NCLEX-RN | QB3 | Practice Exam #47 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. The nurse is at the community center speaking with retired people. To which comment by one of the retirees during a discussion about glaucoma would the nurse give a supportive comment to reinforce correct information?
- "I usually avoid driving at night since lights sometimes seem to make things blur."
- "I take half of the usual dose for my sinuses to maintain my blood pressure."
- "I have to sit at the side of the pool with the grandchildren since I can't swim with this eye problem"
- "I take extra fiber and drink lots of water to avoid getting constipated."
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2. A client with chronic schizophrenia who takes neuroleptic medication is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction:
- tardive dyskinesia.
- dystonia
- neuroleptic malignant syndrome.
- akathisia
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3. The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, "How Is Carol doing? She is my best friend and is seen at your clinic every week." Which is the most appropriate nursing response?
- "I cannot discuss any client situation with you."
- "If you want to know about Carol, you need to ask her yourself.”
- "Only because you're worried about a friend, I'll tell you that she is improving"
- "Being her friend, you know she is having a difficult time and deserves her privacy."
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4. The nurse is applying a topical corticosteroid to a client with eczema. The nurse should apply the medication to which body area? Select all that apply. 1. Back 2. Axilla 3. Eyelids 4. Soles of the feet 5. Palms of the hands
- 1,2,3
- 3,4,5
- 2,3,4
- 1,4,5
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5. Which roommate would be most suitable for the six-year-old male with a fractured femur in Russells traction?
- 16-year-old female with scoliosis
- 12-year-old male with a fractured femur
- 10-year-old male with sarcoma
- 6-year-old male with osteomylitis
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6. Situation: Nette, a nurse palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of her last menstrual period. Leopold's Maneuver is done. The obstetrician told mat she appears to be 20 weeks pregnant. The nurse assesses the woman at 20 weeks gestation and expects the woman to report
- Spotting related to fetal implantation
- Symptoms of diabetes as human placental lactogen is released
- Feeling fetal kicks
- Nausea and vomiting related HCG production
7. A client is receiving a blood transfusion following surgery. In the event of a transfusion reaction any unused blood should be:
- Sealed and discarded in a red bag
- Flushed down the clients commode
- Sealed and discarded in the sharps container
- Returned to the blood bank
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8. Marion is aware that the sampling method that gives equal chance to all units in the population to get picked is:
- Random
- Accidental
- Quota
- Judgment
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9. A client is scheduled for a cystectomy and asks the nurse what the physician will be able to see during the procedure. The most correct reply is the:
- Kidney and ureters
- Bladder and rectum
- Prostate and ureters
- Urethra and bladder
10. The nurse is teaching a client about coughing and deep-breathing techniques to prevent postoperative complications. Which statement is most appropriate for the nurse to make to the client at this time as it relates to these techniques?
- "Use of an incentive spirometer will help prevent pneumonia."
- "Close monitoring of your oxygen saturation will detect hypoxemia.”
- "Administration of intravenous fluids will prevent or treat fluid imbalance.”
- "Early ambulation and administration of blood thinners will prevent pulmonary embolism.”
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11. A client asks the nurse about including her 2 and 12 year-old sons in the care of their newborn sister. Which of the following is an appropriate initial statement by the nurse?
- "Focus on your son's' needs during the first days at home"
- "Tell each child what he can do to help with the baby"
- "Suggest that your husband spend more time with the boys"
- "Ask the children what they would like to do for the newborn"
12. Situation: One important toot a community health nurse uses in the conduct of his/her activities is the CHN Bag. Which of the following BEST DESCRIBES the use of this vital facility for our practice? Q. This is an important procedure of the nurse during home visits?
- protection of the CHN bag
- arrangement of the contents of the CHM bag
- cleaning of the CHN bag
- proper hand washing
13. Situation: The adolescent years have the potential to be very exciting as well as a different time for both the child and his parents. Q. As stated by Erikson, the major concern of the adolescent years is the:
- formation of romantic association
- attainment of independence
- gratification of his needs
- resolution of the crisis of personal identity
14. A child has ingested an entire bottle acetaminophen(Tylenol). Which of the following organs is affected?
- Liver
- Brain
- Kidneys
- Gallbladder
15. A patient with advanced lung cancer is exhibiting cyanosis and edema of the head and upper extremities. Which of the following intervention would MOST likely provide an immediate benefit for this patient?
- Place in Trendelenburg position
- Position on the right side
- Elevate the head of the bed
- Elevate extremities
16. The nurse reviews a client's electrolyte laboratory report and notes that the potassium level is 2.5 mEq/L (2.5 mmol/L). Which patterns should the nurse watch for on the electrocardiogram (ECG) as a result of the laboratory value? Select all that apply. 1. U waves 2. Absent P waves 3. inverted T waves 4. Depressed ST segment 5. Widened QRS complex
- 1,3,4
- 1,2,3,4,5
- 3,4,5
- 1,2,4
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17. When assessing a newborn diagnosed with ductus arteriosus, Nurse Olivia should expect that the child most likely would have an:
- Loud, machinery-like murmur
- Bluish color to the lips.
- Decreased BP reading in the upper extremities
- Increased BP reading in the upper extremities.
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18. Back Care is best describe as:
- Caring for the back by means of massage
- Washing of the back
- Application of cold compress at the back
- Application of hot compress at the back
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19. While caring for a patient with an ileostomy, the nurse would expect the ostomy to be located In Which Quadrant of the abdomen?
- Right lower
- Left upper
- Left lower
- Right upper
20. A nurse administers an albuterol nebulizer on a child with asthma exacerbation. Which of following indicates effectiveness of the treatment?
- Adventitious breath sound with cough
- O2 saturation 94%
- Nasal flaring
- Respiration rate 28
21. Which of the following is a primary factor that affects the BP?
- Obesity
- Age
- Stress
- Gender
22. 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. Q. 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
23. The physician has ordered Dextrose 5% in normal saline for an infant admitted with gastroenteritis. The advantage of administering the infants IV through a scalp vein is:
- The infant can be held and comforted more easily.
- Dextrose is best absorbed from the scalp veins.
- Scalp veins do not infiltrate like peripheral veins.
- There are few pain receptors in the infants scalp.
24. Situation: Harriet, a 38 year-old schoolteacher with rheumatoid arthritis, is admitted to the hospital with severe and swelling of the joints of both hands. Q. The medication the nurse would expect to prescribed to relieve Harriet's pain;
- Xanax 0.5 mg, TID
- Aspirin, 0.6g q4
- Codeine, 30 mg, q4
- Meperidine 30 mg q4 pm
25. The client is admitted with a BP of 210/100. Her doctor orders furosemide (Lasix) 40mg IV stat How should the nurse administer the prescribed furosemide to this client?
- By giving it over 1-2 minutes
- By hanging it IV piggyback
- With normal saline only
- With a filter
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26. A patient comes to the medical office with complaints of some urinary incontinence. The nurse discovers the incontinence occurs because of an inability to delay voiding long enough to reach a toilet after the patient feels a sensation of bladder fullness. This type of incontinence is:
- Stress
- Urge
- Overflow
- Functional
27. The nurse is providing instructions to a pregnant client with human immunodeficiency virus (HIV) infection regarding care to the newborn after delivery. The client asks the nurse about the feeding options that are available. Which response should the nurse make to the client?
- "You will need to bottle-feed your newborn.”
- "You will need to feed your newborn by nasogastric tube feeding.”
- "You will be able to breast-feed for 6 months and then will need to switch to bottle feeding."
- "You will be able to breast-feed for 9 months and then will need to switch to bottle feeding."
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28. Cammile with sickle cell anemia has an increased risk for having a sickle cell crisis during pregnancy. Aggressive management of a sickle cell crisis includes which of the following measures?
- Antihypertensive agents
- Diuretic agents
- IV. fluids
- Acetaminophen (Tylenol) for pain
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29. Which of the following suggestions should the nurse offer the parents of a 4-year-old boy who resists going to bed at night?
- "Allow him to fall asleep in your room, then move him to his own bed."
- "Tell him that you will lock him in his room if he gets out of bed one more time"
- "Encourage active play at bedtime to tire him out so he will fall asleep faster"
- "Read him a story and allow him to play quietly in his bed until he falls asleep."
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30. Preparing the client for the termination phase begins:
- pre orientation
- orientation
- working
- termination
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31. The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation?
- Skin turgor
- Level of edema at burn site
- Adequacy of capillary filling
- Amount of fluid tolerated in 24 hours
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32. The cell and Coombs classification system categorizes allergic reactions and is useful in describing and classifying patient reactions to drugs. Type 1 reactions are immediate hypersensitivity reactions and are mediated by:
- immunoglobulin E (IgE).
- immunoglobulin G (IgG).
- immunoglobulin A (IgA).
- immunoglobulin M (IgM).
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33. A resident who has cancer is expected to die within the next couple of days. Nursing care for this resident should focus on
- helping the resident through the stages of grief.
- providing for the resident's comfort.
- keeping the resident's care routine, such as for bathing.
- giving the resident a lot of quiet time and privacy.
34. A client with a fractured hip is being taught correct use of the walker The nurse is aware that the correct use of the walker is achieved if the:
- Palms rest lightly on the handles
- Elbows are flexed 0°
- Client walks to the front of the walker
- Client carries the walker
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35. Hypertonic saline (fleet) enema works by:
- Distending the rectum.
- Irritating the rectum.
- Lubricating and softening stool
- Moistening stool
36. A gravida III para II is admitted to the labor unit. Vaginal exam reveals that the clients cervix is 8cm dilated with complete effacement The priority nursing diagnosis at this time is:
- Alteration in coping related to pain
- Potential for injury related to precipitate delivery
- Alteration in elimination related to anesthesia
- Potential for fluid volume deficit related to NPO status
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37. Type of recording that integrates all data about the problem, gathered by members of the health team.
- POMR
- Traditional
- Resource oriented
- Source oriented
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38. A 54-year-old client calls her health care practitioner complaining of frequency and burning when she urinates. Which of the following factors that occurred within the preceding 3 days likely contributed to this client's problem?
- She had intercourse with her partner.
- She returned from a trip abroad.
- She stopped taking hormone replacement therapy.
- She started a weight-lifting exercise program.
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39. 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. Q. Baby John develops hyperbilirubinemia. What is a method used to treat hyperbilirubinemia in a newborn?
- Keeping infants in a warm arid dark environment
- Administration of a cardiovascular stimulant
- Gentle exercise to stop muscle breakdown
- Early feeding to speed passage of meconium
40. The nurse is teaching the client with AIDS regarding needed changes in food preparation. Which statement indicates that the client understands the nurses teaching?
- Adding fresh ground pepper to my food will improve the flavor.
- Meat should be thoroughly cooked to the proper temperature.
- Eating cheese and yogurt will prevent AIDS-related diarrhea.
- It is important to eat four to five servings of fresh fruits and vegetables a day.
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41. A client is experiencing stomatitis as a result of chemotherapy. An appropriate nursing intervention related to this condition would be to:
- Provide frequent saline mouthwashes
- Use karaya powder to decrease irritation
- Increase fluid intake to compensate for the diarrhea
- Provide meticulous skin care of the abdomen with Betadine
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42. Which of the following is least likely to influence the potential for a client to comply with lithium therapy after discharge?
- The impact of lithium on the client's energy level and lifestyle.
- The need for consistent blood level monitoring.
- The potential side effects of lithium.
- What the clients friends think of his need to take medication
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43. The client is having a cardiac catheterization. During the procedure the client tells the nurse I'm feeling really hot. Which response would be best?
- You are having an allergic reaction. I will get an order for Benadryl.
- That feeling of warmth is normal when the dye is injected.
- That feeling of warmth indicates that the clots in the coronary vessels are dissolving.
- will tell your doctor and let him explain to you the reason for the hot feeling that you are experiencing.
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44. A home health nurse is setting up a medication administration schedule for an elderly patient The patient is talking Oscal (calcium corbonate), Feosol (ferroussulfate), and Orazinc (Zinc sulfate). The patient eat meals at 8:00 AM, 12 noon, and6:00 PM. Which of the following medication administration times would the nurse MOST likely implement for this patient?
- Oscal, Orazinc, and foesal at 8:00AM
- Oscal at 6:00AM, Orzinc at 12:00 noon, Foesal At 4:00PM
- Oscal and Foesal at 12:00 noon and Orazinc at 6:00PM
- Orazinc at 6:00 AM, Oscal at 12:00 noon, and Foesal at 6:00PM
45. The physician has prescribed imipramine (Tofranil) for a client with depression. The nurse should continue to monitor the clients affect because the maximal effects of tricyclic antidepressant medication do not occur for:
- 48-72 hours
- 5-7 days
- 2-4 weeks
- 3-6 months
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46. A client is being treated for cancer with linear acceleration radiation. The physician has marked the radiation site with a blue marking pen. The nurse should:
- Remove the unsightly markings with acetone or alcohol.
- Cover the radiation site with loose gauze dressing.
- Sprinkle baby powder over the radiated area.
- Refrain from using soap or lotion on the marked area.
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47. Nurse Monett is caring for a client recovering from gastrointestinal bleeding. The nurse should:
- Plan care so the client can receive 8 hours of uninterrupted sleep each night.
- Monitor vital signs every 2 hours.
- Make sure that the client takes food and medications at prescribed intervals.
- Provide milk every 2 to 3 hours.
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48. When examining a client with abdominal pain, Nurse Hazel should assess:
- Symptomatic quadrant either second or first
- The symptomatic quadrant last
- The symptomatic quadrant first
- Any quadrant
49. All of the following factors are increase respiratory rate except:
- Decrease temp.
- Stress.
- Exercise.
- Increase altitude.
50. Which of the following would the nurse identify as a presumptive sign of pregnancy?
- Hegar sign
- Nausea and vomiting
- Skin pigmentation changes
- Positive serum pregnancy test
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