NCLEX-RN | QB1 | Practice Exam #48 (50 questions)

 

1. A client with schizophrenia tells the nurse he hears the voices of his dead parents. To help the client ignore the voices, the nurse should recommend that he:

• sit in a quiet dark room and concentrate on the voices.
• listen to a personal stereo through headphones and sing along with the music.
• call a friend and discuss the voices and his feelings about them.
• engage in strenuous exercise.

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2. A home care nurse visits a diabetic patient who was started on insulin injections. Upon examination, the nurse observes small lumps and dents on the right upper arm where the patient has injected insulin. What is the BEST nursing intervention?

• Refer patient to dermatologist for diabetic cellulites
• Instruct the patient to rotate the sites of injection
• Refer patient to an end for better control of glucose level
• Instruct patient to inject in the muscular area instead of endo area

3. The nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. The nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome?

• Cold, bluish-colored fingers
• Numbness and tingling in the fingers
• Pain that increases when the arm is dependent
• Pain that is out of proportion to the severity of the fracture

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4. Situation: As a nurse in the Oncology Unit, you have to be prepared to provide efficient and effective care to your patients.Q. Which one of the following nursing interventions would be most helpful in preparing the patient for radiation therapy?

• Offer tranquilizers and anti-emetics
• Instruct the patient of the possibility of radiation burn
• Emphasis on the therapeutic value of the treatment
• Map out the precise course of treatment

5. The nurse has provided home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement made by the parents indicates a need for further instruction?

• "A balance of rest and exercise is important."
• "I can apply lotion or powder to the incision if it is itchy."
• "Activities in which my child could fall need to be avoided for 2 to 4 weeks."
• "Large crowds of people need to be avoided for at least 2 weeks after surgery"

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6. The charge nurse enters the nursing diagnosis "Risk for ineffective airway clearance related to an inability to swallow" on the client's care plan. Which nursing intervention is most appropriate for managing the identified problem?

• Keeping the client supine
• Providing frequent oral hygiene
• Removing all head pillows
• Performing oral suctioning

7. Unoccupied bed making means:

• Changing linen when the patient remains in the bed.
• Changing linen when the bed empty.
• State in which a person is relieved of distress.
• None of the above.

8. Situation: With the improvement in life expectancies and the emphasis in the quality of life it is important to provide quality care to our older patients. There are frequently encountered situations and issues relevant to the older, patients.Q. Merle, age 86, is complaining of dizziness when she stands up. This may indicate:

• dementia
• a visual problem
• functional decline
• drug toxicity

9. In putting sterile gloves, Which should be gloved first?

• The dominant hand
• The non dominant hand
• The left hand
• No specific order. Its up to the nurse for her own convenience

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10. In medical and nursing practice, code means a call for:

• DNR state
• call to order
• clinical case
• cardiopulmonary resuscitation

11. Situation: You are going to participate in a Cancer Consciousness Week. You are assigned to take charge of the women to make them aware of cervical cancer. You reviewed its manifestations and management.Q. Late signs and symptoms of cervical cancer include the following EXCEPT:

• urinary/bowel changes
• pain in pelvis, leg of flank
• uterine bleeding
• lymphedema of lower extremities

12. An infection in a central venous access device is not eliminated by giving antibiotics through the catheter How would bacterial glycocalyx contribute to this?

• It protects the bacteria from antibiotic and immunologic destruction.
• Glycocalyx neutralizes the antibiotic rendering it ineffective.
• It competes with the antibiotic for binding sites on the microbe.
• Glycocalyx provides nutrients for microbial growth.

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13. Stage of GAS that results from prolonged exposure to stress. Here, death will ensue unless extra adaptive mechanisms are utilized

• Stage of Alarm
• Stage of Resistance
• Stage of Homeostasis
• Stage of Exhaustion

14. Situation: Nurse Lorena is a Family Planning and Infertility Nurse Specialist and is currently attending to a meeting. The following conditions pertain to meeting the nursing of this particular population group.Q. Lilia is scheduled to have a hysterosalpingogram. Which of the following, instructions would you give her regarding this procedure?

• She will not be able to conceive for 3 months after the procedure
• The sonogram of the uterus will reveal any tumors present
• Many women experience mild bleeding as an after effect
• She may feel some cramping when the dye is inserted

15. Situation: It is common that client ask the nurse personal questions.Q. The client asks for the nurse's telephone number, which of these responses is NOT appropriate?

• "it is confidential I just don't give it to anyone”
• "What would you do with my number if I give it to you?”
• "Are you asking for an official number of the hospital/clinic for your reference?"
• "If I say. No to your request, what are your thoughts about it?"

16. This is the first stage of illness wherein, the person starts to believe that something is wrong. Also known as the transition phase from wellness to illness.

• Symptom Experience
• Assumption of sick role
• Medical care contact
• Dependent patient role

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17. Situation: If a child with diarrhea registers one sign in the pink row and one in the yellow; row in the IMCI ChartXarlo has had diarrhea for 5 days. There is no blood in the stool, he is irritable. His eyes are sunken the nurse offers fluid to Carlo and he drinks eagerly. When the nurse pinched the abdomen, it goes back slowly. How will you classify Carlo's illness?

• severe dehydration
• no dehydration
• some dehydration
• moderate dehydration

18. A client was admitted to the psychiatric unit after complaining to her friends and family that neighbors have bugged her home in order to hear all of her business. She remains aloof from other clients, paces the floor and believes that the hospital is a house of torture. Nursing interventions for the client should appropriately focus on efforts to

• Convince the client that the hospital staff is trying to help
• Help the client to enter into group recreational activities
• Provide interactions to help the client learn to trust staff
• Arrange the environment to limit the client's contact with other clients

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19. A client has sustained a severe head injury and damaged the preoccipital lobe. The nurse should remain particularly alert for which of the following problems?

• Visual impairment
• Swallowing difficulty
• Impaired judgment
• Hearing impairment

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20. When caring for client in thyroid crisis, the nurse would question an order for:

• IV fluid
• Propranolol (Inderal)
• Propylthiouracil
• A hyperthermia blanket

21. A Client with glaucoma has been prescribed with miotics. The nurse is aware that miotics is for:

• Constricting pupil
• Relaxing ciliary muscle
• Constricting intraocular vessel
• Paralyzing ciliary muscle

22. A patient has been transferred to the medical unit following a parathyroidectomy Surgery was performed under general anesthesia and the patients diet my advanceas tolerated. The patient requests a sip of apple juice. The nurse should FIRST assessthe patient's:

• Skin turgor
• Cough reflex
• Lung sounds
• Bowel sounds

23. Which of the following treatment modality is appropriate for a client with paranoid tendency?

• Activity therapy.
• Individual therapy.
• Group therapy.
• Family therapy

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24. The client is receiving total parenteral nutrition (TPN). Which lab test should be evaluated while the client is receiving TPN?

• Hemoglobin
• Creatinine
• Blood glucose
• White blood cell count

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25. Which of the following adverse effects is associated with levothyroxine (Synthroid) therapy?

• Tachycardia
• Bradycardia
• Hypotension
• Constipation

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26. Also known as STERILE TECHNIQUE

• Surgical Asepsis
• Medical Asepsis
• Sepsis
• Asepsis

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27. The nurse is caring for the client following a thyroidectomy when suddenly the client becomes nonresponsive and pale with a BP of 60 systolic. The nurses initial action should be to:

• Lower the head of the bed.
• Increase the infusion of normal saline.
• Administer atropine IV.
• Obtain a crash cart.

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28. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child?

• Platelet count
• Hematocrit level
• Hemoglobin level
• Partial thromboplastin time

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29. Situation: The patient who is depressed will undergo electroconvulsive therapy.Q. The preparation of a patient for ECT ideally is MOST similar to preparation for a patient for:

• electroencephalogram
• general anesthesia
• electrocardiogram
• X-ray

30. Mrs. Hogan, a 43-year-old woman, is admitted to your unit for cholecystectomy.Q. The most common lethal arrhythmia in the first hour of an Ml is:

• Pulseless Ventricular Tachycardia
• Asystole
• Ventricular fibrillation
• First degree heart block.

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31. Mark, a 7-year-old client is brought to the emergency department He's tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and has a nonproductive cough. He recently had a cold. Form this history; the client may have which of the following conditions?

• Acute asthma
• Bronchial pneumonia
• Chronic obstructive pulmonary disease (COPD)
• Emphysema

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32. A gravida 3 Para 2 presents to the Maternity Triage Unit after the amniotic membranes ruptured at home. The fluid is noted to be clear. The neonate's head is engaged into the pelvis and the patient is having contractions every 5 to 7 minutes. Each contraction lasts for 60-90 seconds. An examination of the cervix finds 4 centimeters dilatation and 90 % effacement. She is uncomfortable during contractions and rates the pain at a level 7, on a pain scale of 1-10 Which finding is most indicative that she is in true labor?

• Level of pain
• Cervical dilatation and effacement
• Engagement of presenting part fractions
• Frequency and length of contraction

33. Sally Baker, a 40-year-old woman, is admitted to the hospital with an established diagnosis of mitral stenosis. She is scheduled for surgery to repair her mitral valve.Q. Chemotherapy may be used in combination with surgery in the treatment of lung cancer. Special nursing considerations with chemotherapy include all but which of the following?

• Helping the client deal with depression secondary to the diagnosis and its treatment
• Explaining that the reactions to chemotherapy are minimal
• Careful observation of the IV site of the administration of the drugs
• Careful attention to blood count results

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34. A client refuses to remain on psychotropic medications after discharge from an inpatient psychiatric unit. Which information should the community health nurse assess first during the initial follow-up with this client?

• Income level and living arrangements
• Involvement of family and support systems
• Reason for inpatient admission
• Reason for refusal to take medications

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35. A patient is recovering following surgery for placement of a colostomy. The nurse goes to the patient's room to instruct the patient how to care for the colostomy. The patient's roommate has visitors and the patient does not want to participate at this time. What should the nurse do?

• Document the patient's refusal and add non-compliance to the care plan
• Tell the patient that this is vital information and may delay discharged
• Plan a time convenient to both the patient and the nurse
• Pull the curtain around be bed and speak, ensuring privacy

36. All of the followings are normal characteristics of urine Except:

• Volume: 1200-1500 ml per day
• Straw color.
• Sterile, no microorganisms.
• Cloudy.

37. A Community health nurse is teaching a health class about infectious disease processes. The nurse instructs the class that rabies would be considered which of the following types of infection?

• Viral
• Protozoan
• Fungal
• Bacterial

38. One of your client's has just undergone an ear surgery. Which of the following would be inappropriate in planning for his care?

• Administration of antiemetics and analgesics as ordered
• Daily irrigation of the ear canal
• Walking with assistance at least 24 hours after operation
• Teaching the patient to avoid sneezing, coughing and nose blowing

39. The nurse understands that the diagnosis of oral cancer is confirmed with:

• Biopsy
• Gram Stain
• Oral culture
• Oral washings for cytology

40. Question about ECG, what is the most appropriate diagnosis?

• Atrial Fibrillation
• Atrial Flutter
• Atropine
• None of the above.

41. Incubation period of infection is:

• Person is most infectious and nonspecific sign and symptom.
• Organism growing and multiplying.
• Recovery from infection.
• Presence of specific sign and symptom.

42. A child with leukemia is being discharged after beginning chemotherapy. What instructions will the nurse include in the teaching plan for the parents of this child?

• Provide a diet low in protein and high in carbohydrates
• Avoid fresh vegetables that are not cooked or peeled
• Notify the M.D. if the child's temperature exceeds 101F (39C)
• Increase the use of humidifiers throughout the house

43. A male patient who had surgery 2 days ago for head and neck cancer Is about to make his first attempt to ambulate outside his room. The nurse notes that he is steady on his feet and that his vision was unaffected by the surgery. Which of the following nursing interventions would be appropriate?

• Encourage the patient to walk in the hall alone
• Discourage the patient from walking in the hall for a few more days
• Accompany the patient for his walk.
• Consult a physical therapist before allowing the patient to ambulate

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44. 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. In consideration of the steps in applying the bag technique, which side of the paper lining of the CHN bag is considered clean to make a non­contaminated work area?

• The lower lip
• The outer surface
• The upper lip
• The inside surface

45. A 22 year-old man suffered major injuries to the right leg in a road traffic accident that resulted in an above -the- knee amputation with a rigid dressing. Twelve hours later the patient complains of increasing pressure from the dressing and the feeling that something is crawling around the stump.

• Notify the physician
• Remove and reapply the dressing
• Remind patient phantom limb pain is normal
• Elevate and apply ice to the residual limb

46. If a couple would like to enhance their fertility, the following means can be done: 1.Monitor the basal body temperature of the woman everyday to determine peak period of fertility; 2.Have adequate rest and nutrition. 3.Have sexual contact only during the dry period of the woman; 4.Undergo a complete medical check-up to rule out any debilitating disease

• 1 only
• 1 & 4
• 1,2,3,4
• 1,2,4

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47. Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage?

• Placenta previa
• Ectopic pregnancy
• Incompetent cervix
• Abruptio placentae

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48. A pregnant woman in the three months to have a thrombus in the right leg What do you expect the doctor ordered

• Heparin
• Insulin
• Warfarin
• Aspirin

49. A patient with a spinal cord injury states, "I have no control over my situation, 1 can't do anything for myself". This patient is exhibiting:

• Powerlessness
• Delusions
• Suicidal ideation
• Resignation

50. If a client requires a pneumonectomy, what fills the area of the thoracic cavity?

• The space remains filled with air only
• The surgeon fills the space with a gel
• Serous fluids fills the space and consolidates the region
• The tissue from the other lung grows over to the other side

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NCLEX-RN | QB1 | Practice Exam #48 (50 questions)