NCLEX-RN | QB1 | Practice Exam #40 (50 questions)

 

1. Situation: The infant and child mortality rate in the low to middle income countries is ten times higher than industrialized countries, in response to this the WHO and UNICEF launched protocol integrated Management of Childhood Illness to reduce the morbidity and mortality against childhood illnesses.Fever as used in IMCI includes:

• Axillary temperature of 37.5 or higher
• Rectal temperature of 38 or higher
• Feeling hot to touch
• All of the above

2. The nurse is counseling a couple in their mid 30's who have been unable to conceive for about 6 months. They are concerned that one or both of them may be infertile. What is the best advice the nurse could give to the couple?

• "it is no unusual to take 6-12 months to get pregnant, especially when the partners are in their mid-30s. Eat well, exercise, and avoid stress."
• "Start planning adoption. Many couples get pregnant when they are trying to adopt."
• "Consult a fertility specialist and start testing before you get any older.”
• "Have sex as often as you can, especially around the time of ovulation, to increase your chances of pregnancy."

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3. You are in a clients home to attend to a delivery. Which of the following will you do first?

• Set up a sterile area
• Put on a clean gown and apron
• Cleanse the client's vulva with soap and water
• Note the interval, duration and intensity of labor and contractions

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4. A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:

• Estrogen levels are low
• Lutenizing hormone is high
• The endometrial lining is thin
• The progesterone level is low

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5. In assisting a female client for immediate surgery, the nurse In-charge is aware that she should:

• Encourage the client to void following preoperative medication.
• Explore the clients fears and anxieties about the surgery.
• Assist the client in removing dentures and nail polish.
• Encourage the client to drink water prior to surgery.

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6. The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents?

• Administer the iron at mealtimes.
• Administer the iron through a straw.
• Mix the iron with cereal to administer.
• Add the iron to formula for easy administration.

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7. A client with Lyme disease is being treated with Achromycin (tetracycline HC1). The nurse should tell the client that the medication will be rendered ineffective if taken with:

• Salicylates
• Antacids
• Antihistamines
• Sedative-hypnotics

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8. Which of the following statements should be included when teaching clients about monoamine oxidase inhibitor (MAOI) antidepressants?

• Don't take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
• Have blood levels screened weekly for leucopenia
• Avoid strenuous activity because of the cardiac effects of the drug
• Don't take prescribed or over the counter medications without consulting the physician

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9. A patient complains of severe menstrual cramping. Bleeding is not usually heavy and the patient has no uterine disorders.Which of the following interventions should the nurse anticipate the doctor will order to promote comfort?

• Acetaminophen (Tylenol)
• Strict bed rest
• Heating pad to the back of neck
• Ibuprofen (Motrin)

10. Osteoporosis and degenerative diseases like Osteoarthritis belongs to what type of risk factor?

• Genetics
• Age
• Environment
• Lifestyle

11. The most appropriate means of re-hydration of a seven-month-old with diarrhea and mild dehydration is:

• Oral re-hydration therapy with an electrolyte solution
• Replacing milk-based formula with a lactose-free formula
• Administering intravenous Dextrose 5% % normal saline
• Offering bananas rice and applesauce along with oral fluids

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12. A client with bipolar disorder is being treated with lithium for the first time. The nurse should observe the client for which common adverse effect of lithium?

• Sexual dysfunction
• Constipation
• Polyuria
• Seizures

13. The nurse is caring for a client following the removal of a central line catheter when the client suddenly develops dyspnea and complains of substernal chest pain. The client is noticeably confused and fearful. Based on the clients symptoms the nurse should suspect which complication of central line use?

• Myocardial infarction
• Air embolus
• Intrathoracic bleeding
• Vagal response

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14. To prevent a valsalva maneuver in a client recovering from an acute myocardial infarction the nurse would:

• Assist the client to use the bedside commode
• Administer stool softeners every day as ordered
• Administer antidysrhythmics prn as ordered
• Maintain the client on strict bed rest

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15. A client is brought to the emergency department after being beaten by her husband, a prominent attorney. The nurse caring for this client understands that:

• open boundaries are common in violent families.
• violence usually results from a power struggle.
• domestic violence and abuse span all socioeconomic classes.
• violent behavior is a genetic trait passed from one generation to the next.

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16. Situation: Transurethral resection prostatectomy, (TURP) is performed to Mn Recto, 60 years old, due to prostate enlargement. Post operatively he has continuous irrigation (Cystoclysis).Q. Which of these statements explain the reason for continuous bladder irrigation?

• To remove clot from the bladder
• To maintain the patency of the catheter
• To maintain the patency of me bladder
• To dilute urine

17. To determine the possible sources of sexually transmitted infections, which is the BEST method that may be undertaken by the public health nurse?

• Contact tracing
• Community survey
• Mass screening tests
• Interview suspects

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18. How many minute/s is/are allowed to pass before making a re-reading after the first one?

• 1
• 5
• 15
• 30

19. The client is brought to the emergency department because of serious vehicle accident After an hour, the client has been declared brain dead. The nurse who has been with the client must now talk to the family about organ donation. Which of the following consideration is necessary?

• Include as many family members as possible.
• Take the family to the chapel.
• Discuss life support systems.
• Clarify the family's understanding of brain death.

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20. The community health nurse Is providing a teaching session about anthrax to members of the community and asks the participants about the methods of transmission. Which answers by the participants would indicate that teaching was effective? Select all that apply. 1.Bites from ticks or deer flies. 2.Inhalation of bacterial spores. 3.Through a cut or abrasion in the skin. 4.Direct contact with an infected individual. 5.Sexual contact with an infected individual. 6.Ingestion of contaminated under cooked meat

• 1,2,5,6
• 2,3,6
• 1,2,3,4,5
• 4,5,6

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21. Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the day room while other clients are watching television. He begins cursing and throwing furniture. Nurse Oliver first action is to:

• Check the client's medical record for an order for an as-needed I.M. dose of medication for agitation.
• Place the client in full leather restraints.
• Call the attending physician and report the behavior.
• Remove all other clients from the dayroom.

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22. The client place on NPO for preparation of the blood test Adreno-cortical response is activated and which of the following below is an expected response?

• Low BP
• Decrease Urine output
• Warm, flushed, dry skin
• Low serum sodium levels

23. Situation: As a nurse, you should be aware and prepared of the different roles you play.Q. As a nurse, you protect yourself and co-workers from misinformation and misrepresentations through the following EXCEPT:

• Provide information to clients about a variety of services that can help alleviate the client's pain and other conditions
• Advising the client, by virtue of your expertise, that which can contribute to the client's well-being
• Health education among clients and significant others regarding the use of chemical disinfectant
• Endorsement thru trimedia to advertise your favorite disinfectant solution

24. What will be important to include in the nursing care for the client with angle-closure glaucoma?

• Evaluation of medications to determine if any of them cause an increase in IOP is a side effect.
• Observation for an increase in loss of vision; it can be reversed if promptly identified.
• Control BP to decrease the client's potential loss of peripheral vision.
• Assessment for a level of discomfort; the client may experience considerable pain until the optic nerve atrophies

25. A client has an order for streptokinase. Before administering the medication the nurse should assess the client for:

• Allergies to pineapples and bananas
• A history of streptococcal infections
• Prior therapy with phenytoin
• A history of alcohol abuse

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26. A client is admitted with suspected acute pancreatitis. Which lab finding confirms the diagnosis?

• Blood glucose of 260mg/dL
• White cell count of 21 000cu/mm
• Platelet count of 250 000cu/mm
• Serum amylase level of 600 units/dL

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27. 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. Carmen, is asking the nurse the most appropriate time of the month to do her self-examination of the breast. The MOST appropriate reply by the nurse would be:

• the 26th day of menstrual cycle
• 7-8 days after conclusion of the menstrual period
• During her menstruation
• the same day each month

28. The minimum time in washing each hand should never be below:

• 5 seconds
• 10 seconds
• 15 seconds
• 30 seconds

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29. During the immediate postoperative period, a patient reveals an oxygen saturation level of 91%. The nurse should:

• Position the patient on the left side
• Administer supplemental oxygen
• Continue to provide supportive care
• Lower the temperature of the room

30. The nurse is aware that the following ways in vascular dementia different from Alzheimer's disease is:

• Vascular dementia has more abrupt onset
• The duration of vascular dementia is usually brief
• Personality change is common in vascular dementia
• The inability to perform motor activities occurs in vascular dementia

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31. It is the most effective way of controlling schistosomiasis in an endemic area?

• Use of molluscicides
• Building of foot bridges
• Proper use of sanitary toilets
• Use of protective footwear, such as rubber boots

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32. A 77-year-old male client is admitted for elective knee surgery. Physical examination reveals shallow respirations but no sign of respiratory distress. Which of the following is a normal physiologic change related to aging?

• Increased elastic recoil of the lungs
• Increased number of functional capillaries in the alveoli
• Decreased residual volume
• Decreased vital capacity

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33. While assessing the postpartal client the nurse notes that the fundus is displaced to the right. Based on this finding the nurse should:

• Ask the client to void.
• Assess the blood pressure for hypotension.
• Administer oxytocin.
• Check for vaginal bleeding.

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34. The nurse is preparing a client with gastroesophageal reflux disease (GERD) for discharge. The nurse should tell the client to:

• Eat a small snack before bedtime
• Sleep on his right side
• Avoid carbonated beverages
• Increase his intake of citrus fruits

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35. Following an amputation, the advantage to the client for an immediate prosthesis fitting is:

• Ability to ambulate sooner
• Less change of phantom limb sensation
• Dressing changes are not necessary
• Better fit of the prosthesis

36. Situation: Nurse's attitudes toward the pain influence the way they perceive and interact with clients in pain.Q. Nurses should understand that when a client responds favorably to a placebo, it is known as the placebo effect Placebos do not indicate whether or not a client has:

• Conscience
• Real pain
• Disease
• Drug tolerance

37. A client has had a tracheostomy for 2 weeks after a motor vehicle accident. Which task could the RN safely delegate to unlicensed assistive personnel (UAP)?

• Teach the client how to cough up secretions
• Changes the tracheostomy trach ties
• Monitor if client has shortness of breath
• Perform routine tracheostomy dressing care

38. Which of the following would affect a nurse aide's status on the state's nurse aide registry and also cause the nurse aide to be ineligible to work in a nursing home?

• Having been terminated from another facility for repeated tardiness
• Missing a mandatory infection control in service training program
• Failing to show for work without calling to report the absence
• Having a finding for resident neglect

39. The first techniques used examining the abdomen of a client is:

• Palpation
• Auscultation
• Percussion
• Inspection

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40. Situation:- Marie is 5 % years old and described by the mother as bed wetting at night. Q. All of the following, EXCEPT one comprise the concepts of behavior therapy program:

• reward and punishment
• extinction
• learning
• placebo as a form treatment

41. The nurse is caring for a restless client who is beginning nutritional therapy with parenteral nutrition (PN). The nurse should plan to ensure that which action is taken to prevent the client from sustaining injury?

• Calculate daily intake and output.
• Monitor the temperature once daily.
• Secure all connections in the PN system.
• Monitor blood glucose levels every 12 hours

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42. Mr. Duffy is admitted to the CCU with a diagnosis of R/O 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. Numerous drugs have been used on Mr. Kaplan in an attempt to stabilize him. Regarding his diagnosis and management of his drugs, you know that:

• The half-life of many drugs is decreased in uremia; thus dosage may have to be increased to be effective.
• Drug toxicity is a major concern in uremia; individualization of therapy and often a decrease in dose is essential.
• Drug therapy is not usually affected by this diagnosis
• Precautions should be taken with prescription drugs, but most OTC medications are safe for him to use.

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43. This is also known as Self-suggestion or Self-hypnosis:

• Biofeedback
• Massage
• Autogenic training
• Visualization and Imagery

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44. The nurse administers erythromycin ointment (0.5%) to the eyes of a newborn and the mother asks the nurse why this is performed. Which explanation is best for the nurse to provide about neonatal eye prophylaxis?

• Protects the newborn's eyes from possible infections acquired while hospitalized.
• Prevents cataracts in the newborn born to a woman who is susceptible to rubella.
• Minimizes the spread of microorganisms to the newborn from invasive procedures during labor.
• Prevents an infection called ophthalmia neonatorum from occurring after birth in a newborn born to a woman with an untreated gonococcal infection.

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45. Situation: Graciela 1 and 1/2 year old is admitted the hospital from the emergency room with a fracture of the left femur due to a Tall down a flight of stairs, Graciela is placed oh Bryant's traction.Q, The nurse counsels Graciela's mother ways to safeguard safety white providing opportunities of Graciela to develop a sense of:

• Trust
• Initiative
• Industry
• Autonomy

46. Which of the following is characteristic of a preschooler with mid mental retardation?

• Slow to feed self
• Lack of speech
• Marked motor delays
• Gait disability

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47. Mr. Ashraf aged 35 years old, his pulse rate is found to be 120 bpm. His heart rate could be described as:

• Tachypnea.
• Tachycardia.
• Bradypnea
• Bradycardia.

48. What is the best intervention when the client has just experienced the crisis and still at the first phase of the crisis?

• Behavior therapy
• Gestalt therapy
• Cognitive therapy
• Milieu Therapy

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49. Situation: Survey and Statistics are important part of research that is necessary to explain the characteristics of the population.Q. All but one of the following is not a measure of Central Tendency?

• Variance
• Standard Deviation
• Mode
• Range

50. A 50 year-old male client has a history of many hospitalizations for schizophrenic disorder. He has been on long-term phenothiazines (Thorazine), 400 mg/day. The nurse assessing this client observes that he demonstrates a shuffling gait, drooling and exhibits general dystonic symptoms. From these symptoms and his history, the nurse concludes that the client has developed:

• Tardive dyskinesia
• Parkinsonism
• Dystonia
• Akathisia

 

NCLEX-RN | QB1 | Practice Exam #40 (50 questions)