NCLEX-RN | QB3 | Practice Exam #51 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. Which of the following complications is indicated by a third heart sound (S3)?
- Ventricular dilation
- Systemic hypertension
- Aortic valve malfunction
- Increased atrial contractions
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2. A client suspected of having tetanus asks the nurse about immunizations against tetanus. The nurse explains that the major benefit in using tetanus antitoxin is that it:
- Stimulates plasma cells directly
- Provides a high titer of antibodies
- Provide immediate active immunity
- Stimulates long-lasting passive immunity
3. A patient has returned to the medical-surgical unit after surgery for a benign ovarian tumor The nurse observes that in the first 30 minutes after admission to the unit, the patient's abdomen is rapidly distending and the patient complains of increasing pain. The nurse would anticipate.
- Aspiration pneumonia
- Surgical site infection
- Retention of surgical supplies
- Intra-abdominal hemorrhage
4. 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 diet the nurse would expect the physician to order for Harriet would be:
- Salt free and low fiber
- High calorie with low cholesterol
- High protein with minimal calcium
- Regular diet with vitamins and minerals
5. A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and is complaining of anorexia. The health care provider prescribes a serum digoxin level to be done. The nurse checks the results and should expect to note which level that is outside of the therapeutic range?
- 0.3 ng/mL
- 0.5 ng/mL
- 0.8 ng/mL
- 1.0 ng/mL
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6. The nurse observes the female client in the psychiatric ward that she is having a hard time sleeping at night. The nurse asks the client about it and the client says, "I can't sleep at night because of fear of dying." What is the best initial nursing response?
- "It must be frightening for you to feel that way. Tell me more about it."
- "Don't worry, you won't die. You are just here for some test.”
- "Why are you afraid of dying?"
- "Try to sleep. You need the rest before tomorrow's test"
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7. Knowledge about the disease and prior contact with it is what type of VARIABLE according to the health belief model?
- Demographic
- Sociopsychologic
- Structural
- Cues to action
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8. After a lateral crushing chest injury, obvious right-sided paradoxic motion of the client's chest demonstrates multiple rib fraactures, resulting in a flail chest The complication the nurse should carefully observe for would be:
- Mediastinal shift
- Tracheal laceration
- Open pneumothorax
- Pericardial tamponade
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9. A patient is admitted to the emergency department with stable angina. The physician writes an order for nitroglycerin 1/150 grains sub lingually (SL). Which is the correct dose in milligrams (mg)?
- 0.04 mg
- 0.4 mg
- 4 mg
- 40 mg
10. While providing home care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. The BEST response to this client should be:
- "As you urinate more, you will need less medication to control fluid."
- "You will have to take this medication for about a year."
- "Please talk to your physician about medications and treatments"
- "The medication must be continued so the fluid problem is controlled."
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11. You performed the Leopold's maneuver and found the following: breech presentation, fetal back at the right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) BEST in which location?
- Left lower quadrant
- Right lower quadrant
- Left upper quadrant
- Right upper quadrant
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12. The nursing intervention to relieve pain in breast engorgement while the mother continues to breastfeed is
- Apply cold compress on the engorged breast
- Apply warm compress on the engorged breast
- Massage the breast
- Apply analgesic ointment
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13. In reviewing the burned client's laboratory report of white blood cell count with differential, all the following results are listed. Which laboratory finding indicates the possibility of sepsis?
- The total white blood cell count is 9000/mm3.
- The lymphocytes outnumber the basophils.
- The "bands" outnumber the "segs"
- The monocyte count is 1,800/mm3.
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14. Situation: Please continue responding as a professional nurse in varied health situations through the following questions. Which of the following medications would the nurse expect the physician to order for recurrent convulsive seizures of a 10-year old child brought to your clinic?
- Phenobarbital
- Nifedipine
- Butorphanol
- Diazepam
15. Which of the following clients should be classified as a case of mutibacillary leprosy?
- 3 skin lesions, negative slit skin smear
- 3 skin lesions, positive slit skin smear
- 5 skin lesions, negative slit skin smear
- 5 skin lesions, positive slit skin smear
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16. A parent brings their teenage child the pediatrician's office. The parent reports that the patient frequently complains of abdominal bloating and stomach pain after eating and also has a chronic sore throat The patient's labs show hypokalemia.Which of the following diagnosis should the nurse anticipate?
- Anorexia nervosa
- Bulimia
- Morbid obesity
- Impulsive behavior
17. A patient receives intravenous therapy of 1000 cc normal saline with 20mEq potassium chloride at a rate of 75cc per hour. Upon evaluation of the site, there is no edema, the vein appears slightly red, and the patient complains of pain. What should the nurse do?
- Slow the rate to prevent burning from the solution and continue to monitor
- Discontinue the intravenous line and restart in another site
- Monitor at least every half-hour for edema but continues the order state
- Notify the doctor that the patient is having an adverse reaction to the medication
18. A nurse caring for a patient following cardiac catheterization evaluates the patient post procedure, Which of the following signs and/or syptoms would MOST likely indicate the patient is having a vagal reaction?
- Diaphoresis
- Chest pain
- Tingling in extremities
- Hematoma formation
19. Jannah is admitted to the labor and delivery unit. The critical laboratory result for this client would be:
- Oxygen saturation
- Iron binding capacity
- Blood typing
- Serum Calcium
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20. Mario is admitted to the emergency room with drug-included anxiety related to over ingestion of prescribed antipsychotic medication. The most important piece of information the nurse in charge should obtain initially is the:
- Length of time on the med.
- Name of the ingested medication & the amount ingested
- Reason for the suicide attempt
- Name of the nearest relative & their phone number
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21. A client is admitted to a hospital with a diagnosis of diabetic ketoacidosis (DKA). The initial blood glucose level is 950 mg/dL (54.2 mmol/L). A continuous intravenous (IV) infusion of short-acting insulin is initiated, along with IV rehydration with normal saline. The serum glucose level is now decreased to 240 mg/dL (13.7 mmol/L). The nurse would next prepare to administer which medication?
- An ampule of 50% dextrose
- NPH insulin subcutaneously
- IV fluids containing dextrose
- Phenytoin for the prevention of seizures
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22. Which psychosocial influence has been causally related to the development of aggressive behavior and conduct disorder?
- An overbearing mother
- Rejection by peers
- A history of schizophrenia in the family
- Low socioeconomic status
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23. Budgeting is under in which part of management process?
- Directing
- Controlling
- Organizing
- Planning
24. A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action?
- Take an extra dose if fever develops
- Take the medication with meals only
- Take the tablet with a full glass of water
- Decrease the amount of daily fluid intake
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25. A pregnant client reports to a health care clinic, complaining of loss of appetite, weight loss, and fatigue. After assessment of the client, tuberculosis is suspected. A sputum culture is obtained and identifies Mycobacterium tuberculosis. Which instruction should the nurse include in the client's teaching plan?
- Therapeutic abortion is required.
- Isoniazid plus rifampin will be required for 9 months.
- She will have to stay at home until treatment is completed.
- Medication will not be started until after delivery of the fetus.
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26. Nurse Sugar is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?
- Pitting edema of the legs
- An irregular apical pulse
- Dry mucous membranes
- Frequent urination
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27. Situation: Burn is cause by transfer of heat source to the body. It can be thermal, electrical radiation or chemical. Q. While in the emergent phase, the nurse knows that the priority is to:
- Prevent infection
- Control pain
- Prevent deformities and contractures
- Return the hemodynamic stability via fluid resuscitation
28. Betaxolol hydrochloride eye drops have been prescribed for a client with glaucoma. Which nursing action is most appropriate related to monitoring for side and adverse effects of this medication?
- Assessing for edema
- Monitoring temperature
- Monitoring blood pressure
- Assessing blood glucose level
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29. Situation: You are assigned to take care of a group of patients across the lifespan. According to De Rosa and Kochura's (2006) article entitled "Implement Culturally Health Care in your workplace," cultures have different patterns of verbal and nonverbal communication. Which difference does NOT necessarily belong?
- Personal behaviour
- Eye contact
- Subject Matter
- Conversational style
30. Nurse Anna can minimize agitation in a disturbed client by?
- Increasing stimulation
- limiting unnecessary interactionin
- increasing appropriate sensory perception
- ensuring constant client and staff contact
31. Which snack selection by a client with osteoporosis indicates that the client understands the dietary management of the disease?
- A granola bar
- A bran muffin
- Yogurt
- Raisins
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32. During a farming accident Mr. Steve Rumsey's arm gets caught in a corn auger. His lower left arm and band are crushed. Which of the following assessments would the nurse typically find when the paramedics bring Mr. Rumsey to the hospital in shock? The client would have:
- Decreased heart rate
- Decreasing blood pressure
- Increasing bowel sounds
- Increasing urine output
33. A patient is transferred to the Intensive Care Unit following a craniotomy. The patient is difficult to arouse and the pupils are pinpoint and non-reactive. Blood pressure: 118/70 mmHg Heart rate: 58/min Respiratory rate: 11/mm Temperature: 37.2C. Which medication should the nurse prepare to administer?
- Adrenaline
- Thiamine
- Naloxone
- Dextrose 50%
34. To promote and maintain safety for a client after a stapedectomy. What would be included in the nursing care plan?
- Implement fall precautions
- Prevent aspirations
- Begin oxygen 2-4L/min via nasal cannula
- Change inner ear dressing when saturated
35. Kevin is a member of the Nursing Research Council of the hospital. His first assignment is to determine the level of patient satisfaction on the care they received from the hospital. He plans to include all adult patients admitted from April to May, with average length of stay of 3-4 days, first admission, and with no complications. Which of the following is an extraneous variable of the study?
- Date of admission
- Length of stay
- Age of patients
- Absence of complications
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36. A nurse is caring for a patient who had a pneumonectomy 2 days ago for lung cancer. Which observation wouid indicate that the patient is progressing towards discharge goal?
- Cough productive of serosanguineous fluid
- 1+ pretibial edema
- Nap after completing bed bath
- Frequent premature ventricular contractions (PVC)
37. A man has been experiencing night-blindness. What vitamin could he be deficient in?
- Vitamin A
- Vitamin B
- Vitamin C
- Vitamin D
38. The nurse is assigned to care for a client with urinary calculi. Fluid intake of 2L/day is encouraged to the client, the primary reason for this is to:
- Reduce the size of existing stones.
- Prevent crystalline irritation to the ureter.
- Reduce the size of existing stones
- Increase the hydrostatic pressure in the urinary tract.
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39. The nurse is performing an assessment on a client who is at 38 weeks1 gestation and notes that the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding, what is the priority nursing action?
- Document the finding.
- Check the mother's heart rate.
- Notify the health care provider (HCP).
- Tell the client that the fetal heart rate is normal.
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40. An elderly client with glaucoma has been prescribed Timoptic eyedrops. Timoptic should be used with caution in clients with a history of:
- Diabetes
- Gastric ulcers
- Emphysema
- Pancreatitis
41. The nurse is teaching the client who is to have a gallium scan about the procedure. The nurse includes which of the following items as part of the instructions?
- The gallium will be injected intravenously 2 to 3 hours before the procedure
- The procedure takes about 15 minutes to perform
- The client must stand erect during the filming
- The client should remain on bed rest for the remainder of the day after the scan
42. Mr. Ramsey, who has not regained consciousness, rushed to surgery where his arm is amputated above the elbow. When Mr. Ramsey reacts from the anesthesia, he sees that his forearm is missing. He screams obscenities and sobs uncontrollably. Which of the following is the best action the nurse can take at this time?
- Leave the room until he has worked through his anger
- Stay with him quietly in the room at his bedside
- Tell him to get control of himself
- Call the hospital chaplain for him
43. The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement which priority interventions? Select all that apply. 1. Administering oxygen 2. Inserting a Foley catheter 3. Administering furosemide 4. Administering morphine sulfate intravenously 5. Transporting the client to the coronary care unit 6. Placing the client in a low Fowler's side-lying position
- 1,2,3,4
- 2,3,4,5
- 2,3,5
- 1,2,4
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44. The nurse notes documentation that a client is exhibiting Cheyne-Stokes respirations. On assessment of the client, the nurse should expect to note which finding?
- Rhythmic respirations with periods of apnea
- Regular rapid and deep, sustained respirations
- Totally irregular respiration in rhythm and depth
- Irregular respirations with pauses at the end of inspiration and expiration
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45. The nurse is preparing a continuous intravenous (IV) infusion at the medication cart As the nurse goes to insert the spike end of the IV tubing into the IVbag, the tubing drops and the spike end hits the top of the medication cart. The nurse should take which action?
- Obtain a new IV bag.
- Obtain new IV tubing.
- Wipe the spike end of the tubing with povidone iodine.
- Scrub the spike end of the tubing with an alcohol swab.
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46. A patient is experiencing intermittent claudication in the legs while at rest. Which of the following should the nurse take ?
- Vigorously massage the extremity
- Place ice on the ankles every 20 mnts
- Elevate the legs to heart level
- Position the legs in dependent position
47. Also known as HEALTH MAINTENANCE prevention.
- Primary
- Secondary
- Tertiary
- None of the above
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48. Situation: Mr. Roberto's condition continues to worsen and the doctor suggested Kidney Transplantation. Q. Mr. Roberto has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following condition is a major complication of this drug therapy?
- Depression
- Hemorrhage
- Infection
- Peptic ulcer disease
49. Ms. Angela Freeman has acute low back pain. She has pelvic-belt traction, which she uses intermittently throughout the day. When the nurse helps Ms. Freeman apply the pelvic traction, it would be best to place the top of the belt:
- Just below the ribcage
- Even with her waistline
- Level with the iliac crest
- Where it is most comfortable
50. In collecting a urine from a catheterized patient, Which of the following statement indicates an accurate performance of the procedure?
- Clamp above the port for 30 to 60 minutes before drawing the urine from the port
- Clamp below the port for 30 to 60 minutes before drawing the urine from the port
- Clamp above the port for 5 to 10 minutes before drawing the urine from the port
- Clamp below the port for 5to 10 minutes before drawing the urine from the port