NCLEX-RN | QB1 | Practice Exam #12 (50 questions)

 

1. Situation: A computer analyst; Mr Ricardo J. Santos, 25 was brought to the hospital for diagnostic workup after he had experienced seizure in his office.Q. Mr. Santos is scheduled for CT SCAN for the next day, noon time. Which of the following is the correct preparation as instructed by the nurse?

• Shampoo hair thoroughly to remove oil and dirt
• No special preparation is needed. Instruct the patient to keep his head still and stead,
• Give a cleansing enema and give until 8 AM
• Shave scalp and securely attach electrodes to it

2. A couple asks the nurse about risks of several birth control methods. What is the most appropriate response by the nurse?

• Norplant is safe and may be removed easily
• Oral contraceptives should not be used by smokers
• Depo-Provera is convenient with few side effects
• The IUD gives protection from pregnancy and infection

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3. A client has a bone marrow aspiration performed, immediately after the procedure, the nurse should:

• Position the client on the affected side
• Begin frequent monitoring of vital signs
• Cleanse the site with an antiseptic solution
• Briefly apply pressure over the aspiration site

4. Situation: The question with regards to the OPERATING ROOM.Q. During surgery, movement of personnel should be:

• kept to a minimum
• restricted
• monitored
• eliminated when possible

5. Nurse Patricia finds a female client who is post-myocardial infarction (Ml) slumped on the side rails of the bed and unresponsive to shaking or shouting. Which is the nurse next action?

• Call for help and note the time
• Give two sharp thumps to the precordium, and check the pulse.
• Clear the airway
• Administer two quick blows.

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6. A client receiving Parnate (tranylcypromine) is admitted in a hypertensive crisis. Which food is most likely to produce a hypertensive crisis when taken with the medication?

• Processed cheese
• Cottage cheese
• Cream cheese
• Cheddar cheese

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7. When a nurse is teaching a woman about her menstrual cycle she mentions that which of the following is the most important change that happens during the follicular phase of the menstrual cycle?

• Multiplication of the fimbriae.
• Maturation of the graafian follicle.
• Proliferation of the endometrium.
• Secretion of human chorionic gonadotropin.

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8. What is the best position in palpating the breast?

• Trendelenburg
• Side lying
• Supine
• Lithotomy

9. A client tells the nurse that she is allergic to eggs, dogs, rabbits and chicken feathers. Which order should the nurse question?

• TB skin test
• Rubella vaccine
• ELISA test
• Chest x-ray

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10. Marianne is now at the Defervescence stage of the fever, which of the following is expected?

• Delirium
• Goose flesh
• Cyanotic nail beds
• Sweating

11. Period of nursing where religious Christian orders emerged to take care of the sick

• Apprentice period
• Dark period
• Contemporary period
• Educative period

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12. Wilfredo with a recent history of rectal bleeding is being prepared for a colonoscopy. How should the nurse Patricia position the client for this test initially?

• Lying on the right side with legs straight
• Lying on the left side with knees bent
• Prone with the torso elevated
• Bent over with hands touching the floor

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13. What is Nurse John likely to note in a male client being admitted for alcohol withdrawal?

• Perceptual disorders.
• Impending coma.
• Recent alcohol intake.
• Depression with mutism.

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14. Therapeutic communication begins with?

• Knowing your client
• Knowing yourself
• Encoding
• Showing empathy

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15. When do coronary arteries primarily receive blood flow?

• During inspiration
• During diastole
• During expiration
• During systole

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16. A patient has exacerbation of congestive heart failure, with one of the nursing diagnosis being excess fluid (lasix). The nurse closely monitors fluid intake and output and administers furesemide (lasix). Which of the following indicates theefficacy of the nursing intervention?

• The patient has leg edema
• The patient has shortness of breath
• The patient has decreased in weight
• The patient has jugular vein distention

17. During the second day of hospitalization of the client after a Myocardial Infarction. Which of the following is an expected outcome?

• Able to perform self-care activities without pain
• Severe chest pain
• Can recognize the risk factors of Myocardial Infarction
• Can Participate in cardiac rehabilitation walking program

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18. Situation: Nurse Parmigiani is the staff nurse assigned at the Emergency Department. During her shift, a patient was rushed - in the ED complaining of severe heartburn, vomiting and pain that radiates to the flank. The doctor suspects gastric ulcer. Q. She is for occult blood test, what specimen will you collect? A

• Blood
• Urine
• Stool
• Gastric Juice

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19. Situation: - The nurse-patient relationship is a modality through which the nurse meets the clients needs.Q. All of the following response are non therapeutic. Which is the MOST direct violation of the concept, congruence of behavior?

• Responding in a punitive manner to the client
• Rejecting the client as a unique human being
• Tolerating all behavior in the client
• Communicating ambivalent messages to the client

20. She notes that there is an increasing unrest of the staff due to fatigue brought about by shortage of staff. Which action is a priority?

• Evaluate the overall result of the unrest
• Initiate a group interaction
• Develop a plan and implement it
• Identify external and internal forces.

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21. A patient who is receiving chemotherapy has a platelet count of 49,000/mm3 (normal value 150,000 to 400,000/ mm3 )< Which of the following nursing action is necessary?

• Minimize invasive procedure
• Crush oral medications
• Limit intake of vitamin K rich foods
• Monitor the temperature every 4 hours

22. A patient admitted with a cerebrovascular accident (CVA), is unable to chew or swallowed. The patient is a risk for aspiration. The nurse would anticipate receiving which of the following orders for this patient?

• Give no food by mouth and start intravenous hydration
• Start a pureed diet with thickened liquids
• Refer the patient to a psychiatrist for depression related to the CVA
• Refer the patient to physical therapy for muscle strengthening

23. The nurse is aware that the most common indication in using ECT is:

• Bipolar
• Schizophrenia
• Anorexia Nervosa
• Depression

24. A client with paranoid type schizophrenia becomes angry and tells the nurse to leave him alone. The nurse should

• tell him that shell leave for now but will return soon.
• ask him if it's okay if she sits quietly with him.
• ask him why he wants to be left alone.
• tell him that she won't let anything happen to him

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25. The nurse is aware that cocaine is classified as:

• Hallucinogen
• Psycho stimulant
• Anxiolytic
• Narcotic

26. BCG in community health nursing is what type of prevention?

• Primary
• Secondary
• Tertiary
• None of the above

27. The nurse recognizes that which of the following would be most appropriate to wear when providing direct care to a client with a cough?

• Mask
• Gown
• Gloves
• Shoe covers

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28. The client with an ileostomy is being discharged. Which teaching should be included in the plan of care?

• Using Karaya powder to seal the bag.
• Irrigating the ileostomy daily.
• Using stomahesive as the best skin protector
• Using Neosporin ointment to protect the skin.

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29. A patient has a central line catheter and is receiving a three-in-one total parenteral nutrition that contains glucose, proteins and lipids. The pump is set to deliver the infusion over a 12- hour period. After how many hours should the intravenous administration set be changed?

• 12
• 24
• 48
• 72

30. A vaginal exam reveals that the cervix is 4cm dilated with intact membranes and a fetal heart tone rate of 160 to 170bpm. The nurse decides to apply an external fetal monitor The rationale for this implementation is:

• The cervix is closed.
• The membranes are still intact
• The fetal heart tones are within normal limits.
• The contractions are intense enough for insertion of an internal monitor.

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31. A nurse is assessing the urine of a client with a urinary tract infection. For which characteristic should the nurse assess each specimen of urine?

• Clarity
• Viscosity
• Glucose level
• Specific gravity

32. The autopsy results in SIDS-related death will show the following consistent findings:

• Abnormal central nervous system development
• Abnormal cardiovascular development
• Intraventricular hemorrhage and cerebral edema
• Pulmonary edema and intrathoracic hemorrhages

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33. A home care nurse visits a patient who is wheelchair bound due to recent motor vehicle accident. The patient has been sitting in the wheel chair for extended periods of time which resulted in the development of a stage pressure sore on the right buttocks. What is the BEST nursing intervention?

• Instruct caretaker to change the patient's position every 2 hours
• Apply hydrogel to the stage I pressure sore every 8 hours
• Refer the patient to wound care specialist for debridement
• Encourage the patient to consume an increased amount of calcium

34. To further assess a client's suicidal potential Nurse Katrina should be especially alert to the client expression of:

• Frustration & fear of death
• Anger & resentment
• Anxiety & loneliness
• Helplessness & hopelessness

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35. Situation: Miss Matias, found out that Mr. Carding, newly admitted patient, has terminal cancer and that his nurse has not yet informed him of the diagnosis.Q. Which of the following will be the most helpful therapy for the Grieving family?

• Watching the video of the dying client over and over to encourage moving on
• A course on death and dying
• Psychotherapy
• Group meeting with other grieving families

36. The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? Select all that apply. 1. Restrict fluid intake.2. Position for comfort.3. Avoid strain on painful joints. 4. Apply nasal oxygen at 2 L/minute.5. Provide a high-calorie, high-protein diet.6. Give meperidine, 25 mg intravenously, every 4 hours for pain.

• 1,3,5
• 2, 3, 4, 5, 6
• 1,6
• 4,6

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37. The nurse is preparing to administer eye drops. Which interventions should the nurse take to administer the drops? Select all that apply. 1.Wash hands. 2.Put gloves on. 3.Place the drop in the conjunctival sac. 4.Pull the lower lid down against the cheekbone. 5.Instruct the client to squeeze the eyes shut after instilling the eye drop. 6.Instruct the client to tilt the head forward, open the eyes, and look down.

• 1, 2, 3, 4
• 1, 2, 3, 4, 5
• 2,3,4
• 1,2,5

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38. Which of the following is an adverse reaction to glipizide (Glucotrol)?

• headache
• constipation
• hypotension
• photosensitivity

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39. A 28 year old male is recovering from a moderate concussion following a motor vehicle accident 2 weeks ago, when he suddenly develops an increased thirst, craving coldwaten The patient urinates very large amount of dilute, water like urine with aspecific gravity of 1.001 to 1.005 the patient is MOST likely developing

• Diabetic mellitus
• Diabetic insipidus
• Hypothyroidism
• Thyroid storm

40. The nurse is caring for a client who sustained superficial partial-thickness burns on the anterior lower legs and anterior thorax. Which finding does the nurse expect to note during the resuscitation/emergent phase of the burn injury?

• Decreased heart rate
• Increased urinary output
• Increased blood pressure
• Elevated hematocrit levels

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41. A nurse is teaching a class about immunizations to members of a grammar school’s Parent-Teachers Association. Which childhood disease is the nurse discussing when explaining that it is a viral disease that starts with malaise and a highly pruritic rash that begins on the abdomen, spreads to the face and proximal extremities, and can result in grave complications?

• Rubella
• Rubeola
• Chickenpox
• Scarlet fever

42. Nurse Karen is caring for clients in the OR. The nurse is aware that the last physiologic function that the client loss during the induction of anesthesia is:

• Consciousness
• Respiratory movement
• Gag reflex
• Corneal reflex

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43. The nurse is in public area of the health care facility when an adult falls to the floor. Which of the following actions should the nurse take NEXT?

• Open the airway
• Determine unresponsiveness
• Activate the emergency call system
• Obtain the automatic electronic defibrillator(AED)

44. A couple seeks medical advice in the community health care unit A couple has been unable to conceive; the man is being evaluated for possible problems. The physician ordered semen analysis. Which of the following instructions is correct regarding collection of a sperm specimen?

• Collect a specimen at the clinic, place in iced container, and give to laboratory personnel immediately.
• Collect specimen after 48-72 hours of abstinence and bring to clinic within 2 hours.
• Collect specimen in the morning after 24 hours of abstinence and bring to clinic immediately.
• Collect specimen at night, refrigerate, and bring to clinic the next morning.

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45. Situation:- it is the first day of clinical experience of nursing students at the Psychiatry Ward- During the orientation, the nurse emphasizes that the team members including nursing students are legally responsible to safeguard patient's records from loss or destruction or from people not authorized to bead it.Q. The following are SOAP (Subjective - Objective - Analysis - Plan) statements on a problem: Anxiety about diagnosis. What is the objective data?

• Relate patient's feelings to physician initiate and encourage her to verbalize her fears give emotional support by spending more time with patient, continue to make necessary explanations regarding diagnostic test.
• Has periods of crying, frequently verbalizes fear of what diagnostic tests will reveal
• Anxiety due to the unknown
• "I'm so worried about what else they'll find wrong with me"

46. Situation : In the OR, there are safety protocols that should be followed. The OR nurse should be well versed with ail these to safeguard the safety and quality of patient delivery outcome.Q. Surgeries like I and D (incision and drainage) and debridement are relatively short procedures but considered 'dirty cases'. When are these procedures best scheduled?

• Last case
• In between cases
• According to availability of anaesthesiologist
• According to the surgeon's preference

47. The neonate of a mother with diabetes mellitus is prone to developing hypoglycemia because:

• The pancreas is immature and unable to secrete the needed insulin
• There is rapid diminution of glucose level in the baby's circulating blood and his pancreas is normally secreting insulin
• The baby is reacting to the insulin given to the mother
• His kidneys are immature leading to a high tolerance for glucose

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48. A 45-yr-old auto mechanic comes to the physician's office because an exacerbation of his psoriasis is making it difficult to work. He telis the nurse that his finger joints are stiff and sore in the morning. The nurse should respond by:

• Inquiring further about this problem because psoriatic arthritis can accompany psoriasis vulgaris
• Suggesting he take aspirin for relief because it's probably early rheumatoid arthritis
• Validating his complaint but assuming it's an adverse effect of his vocation
• Asking him if he has been diagnosed or treated for carpal tunnel syndrome

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49. A patient who is scheduled for a tonsillectomy is in the preoperative unit The nurse notes an order for preanesthetic medication to be given "on call to operating room" The nurse should give this medication.

• Immediately upon being notified to prepare the patient fortransport
• When the operating room staff arrives to transport the patient
• Only if clearly needed after
• None of the above

50. Which of the following clinical manifestations would alert the nurse to lithium toxicity?

• Increasingly agitated behaviour.
• Markedly increased food intake
• Sudden increase in blood pressure.
• Anorexia with nausea and vomiting.

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NCLEX-RN | QB1 | Practice Exam #12 (50 questions)