QB1 | Practice Exam #20 -> answers with explanation
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NCLEX-RN | QB1 | Practice Exam #20 (50 questions)
1. The nurse is collecting data from a client Which symptom described by the client is characteristic of an early symptom of benign prostatic hyperplasia?
- Nocturia
- Scrotal edema
- Occasional constipation
- Decreased force in the stream of urine
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2. SITUATION: John Lloyd, a 27 basketball player sustained inhalation burn that required him to have tracheostomy due to massive upper airway edema.Q. Wilma knew that the maximum time when suctioning John Lloyd is
- 10 seconds
- 20 seconds
- 30 seconds
- 45 seconds
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3. A client newly diagnosed with diabetes mellitus is instructed by the health care provider to obtain glucagon for emergency home use. The client asks a home care nurse about the purpose of the medication. What is the nurse's best response to the client's question?
- "It will boost the cells in your pancreas if you have insufficient insulin."
- "It will help to promote insulin absorption when your glucose levels are high."
- "It is for the times when your blood glucose is too low from too much insulin."
- "It will help to prevent lipoatrophy from the multiple insulin injections over the years."
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4. Situation: Ensuring safety is one of your most important responsibilities. You will need to provide instructions and information to your clients to prevent complications.Q. When caring for Larry after an exploratory chest surgery and pneumonectomy, your priority would be to maintain:
- supplementary oxygen
- ventilation exchange
- chest tube drainage
- blood replacement
5. Included in teaching the client with tuberculosis taking INH about follow-up home care, the nurse should emphasize that a laboratory appointment for which of the following lab tests is critical?
- Liver function
- Kidney function
- Blood sugar
- Cardiac enzymes
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6. A client with diabetes insipidus is receiving DDAVP (desmopressin acetate). Which lab finding indicates that the medication is having its intended effect?
- Blood glucose 92mg/dL
- Urine specific gravity 1.020
- White blood count of 7 500
- Glycosylated hemoglobin 3.5mg/dL
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7. The nurse is administering augmentin to her patient with a sinus infection. Which is the best way for her to insure that she is giving it to the right patient?
- Call the patient by name
- Read the name of the patient on the patient's door
- Check the patient's wristband
- Check the patient's room number on the unit census list
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8. The client is admitted to the emergency room with shortness of breath anxiety and tachycardia. His ECG reveals atrial fibrillation with a ventricular response rate of 130 beats per minute. The doctor orders quinidine sulfate. While he is receiving quinidine the nurse should monitor his ECG for:
- Peaked P wave
- Elevated ST segment
- Inverted T wave
- Prolonged QT interval
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9. Situation: Nurse Nico is caring to a 38-year-old female, G3P3 client who has been diagnosed with hemorrhoids.Q. Client education should include minimizing client discomfort due to hemorrhoids. Nursing management should include:
- Advise to wear silk undergarments
- Suggest to eat low roughage diet
- Avoid straining during defecation
- Use of sitz bath for 30 minutes
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10. Which of the following is TRUE with regards to the concept of Modern Stress Theory?
- Stress is essential
- Man does not encounter stress if he is asleep
- A single stress can cause a disease
- Stress always leads to distress
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11. Situation: Milo 16 y/o has been diagnosed to have AIDS, he worked as entertainer in a cruise ship:Which method of transmission is common to contract AIDS:
- Syringe and needles
- Body fluids
- Sexual contact
- Transfusion
12. The best size cathlon for administration of a blood transfusion to a six-year-old is:
- 18 gauge
- 19 gauge
- 22 gauge
- 20 gauge
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13. A 64 year-old man present with a weight gain of four kilograms in the past week A physical examination shows an enlarged liver, an enlarged abdomen with a fluid wave, and jugular venous distension. The nurse creates a care plan based on the following nursing diagnosis. Decreased cardiac output related to ventricular damage, ischemia and restriction secondary to fluid overload.Which would be an appropriate defining characteristic?
- Altered preload
- Altered afterload
- Poor ventricular contractility
- Increased pulmonary congestion
14. Situation:- Graciela 1 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. Graciela is assessed to have no head injury. The Bryant's traction is removed. A plaster of Paris his spica is applied. Which of these finding as a concern of immediate attention that must be reported to the physician immediately?
- Graciela is scratching the cast over her abdomen
- The toes of Graciela's left foot blanch when the nurse applies pressure on them
- Graciela's cast is still damp
- The nurse is unable to insert a finger under the edge of Graciela's cast on her left foot
15. Situation: Understanding different models of care is a necessary part of the nurse patient relationship.Q. The client asks the nurse about the Milieu therapy. The nurse responds knowing that the primary focus of milieu therapy can be best described by which of the following?
- A form of behaviour modification therapy
- A cognitive approach of changing the behaviour
- A living learning or working environment
- A behavioural approach to changing behaviour
16. When should a nurse suction a client?
- As desired
- As needed
- Every 1 hour
- Every 4 hours
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17. The nurse is assessing a client for meningeal irritation and elicits a positive Brudzinski's sign. Which finding did the nurse observe?
- The client rigidly extends the arms with pronated forearms and plantar flexion of the feet.
- The client flexes a leg at the hip and knee and reports pain in the vertebral column when the leg is extended.
- The client passively flexes the hip and knee in response to neck flexion and reports pain in the vertebral column.
- The client's upper arms are flexed and held tightly to the sides of the body and the legs are extended and internally rotated.
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18. David, an adolescent has a history of truancy from school, running away from home and "borrowing" other people's things without their permission. The adolescent denies stealing, rationalizing instead that as long as no one was using the items, it was all right to borrow them. It is important for the nurse to understand the psychodynamically, this behavior may be largely attributed to a developmental defect related to the:
- Ego
- Superego
- Oedipal complex
- Id
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19. Which of the following is true about an individual's caloric needs?
- All individual have the same caloric needs
- Females in general have higher BMR and therefore, require more calories
- During cold weather, people need more calories due to increase BMR
- Dinner should be the heaviest meal of the day
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20. Situation: Ms. J., a 34-year old white female, is admitted via the emergency room complaining of abdominal pain, fatigue, anorexia, muscle cramping, and nausea. She is a diabetic who been managed at 30 U NPH insulin every AM and a 1200-calorie ADA diet. Her glucose in ER 700 mg/dL. Regular insulin 30 U was given and a repeat glucose were drawn. Results were not available upon transfer to the unitQ. Given the above Information, which nursing activities should be highest priority?
- Monitoring vital signs
- Obtaining blood glucose results
- Assessing neurological status
- Assessing pedal pulses and feet
21. What additional laboratory test should be performed on any African American client who sustains a serious burn injury?
- Total protein
- Tissue type antigens
- Prostate specific antigen
- Hemoglobin S electrophoresis
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22. Situation: Ronald 23 years old was voluntarily admitted to the in-patient unit with a diagnosis of paranoid schizophrenia.Q. An appropriate activity for the nurse is to recommend for a client who is extremely agitated is:
- Competitive sports
- Bingo
- Trivial Pursuit
- Daily walks
23. The client has surgery for removal of a Prolactinoma. Which of the following interventions would be appropriate for this client?
- Place the client in Trendelenburg position for postural drainage.
- Encourage coughing and deep breathing every two hours.
- Elevate the head of the bed 30°
- Encourage the Valsalva maneuver for bowel movements.
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24. A client is to receive Dilantin (phenytoin) via a nasogastric (NG) tube. When giving the medication the nurse should:
- Flush the NG tube with 2-4mL of water before giving the medication
- Administer the medication flush with 5mL of water and clamp the NG tube
- Flush the NG tube with 5mL of normal saline and administer the medication
- Flush the NG tube with 2-4oz of water before and after giving the medication
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25. A patient visiting the clinic 10 days after sinus surgery for checkup complains of having a bad taste in the mouth. When the nurse smells a foul odor while examining the patients mouth, the nurse suspects the patient have an:
- Pulmonary decompensation
- Hemorrhage
- Aspiration
- Infection
26. The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?
- The client with methicillin resistant-staphylococcus aureas (MRSA)
- The client with diabetes
- The client with pancreatitis
- The client with Addisons disease
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27. A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation?
- It is positive.
- It is negative.
- It is inconclusive.
- It requires rescreening at age 6 weeks.
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28. Situation: Nurse Nico is caring to a 38-year-old female, G3P3 client who has been diagnosed with hemorrhoids.Q. The doctor orders for Witch Hazel 5 %. Nurse Nico knows that the action of this astringent is:
- temporarily relieves pain, burning, and itching by numbing the nerve endings
- causes coagulation (clumping) of proteins in the cells of the perianal skin or the lining of the anal canal
- inhibits the growth of bacteria and other organisms
- causes the outer layers of skin or other tissues to disintegrate
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29. The nurse is speaking to a group of women about early detection of breast cancer The average age of the women in the group is 47. Following the American Cancer Society (ACS) guidelines, the nurse should recommend that the women:
- perform breast self-examination annually
- have a mammogram annually
- have a hormonal receptor assay annually
- have a physician conduct a clinical evaluation every 2 years
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30. Nurse Jocelyn is caring for a client with nasogastric tube that is attached to low suction. Nurse Jocelyn assesses the client for symptoms of which acid-base disorder?
- Respiratory alkalosis
- Respiratory acidosis
- Metabolic acidosis
- Metabolic alkalosis
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31. While a nurse is assessing a patient who reports indigestion that radiates into the jaw. The jaw pain is rated 8 scale of 0 (no pain) to 10 (severe pain). The patient reports the pain started an hour ago. The nurse should IMMEDIATELY:
- Assess the patient's oral temperature
- Determine what foods the patient ate
- Place the patient in reverse Trendelenburg position
- Obtain order and administer morphine sulfate
32. Which nursing action is best when trying to diffuse a client's impending violent behavior?
- Helping the client identify and express feelings of anxiety and anger
- Involving the client in a quiet activity to divert attention
- Leaving the client alone until the client can talk about feelings
- Placing the client in seclusion
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33. The nurse is caring for the client with a five-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?
- The client has traveled out of the country in the last six months.
- The clients parents are skilled stained-glass artists.
- The client lives in a house built in 1990.
- The client has several brothers and sisters.
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34. Ms. Hull has had an electrocauterization of her cervix for chronic cervicitis. Following the procedure the nurse should instruct Ms. Hull to:
- Douche the next day to remove debris and blood cloth
- Avoid straining and heavy lifting until the physician permits this activity
- Stay in bed for the next 5 days
- Return in bed for the next 5 days
35. Is a multi dimensional model developed by PENDER that describes the nature of persons as they interact within the environment to pursue health
- Ecologic Model
- Health Belief Model
- Health Promotion Model
- Health Prevention Model
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36. A client has begun therapy with theophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication?
- Coffee, cola, and chocolate
- Oysters, lobster, and shrimp
- Melons, oranges, and pineapple
- Cottage cheese, cream cheese, and dairy creamers
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37. The nurse should include which interventions in the plan of care for a client with hypothyroidism? Select all that apply. 1. Provide a cool environment for the client 2. Instruct the client to consume a high-fat diet. 3. Instruct the client about thyroid replacement therapy.4. Encourage the client to consume fluids and high-fiber foods in the diet.5. Inform the client that iodine preparations will be prescribed to treat the disorder.6. Instruct the client to contact the health care provider (HCP) if episodes of chest pain occur.
- 1,2,3
- 3,4,6
- 1,3,5
- 1,2,4,5
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38. A patient has had hepatitis B (HBV) and is now a chronic carrier In planning care, the nurse would explain an HBV carrier would most likely be at risk for developing a super infection with which other type of hepatitis? A
- A
- B
- C
- D
39. 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. Using the rule of nine, the percentage of the burned area on Nanette's skin is:
- 63%
- 81%
- 90%
- 72%
40. What clinical manifestation indicates that an escharotomy is needed on a circumferential extremity burn?
- The burn is full thickness rather than partial thickness.
- The client is unable to fully pronate and supinate the extremity.
- Capillary refill is slow in the digits and the distal pulse is absent.
- The client cannot distinguish the sensation of sharp versus dull in the extremity.
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41. The physician orders the administration of high-humidity oxygen by face mask and placement of the patient in a high Fowler's position. After assessing Mrs. Paul, the nurse writes the following nursing diagnosis: Impaired gas exchange related to increased secretions. Which of the following nursing interventions has the greatest potential for improving this situation?
- Encourage the patient to increase her fluid intake to 200 ml every 2 hours
- Place a humidifier in the patient's room.
- Continue administering oxygen by high humidity face mask
- Perform chest physiotherapy on a regular schedule
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42. During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the mother at the upper quadrant. The interpretation is that the position of the fetus is:
- LOA
- ROP
- LOP
- ROA
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43. Which of the following antituberculosis drugs can damage the Sth cranial
- Isoniazid (INH)
- Para Aminosalicylic acid (PAS)
- Ethambutol hydrochloride (myambutol)
- Streptomycin
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44. The nurse provides instructions to a client about measures to treat inflammatory bowel syndrome (IBS). Which statement by the client indicates a need for further teaching?
- "I need to limit my intake of dietary fiber"
- "I need to drink plenty at least 8 to 10 cups daily."
- "I need to eat regular meals and chew my food well"
- "I will take the prescribed medications because they will regulate my bowel patterns"
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45. A process of heat loss which involves the transfer of heat from one surface to another is:
- Radiation
- Conduction
- Convection
- Evaporation
46. The nurse is caring for a client with laryngeal cancer. Which finding ascertained in the health history would not be common for this diagnosis?
- Foul breath
- Dysphagia
- Diarrhea
- Chronic hiccups
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47. When should the nurse starts giving XANAX?
- When anxiety is +1
- When the client starts to have a narrow perceptual field and selective inattentiveness
- When problem solving is not possible
- When the client is immobile and disorganized
48. A hospitalized client has begun taking bupropion as an antidepressant agent The nurse determines that which is an adverse effect, indicating that the client is taking an excessive amount of medication?
- Constipation
- Seizure activity
- Increased weight
- Dizziness when getting upright
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49. A patient with SLE(systemic lupus erythematous) report decreased urinary output during the past 2-4 days and chest pain that is aggravated by breathing and coughing. The patient vital signs remain within the baseline normal range si and s2 are present with audible friction rub. Which of the following statement would be appropriate for the nurse to make?
- It sounds like SLE is being well controlled
- I need to get some nitroglycerine for your chest pain
- There may be some inflammation surrounding your heart
- Your symptoms may be due to a urinary tract infection
50. The nurse is reviewing the lab results of a clients arterial blood gases. The PaCO2 indicates effective functioning of the:
- Kidneys
- Pancreas
- Lungs
- Liver
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NCLEX-RN | QB1 | Practice Exam #20 (50 questions)