QB1 | Practice Exam #53 -> answers with explanation - Free NCLEX Exam Practice

NCLEX-RN | QB1 | Practice Exam #53 (50 questions)

 

1. Which of the following diet instructions should be given to the client with recurring urinary tract infections?

• Increase intake of meats.
• Avoid citrus fruits.
• Perform pericare with hydrogen peroxide.
• Drink a glass of cranberry juice every day.

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2. The mother of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms1 tumor, should avoid which during the physical assessment?

• Palpating the abdomen for a mass
• Assessing the urine for the presence of hematuria
• Monitoring the temperature for the presence of fever
• Monitoring the blood pressure for the presence of hypertension

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3. During the assessment stage, a client with schizophrenia leaves his arm in the air after the nurse has taken his blood pressure. His action shows evidence of:

• somatic delusions.
• waxy flexibility.
• neologisms
• nihilistic delusions.

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4. A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventiiating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/ minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding?

• A decreased pH and an increased PaCO2
• An increased pH and a decreased PaCO2
• A decreased pH and a decreased HC03A
• An increased pH and an increased HC03A

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5. Situation: Children have a special fascination with the workings of the digestive system. To fully understand the digestive processes. Nurse Lavigna must be knowledgeable of the anatomy and physiology of the gastrointestinal system.Q. Pharynx is lined with mucous membranes and mucous secreting glands to ease the passage of food. The laryngopharynx serves as passageway for:

• air only
• air and water
• food, fluids and air
• air and food

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6. The nurse must administer a medication to reverse or prevent Parkinson-type symptoms in a client receiving an antipsychotic. The medication the client will likely receive is:

• Benztropine (Cogentin).
• diphenhydramine (Benadryl).
• propranolol (Inderal).
• haloperidol (Haldol).

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7. A male client tells the nurse that there is a big bug in his bed. The most therapeutic nursing response would be:

• Silence.
• "Where's the bug? I’ll kill it for you"
• "I don't see a bug in your bed, but you seem afraid."
• "You must be seeing things”

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8. The nurse is caring for a 4-year-old patient with a diagnosis of cystic fibrosis and pneumonia. The child is feeling better on the 3rd day of the hospitalization and "wants to play" What would be the best choice of entertainment?

• Blowing bubbles
• Looking at picture books
• Watching videos
• Riding in a wagon

9. A client is scheduled for routine glycosylated hemoglobin (HbAlc) test. What is important for the nurse to tell the client before this test?

• Drink only water after midnight and come to the clinic early in the morning
• Eat a normal breakfast and be at the clinic 2 hours because of the multiple blood draws
• Expect to be at the clinic for several hours because of the multiple blood draws
• Come to the clinic at the earliest convenience to have blood drawn

10. A patient about to undergo abdominal inspection is best placed in which of the following positions?

• Prone
• Trendelenburg
• Supine
• Side-lying

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11. The nurse manager is discussing the facility protocol in the event of a tornado with the staff. Which instructions should the nurse manager include in the discussion? Select all that apply. 1. Open doors to client rooms.2. Move beds away from windows.3. Close window shades and curtains.4. Place blankets over clients who are confined to bed.5. Relocate ambulatory clients from the hallways back into their rooms.

• 2,3,4
• 1,2,3,4
• 3,4,5
• 1,3,4

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12. All of the following are therapeutic bathes except:

• Shampooing bath.
• Whirlpool bath.
• Medicated bath.
• Sitz bath.

13. A health care provider prescribes 1000mL D5W to infuse at a rate of 125 mL/hour. The nurse determines that it will take how many hours for 1 L to infuse?

• 10 hours.
• 8 hours.
• 12 hours.
• 5 hours.

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14. The term holism refers to:

• Reactions that occur when equilibrium is disturbed.
• How an organism responds to change.
• A relatively stable state of physiologic equilibrium.
• The sum of physiological, emotional, social, and spiritual health, and determines how whole person feels.

15. Situation: ENTEROSTOMAL THERAPY is now considered especially in nursing. You are participating in the OSTOMY CARE CLASS.Q. When preparing to teach Fermin how to irrigate his colostomy, you should plan to do the procedure:

• When Fermin would have normal bowel movement
• At least 2 hours before visiting hours
• Prior to breakfast and morning care
• After Fermin accepts alteration in body image

16. A male client with a gunshot wound requires an emergency blood transfusion. His blood type is AB negative. Which blood type would be the safest for him to receive?

• AB Rh-positive
• A Rh-positive
• A Rh-negative
• 0 Rh-positive

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17. The nurse is conducting a lecture to a class of nursing students about advance directives to preoperative clients. Which of the following statement by the nurse is correct?

• "The spouse, but not the rest of the family, may override the advance directive"
• "An advance directive is required for a "do not resuscitate" order."
• "A durable power of attorney, a form of advance directive, may only be held by a blood relative"
• "The advance directive may be enforced even in the face of opposition by the spouse"

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18. The nurse is caring for a client with a closed head injury. A late sign of increased intracranial pressure is:

• Changes in pupil equality and reactivity
• Restlessness and irritability
• Complaints of headache
• Nausea and vomiting

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19. Which of the following is the BEST goal for crisis intervention?

• Bring back the client in the pre crisis state
• Make sure that the client becomes better
• Achieve independence
• Provide alternate coping mechanism

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20. Following a diagnosis of acute glomerulonephritis (AGN) in their 6 year-old child, the parents remark: “We just don't know how he caught the disease!" The nurse's response is based on an understanding that

• AGN is a streptococcal infection that involves the kidney tubules
• The disease is easily transmissible in schools and camps
• The illness is usually associated with chronic respiratory infections
• It is not “caught" but is a response to a previous B-hemolytic strep infection

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21. A substance usually intended for use on inanimate objects, that destroys pathogens but not the spores.

• Sterilization
• Disinfectant
• Antiseptic
• Autoclave

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22. Situation: Johnny, sought consultation to the hospital before. Q. In administering Lugol's solution, the precautionary measure should include:

• Hypokalemia
• Dilute with juice and administer with a straw
• Administer it with milk and drink it
• Follow it with milk of magnesia

23. Situation: Breast cancer is the 2nd most common type of cancer after lung cancer and 99% of which, occurs in women. Survival rate is 98% if this is detected early and treated promptly. Carmen is a 53 year old patient in the high risk group for breast cancer was recently diagnosed with Breast Cancer.Q. If you are to instruct a postmenopausal woman about BSE, when would you tell her to do BSE:

• on the same day of each month
• right after the menstrual period
• on the first day of her menstruation
• on the last day of her menstruation

24. Which of the following is TRUE in the concept of stress?

• Stress is not always present in diseases and illnesses
• Stress are only psychological and manifests psychological symptoms
• All stressors evoke common adaptive response
• Hemostasis refers to the dynamic state of equilibrium

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25. A patient had a craniotomy with resection of a nonmalignant neoplasm for the temporal lobe. The patient's vital signs are within the base line normal range. The nurse observes that the patient has developed bilateral per orbital edema. Which of the following actions would be appropriate for the nurse to take?

• Apply cold compresses to the patient's eyes
• Elevate the head of the patient's bed to 60 degrees
• Apply warm compresses to the patient's eyes
• Elevate the head of the patient's bed to 45 degrees

26. Freud stresses out that the EGO

• Distinguishes between things in the mind and things in the reality.
• Moral arm of the personality that strives for perfection than pleasure.
• Reservoir of instincts and drives
• Control the physical needs instincts.

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27. A client with a total knee replacement has a CPM (continuous passive motion device) applied during the post-operative period. Which statement made by the nurse indicates understanding of the CPM machine?

• Use of the CPM will permit the client to ambulate during the therapy.
• The CPM machine controls should be positioned distal to the site.
• If the client complains of pain during the therapy I will turn off the machine and call the doctor.
• Use of the CPM machine will alleviate the need for physical therapy after the client is discharged.

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28. A patient recently diagnosed with multiple sclerosis has been taking the following prescribed medications: baclofen(lioresal), diazepam(valium), Amantadine(symmetrel), and phenytoin( dilantin). When the patient presents with complaints of fatigue, the nurse should address the dosage and frequency of which medication?

• Baclofen
• Diazepam
• Amantadine
• Phenytoin

29. A client with schizophrenia spends much of his time pacing the floor rocking back and forth and moving from one foot to another The clients behaviors are an example of:

• Dystonia
• Tardive dyskinesia
• Akathisia
• Oculogyric crisis

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30. When providing therapeutic play which of the following toys would best promote imaginative play in a 4-year-old?

• Large blocks
• Dress-up clothes
• Wooden puzzle
• Big wheels

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31. How soon after chlorpromazine (Thorazine) administration should the nurse expect to see a clients delusional thoughts and hallucinations eliminated?

• Several minutes
• Several hours
• Several days
• Several weeks

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32. A child of 10 years old is to receive 400 cc of IV fluid in an 8 hour shift. The IV drip factor is 60. The IV rate that will deliver this amount is:

• 50 cc/ hour
• 55 cc/ hour
• 24 cc/ hour
• 66 cc/ hour

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33. In the immediate postoperative period after a gastrectomy, the client’s nasogastric tube is draining a light-red liquid. For how long should the nurse expect this type of drainage?

• 1 to 2 hours
• 3 to 4 hours
• 10 to 12 hours
• 24 to 48 hours

34. Dianne, 24 year-old is 27 weeks1 pregnant arrives at her physician's office with complaints of fever, nausea, vomiting, malaise, unilateral flank pain, and costovertebral angle tenderness. Which of the following diagnoses is most likely?

• Asymptomatic bacteriuria
• Bacterial vaginosis
• Pyelonephritis
• Urinary tract infection (UTI)

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35. Situation: Health education and Health Promotion is an important part of nursing responsibility in the community, immunization is a form of health promotion that aims at preventing the common childhood illnesses.These vaccines are given 3 doses at one month intervals:

• DPT, BCG, TT
• DPTTT, OPV
• OPV, Hep. B, DPT
• Measles, OPV, DPT

36. The nursing instructor asks a nursing student to explain the characteristics of the amniotic fluid. The student responds correctly by explaining which as characteristics of amniotic fluid? Select all that apply. 1. Allows for fetal movement. 2. Surrounds, cushions, and protects the fetus. 3. Maintains the body temperature of the fetus. 4. Can be used to measure fetal kidney function. 5. Prevents large particles such as bacteria from passing to the fetus. 6. Provides an exchange of nutrients and waste products between the mother and the fetus

• 2,3,4,5
• 1,2,3,4
• 1,2,5
• 2,3,4,5,6

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37. Which clients are considered targets for DOTS category?

• Sputum negative cavitary cases
• Clients returning after default
• Relapses and failures of previous PTB treatment regimens
• Clients diagnosed for the first time through a positive sputum exam

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38. The intensive care unit is full and the emergency room just called in a report on a ventilator­ dependent client who is being admitted to the medical surgical unit It would be essential that the nurse have which piece of equipment at the clients bedside?

• Cardiac monitor
• Intravenous controller
• Manual resuscitator
• Oxygen by nasal cannula

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39. Situation: The body has regulatory mechanism to maintain the needed electrolytes. However there are conditions/surgical interventions that could compromise life. You have to understand how management of these conditions are done.Q. Which of the following nursing interventions is appropriate after a total thyroidectomy?

• Place pillows under your patients shoulders
• Raise the knee-gatch to 30 degrees
• Keep your patient in a high-fowler's position
• Support the patient's head and neck with pillows and sandbags

40. A client is taking fluoxetine hydrochloride (Prozac) for treatment of depression. The client asks the nurse when the maximum therapeutic response occurs. The nurse's best response is that the maximum therapeutic response for fluoxetine hydrochloride may occur in the:

• 10-14 days
• First week
• Third week
• Fourth week

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41. A nurse is talking to a client with bulimia nervosa about the complications of Laxative abuse. Which of the following complications should be included?

• Loss of taste
• Swollen glands
• Dental problems
• Malabsorption of nutrients

42. Situation: Records and Records management is one of the core of professional nursing practice.Q. If The research team finished the research about Ana s case and they are done disseminating data and after the report has been completed and written. Pre- processed data about Ana should be:

• Preserved
• Destroyed by Burning or Shredding
• Stored for future use
• Keep in a private file nobody can access

43. While changing the tapes on a newly inserted tracheostomy tube, the client coughs and the tube is dislodged. Which is the initial nursing action?

• Call the health care provider to reinsert the tube.
• Grasp the retention sutures to spread the opening.
• Call the respiratory therapy department to reinsert the tracheotomy.
• Cover the tracheostomy site with a sterile dressing to prevent infection.

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44. The best position for examining the rectum is:

• Prone
• Sim's
• Knee-chest
• Lithotomy

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45. The nurse is caring for a client with cerebral palsy. The nurse should provide frequent rest periods because:

• Grimacing and writhing movements decrease with relaxation and rest.
• Hypoactive deep tendon reflexes become more active with rest.
• Stretch reflexes are increased with rest.
• Fine motor movements are improved by rest.

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46. The nurse is caring for a client with chronic back pain. Codeine has been prescribed for the client. Specific to this medication, which intervention should the nurse include in the plan of care while the client is taking this medication?

• Monitor radial pulse.
• Monitor bowel activity.
• Monitor apical heart rate.
• Monitor peripheral pulses.

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47. An elderly home-bound patient is visited by the community health nurse. During evaluation, decreased skin turgor is noted. When asked about fluids intake, the patient states that she does not drink any fluids after lunch each day, and wake sup very thirsty. The MOST appropriate question for the nurse to ask is:

• "How much protein does you norma!ly eats for dinner?"
• "How much caffeine are you consuming each day?"
• "Are you having trouble controlling your bladder at night?"
• "Do you have enough money to buy liquids to drink?"

48. The nurse is suctioning the tracheostomy of an adult client. The recommended pressure setting for performing tracheostomy suctioning on the adult client is:

• 40-60mmHg
• 60-80mmHg
• 80-120mmHg
• 120-140mmHg

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49. Which of the following best illustrates this statement?

• The community health nurse continuously develops himself personally and professionally
• Health education and community organizing are necessary in providing community health services
• Community health nursing in intended primarily for health promotion and prevention and treatment of disease.
• The goal of community health nursing is to provide nursing services to people in their own place of residence

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50. Situation: Celina age 25, a ramp model, suddenly became blind after her boyfriend broke off with hen A thorough workup did not reveal any pathological findings.Q. The loss or alteration of physical functioning without organize cause bit is an expression of a psychological needs is known as:

• Somatization
• Depersonalization
• Hypochondriasis
• Conversion

 

NCLEX-RN | QB1 | Practice Exam #53 (50 questions)