NCLEX-RN | QB1 | Practice Exam #50 (50 questions)
1. One of the most serious blood coagulation complications for Individuals with cancer and for those undergoing cancer treatments is disseminated intravascular coagulation (DIC). The most common cause of this bleeding disorder is:
- Underlying liver disease
- Brain metastasis
- Intravenous heparin therapy
- Sepsis
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2. When taking a dietary history from a newly admitted female client, Nurse Len should remember that which of the following foods is a common allergen?
- Bread
- Carrots
- Orange
- Strawberries
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3. SITUATION: Alfred, a 40 year old construction worker developed cough, night sweats and fever He was brought to the nursing unit for diagnostic studies. He told the nurse he did not receive a BCG vaccine during childhood. Q. The nurse told Alfred to come back after:
- 48 hours
- 1 day
- 4 days
- a week
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4. The nurse is performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. The nurse should assess for which probable signs of pregnancy? Select all that apply. 1.Ballottement. 2.Chadwick's sign. 3.Uterine enlargement. 4.Positive pregnancy test. 5.Fetal heart rate detected by a nonelectronic device. 6.Outline of fetus via radiography or ultrasonography
- 1,2,3,4
- 3,4,5,6
- 2,4,5
- 1,3,5
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5. When taking a health history from a female client who has a moderate level of cognitive impairment due to dementia, the nurse would expect to note the presence of:
- Accentuated premorbid traits
- Enhance intelligence
- Increased inhibitions
- Hyper vigilance
6. A patient with chronic obstructive pulmonary disease (COPD) experiencing frequent dyspnoea which of the following exercise would teach the patient how to BETTER control breathing?
- Lower side rib
- Segmental
- Pursed-lip
- Diaphragmatic
7. The nurse is caring for a patient with a coronary thrombosis who is receiving prescribed streptokinase (striptease). The patient reports the onset of a rash as well as feeling hot while experiencing chills. The nurse should IMMEDIATELY implemented the plan of care for:
- A medication side effect
- An allergic embolus
- A Pulmonary embolus
- Peripheral artery occlusion
8. A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to:
- take the client's vital signs.
- explore the content of the hallucinations.
- tell him his fear is unrealistic.
- engage the client in reality-oriented activities.
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9. The clinic nurse is preparing to explain the concepts of Kohlberg's theory of moral development with a parent. The nurse should tell the parent that which factor motivates good and bad actions for the child at the preconventional level?
- Peer pressure
- Social pressure
- Parents' behavior
- Punishment and reward
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10. Tonometry is performed on a client with a suspected diagnosis of glaucoma. The nurse looks at the documented test results and notes an intraocular pressure (IOP) value of 23. What should be the nurse's initial action?
- Apply normal saline drops.
- Note the time of day the test was done.
- Contact the health care provider (HCP).
- Instruct the client to sleep with the head of the bed flat.
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11. A client is admitted with Parkinsons disease who has been taking Carbidopa/levodopa (Sinemet) for one year. Which clinical manifestation would be most important to report?
- Dry mouth
- Spasmodic eye winking
- Dark urine color
- Complaints of dizziness
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12. Following a thyroidectomy the client experiences hemorrhage. The nurse would prepare for which of the following emergency interventions?
- intravenous administration of calcium
- insertion of an oral airway
- Creation of a tracheostomy
- Intravenous administration of thyroid hormone
13. Nurse Myrna is aware that the Board of Nursing has quasi-judicial power An example of this power is:
- The Board can issue rules and regulations that will govern the practice of nursing
- The Board can investigate violations of the nursing law and code of ethics
- The Board can visit a school applying for a permit in collaboration with CHED
- The Board prepares the board examinations
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14. Dr. Esteves decides to artificially rupture the membranes of a mother who is on labor. Following this procedure, the nurse Hazel checks the fetal heart tones for which the following reasons?
- To determine fetal well-being.
- To assess for prolapsed cord
- To assess fetal position
- To prepare for an imminent delivery
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15. In evaluating a patient after a cerebrovascular accident (eVA)J which of the following is an expected outcome of the nursing diagnosis of impaired physical mobility related to motor deficits?
- Oriented to person, lace, and time
- Maintains body alignment, no contractures
- Communicates appropriately
- Voids on command at 2-hour intervals
16. Situation: There are other important basic knowledge in the performance of our task as Community Health Nurse in relation to IMMUNIZATION these include:This is the vaccine needed before a child reaches one (1) year in order for him/her to qualify as a “fully immunized child".
- DPT
- Measles
- Hepatitis B
- BCG
17. 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 illnessesJn correcting misconceptions and myths about certain diseases and their management, the health worker should first:
- Identify the myths and misconceptions prevailing in the community
- Identify the source of these myths and misconceptions
- Explain how and why these myths came about
- Select the appropriate IEC strategies to correct them.
18. A 10 year old child with type 1 diabetes develops diabetic ketoacidosis and receives a continuous insulin infusion. Which condition represents the greatest risk to this child?
- Hypernatremia
- Hypokalemia
- Hyperphosphatemia
- Hypercalcemia
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19. Mr. Duffy is admitted to the CCU with a diagnosis of R/0 Ml. He presented in the ER with a typical description of pain associated with an Mi, 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. The pulmonic component of which heart sound is best heard at the 2nd LICS at the LSB?
- S1
- S2
- S3
- S4
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20. A postoperative patient has the nursing diagnosis of ineffective tissue perfusion. To assess for tissue perfusion the nurse should check all of the following except:
- Skin and nail bed color
- Temperature of extremities
- Respiratory rate
- Peripheral pulses
21. Mark, a 15 year old high school student asked you. What is the mode of transmission of Lyme disease. You correctly answered him that Lyme disease is transmitted via:
- Direct contact transmission
- Vehicle borne transmission
- Air borne transmission
- Vector borne transmission
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22. A child with Down syndrome has a developmental age of four years. According to the Denver Developmental Assessment the four-year-old should be able to:
- Draw a man in six parts
- Give his first and last name
- Dress without supervision
- Define a list of words
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23. Situation: As a nurse you are expected to participate in initiating or participating in the conduct of research students to improve nursing practice. You to be updated on the latest trends and issues affected the profession and the best practices arrived at by the profession.Q. In the hypothesis: "The utilization of technology in teaching improves the retention and attention of the nursing students." Which is the dependent variable?
- Utilization of technology
- Improvement in the retention and attention
- Nursing students
- Teaching
24. A nurse is preparing to meet with an individual whose spouse recently diagnosed with Alzheimer's disease. The nurse should know that the primary goals of treatment are:
- Curing the Alzheimer's disease
- Maximizing the functional ability and improve quality of life
- Having the Alzheimer's patient placed in a safe controlled environment
- Making all decisions for the patient and confirming to home
25. The abrasion is:
- Open wound involving skin only
- It is due to surface scrape.
- It is painful wound.
- All of the above.
26. A patient with measles (rubella) is on airborne precautions, which of the following Precautions techniques would be ESSENTIAL to implement for non-immune person entering the room?
- Gloves
- Gowns
- Face shields
- Masks
27. Adult patient complains of diarrhea, vomiting, abdomen cramp and pain within the past 2 weeks. The patient reported that the pain increases when he eats and relieves when he passes stool. Which of the following may be the cause:
- Appendicitis
- Crohn's disease
- Ectopic pregnant
- Cholecystitis
28. 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. Based on the DOH and World Health Organization (WHO) guidelines, the mainstay for early detection method for breast cancer that is recommended for developing countries is:
- a monthly breast self examination (BSE) and an annual health worker breast examination (HWBE)
- an annual hormone receptor assay
- an annual mammogram
- a physician conduct a breast clinical examination every 2 years
29. When teaching a client about the signs of colorectal cancer, Nurse Trish stresses that the most common complaint of persons with colorectal cancer is:
- Abdominal pain
- Hemorrhoids
- Change in caliber of stools
- Change in bowel habits
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30. What clinical finding does a nurse anticipate when admitting a client with an extracellular fluid volume excess?
- Rapid, thready pulse
- Distended jugular veins
- Elevated hematocrit level
- Increased serum sodium level
31. The doctor has ordered antithrombolic stockings to be applied to the legs of the client with peripheral vascular disease. The nurse knows antithrombolic stockings should be applied:
- Before rising in the morning
- With the client in a standing position
- After bathing and applying powder
- Before retiring in the evening
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32. It is the name for a comprehensive strategy which primary health services around the world is using to detect and cure TB patients.
- National TB program
- Direct Observe Treatment Short Course (DOTS)
- Center for Communicable diseases
- international TB control Organization
33. A community health nurse visits a patient who had right foot amputation. Which of the following would suggest that the patient is meeting expected outcome for this type surgery?
- Stays in bed
- Verbalize constant pain
- Avoids social gathering
- Accepts altered body image
34. The nurse is instructing a client how to perform a testicular self-examination (TSE). The nurse should explain that which is the best time to perform this exam?
- After a shower or bath
- While standing to void
- After having a bowel movement
- While lying in bed before arising
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35. Situation: Michelle is a 6 year old preschooler. She was reported by her sister to have measles but she was at home because of fever, upper respiratory problem and white sports in her mouth.As a public health nurse, you teach mother and family members the prevention of complication of measles. Which of the following should be closely watched?
- Temperature fails to drop
- Inflammation of the conjunctiva
- Inflammation of the nasopharynx
- Ulcerative stomatitis
36. A client is diagnosed with multiple myeloma. The client asks the nurse about the diagnosis. The nurse bases the response on which of the following descriptions of this disorder?
- Malignant exacerbation in the number of leukocytes.
- Altered red blood cell production.
- Altered production of lymph nodes
- Malignant proliferation of plasma cells and tumors within the bone.
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37. Situation: In a client with widespread colon cancer, A colectomy is the surgical procedure of choice instead of an Abdominal perineal resection.Q. Which of the following indicates a need for further teaching in client's with ileostomy?
- "I am expecting a change in my diet.”
- "I can remove the appliance during sleep.”
- "I can still swim"
- "I am prone to dehydration because of the ileostomy"
38. A healthy 2-years-old child is brought to the community health clinic for a routine checkup. At this visit the nurse should administer the following vaccine:
- Rotavirus
- Hepatitis B
- None at this time
- Varicella
39. The responsibility for teaching patients how to take medications safely when they are discharged from the hospital belongs to the:
- Nurse
- Physician
- Dietitian
- Therapist
40. The nurse is assessing the mental status of a client admitted with possible organic brain disorder. Which of these questions will best assess the function of the client's recent memory?
- "Name the year." "What season is this?" (pause for answer after each question)
- "Subtract 7 from 100 and then subtract 7 from that." (pause for answer) "Now continue to subtract 7 from the new number."
- "I am going to say the names of three things and I want you to repeat them after me: blue, ball, pen."
- "What is this on my wrist?" (point to your watch) Then ask, "What is the purpose of it?"
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41. Situation: The patients chart is a legal documentation the is admissible in the court In working with the client, The protection of the information on the chart and patient's privacy is one of the priority. You are caring for Ana, a 12 year old grade 6 pupil from manila and is one of the daughters of Maria, A 38 year old mother of 12.Q. If the court issues an investigation necessitating the utilization of Ana's chart, you know that the chart will not be admissible IF:
- Maria refuses
- Ana refuses
- The chart is not legible
- The chart is missing
42. Situation: A patient was admitted in the Medical Floor at St Luke's Hospital. He was asymptomatic. The doctor suspects diverticulosis.Q. Which of the following definitions best describes diverticulosis?
- An inflamed outpouching of the intestine
- A non-inflamed outpouching of the intestine
- The partial impairment of the forward flow of intestinal contents
- An abnormal protrusions of an oxygen through the structure that usually holds it
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43. Miranda a psychiatric client is to be discharged with orders for haloperidol (haidol) therapy. When developing a teaching plan for discharge, the nurse should include cautioning the client against:
- Driving at night
- Staying in the sun
- Ingesting wines and cheeses
- Taking medications containing aspirin
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44. The nurse has just received the change of shift report Which client should the nurse assess first?
- A client two hours post-lobectomy with 150ml drainage
- A client two days post-gastrectomy with scant drainage
- A client with pneumonia with an oral temperature of 102°F
- A client with a fractured hip in Bucks traction
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45. The nurse is caring for a client hospitalized with nephrotic syndrome. Based on the clients treatment the nurse should:
- Limit the number of visitors.
- Provide a low-protein diet.
- Discuss the possibility of dialysis.
- Offer the client additional fluids.
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46. The nurse is caring for a client with a head injury who has an intracranial pressure monitor in place. Assessment reveals an ICP reading of 66. What is the nurses best action?
- Notify the physician.
- Record the reading as the only action.
- Turn the client and recheck the reading.
- Place the client supine.
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47. A nurse is evaluating the effectiveness of treatment for a client with excessive fluid volume. What clinical finding indicates that treatment has been successful?
- Clear breath sounds
- Positive pedal pulses
- Normal potassium level
- Increased urine specific gravity
48. The nurse is providing care for a client with a recent transverse colostomy. Which observation requires immediate notification of the health care provider?
- Stoma is beefy red and shiny
- Purple discoloration of the stoma
- Skin excoriation around the stoma
- Semi-formed stool noted in the ostomy pouch
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49. As the nurse aide begins his/her assignment, which of the following should the nurse aide do first?
- Collect linen supplies for the shift
- Check all the nurse aide's assigned residents
- Assist a resident that has called for assistance to get off the toilet
- Start bathing a resident that has physical therapy in one hour
50. Situation: The OR is divided in three zones to control traffic flow and contamination.Q. The doctor ordered to incorporate 1000 "u" insulin to the remaining ongoing IV. The strength is 500/ml. How much should you incorporate into the IV solution?
- 10 ml
- 2 ml
- 0.5 ml
- 5 ml
NCLEX-RN | QB1 | Practice Exam #50 (50 questions)