NCLEX-RN | QB3 | Practice Exam #50 (50 questions)
All 50 questions are randomized each time you take the test, and do not appear in the same order.
1. A four year-old girl was playing outside in a park when she came running to her mother crying and holding her right, upper arm, with pain and itching at the site as well as swelling of the oral mucosa. The child seems anxious What is the next most appropriate step in management?
- Administer subcutaneous epinephrine
- Maintain a patent airway
- Administer oral diphenhydramine
- Prepare intubation equipment
2. A 36-year-old man with lymphoma presents with signs of impending septic shock 9 days after chemotherapy. The nurse could expect which of the following to be present?
- Flushing, decreased oxygen saturation, mild hypotension
- Low-grade fever, chills, tachycardia
- Elevated temperature, oliguria, hypotension
- High-grade fever, normal blood pressure, increased respirations
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3. Otorrhea and rhinorrhea are most commonly seen with which type of skull fracture?
- basilar
- temporal
- occipital
- parietal
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4. A client with glomerulonephritis is placed on a low-sodium diet. Which of the following snacks is suitable for the client with sodium restriction?
- Peanut butter cookies
- Grilled cheese sandwich
- Cottage cheese and fruit
- Fresh peach
5. The expected weight gain in a normal pregnancy during the 3rd trimester is
- 1 pound a week
- 2 pounds a week
- 10 lbs a month
- 10 lbs total weight gain in the 3rd trimester
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6. Situation: The patient who is depressed will undergo electroconvulsive therapy. Q. After ECT, the nurse should do this action before giving the client fluids, food or medication:
- assess the gag reflex
- assess the sensorium
- next of kin or guardian
- check O2 Sat with a pulse oximeter
7. Before an amniocentesis, nurse Alexandra should:
- Initiate the intravenous therapy as ordered by the physiscian
- Inform the client that the procedure could precipitate an infection
- Assure that informed consent has been obtained from the client
- Perform a vaginal examination on the client to assess cervical dilation
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8. Which of the following is NOT TRUE about profession according to Marie Jahoda?
- A profession is an organization of an occupational group based on the application of special knowledge
- It serves specific interest of a group
- It is altruistic
- Quality of work is of greater importance than the rewards
9. A client requiring surgery is anxious about the possible need for a blood transfusion during or after the procedure. The nurse suggests to the client to take which actions to reduce the risk of possible transfusion complications? Select all that apply. 1. Ask a family member to donate blood ahead of time. 2. Give an autologous blood donation before the surgery. 3. Take iron supplements before surgery to boost hemoglobin levels. 4. Request that any donated blood be screened twice by the blood bank. 5. Take adequate amounts of vitamin C several days prior to the surgery date.
- 1,2,3
- 2,4,5
- 1,2
- 3,4,5
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10. What is the purpose of "tunneling" (inserting the catheter 2-4 inches under the skin) when the surgeon inserts a Hickman central catheter device?
- Increases the patient's comfort level.
- Decreases the risk of infection.
- Prevents the patient's clothes from having contact with the catheter
- Makes the catheter less visible to other people.
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11. A nurse visits the home of a patient who is 1 week post-left-breast mastectomy. Which of the following should be including in patient education?
- It is OK to use a straight edge razor when shaving
- Blood pressure checks should be done in the left arm
- Cuticle should not be cut
- Avoid insect repellent on the left arm
12. The nurse is monitoring a patient recovering parenteral nutrition via a central line catheter for the 24 hours. The patient has polyuria and complaint thirst and headache. Blood pressure: 120/76 mmHg. Heart rate: 88/min. Respiratory rate: 16/mm. Temperature: 37.1°C. Oxygen Saturation: 99% an room air. What will the nurse most likely administers?
- Insulin
- Dextrose 5% in water
- Normal saline
- Calcium gluconate
13. Which of the following would be an appropriate nursing diagnosis for a hospitalized client with bacterial pneumonia and shortness of breath?
- Ineffective cardiopulmonary tissue perfusion related to myocardial damage
- Risk for self-care deficit related to fatigue
- Deficient fluid volume related to nausea and vomiting
- Disturbed thought processes related to inadequate relief of chest pain
14. A client is admitted for detoxification after a cocaine overdose. The client tells the nurse that he frequently uses cocaine but that he can control his use if he chooses. Which coping mechanism is he using?
- Withdrawal
- Logical thinking
- Repression
- Denial
15. An additional Vitamin C is required during all of the following periods except:
- Infancy
- Young adulthood
- Childhood
- Pregnancy
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16. Nurse Linda prepares to perform an otoscopic examination on a female client. For proper visualization, the nurse should position the client's ear by:
- Pulling the lobule down and back
- Pulling the helix up and forward
- Pulling the helix up and back
- Pulling the lobule down and forward
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17. The nurse is teaching a client with emphysema about positions that help breathing during dyspneic episodes. The nurse instructs the client that which positions alleviate dyspnea? Select all that apply. 1. Sitting up and leaning on a table 2. Standing and leaning against a wall 3. Lying supine with the feet elevated 4. Sitting up with the elbows resting on knees 5. Lying on the back in a low Fowler's position
- 1,2,3,4
- 1,3,5
- 2,3,5
- 1,2,4
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18. Regardless of the size of a work group, enough staff must be available at all times to accomplish certain purposes. Which of these purposes is NOT included?
- Meet the needs of patients
- Provide a pair of hands to other units as needed
- Cover all time periods adequately.
- Allow for growth and development of nursing staff.
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19. Which of the following is TRUE with regards to learning?
- Start from complex to simple
- Goals should be hard to achieve so patient can strive to attain unrealistic goals
- Visual learning is the best for every individual
- Do not teach a client when he is in pain
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20. The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development. Which characteristic is associated with babies born to mothers who smoked during pregnancy?
- Low birth weight
- Large for gestational age
- Preterm birth but appropriate size for gestation
- Growth retardation in weight and length
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21. A patient with heart failure has the following vital signs: blood pressure level, 136/84 mmHg, heart rate 48, temperature 37.1 C 98.8 F); and respiration rate 20 per minute. Which of these vital signs should be reported to the physician prior to administering the next dose of digoxin?
- Blood pressure
- Pulse
- Temperature
- Respiration rate
22. A client with Crohn's disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness of treatment?
- Monitoring the leukocyte count for 2 days after the infusion
- Checking the frequency and consistency of bowel movements
- Checking serum liver enzyme levels before and after the infusion
- Carrying out a Hematest on gastric fluids after the infusion is completed
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23. To instill drops in the adult patient, the ear canal is opened by pulling the ear
- up and back
- down and back
- up and forward
- back and forward
24. What is the most common complication of a myocardial infarction?
- Cardiogenic shock
- Arrhythmias
- Heart failure
- Pericarditis
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25. After delivery of a baby girl. Nurse Gina examines the umbilical cord and expects to find a cord to:
- Two arteries and two veins
- One artery and one vein
- Two arteries and one vein
- One artery and two veins
26. A 37-year-old male client was admitted to the coronary care unit (CCU) 2 days ago with an acute myocardial infarction. Which of the following actions would breach the client confidentiality?
- The CCU nurse gives a verbal report to the nurse on the telemetry unit before transferring the client to that unit
- The CCU nurse notifies the on-call physician about a change in the client's condition
- The emergency department nurse calls up the latest electrocardiogram results to check the client's progress.
- At the client's request, the CCU nurse updates the client's wife on his condition
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27. Septal involvement occurs in which type of cardiomyopathy?
- Congestive
- Dilated
- Hypertrophic
- Restrictive
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28. A client is being discharged after lithotripsy for removal of a kidney stone. Which statement by the client indicates understanding of the nurses instructions?
- I will need to strain my urine starting in the morning.
- I will need to save all my urine.
- I will be careful to strain alI the urine and save the stone.
- I wont need to strain my urine now that the procedure is complete.
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29. While visiting a patient with a new colostomy, the home care nurse observes that the skin around the stoma site is red. Which intervention should the nurse do next?
- Apply pectin, gelatin or synthetic skin barrier around the stoma
- Apply triple antibiotic to the raw skin and leave it open to the air
- Instruct to empty the pouch as soon as stool is present
- Instruct to remove the bag and skin barrier after each stool
30. A nurse is eating in the hospital cafeteria when a toddler at a nearby table chokes on a piece of food and appears slightly blue. The appropriate initial action should be to:
- Begin mouth to mouth resuscitation
- Give the child water to help in swallowing
- Perform 5 abdominal thrusts
- Call for the emergency response team
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31. A 27 y.o adult is admitted for treatment of Crohn's disease. Which information is most significant when the nurse assesses nutritional health?
- Anthropometric measurements
- bleeding gums
- dry skin
- facial rubor
32. Stephanie considers shifting to transformational leadership. Which of the following statements best describes this type of leadership?
- Maintains full trust and confidence in the subordinates
- Uses visioning as the essence of leadership.
- Serves the followers rather than being served.
- Transformational leadership relies heavily on visioning as the core of leadership.
33. A client hospitalized with renal calculi complains of severe pain in the right flank. In addition to complaints of pain the nurse can expect to see changes in the client's vital signs that include:
- Decreased pulse rate
- Increased blood pressure
- Decreased respiratory rate
- Increased temperature
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34. Mary is screened for tuberculosis during her first prenatal visit. An intradermal injection of purified protein derivative (PPD) of the tuberculin bacilli is given. She is considered to have a positive test for which of the following results?
- An indurated wheal under 10 mm in diameter appears in 6 to 12 hours.
- An indurated wheal over 10 mm in diameter appears in 48 to 72 hours.
- A flat circumcised area under 10 mm in diameter appears in 6 to 12 hours.
- A flat circumcised area over 10 mm in diameter appears in 48 to 72 hours.
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35. When the occupational health nurse employs ergonomic principles, she is performing which of her roles?
- Health care provider
- Health educator
- Health care coordinator
- Environment manager
36. A client with severe anemia is to receive a unit of packed red blood cells. In the event of a transfusion reaction the first action by the nurse should be to:
- Notify the physician and the nursing supervisor.
- Stop the transfusion and maintain an IV of normal saline.
- Call the lab for verification of type and cross match.
- Prepare an injection of Benadryl (diphenhydramine).
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37. Which of the following medications usually is given to a client with leukemia as prophylaxis against P. carinii pneumonia?
- Bactrim
- Oral nystatin suspension
- Prednisone
- Vincristine (Oncovin)
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38. Arubella titer result of a 1-day postpartum client is less than 1:8, and a rubella virus vaccine is prescribed to be administered before discharge. The nurse provides which information to the client about the vaccine? Select all that apply. 1.Breast-feeding needs to be stopped for 3 months. 2.Pregnancy needs to be avoided for 1 to 3 months. 3.The vaccine is administered by the subcuta- neous route. 4.Exposure to immunosuppressed individuals needs to be avoided. 5.A hypersensitivity reaction can occur if the client has an allergy to eggs. 6.The area of the injection needs to be covered with a sterile gauze for 1 week.
- 2,3,4,5
- 1,2,3,4
- 3,4,5
- 2,3,5
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39. Which of the following is not true about the Large Intestine?
- It absorbs around 1L of water making the feces around 75% water and 25% solid
- The stool formed in the transverse colon is not yet well formed
- It is a sterile body cavity
- It is called large intestine because it is longer than the small intestine
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40. Nurse Katrina would recognize that the demonstration of crutch walking with tripod gait was understood when the client places weight on the:
- Palms of the hands and axillary regions
- Palms of the hand
- Axillary regions
- Feet, which are set apart
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41. A client is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor?
- Bedrest
- Ibuprofen
- Bending or lifting
- Application of heat
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42. The nurse checks for residual before administering a bolus tube feeding to a client with a nasogastric tube and obtains a residual amount of 150 mL. What is the most appropriate action for the nurse to take?
- Hold the feeding and reinstill the residual amount.
- Reinstill the amount and continue with administering the feeding.
- Elevate the clients head at least 45 degrees and administer the feeding.
- Discard the residual amount and proceed with administering the feeding.
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43. A client complains of sharp stabbing pain in the right lower quadrant that is graded as level 8 on a scale of 10. The nurse knows that pain of this severity can best be managed using:
- Aleve (naproxen sodium)
- Tylenol with codeine (acetaminophen with codeine)
- Toradol (ketorolac)
- Morphine sulfate (morphine sulfate)
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44. A nurse is caring for a post operative patient who is on subcutaneous, low dose of heparin. When administering injection on the abdomen, the nurse avoids the umbilicus area because of the possibility of:
- Entering a larger body vessel
- Causing increased pain
- Precipitating hyperventilation
- umbilical infection
45. Which of the following blood tests should be performed before a blood transfusion?
- Prothrombin and coagulation time
- Blood typing and cross-matching
- Bleeding and clotting time
- Complete blood count (CBC) and electrolyte levels.
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46. The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin?
- Prothrombin time
- Clot retraction time
- Partial thromboplastin time
- Bleeding time
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47. The nurse is caring for a patient with chest tubes connected to close suction. The nurse should make sure that which of the following remains readily available at the patients bed side?
- A sterile towel
- Petroleum gauze
- Normal saline solution
- Sterile gloves
48. The nurse is assessing a client who has just been admitted to the emergency department Which signs would suggest an overdose of an antianxiety agent?
- Combativeness, sweating, and confusion
- Agitation, hyperactivity, and grandiose ideation
- Emotional lability euphoria, and impaired memory
- Suspiciousness, dilated pupils, and increased blood pressure
49. A client is suspected to develop tetany after a subtotal thyroidectomy. Which of the following symptoms might indicate tetany?
- Tingling in the fingers
- Pain in hands and feet
- Tension on the suture lines
- Bleeding on the back of the dressing
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50. Mary was recently diagnosed with a genitourinary problem and is being examined in the emergency department. When palpating the her kidneys, the nurse should keep which anatomical fact in mind?
- The left kidney usually is slightly higher than the right one.
- The kidneys are situated just above the adrenal glands.
- The average kidney is approximately 5 cm (2") long and 2 to 3 cm (3/4 to 1-1/8") wide.
- The kidneys lie between the 10th and 12th thoracic vertebrae.
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