nutrition (PN) solution bag and tubing. The clients central venous line is located in the right subclavian vein. The nurse asks the client to take which essential action during the tubing change?
- Breathe normally.
- Turn the head to the right.
- Exhale slowly and evenly.
- Take a deep breath, hold it, and bear down.
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35. The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, which is the nurse's immediate priority of care?
- Provide safety for the client and other clients on the unit.
- Provide the clients on the unit with a sense of comfort and safety.
- Assist the staff in caring for the client in a controlled environment.
- Offer the client a less stimulating area in which to calm down and gain control.
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36. What information should the nurse give a new mother regarding the introduction of solid foods for her infant?
- Solid foods should not be given until the extrusion reflex disappears at 810 months of age.
- Solid foods should be introduced one at a time with 4- to 7-day intervals.
- Solid foods can be mixed In a bottle or infant feeder to make feeding easier.
- Solid foods should begin with fruits and vegetables.
37. After leech therapy, Where should you put the leeches?
- In specially marked BIO HAZARD Containers
- Yellow trashcan
- Black trashcan
- Leeches are brought back to the culture room, they are not thrown away for they are reusable
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38. While performing a neurodevelopmental assessment on a 3-month-old infant, which of the following characteristics would be expected?
- A strong Moro reflex
- A strong parachute reflex
- Rolling from front to back
- Lifting of head and chest when prone
A 3-month-old infant should be able to lift the head and chest when prone. The Moro reflex typically diminishes or subsides by 3 months. The parachute reflex appears at 9 months. Rolling from front to back usually is accomplished at about 5 months.{/spoiler}
39. Situation: A "disaster" is a large-scale emergency even a small emergency left unmanaged may turn into a disaster. Disaster preparedness is crucial and is everybody's business. There are agencies that are in charge of ensuring prompt response. Comprehensive Emergency Management (CEM) is an integrated approach to the management of emergency program and activities for all four emergency phases (mitigation, preparedness, response, and recovery), for all type of emergencies and disasters (natural, man-made, and attack) and for all levels of government and the private sector. Q. Which of the following terms refer to a process by which the individual receives education about recognition of stress reactions and management strategies for handling stress which may be instituted after a disaster?
- Critical incident stress management
- Follow-up
- Debriefing
- Defusion
40. In teaching a client about Alcoholics Anonymous, the nurse states that Alcoholics Anonymous has helped in the rehabilitation of many alcoholics, probably because many people find it easier to change their behavior when they:
- Have the support of rehabilitated alcoholics.
- Know that rehabilitated alcoholics will sympathize with them.
- Can depend on rehabilitated alcoholics to help them identify personal problems related to alcoholism.
- Realize that rehabilitated alcoholics will help them develop defense mechanisms to cope with their alcoholism.
41. The following are strategies implemented by the DOH to prevent mosquito-borne diseases. Which of these is most effective in the control of Dengue fever?
- Stream seeding with larva-eating fish
- Destroying breeding places of mosquitoes
- Chemoprophylaxis of non-immune persons going to endemic areas
- Teaching people in endemic areas to use chemically treated mosquito nets
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42. The nurse is caring for a client following a transphenoidal hypophysectomy. Post-operatively the nurse should:
- Provide the client a toothbrush for mouth care.
- Check the nasal dressing for the halo sign.
- Tell the client to cough forcibly every two hours.
- Ambulate the client when he is fully awake.
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43. The nurse is caring for a client on a ventilator that is set on intermittent mandatory ventilation (IMV). Assessment on the ventilator is IMV mode of eight breaths per minute. The nurse assesses the clients respiratory rate of 13 per minute. What do these findings indicate?
- The client is fighting the ventilator and needs medication.
- Pressure support ventilation is being used.
- Additional breaths are being delivered by the ventilator.
- The client is breathing five additional breaths on his own.
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44. The nurse has an order to get the client out of bed to a chair on the first postoperative day after a total knee replacement. The nurse plans to do which of the following to protect the knee joint:
- Apply a knee immobilizer before getting the client up and elevate the client’s surgical leg while sitting
- Apply an Ace wrap around the dressing and put ice on the knee while sitting
- Lift the client to the bedside change leaving the CPM machine in place
- Obtain a walker to minimize weight bearing by the client on the affected leg
45. A 7-years-old child is brought to the physician office due to sudden onset of bright redness on the cheeks. The nurse observes that the child has a temperature of 380 C (100.40 F) With chills the nurse suspects that the MOST like diagnosis would be:
- Fifth disease
- Rotavirus
- Roseolainfanturn
- None of the above.
46. A nurse has been visiting a bed-bound patient with decreased bowel mobility in the home for one month. The family tells the nurse that the patient is becoming incontinent of feces. The nurse evaluates the plan of care and notes which of the following intervention would MOST likely beneficial?
- An enema two times a week
- Increased fiber in the diet
- A routine bisacodyl (Dulcolax) suppository
- An enema three times a week
47. The complete blood count of a client admitted with anemia reveals that the red blood cells are hypochromic and microcytic. The nurse recognizes that the client has:
- Aplastic anemia
- Iron-deficiency anemia
- Pernicious anemia
- Hemolytic anemia
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48. An elderly home-bound patient is visited by the community health nurse. During evaluation, decreased skin turgor is noted. When asked about fluids intake, the patient states that she does not drink any fluids after lunch each day, and wake sup very thirsty. The MOST appropriate question for the nurse to ask is:
- "How much protein does you normally eats for dinner?”
- "How much caffeine are you consuming each day?”
- "Are you having trouble controlling your bladder at night?"
- "Do you have enough money to buy liquids to drink?"
49. Which of the following risk factors for coronary artery disease cannot be corrected?
- Cigarette smoking
- Heredity
- HPN
- DM
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50. Situation: Understanding different models of care is a necessary part of the nurse patient relationship. Q. Which of the following therapies has been strongly advocated for the treatment of post traumatic stress disorders?
- ECT
- Group Therapy
- Hypnotherapy
- Psychoanalysis