QB1 | Practice Exam #43 -> answers with explanation - Free NCLEX Exam Practice

NCLEX-RN | QB1 | Practice Exam #43 (50 questions)

 

1. The nurse is formulating a teaching plan for a client who has just experienced a transient ischemic attack (TIA). Which fact should the nurse include in the teaching plan?

• TIA symptoms may last 24 to 48 hours.
• Most clients have residual effects after having a TIA.
• TIA may be a warning that the client may have cerebrovascular accident (CVA)
• The most common symptom of TIA is the inability to speak.

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2. Which of the following descriptions of a clients experience and behavior can be assessed as an illusion?

• The client tries to hit the nurse when vital signs must be taken
• The client says, "I keep hearing a voice telling me to run away"
• The client becomes anxious whenever the nurse leaves the bedside
• The client looks at the shadow on a wall and tells the nurse she sees frightening faces on the wall.

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3. Chemotherapy induces vomiting by:

• Stimulating neuroreceptors in the medulla.
• Inhibiting the release of catecholamines.
• Autonomic instability.
• Irritating the gastric mucosa.

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4. Jen a nursing student is anxious about the upcoming board examination but is able to study intently and does not become distracted by a roommate's talking and loud music. The student's ability to ignore distractions and to focus on studying demonstrates:

• Mild-level anxiety
• Panic-level anxiety
• Severe-level anxiety
• Moderate-level anxiety

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5. Nurse John is a aware that most crisis situations should resolve in about:

• 1 to 2 weeks
• 4 to 6 weeks
• 4 to 6 months
• 6 to 12 months

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6. A 16 year-old boy is in the Post-Operative Care Unit two hours after a tonsillectomy. He is alert and oriented but complains of severe throat pain and difficulty swallowing. He rates the pain at a level 7, on a scale of 1-10. The urine output from the folly catheter is 45 ml over the past two hours. Blood pressure: 130/74 mmHg. Heart rate: 64/min. Respiratory rate: 18/min. Oxygen saturation: 98% on room air. Which clinical finding is most important to report to the doctor?

• Oxygen saturation
• Difficulty swallowing
• Urinary output
• Pain level

7. The nurse is teaching a client with hyperparathyroidism how to manage the condition at home. Which response by the client indicates the need for additional teaching?

• "I should limit my fluids to 1 liter per day."
• "I should use my treadmill or go for walks daily"
• "I should follow a moderate-calcium, high-fiber diet"
• "My alendronate helps to keep calcium from coming out of my bones"

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8. The nurse is caring for a client with a long leg cast. During discharge teaching about appropriate exercises for the affected extremity, the nurse should recommend exercises

• isometric
• range of motion
• aerobic
• isotonic

9. Situation: As a nurse, you should be aware and prepared of the different roles you play.Q. One very common cause of postoperative pain is:

• Forceful traction during surgery
• Prolonged surgery
• Break in aseptic technique
• Inadequate anesthetic

10. Which vitamin should be administered with INH (isoniazid) in order to prevent possible nervous system side effects?

• Thiamine
• Niacin
• Pyridoxine
• Riboflavin

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11. Situation: Some equipments and materials in our hospital are color coded, this is to increase the safety and proficiency of rendering patients care.Q. An anesthesiologist is preparing to do a spinal anesthesia to a 220 lb, 30 year old athlete she request the circulating nurse to prepare a pink spinal set with another blue set as stand by. What gauge spinal sets will make available in the OR suite?

• Gauge 16 and 22
• Gauge 18 and 16
• Gauge 16 and 20
• Gauge 5 and 22

12. Which of the following foods should a client with leukemia avoid?

• White bread
• Carrot sticks
• Stewed apples
• Medium rare steak

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13. Child has burns What is the nursing intervention to prevent Aspiration for this child

• Child sitting put all the time
• Keep the child seated 10 minutes after eating
• Keep baby sitting from 30-45 minutes after eating
• Keep baby sitting 24 hours

14. Megestrol acetate, an antineoplastic medication, is prescribed for a client with metastatic endometrial carcinoma. The nurse reviews the clients history and should contact the health care provider if which diagnosis is documented in the client's history?

• Gout
• Asthma
• Myocardial infarction
• Venous thromboembolism

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15. You respond to a call for help from the ED waiting room. There is an elderly patient lying on the floor. List the order for the actions that you must perform. A. Perform the chin lift or jaw thrust maneuver. B. Establish unresponsiveness. C. Initiate cardiopulmonary resuscitation (CPR). D. Call for help and activate the code team. E. Instruct a nursing assistant to get the crash cart.

• A, B, D, C, E
• D, A, B, C, E
• E, A, C, D, B
• B, D, A, C, E

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16. Methotrexate is a folate antagonist It inhibits enzymes required for DNA base synthesis. To prevent harm to normal ceils, a fully activated form of folic acid known as leucovorin (folinic acid; citrovorum factor) can be administered. Administration of leucovorin is known as:

• Induction therapy.
• Consolidation therapy.
• Pulse therapy.
• Rescue therapy

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17. A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis?

• Clear CSF, decreased pressure, and elevated protein level
• Clear CSF, elevated protein, and decreased glucose levels
• Cloudy CSF, elevated protein, and decreased glucose levels
• Cloudy CSF, decreased protein, and decreased glucose levels

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18. Situation: You are actively practicing nurse who has just finished your graduate studies. You learned the value of research and would like to utilize the knowledge and skills gained in the application of research to the nursing service. The following questions apply to research. Q. Which of the following studies is based on quantitative research?

• A study examining the bereavement express in spouse or clients with terminal cancer
• A study exploring the factors influencing weight control behavior
• A study measuring the effects of sleep deprivation on patients healing
• A study examining client's feeling before, during and after bone marrow aspiration.

19. The reason nurse May keeps the neonate in a neutral thermal environment is that when a newborn becomes too cool, the neonate requires:

• Less oxygen, and the newborn's metabolic rate increases.
• More oxygen, and the newborn's metabolic rate decreases.
• More oxygen, and the newborn's metabolic rate increases.
• Less oxygen, and the newborn's metabolic rate decreases.

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20. Situation: John Mark is a 21 year old male client who was rushed following an automobile accident He is very anxious, dyspneic and in severe pain. Q. He is intubated with an endotracheal tube and is placed on a mechanical ventilator. Which findings alerts the nurse to an additional problem with regards to the respiratory function?

• Dull on percussion in the 3rd to 5th intercostal space, midclavicular line
• Decreased paradoxical motion
• Louder breath sounds on the right chest
• Vesicular breath sound heard at the lung bases

21. A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?

• Alteration in nutrition
• Alteration in bowel elimination
• Alteration in skin integrity
• Ineffective individual coping

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22. The primary advantage of gastrostomy feeding is

• Ensures adequate nutrition
• It prevents aspiration
• Maintains Gastro esophageal sphincter integrity
• Minimizes fluid-electrolyte imbalance

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23. When checking patellar reflexes the nurse is unable to elicit a knee-jerk response. To facilitate checking the patellar reflex the nurse should tell the client to:

• Pull against her interlocked fingers
• Shrug her shoulders and hold for a count of five
• Close her eyes tightly and resist opening
• Cross her legs at the ankles

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24. Situation: A nurse is working with an aggressive client in the psychiatric unit. Q. A patient grabs and about to throw it The nurse best responds saying.

• "Stop! Put that chair down."
• "Don't be silly."
• "Stop! The security will be here in a minute"
• "Calm down"

25. Jun has been hospitalized for major depression and suicidal ideation. Which of the following statements indicates to the nurse that the client is improving?

• "I'm of no use to anyone anymore"
• "I know my kids don't need me anymore since they're grown”
• "I couldn't kill myself because I don't want to go to hell.”
• "I don't think about killing myself as much as I used to.”

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26. If the client with lung cancer also has preexisting pulmonary disease, which of the following statements best describes how the extent of that can be performed?

• It doesn't affect it.
• It may require a whole lung to be removed.
• The entire tumor may not be able to be removed
• It may prevent surgery if the client can't tolerate lung tissue removal

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27. When assessing the client with celiac disease, the nurse can expect to find which of the following?

• steatorrhea
• jaundiced sclerae
• clay-colored stools
• widened pulse pressure

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28. Situation: Mrs. Pichay is admitted to your ward. The MD ordered "Prepare for thoracentesis this pm to remove excess air from the pleural cavity. Q. Mrs. Pichay who is for thoracentesis is assigned by the nurse to which of the following positions?

• Trendelenburg position
• Supine position
• Dorsal Recumbent position
• Orthopneic position

29. A male client is brought to the emergency department due to motor vehicle accident. While monitoring the client, the nurse suspects increasing intracranial pressure when:

• Client is oriented when aroused from sleep, and goes back to sleep immediately.
• Blood pressure is decreased from 160/90 to 110/70.
• Client refuses dinner because of anorexia.
• Pulse is increased from 88-96 with occasional skipped beat.

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30. The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia?

• Difficulty in breathing after exertion
• Numbness and tingling in the extremities
• A faster than usual heart rate
• Feelings of lightheadedness

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31. A male client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?

• Stool Hematest
• Carcinoembryonic antigen (CEA)
• Sigmoidoscopy
• Abdominal computed tomography (CT) scan

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32. A patient is being evaluating due to onset of paleness, shortness of breath and sensations of heart palpitations. Which of the following component of complete blood count (CBC) should the nurse review to determine if the patient has anemia

• Leukocytes
• Platelets
• Erythrocytes
• Thrombocytes

33. A nurse who is maintaining a private clinic in the community renders service on maternal and child health among the neighborhood for a fee is:

• Primary care nurse
• Independent nurse practitioner
• Nurse-Midwife
• Nurse specialist

34. A client has been started on long-term therapy with rifampin. The nurse should provide which information to the client about the medication?

• Should always be taken with food or antacids
• Should be double-dosed if 1 dose is forgotten
• Causes orange discoloration of sweat tears, urine, and feces
• May be discontinued independently if symptoms are gone in 3 months

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35. Medications bound to protein have the following effect

• Enhancement of drug availability.
• Rapid distribution of the drug to receptor sites.
• The more drug bound to protein, the less available for desired effect.
• Increased metabolism of the drug by the liver.

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36. A client with leukemia has neutropenia. Which of the following functions must be frequently assessed?

• Blood pressure
• Bowel sounds
• Heart sounds
• Breath sounds

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37. Rho(D) immune globulin is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines that the woman understands the purpose if the woman states that it will protect her next baby from which condition?

• Having Rh-positive blood
• Developing a rubella infection
• Developing physiological jaundice
• Being affected by Rh incompatibility

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38. The following clients are to be assigned for daily care. The newly licensed nurse should not be assigned to provide primary care for the client with:

• Full-thickness burns of the abdomen and upper thighs
• A fractured hip scheduled for hip replacement
• Ileal reservoir following a cystectomy
• Noncardiogenic pulmonary edema (ARDS)

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39. The nurse is caring for a client who was in voluntarily hospitalized to a mental health unit and is scheduled for electroconvulsive therapy. The nurse notes that an informed consent has not been obtained for the procedure. Based on this information, what is the nurse's best determination in planning care?

• The informed consent does not need to be obtained.
• The informed consent should be obtained from the family.
• The informed consent needs to be obtained from the client.
• The health care provider will provide the informed consent.

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40. The physician has ordered increased oral hydration for a client with renal calculi. Unless contraindicated the recommended oral intake for helping with the removal of renal calculi is:

• Eggs
• Horses
• Shellfish
• Pork

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41. A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the following would be the priority when assessing the client?

• Glucosuria
• Depression
• Hand/face edema
• Dietary intake

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42. In patients with acute pancreatitis, the administration of the analgesic morphine may cause:

• addiction
• urinary retention
• spasms of the sphincter of Oddi
• paralytic ileus

43. A client is receiving Pergonal (menotropins) intramuscularly for ovarian stimulation. Which of the following is a common side effect of this therapy?

• Piercing rectal pain.
• Mood swings.
• Visual disturbances.
• Jerky tremors.

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44. Proposed the HEALTH CARE SYSTEM MODEL.

• Henderson
• Orem
• Parse
• Neuman

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45. In educating clients about non-pharmaceutical alternatives, which topic could you delegate to an experienced LPN/LVN, who will function under your continued support and supervision?

• Therapeutic touch
• Use of heat and cold applications
• Meditation
• Transcutaneous electrical nerve stimulation (TENS)

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46. The lower limit of viability for infants in terms of age of gestation is:

• 21-24 weeks
• 28-30 weeks
• 25-27 weeks
• 38-40 weeks

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47. 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?"

48. Situation: The abuse of dangerous drug is a serious public health concern that nurses need to address. The mother of a drug dependent would never consider referring her son to a drug rehabilitation agency because she fears her son might just becomes worse while relating with other drugs users. The mother's behavior can be described as:

• Unhelpful
• Codependent
• Caretaking
• Supportive

49. Following a heart transplant a client is started on medication to prevent organ rejection. Which category of medication prevents the formation of antibodies against the new organ?

• Antivirals
• Antibiotics
• Immunosuppressants
• Analgesics

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50. Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?

• Abdominal pain
• Absent pedal pulses
• Angina
• Lower back pain

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NCLEX-RN | QB1 | Practice Exam #43 (50 questions)