NCLEX-RN | QB3 | Practice Exam #52 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. An oxygen delivery system is prescribed for a client with chronic obstructive pulmonary disease to deliver a precise oxygen concentration. Which oxygen delivery system would the nurse prepare for the client?
- Facetent
- Venturi mask
- Aerosol mask
- Tracheostomy collar
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2. A patient who is scheduled for a tonsillectomy is in pre-operative unit. The nurse notes an order for pre-anesthetic medication to be given "on call to operation room". The nurse should give this medication:
- Immediately upon being notified to prepare the patient for transport
- When the operation room staff arrive to transport the patient
- Only if clearly needed after assessment
- Upon the patient's arrival in the operation room
3. All but one of the following is a purpose of steam inhalation:
- Mucolytic
- Warm and humidify air
- Administer medications
- Promote bronchoconstriction
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4. Situation: Annette, 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. Q. Annette explains this because the fundus is:
- At the level the umbilicus, and the fetal heart can be heard with a fetoscope
- 18 cm, and the baby is just about to move
- is just over the symphysis, and fetal heart cannot be heard
- 28 cm, and fetal heart can be heard with a Doppler
5. Type of healing when scars are minimal due to careful surgical incision and good healing
- First intention
- Second intention
- Third intention
- Fourth intention
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6. Situation: Stacy is diagnosed with acute lymphoid leukemia (ALL) and beginning chemotherapy. Q. Stacy is discharged from the hospital following her chemotherapy treatments. Which statement of Stacy's mother indicated that she understands when she will contact the physician?
- "I should contact the physician if Stacy has difficulty in sleeping".
- "I will call my doctor if Stacy has persistent vomiting and diarrhea".
- "My physician should be called if Stacy is irritable and unhappy".
- "Should Stacy have continued hair loss, I need to call the doctor".
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7. A teenager arrives by private car. He is alert and ambulatory, but this shirt and pants are covered with blood. He and his hysterical friends are yelling and trying to explain that that they were goofing around and he got poked in the abdomen with a stick. Which of the following comments should be given first consideration?
- "There was a lot of blood and we used three bandages."
- "He pulled the stick out, just now, because it was hurting him.”
- "The stick was really dirty and covered with mud.”
- "He's a diabetic, so he needs attention right away."
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8. The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions include:
- turning on the lights and opening the windows so that the client doesn't feel crowded.
- leaving the client alone.
- staying with the client and speaking in short sentences.
- turning on stereo music.
9. The nurse assesses a client's surgical incision for signs of infection. Which finding by the nurse would be interpreted as a normal finding at the surgical site?
- Red hard skin
- Serous drainage
- Purulent drainage
- Warm, tender skin
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10. The clinic nurse is performing a psychosocial assessment of a client who has been told that she is pregnant. Which assessment findings indicate to the nurse that the client is at risk for contracting human immunodeficiency virus (HIV)? Select all that apply. 1. The client has a history of intravenous drug use. 2. The client has a significant other who is heterosexual. 3. The client has a history of sexually transmit- ted infections. 4. The client has had one sexual partner for the past 10 years. 5. The client has a previous history of gestational diabetes mellitus.
- 2,5
- 3,4,5
- 1,3
- 1,2
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11. The classic signs and symptoms of rheumatoid arthritis include which of the following?
- Pain on weight-bearing, rash and low-grade fever
- Joint swelling, joint stiffness in the morning and bilateral joint movement
- Crepitus, development of Heberden's nodes and anemia
- Fatigue, leucopenia and joint pain
12. A 3-week-old infant is hospitalized with jaundice. When considering the fluid needs relative to body size of the infant as compared to the fluid needs of an adult The nurse knows this infant requires:
- Less fluids
- More fluids
- Same amount of fluids
- Much less fluid
13. Test sensory function by asking the client to close the eyes and then lightly touching the forehead, cheeks, and chin.
- A weight loss of 2 pounds in 1 day
- A serum creatinine 1.25mg/dL
- Urinary output of 50mL/hr
- Rising blood pressure
14. A client presents at the health care provider's office with complaints of a ring-like rash on his upper leg. Which question should the nurse ask first?
- "Do you have any cats in your home?"
- "Have you been camping in the last month?"
- "Have you or close contacts had any flu-like symptoms within the last few weeks?"
- "Have you been in physical contact with anyone who has the same type of rash?"
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15. Which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all that apply. 1. Monitor vital signs. 2. Provide a safe environment. 3. Address hallucinations therapeutically. 4. Provide stimulation in the environment. 5. Provide reality orientation as appropriate. 6. Maintain NPO (nothing by mouth) status.
- 1,2,3,5
- 1,2,3,4
- 2,3,4,5
- 3,4,5
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16. Which statement by the client with chronic obstructive lung disease indicates an understanding of the major reason for the use of occasional pursed-lip breathing?
- "This action of my lips helps to keep my airway open."
- "I can expel more when I pucker up my lips to breathe out"
- "My mouth doesn't get as dry when I breathe with pursed lips."
- "By prolonging breathing out with pursed lips the little areas in my lungs don't collapse."
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17. Situation: You are a nurse working in the medical ward. Q. Mr. E.O. age 52 had a laryngectomy due to cancer of the larynx. Discharge instructions are given to Mr.F.O. and his family. Which response by written communication from Mr. F.O. or verbal response from the family, will be a signal to the nurse that the instructions need to be clarified?
- it is acceptable to take over-the-counter medications now that condition is stable
- the suctioning at home must be a clean procedure, not sterile.
- report swelling, pain or excessive drainage
- cleans skin around stoma BID, use hydrogen peroxide and rinse with water, pat dry.
18. The nurse is testing the extraocular movements in a client to assess for muscle weakness in the eyes. The nurse should implement which assessment technique to assess for muscle weakness in the eye?
- Test the corneal reflexes.
- Test the 6 cardinal positions of gaze.
- Test visual acuity, using a Snellen eye chart.
- Test sensory function by asking the client to close the eyes and then lightly touching the forehead, cheeks, and chin.
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19. Which of the following is evidence that the controlling process is effective?
- The things that were planned are done
- Physicians do not complain.
- Employees are contended
- There is an increase in customer satisfaction rate.
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20. The nurse has just received the change of shift report The nurse should give priority to assessing the client with:
- A thoracotomy with 110mL of drainage in the past hour
- A cholecystectomy with an oral temperature of 100°F
- A transurethral prostatectomy who complains of urgency to void
- A stapedectomy who reports diminished hearing in the past hour
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21. The client taking Glyburide (Diabeta) should be cautioned to:
- Avoid eating sweets.
- Report changes in urinary pattern.
- Allow three hours for onset.
- Check the glucose daily.
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22. Kenneth who has diagnosed with uremic syndrome has the potential to develop complications. Which among the following complications should the nurse anticipates:
- Flapping hand tremors
- An elevated hematocrit level
- Hypotension
- Hypokalemia
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23. To assess the kidney function of a patient with an indwelling urinary Joley) catheter, the nurse measures his hourly urine output. She should notify the physician if the urine output is:
- Less than 30 ml/hour
- 64 ml in 2 hours
- 90 ml in 3 hours
- 125 ml in 4 hours
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24. Allopurinol is prescribed for a client and the nurse provides medication instructions to the client Which instruction should the nurse provide?
- Drink 3000mL of fluid a day.
- Take the medication on an empty stomach.
- The effect of the medication will occur immediately.
- Any swelling of the lips is a normal expected response.
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25. Reprimanding a staff nurse for work that is done incorrectly is an example of what type of reinforcement?
- Feedback
- Positive reinforcement
- Performance appraisal
- Negative reinforcement
26. To promote comfort during labor, the nurse John advises a client to assume certain positions and avoid others. Which position may cause maternal hypotension and fetal hypoxia?
- Lateral position
- Squatting position
- Supine position
- Standing position
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27. The physician orders laboratory tests to confirm hyperthyroidism in a female client with classic signs and symptoms of this disorder. Which test result would confirm the diagnosis?
- No increase in the thyroid-stimulating hormone (TSH) level after 30 minutes during the TSH stimulation test
- A decreased TSH level
- An increase in the TSH level after 30 minutes during the TSH stimulation test
- Below-normal levels of serum triiodothyronine (T3) and serum thyroxine (T4) as detected by radioimmunoassay
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28. Situation: Because of the serious consequences of severe burns management requires a multidisciplinary approach. You have important responsibilities as a nurse. Q. Sergio is brought to the Emergency Room after the barbecue grill accident. Based on the assessment of the physician, Sergio sustained superficial partial thickness bums on his trunk, right upper extremities and right lower extremities. His wife asks what that means. Your most accurate response would be:
- Structures beneath the skin are damaged
- Dermis is partially damaged
- Epidermis and dermis are both damaged
- Epidermis is damaged
29. Nurse Nina is assigned to care for a client diagnosed with Catatonic Stupor. When Nurse Nina enters the client's room, the client is found lying on the bed with a body pulled into a fetal position. Nurse Nina should?
- Ask the client direct questions to encourage talking
- Rake the client into the dayroom to be with other clients
- Sit beside the client in silence and occasionally ask open-ended question
- Leave the client alone and continue with providing care to the other clients
30. A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
- 1 week
- 2 weeks
- 4 weeks
- 6 weeks
31. Thirty minutes after the nurse removes a nasogastric tube that has been In place for seven days, the patient experiences epistaxis (nosebleed). Which of the following nursing actions is most appropriate to control the bleeding?
- Apply pressure by pinching the anterior portion of the for five to ten minutes
- Place the patient in a sitting position with the neck hyperextended
- Pack the nostrils with gauze and keep the gauze in place for four to five days
- Apply ice compresses to the patient's forehead and back of the neck
32. 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. Q. If you were Minette, which of the following actions, would alert you that a new mother is entering a postpartum at taking-hold phase?
- She urges the baby to stay awake so that she can breastfeed him in her
- She tells you she was in a lot of pain all during labor
- She says that she has not selected a name for the baby as yet
- She sleeps as if exhausted from the effort of labor
33. Mr. Duffy is admitted to the CCU with a diagnosis of R/O MI. 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. Numerous drugs have been used on Mr. Kaplan in an attempt to stabilize him. Regarding his diagnosis and management of his drugs, you know that:
- The half-life of many drugs is decreased in uremia; thus dosage may have to be increased to be effective.
- Drug toxicity is a major concern in uremia; individualization of therapy and often a decrease in dose is essential.
- Drug therapy is not usually affected by this diagnosis
- Precautions should be taken with prescription drugs, but most OTC medications are safe for him to use.
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34. The nurse is in public area of the health care facility when an adult falls to the floor. Which of the following actions should the nurse take NEXT?
- Open the airway
- Determine unresponsiveness
- Activate the emergency call system
- Obtain the automatic electronic defibrillator(AED)
35. He asserts the importance of promoting a positive organizational culture in their unit Which of the following behaviors indicate that this is attained by the group?
- Proactive and caring with one another
- Competitive and perfectionist
- Powerful and oppositional
- Obedient and uncomplaining
36. The mother of a six-month-old asks when her child will have all his baby teeth. The nurse knows that most children have all their primary teeth by age:
- 12 months
- 18 months
- 24 months
- 30 months
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37. Situation: At the medical-surgical ward, the nurse must also be concerned about drug interactions. Q. One patient has a 'runaway' IV of 50% dextrose. To prevent temporary excess of insulin transient hyperinsulin reaction, what solution should you prepare in anticipation of the doctors order?
- Any IV solution available to KVO
- Isotonic solution
- Hypertonic solution
- Hypotonic solution
38. A client has been taking benzonatate (Tessalon) as ordered. The nurse tells the client that this medication should do which of the following?
- take away nausea and vomiting
- calm the persistent cough
- decrease anxiety level
- increase comfort level
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39. The following are basic steps in the controlling process of the department. Which of the following is NOT included?
- Measure actual performance
- Set nursing standards and criteria
- Compare results of performance to standards and objectives
- Identify possible courses of action
40. Which finding is the best indication that a client with ineffective airway clearance needs suctioning?
- Oxygen saturation
- Respiratory rate
- Breath sounds
- Arterial blood gases
41. The doctor has prescribed aspirin 325mg daily for a client with transient ischemic attacks. The nurse explains that aspirin was prescribed to:
- Prevent headaches
- Boost coagulation
- Prevent cerebral anoxia
- Decrease platelet aggregation
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42. The nurse is caring for client with a new donor site that was harvested to treat a new burn. The nurse position the client to:
- allow ventilation of the site
- make the site dependent
- avoid pressure on the site
- keep the site fully covered
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43. A client was transferred to the hospital unit as a direct admit from a small community hospital. While the nurse is obtaining part of the admission history information the client suddenly becomes semiconscious. Assessment reveals a systolic BP of 70 heart rate of 130 and respiratory rate of 24. What is the nurse initial action?
- Lower the head of the clients bed.
- Initiate an IV with a large bore needle.
- Notify the physician of the assessment results.
- Call for the cardiopulmonary resuscitation team.
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44. An infant weighs seven pounds at birth. The expected weight by one year should be:
- 10 pounds
- 12 pounds
- 18 pounds
- 21 pounds
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45. The initial response of tissue after injury is:
- Immediate Vasodilation
- Transient Vasoconstriction
- Immediate Vasoconstriction
- Transient Vasodilation
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46. A patient with a weight loss of 12 in 60 days has a nursing care plan written interventions including offering a dietary supplement three times per day. After 2 weeks, the patient has had another 1% weight loss. The patient indicates no likely the supplements. The nurse should:
- Continue the plan of care as written
- Replace the supplement with a high calorie food that the patient likes
- Encourage the patient drink supplements
- Offer smaller amounts of supplement more frequently
47. A health care provider's prescription reads potassium chloride 30 mEq to be added to 1000 mL normal saline (NS) and to be administered over a 10-hour period. The label on the medication bottle reads 40 mEq/20 mL. The nurse prepares how many milliliters of potassium chloride to administer the correct dose of medication?
- 20 mL.
- 25 mL.
- 15 mL.
- 10 mL.
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48. A female client was recently admitted. She has fever, weight loss, and watery diarrhea is being admitted to the facility. While assessing the client, Nurse Hazel inspects the client's abdomen and notice that it is slightly concave. Additional assessment should proceed in which order:
- Palpation, auscultation, and percussion.
- Percussion, palpation, and auscultation.
- Palpation, percussion, and auscultation.
- Auscultation, percussion, and palpation.
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49. Situation: You are a nurse working in the medical ward. Q. Dr Kelso scheduled Mrs. Ellie for a right breast mass incision with frozen section and possible mastectomy on Monday, first case. As the nurse in-charge for scheduling you will collaborate with the following departments EXCEPT:
- pathology
- dietary
- anesthesia
- surgery
50. A child was admitted to the hospital three hours ago with a closed head injury. The child responds appropriately but sluggishly to stimuli, and drift in and out of sleep. Which of the following best describes this patients level of consciousness?
- Lethargic
- Obtunded
- Semi comatose
- Comatose