NCLEX-RN | QB1 | Practice Exam #49 (50 questions)
1. You are the public health nurse in a municipality with a total population of about 20,000. There are 3 health midwives among the RHU personnel. How many more midwife items will the RHU need?
- 1
- 2
- 3
- 4
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2. The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?
- Bile-stained fecal emesis
- The passage of currant jelly-like stools
- Failure to pass meconium stool in the first 24 hours after birth
- Sausage-shaped mass palpated in the upper right abdominal quadrant
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3. Which procedure or practice requires surgical asepsis?
- Hand washing
- Nasogastric tube irrigation
- IV. cannula insertion
- Colostomy irrigation
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4. A 35-year-old client is being seen for her yearly gynecological examination. She states that she and her partner have been trying to become pregnant for a little over 6 months, and that a friend had recently advised her partner to take ginseng to improve the potency of his sperm. The woman states that they have decided to take their friend's advice. On which of the following information should the nurse base his or her reply?
- Based on their history, the client and her partner have made the appropriate decision regarding their fertility.
- Ginseng can cause permanent chromosomal mutations and should be stopped immediately.
- It is unnecessary to become concerned about this woman's fertility because she has only tried to become pregnant for a few months.
- Although ginseng may be helpful, it would be prudent to encourage the woman to seek fertility counseling
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5. Which of the following is the best position for the client to assume if the back is to be examined by the nurse?
- Standing
- Sitting
- Side lying
- Prone
6. Situation: At the medical-surgical ward, the nurse must also be concerned about drug interactions. How can nurse prevent drug interaction including absorption?
- Always flush with NSS after IV administration
- Administering drugs with more diluents
- Improving on preparation techniques
- Referring to manufacturer's guidelines
7. The nurse is caring for full-term newborn who was delivered vaginally 5 minutes ago. The infants APGAR Score was 8 at one minute and 10 at 5 minutes. Which of the following has the highest priority?
- Maintaining the infant in the supine position
- Assessing the infant's red reflex
- Preventing heat loss from the infant
- Administering humidified oxygen to the infant
8. Situation: Blood transfusion was ordered for Andre after an episode of severe bleeding.Q. The nurse knows that after receiving the blood from the biood bank, it should be administered within:
- 1 hour
- 2 hours
- 4 hours
- 6 hours
9. Which of the following is the abbreviation of drops?
- Gtt.
- Gtts.
- Dp.
- Dr.
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10. Situation: Tony, 11 years old, has 'kissing tonsils' and is scheduled for tonsillectomy and adenoidectomy or T and A.Q. You are the nurse of Tony who will undergo T and A in the morning. His mother asked you if Tony will be put to sleep. Your teaching will focus on:
- spinal anesthesia
- anesthesiologist's preference
- local anesthesia
- general anesthesia
11. Situation: Mrs. Diaz is assigned in the female surgical ward. While on duty, an 15 year old client, married, was admitted for CS. The informed consent for the operation has to be obtained.Q. The medical intern who assisted in the operation gave post operative orders. In this case, Mrs.Diaz should:
- Validate the order from the surgeon and request him to counter sign
- Follow the order as long as they are within the scope of nursing practice
- Clarify from the medical intern those that are ambiguous
- Refuse to follow the order because it is not legal
12. Which client is at greater risk for respiratory depression while receiving opioids for analgesia?
- An elderly chronic pain client with a hip fracture
- A client with a heroin addiction and back pain
- A young female client with advanced multiple myeloma
- A child with an arm fracture and cystic fibrosis
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13. Which of the following is true in SURGICAL ASEPSIS?
- Autoclaved linens and gowns are considered sterile for about 4 months as long as the bagging is intact
- Surgical technique is a sole effort of each nurse
- Sterile conscience, is the best method to enhance sterile technique
- If a scrubbed person leaves the area of the sterile field, He/she must do handwashing and gloving again, but the gown need not be changed.
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14. A client in the ICU has been diagnosed with DIG. The nurse will anticipate administering which of the following fluids?
- Packed RBC
- Fresh Frozen plasma (FFP)
- Volume expanders, such as D10W
- Whole blood
15. Elton, 21 year old nursing student is taking the board examination. She is sweating profusely, has decreased awareness of his environment and is purely focused on the exam questions characterized by his selective attentiveness. What anxiety level is Elton exemplifying?
- Mild
- Moderate
- Severe
- Panic
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16. The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy?
- Anemia
- Decreased platelets
- Increased uric acid level
- Decreased leukocyte count
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17. Which of the following factors would the nurse suspect as predisposing a client to placenta previa?
- Multiple gestation
- Uterine anomalies
- Abdominal trauma
- Renal or vascular disease
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18. Situation: Mr. Punsalan is 36 years old, was admitted to the hospital with complaints of a burning sensation in the epigastric area after eating and inability to sleep at night. He was placed on bed rest and schedule for diagnostic studies. A diagnosis of Peptic Ulcer was made.Q. X -ray examination for Mr. Punsalan to detect tumors or ulcerations of the stomach and duodenum is:
- Gastroscopy
- GIT series
- Cold G.l. series
- Ba enema
19. The nurse is monitoring a postpartum client who received epidural anesthesia for delivery for the presence of a vulvar hematoma. Which assessment finding would best indicate the presence of a hematoma?
- Changes in vital signs
- Signs of heavy bruising
- Complaints of intense pain
- Complaints of a tearing sensation
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20. The mother with human immunodeficiency virus (HIV) infection brings her 10-month-old infant to the clinic for a routine checkup. The health care provider has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV infection. The nurse should make which most appropriate response to the mother?
- "I am so pleased also that everything has turned out fine."
- "Because symptoms have not developed, it is unlikely that your infant will develop HIV infection."
- "Everything looks great, but be sure to return with your infant next month for the scheduled visit."
- "Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old.”
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21. The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?
- Continue with the instructions, verifying client understanding.
- Walk around the client so that the nurse constantly faces the client
- Give the client a dietary booklet and return later to continue with the instructions.
- Tell the client about the importance of the instructions for the maintenance of health care.
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22. The nurse is infusing total parenteral nutrition (TPN). The primary purpose for closely monitoring the clients intake and output is:
- To determine how quickly the client is metabolizing the solution
- To determine whether the clients oral intake is sufficient
- To detect the development of hypovolemia
- To decrease the risk of fluid overload
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23. Situation: Sterilization is the process of removing ALL living microorganism. To be free of ALL living microorganism is sterility.Q. Chemical indicators communicate that:
- The items are sterile
- That the items had undergone sterilization process but not necessarily sterile
- The items are disinfected
- That the items had undergone disinfection process but not necessarily disinfected
24. A nurse is caring for a hospitalized diabetic patient with advanced peripheral recovery. Which of the following nursing action is MOST important?
- Moisturizing the skin with lotion each day
- Ensuring that foods are not too hot
- Facing the patient when speaking
- Assessing the heels for breakdown
25. Situation: Nursing care for the elderly.Q. A healthy adaptation to aging is primarily related to an individual
- Number of accomplishments
- Ability to avoid interpersonal conflict
- Physical health throughout life
- Personality development in his life span
26. Which is the drug of choice for treating Tourette syndrome?
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- haloperidol (Haldol)
- paroxetine (Paxil)
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27. The process of removing poisonous substance through gastric intubation is called:
- Gastric Lavage
- Gastric Gavage
- Gastric Decompression
- Gastric Tamponade
28. Virgie with a positive Mantoux test result will be sent for a chest X-ray. The nurse is aware that which of the following reasons this is done?
- To confirm the diagnosis
- To determine if a repeat skin test is needed
- To determine the extent of lesions
- To determine if this is a primary or secondary infection
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29. A young child named Richard is suspected of having pinworms. The community nurse collects a stool specimen to confirm the diagnosis. The nurse should schedule the collection of this specimen for:
- Just before bedtime
- After the child has been bathe
- Any time during the day
- Early in the morning
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30. Before Ms. Elkins leaves the emergency department, the nurse demonstrates how to apply the roller bandage. She is told to remove it for approximately 20 minutes and reapply it three times a day. It is essential that the nurse tells Ms. Elkins to loosen-the bandage if:
- Her toes feel fairly warm
- Her ankle feels painful
- Her toes appear swollen
- She wears a cotton sock
31. Patrick is in the oliguric phase of acute tubular necrosis and is experiencing fluid and electrolyte imbalances. The client is somewhat confused and complains of nausea and muscle weakness. As part of the prescribed therapy to correct this electrolyte imbalance, the nurse would expect to:
- Administer Kayexalate
- Restrict foods high in protein
- Increase oral intake of cheese and milk.
- Administer large amounts of normal saline via I.V.
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32. A nurse is taking history from a patient who has just been admitted to the hospital with an acute myocardial infarction. Which of the following questions would be most important for the nurse to ask?
- "At what time did the pain start?"
- "When did you eat your last meal?"
- "Have you experienced a pounding headache?"
- "Did you feel fluttering in your chest"
33. Diptheria is a:
- Bacterial toxin
- Killed bacteria
- Live attenuated
- Plasma derivatives
34. In the diagnosis of a possible pervasive developmental autistic disorder The nurse would find it most unusual for a 3 year old child to demonstrate:
- An interest in music
- An attachment to odd objects
- Ritualistic behavior
- Responsiveness to the parents
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35. The physician has ordered Pyridium (phenazopyridine) for a client with urinary urgency. The nurse should tell the client that:
- The urine will have a strong odor of ammonia.
- The urinary output will increase in amount.
- The urine will have a red-orange color
- The urinary output will decrease in amount.
36. The nurse knows that neurologic complications of multiple myeloma (MM) usually involve which of the following body system?
- Brain
- Muscle spasm
- Renal dysfunction
- Myocardial irritability
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37. A client is being tapered off opioids and the nurse is watchful for signs of withdrawal What is one of the first signs of withdrawal?
- Fever
- Nausea
- Diaphoresis
- Abdominal cramps
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38. Malou is diagnosed with major depression spends majority of the day lying in bed with the sheet pulled over his head. Which of the following approaches by the nurse would be the most therapeutic?
- Question the client until he responds
- Initiate contact with the client frequently
- Sit outside the clients room
- Wait for the client to begin the conversation
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39. The nurse caring for a client with a chest tube turns the client to the side and the chest tube accidentally disconnects from the water seal chamber Which initial action should the nurse take?
- Call the health care provider (HCP).
- Place the tube in a bottle of sterile water.
- Replace the chest tube system immediately.
- Place a sterile dressing over the disconnection site.
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40. Which Vitamin is not given in conjunction with the intake of LEVODOPA in cases of Parkinson's Disease due to the fact that levodopa increases its level in the body?
- Vitamin B1
- Vitamin B2
- Vitamin B3
- Vitamin B6
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41. In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal discharge and a negative pregnancy tests?
- Threatened
- Imminent
- Missed
- Incomplete
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42. The nurse is teaching a patient who was just diagnosed with narcolepsy. The nurse should teach the patient that which of the following typically INCREASES the level of fatigue?
- Taking brief naps
- Participating in anexercise program
- Eating large meals
- Working in a coolenvironment
43. What is the peak age range in acquiring acute lymphocytic leukemia (ALL)?
- 4 to 12 years.
- 20 to 30 years
- 40 to 50 years
- 60 to 70 years
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44. A 57-year-old patient in a hospital clinic is scheduled for a colon biopsy. The patient speaks a different language than the hospital staff, but does understand simple communication in the language of the staff. When conduction patient education prior to the procedure, the nurse should plan to:
- Write all communication and avoid speech
- Raise the volume and pitch of the voice
- Obtain an interpreter
- Smile and nod frequently
45. Situation: As a nurse you need to anticipate the occurrence of complications of stroke so that life threatening situations can be prevented.Q. Wendy is admitted to the hospital with signs and symptoms of stroke. Her Glasgow Coma Scale is 6 on admission. A central venous catheter was inserted and an I.V. infusion was started. As a nurse assigned to Wendy what will he your priority goal?
- Prevent skin breakdown
- Preserve muscle function
- Promote urinary elimination
- Maintain a patent airway
46. Situation: Nanette was rushed to the hospital due to burns. Witnesses told the emergency team that Nanette fell asleep while she is holding her cigarette thus, burning the bed sheets and herself. 2nd and 3rd degree burns are on the face, neck, anterior and posterior trunk as well as the anterior of the left leg and the whole right arm was burned. First degree burns are located on the anterior portion of the right leg and the anterior portion of the right and left arm. Nanette is a 110 lbs female client.Q. A second degree burn on Nanette is characterized by:
- Eschars
- Broken skin with fat exposed
- Blisters and Edema
- Insensate wound draining purple fluid
47. In planning care for the patient with ulcerative colitis the nurse identifies which nursing diagnosis as a priority?
- Anxiety
- Impaired skin integrity
- Fluid volume deficit
- Nutrition altered less than body requirements
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48. Situation: Josh is a 2-year old child who was born with a unilateral cleft lip and palate. He is being readmitted for a palate repair.Q. Prior to a repair of a unilateral cleft lip and palate, feeding will probably be:
- Limited to IV fluids
- Wish a soft, large altered nipple
- Accomplished per gastrostomy tube
- Facilitated by the use of spoon or medicine dropper
49. A child with a diagnosis of tetralogy of fallot is scheduled to be discharged from the hospital the nurse planning discharge education should instruct the caregivers that during a hyper cyanotic spell the position MOST likely to benefit the child is:
- Supine
- Side-lying
- Prone
- Knee-chest
50. Situation: Biood transfusion was ordered for Andre after an episode of severe bleeding.Q. In any event of an adverse hemolytic reaction during blood transfusion, Nursing intervention should focus on:
- Slow the infusion, Call the physician and assess the patient
- Stop the infusion, Assess the client, Send the remaining blood to the laboratory and cal the physician
- Stop the infusion, Call the physician and assess the client
- Slow the confusion and keep a patent IV line open for administration of medication
NCLEX-RN | QB1 | Practice Exam #49 (50 questions)