QB1 | Practice Exam #57 -> answers with explanation - Free NCLEX Exam Practice

NCLEX-RN | QB1 | Practice Exam #57 (50 questions)

 

1. The client with a history of diabetes insipidus is admitted with polyuria polydipsia and mental confusion. The priority intervention for this client is:

• Measure the urinary output.
• Check the vital signs.
• Encourage increased fluid intake.
• Weigh the client.

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2. Situation: You are assigned to take care of a group of patients across the lifespan.Which of the following signs and symptoms would you most likely find when assessing an infant with Arnold-Chiari malformation?

• Weakness of the leg muscles, loss of sensation in the legs, and restlessness
• Difficulty swallowing, diminished or absent gag reflex and respiratory distress
• Difficulty sleeping, hypervigilant and an arching of the back
• Paradoxical irritability, diarrhea and vomiting

3. Drugs can cause adverse events in a patient Bone marrow toxicity is one of the most frequent types of drug-induced toxicity. The most serious form of bone marrow toxicity is:

• aplastic anemia.
• thrombocytosis.
• leukocytosis.
• granulocytosis.

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4. Which of the following statement is true regarding temperature?

• Oral temperature is more accurate than rectal temperature
• The bulb used in Rectal temperature reading is pear shaped or round
• The older the person, the higher his BMR
• When the client is swimming, BMR Decreases

5. A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse should schedule the medication for which times?

• With meals and at bedtime
• Every 6 hours around the clock
• One hour after meals and at bedtime
• One hour before meals and at bedtime

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6. The nurse is caring for a patient with a colostomy. The patient asks Will I ever be able to swim again? The nurses best response would be:

• Yes you should be able to swim again even with the colostomy.
• You should avoid immersing the colostomy in water.
• No you should avoid getting the colostomy wet.
• Don't worry about that. You will be able to live just like you did before.

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7. The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply. 1.Pal1or. 2.Edema. 3.Anorexia. 4.Proteinuria. 5.Weight loss. 6.Decreased serum lipids

• 1,2,3,4
• 2,3,5
• 3,4,5
• 1,3,5

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8. Nurse Kris is teaching a client with history of atherosclerosis. To decrease the risk of atherosclerosis, the nurse should encourage the client to:

• Avoid focusing on his weight.
• Increase his activity level.
• Follow a regular diet.
• Continue leading a high-stress lifestyle.

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9. A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply. 1.Administer methimazole with food. 2.Place the client on a low-calorie, low-protein diet. 3.Assess the client for unexplained bruising or bleeding. 4.Instruct the client to report side and adverse effects such as sore throat, fever, or headaches. 5.Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration.

• 1,2,3
• 1,3,4,5
• 1,3,4
• 1,3,5

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10. SituationFe is experiencing left sharp pain and occasional hematuria. She was advised to undergo IVP by her physician.Q. What will the nurse monitor and instruct the client and significant others, post IVP?

• Report signs and symptoms for delayed allergic reactions
• Observe NPO for 6 hours
• Increase fluid intake
• Monitor intake and output

11. The nurse is performing an assessment on a client with a suspected diagnosis of cataract Which clinical manifestation should the nurse expect to note in the early stages of cataract formation?

• Diplopia
• Eye pain
• Floating spots
• Blurred vision

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12. A nurse is caring for a patient who had rhinoplasty 2-weeks ago. Which of the following is an expected outcome?

• Oral mucus membranes dry ,but pink and intact
• Face and nose free from swelling
• Able to make needs know, speech therapy started
• Demonstrate throat clearing while eating

13. A patient is seen in the emergency department with complaints of angina. Nitroglycerin (Nitrostat) I sordered by the physician.This medication is to be administered via which of the following routes?

• Intradermal
• Buccal
• Parental
• Topical

14. Situation: Ricky is a 12 year old-boy with Down's syndrome. He stands 5' V and weight 100 lbs. He is slim and walks sluggishly with a limp. He wears a neck brace as support for his neck. X - ray of cervical spine showed "subluxation of Cl in relation to C2 with cord compression." He attends a school for special education. Q. Ricky's IQ falls within the range of 50-55. He can be expected to:

• Profit from vocational training with moderate supervision
• Live successfully in the community
• Perform simple tasks in closely supervised settings
• Acquire academic skills of 6th grade level

15. Situation: Radiation therapy is another modality of cancer management With emphasis on multidisciplinary management you have important responsibilities as a nurseQ. What intervention should you include in your care plan?

• Inspect his skin for petechiae, bruising, Gl bleeding regularly
• Place Albert on strict isolation precaution
• Provide rest in between activities
• Administer antipyretics if his temperature exceeds 38 C

16. A mother brings her 26 month-old to the well-child clinic. She expresses frustration and anger due to her child's constantly saying "no" and his refusal to follow her directions. The nurse explains this is normal for his age, as negativism is attempting to meet which developmental need?

• Trust
• Initiative
• Independence
• Self-esteem

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17. An adolescent with cystic fibrosis has an order for pancreatic enzyme replacement. The nurse knows that the medication should be given:

• At bedtime
• With meals and snacks
• Twice daily
• Daily in the morning

18. One of your patients complains of difficulty of breathing, all of the following measurement which help improve breathing EXCEPT:

• Put your patient in semi-fowler's position
• Teach patient breathing techniques
• Put the patient in prone position
• Give oxygen therapy

19. Situation: IBD is a common inflammatory functional bowel disorder also known as spastic bowel, functional colitis and mucous colitis. Q. Which of the following factors is believed to be linked to Crohn's disease?

• Diet
• Constipation
• Heredity
• Lack of exercise

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20. Which play activity is best suited to the gross motor skills of a toddler?

• Coloring book and crayons
• Ball
• Building cubes
• Swing set

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21. Nurse Janah is monitoring the ongoing care given to the potential organ donor who has been diagnosed with brain death. The nurse determines that the standard of care had been maintained if which of the following data is observed?

• Urine output: 45 ml/hr
• Capillary refill: 5 seconds
• Blood pressure: 90/48 mmHg
• Serum pH: 7.32

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22. A client who uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which finding is noted?

• Resolved diarrhea
• Relief of epigastric pain
• Decreased platelet count
• Decreased white blood cell count

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23. A client with dysthymic disorder reports to a nurse that his life is hopeless and will never improve in the future. How can the nurse best respond using a cognitive approach?

• Agree with the clients painful feelings
• Challenge the accuracy of the client's belief
• Deny that the situation is hopeless
• Present a cheerful attitude

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24. Stimulation of the sympathetic nervous system produces which of the following responses?

• Bradycardia
• Tachycardia
• Hypotension
• Decreased myocardial contractility

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25. The leader of the study knows that certain patients who are in a specialized research setting tend to respond psychologically to the conditions of the study. This referred to as:

• Cause and effect
• Hawthorne effect
• Halo effect
• Horns effect

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26. 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. Which among the following is important in the use of the bag technique during home visit?

• Arrangement of the bag's contents must be convenient to the nurse
• The bag should contain all necessary supplies and equipment ready for use
• c Be sure to thoroughly clean your bag especially when exposed to communicable disease
• Minimize if not totally prevent the spread of infection

27. The nurse is assessing the growth and development of a healthy three year-old child. The nurse should expect the child to be able to:

• Ride a bicycle
• Jump rope
• Throw a ball overhead
• Hop on one foot

28. While Obtaining the pre-operative history of a patient schedules for cosmetic surgery, the most valuable skill at the nurse disposal is:

• knowledge of the procedure
• Time management skills
• Listening skills
• Empathy

29. The patient complaint of vomiting, diarrhea and restlessness after taking lithane. The nurse's initial intervention is:

• recognize that this is a sign of toxicity and withhold the next medication.
• Notify the physician.
• Check V/S to validate patient's concerns.
• Recognize that this is a normal side effects of lithium and still continue the drug.

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30. Nurse Carla Is aware that Myla's second stage of labor is beginning when the following assessment is noted:

• Bay of water is broken
• Contractions are regular
• Cervix is completely dilated
• Presence of bloody show

31. The nurse is measuring the duration of the clients contractions. Which statement is true regarding the measurement of the duration of contractions?

• Duration is measured by timing from the beginning of one contraction to the beginning of the next contraction.
• Duration is measured by timing from the end of one contraction to the beginning of the next contraction.
• Duration is measured by timing from the beginning of one contraction to the end of the same contraction.
• Duration is measured by timing from the peak of one contraction to the end of the same contraction.

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32. A 52 year-old woman Is scheduled to undergo an abdomino-perineal resection in three days for removal of a cancer of the rectum. The nurse reviews the care plan with the patient The patient will receive prophylactic antibiotics and will be given a mechanical bowel preparation the day before. Which additional preparation should the patient undertake at this time?

• Wear pressure stockings
• Perform leg strengthening exercises
• Maintain high-protein, low-residue diet
• Take daily ferrous iron tablets

33. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which findings support this diagnosis? Select all that apply. 1.Increase in pH. 2.Comatose state. 3.Deep,rapid breathing. 4.Decreased urine output. 5.Elevated blood glucose

• 2,3,5
• 1,2,3
• 2,3,4
• 1,3,4

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34. The physician has ordered a guaiac test for a client with a history of intestinal polyps. Which instruction should be given to the client regarding his diet prior to the test?

• Increase the intake of whole grains and cereals.
• Limit the intake of dairy products.
• Avoid citrus juices and vitamin C.
• Increase foods containing omega 3 oils.

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35. Icheanne then asked you, what is the first process that occurs in the inflammatory response after injury, You tell her:

• Phagocytosis
• Emigration
• Pavementation
• Chemotaxis

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36. Most couples are using "natural" family planning methods. Most accidental pregnancies in couples preferred to use this method have been related to unprotected intercourse before ovulation. Which of the following factor explains why pregnancy may be achieved by unprotected intercourse during the preovulatory period?

• Ovum viability.
• Tubal motility.
• Spermatozoal viability.
• Secretory endometrium.

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37. A helping relationship is a process characterized by:

• recovery promoting
• mutual interaction
• growth facilitating
• health enhancing

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38. A client with paranoid schizophrenia has been experiencing auditory hallucinations for many years. One approach that has proven to be effective for hallucinating clients is to:

• take an as-needed dose of psychotropic medication whenever they hear voices.
• practice saying "Go away" or "Stop" when they hear voices.
• sing loudly to drown out the voices and provide a distraction.
• go to their room until the voices go away.

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39. A pregnant client in the first trimester calls the nurse at a health care clinic and reports that she has noticed a thin, colorless vaginal drainage. The nurse should make which statement to the client?

• "Come to the clinic immediately."
• "The vaginal discharge may be bothersome, but is a normal occurrence”
• "Report to the emergency department at the maternity center immediately."
• "Use tampons if the discharge is bothersome, but be sure to change the tampons every 2 hours.”

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40. A 62 year-old patient has been treated for congestive heart failure and a nursing diagnosis of fluid volume excess. After diuretic therapy and dietary interventions, the patient has met all short-term goals. The nurse should.

• Revise the care plan with a diagnosis of risk for alteration in fluid balance
• Add a new diagnosis of risk of fluid volume deficit
• Discontinue the care plane as the diagnosis is resolved
• Continue the care plan as written

41. Eighteen hours after undergoing an emergency appendectomy a client with a reported history of social drinking displays these vital signs: temperature, 101.6° F (38.7° C); heart rate, 126 beats/minute; respiratory rate, 24 breaths/minute; and blood pressure, 140/96 mm Hg. The client exhibits gross hand tremors and is screaming for someone to kill the bugs in the bed. The nurse should suspect:

• a postoperative infection.
• alcohol withdrawal.
• acute sepsis.
• pneumonia.

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42. When caring for a ventilator-dependent client who is receiving tube feedings the nurse can help prevent aspiration of gastric secretions by:

• Keeping the head of the bed flat
• Elevating the head of the bed 30-45°
• Placing the client on his left side
• Raising the foot of the bed 10-20°

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43. Which of the following is a TRUE statement about normal ovulation?

• It occurs on the 14th day of every cycle
• It may occur between 14-16 days before next menstruation
• Every menstrual period is always preceded by ovulation
• The most fertile period of a woman is 2 days after ovulation

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44. The nurse is performing discharge teaching on a client with diverticulitis who has been placed on a low-roughage diet. Which food would have to be eliminated from this clients diet?

• Roasted chicken
• Noodles
• Cooked broccoli
• Custard

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45. A client is admitted to the hospital following a burn injury to the left hand and arm. The clients burn is described as white and leathery with no blisters. Which degree of severity is this burn?

• First degree burn
• Second degree burn
• Third degree burn
• Fourth degree burn

46. When caring for a patient with an ostomy, the nurse knows that extra skin protection for the peristomal skin is MOST important for those with a(n):

• Ileostomy
• Ascending colostomy
• Transverse colostomy
• Sigmoid colostomy

47. Situation: In your professional nursing role, it is essential to establish a meaningful nurse­ patient relationship. Q. Therapeutic communication begins with:

• Knowing the patient
• Interacting with the patient
• Trust
• Knowing yourself

48. After total knee replacement a patient being discharged to have after which he will ambulate with for-prong cane. When providing patient teaching regarding giving up and down stairs with the cane, the first step in going up stairs is to

• Place the cane and the affected extremities upon the step
• Place the cane and the unaffected extremity upon the step
• Step up on the affected extremity
• Step up on the unaffected extremity

49. Which is the BEST control measure for AIDS?

• Being faithful to a single sexual partner
• Using a condom during each sexual contact
• Avoiding sexual contact with commercial sex workers
• Making sure that one's sexual partner does not have signs of AIDS

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50. A client had a new colostomy created 2 days earlier and is beginning to pass malodorous flatus from the stoma. What is the correct interpretation by the nurse?

• This is a normal, expected event.
• The client is experiencing early signs of ischemic bowel.
• The client should not have the nasogastric tube removed.
• This indicates inadequate preoperative bowel preparation.

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NCLEX-RN | QB1 | Practice Exam #57 (50 questions)