NCLEX-RN | QB1 | Practice Exam #6 (50 questions)
1. Situation: Francis, age 46 is admitted to the hospital with diagnosis of Chronic Lymphocytic Leukemia.Q. During routine care, Francis asks the nurse, "How can I be anemic if this disease causes increased my white blood cell production?" The nurse in-charge best response would be that the increased number of white blood cells (WBC) is:
- Crowded red blood cells
- Are not responsible for the anemia.
- Uses nutrients from other cells
- Have an abnormally short life span of cells.
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2. The nurse is administering an antibiotic to her pediatric patient. She checks the patient's armband and verifies the correct medication by checking the physician's order, medication kardex, and vial. Which of the following is not considered one of the five "rights" of drug administration?
- Right dose
- Right route
- Right frequency
- Right time
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3. After the client returns from surgery for a deviated nasal septum, the nurse would anticipate placing her in what position?
- Supine
- Left side-lying
- Semi-Fowler's
- Reverse Trendelenburg's
4. When an order reads that a drug be administered Ltd, how often should this drug be given?
- Every three hours
- Three times a day
- Four times a day
- Every other day
5. A primigravida asks the nurse, "When will I feel the baby move?" The correct response of the nurse is:
- 3 mos
- 5 mos
- 4 mos
- 6 mos
6. The nurse is preparing a plan of care for a client with diabetes mellitus who has hyperglycemia. The nurse places priority on whichc lient problem?
- Lack of knowledge
- Inadequate fluid volume
- Compromised family coping
- Inadequate consumption of nutrients
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7. A patient presents to the emergency department with complaints of head ache,dizziness and confusion. Clinical symptoms include7 tachypnoea and dyspnea with the use of accessory muscles to facilitate breathing. Which of the following orders would the nurse MOST likely implement to reduce the patient's confusion and disorientation?
- Oxygen therapy
- Chest physical therapy
- Bronchodilators
- Hydration fluids
8. Nurse Linda tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. Which form of organizational structure is this?
- Centralized
- Decentralized
- Matrix
- Informal
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9. The nurse is suspected of charting medication administration that he did not give. After talking to the nurse the charge nurse should:
- Call the Board of Nursing.
- File a formal reprimand.
- Terminate the nurse.
- Charge the nurse with a tort.
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10. A client with Addisons disease has been receiving glucocorticoid therapy. Which finding indicates a need for dosage adjustment?
- Dryness of the skin and mucus membranes
- Dizziness when rising to a standing position
- A weight gain of six pounds in the past week
- Difficulty in remaining asleep
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11. Nurse Ron performed mantoux skin test today (Monday) to a male adult client Which statement by the client indicates that he understood the instruction well?
- I will come back later
- I will come back next month
- I will come back on Friday
- I will come back on Wednesday same time, to read the result
12. The client has an allergy with penicillin. What is the best way to communicate this information?
- Place an allergy alert in the Kardex
- Notify the attending physician
- Write it on the patients chart
- Take note when giving medications
13. Situation: A nurse is working with an aggressive client in the psychiatric unitQ. All of the following concepts are true EXCEPT:
- Hostility is destructive
- Frustration develops in response to unmet needs, wants and desire
- Anger is always incompatible with love
- Aggression can be expressed in a constructive as well as a destructive manner.
14. A nurse is assigned to a patient who is scheduled for an above the knee amputation of the left leg . During the preoperative procedure the nurse should ask the patient to:
- Write YES on the leg
- Write OTHER ONE on the right leg
- Draw an arrow on the left knee pointing upward
- Draw an arrow on the left knee pointing downward
15. Nurse Gina is aware that the most common condition found during the second-trimester of pregnancy is:
- Metabolic alkalosis
- Respiratory acidosis
- Mastitis
- Physiologic anemia
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16. A nurse is caring for a patient who is 6-hours post-left lobectomy. On assessment the nurse observes that the patient has become very restless and the nail beds are blue. The vital signs reveal tachycardia, tachypnoea and the blood pressure is rising. Which of the following complications is most likely?
- Pneumonia
- Hypoxia
- Postoperative bleeding
- Bronchopleural fistula
17. The nurse is teaching a 17-year old client and the clients family about what to expect with high-dose chemotherapy and the effects of neutropenia. What should the nurse teach as the most reliable early indicator of infection in a neutropenic client?
- Fever
- Chills
- Tachycardia
- Dyspnea
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18. Breastfeeding is being enforced by milk code or:
- FO 51
- R.A. 7600
- R.A. 6700
- P.D. 996
19. The major rationale for the use of acetylsalicylic acid (aspirin) in the treatment of rheumatoid arthritis is to:
- Reduce fever
- Reduce the inflammation of the joints
- Assist the client's range of motion activities without pain
- Prevent extension of the disease process
20. A child in the postictal state of a seizure should show which of the following signs or symptoms?
- Feeling sleepy or exhausted
- Stiffness over entire body
- Verbalizes having an aura
- Eyes fixed in one position
21. Signs and symptoms of Hypovolemic shock are all of the following except
- Tachycardia
- Hypertension
- Pallor and cyanosis
- Tachypnea
22. A patient has returned to his room after femoral arteriography. All of the following are appropriate nursing interventions except
- Assess femoral, popliteal, and pedal pulses every 15 minutes for 2 hours
- Check the pressure dressing for sanguineous drainage
- Assess a vital signs every 15 minutes for 2 hours
- Order a hemoglobin and hematocrit count 1 hour after the arteriography
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23. A patient admitted to the hospital with acute cholecystitis, is scheduled for surgery in the morning and is NPO. At Bamthe patient develops a fever of 102.4 F (39 J C).medication orders include acetaminophen 650 mg orally every four hours asneeded. The nurse should:
- Give the medication asordered by the physician
- Administer the ordered dose rectally
- Put moist cool cloths on thepatient's forehead and axillae
- Notify the physician andrequest other orders
24. The nurse is caring for a client with a resolved intestinal obstruction who has a nasogastric tube in place. The health care provider has now prescribed that the nasogastric tube be removed. What is the priority nursing assessment prior to removing the tube?
- Checking for normai serum electrolyte levels
- Checking for normal pH of the gastric aspirate
- Checking for proper nasogastric tube placement
- Checking for the presence of bowel sounds in all 4 quadrants
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25. The nurse administered a dose of morphine sulfate as prescribed to a patient who is in the post anesthesia care unit (PACU). The patient appears to be resting comfortably, the respiratory rate is 8 and the O2 saturation is 21 oxygen via cannula is 86%. The nurse should IMMEDIATELY administer:
- Flumazenil (Ftomazicon)
- Medazolum (versed)
- Naloxone (Narcan)
- Ondansetron (Zofran)
26. Situation. You are assigned in the Orthopedic Ward where clients are complaining of pain in varying degrees upon movement of body parts.Q. Pain in Ortho cases may not be mainly due to the surgery. There might be other factors such as cultural or psychological that influence pain. How can you alter these factors as the nurse?
- Explain all the possible interventions that may cause the client to worry.
- Establish trusting relationship by giving his medication on time
- Stay with the client during pain episodes
- Promote client's sense of control and participation in pain control by listening to his concerns
27. Situation: Mr. Roberto was long diagnosed with chronic renal failure. You are his nurse and the following question assesses your knowledge in the different fluid and electrolyte imbalances that are associated with chronic renal failure.Q. When caring for Mr. Roberto's AV shunt on his right arm, you should:
- Cover the entire cannula with an elastic bandage
- Notify the physician if a bruit and thrill are present
- User surgical aseptic technique when giving shunt care
- Take the blood pressure on the right arm instead
28. Which of the following is Pancreatitis Patients frequently feel constant pain in the
- lower right
- upper Left
- lower Left
- upper right
29. Which one of the following clients is most likely to develop acute respiratory distress syndrome?
- A 20-year-old with fractures of the tibia
- A 36-year-old who is HIV positive
- A 40-year-old with duodenal ulcers
- A 32-year-old with barbiturate overdose
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30. Situation: Mrs. Diaz is assigned in the female surgical ward. While on duty, an 15 year old client, married, was admitted for CS. The informed consent for the operation has to be obtained.Q. Mr. Diaz has to remember the following with regard to the Informed Consent:
- Because the patient is a minor, the parents should be asked to sign the consent.
- The informed consent should be signed either by the patient or her 20 year old husband if patient is unconscious
- Nurses has the responsibility to obtain the informed consent prior to surgery
- Legal guardian should sign the consent since the client is 15 year old
31. Icheanne asked you again, What is that term that describes the magnetic attraction of injured tissue to bring phagocytes to the site of injury?
- Icheanne, you better sleep now, you asked a lot of questions
- It is Diapedesis
- We call that Emigration
- I don't know the answer, perhaps I can tell you after I find it out later
32. The nurse is caring for a patient who just had a chest tube inserted due to spontaneous pneumothorax. An appropriate goal is that the patient will:
- Be free of pain with in 4hours
- Report decreased pain
- Rest quietly
- Sleep with few movements
33. The nurse is visiting the asthmatic patient at home to reinforce the importance of eliminating environmental allergens and to assess the patients response to the environmental changes. This type of implementation is called:
- Supervision and coordination
- Discharge planning
- Monitoring and surveillance
- None of the above
34. The mother asks the nurse. “What's wrong with my son's breasts? Why are they so enlarged?'' Whish of the following would be the best response by the nurse?
- "The breast tissue is inflamed from the trauma experienced with birth"
- "A decrease in material hormones present before birth causes enlargement"
- "You should discuss this with your doctor. It could be a malignancy"
- "The tissue has hypertrophied while the baby was in the uterus"
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35. Marina with acute renal failure moves into the diuretic phase after one week of therapy. During this phase the client must be assessed for signs of developing:
- Hypovolemia
- renal failure
- metabolic acidosis
- hyperkalemia
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36. An adult arrived at the outpatient facility due to the onset of chest pain. The patient suddenly falls to the floor and is unresponsive. What action should the nurse take NEXT?
- Activate emergency call system
- Open the patient's airway
- Check for a carotid pulse
- Administer 2 rescue breaths
37. A nurse is documenting in patient records several events that occurred during home visits.Which of the following is an example of the correct way to document patient information?
- Patient fell walking to bathroom. Busy preparing for sterile dressing change when patient left the room
- Patient got out of bed without assistance. Denies any symptoms when ambulating alone
- Patient sitting in chair. Strict bedrest orders ignored
- Patient showering. Electronic epidural infusion pump on floor by shower stall
38. A client has driven himself to the ER. He is 50 years old, has a history of hypertension, and informs the nurse that his father died of a heart attack at 60 years of age. The client is presently complaining of indigestion. The nurse connects him to an ECG monitor. The nurse's next action would be to:
- Start intravenous line and draw blood for cardiac enzymes
- Begin intravenous line then call doctor
- Administering oxygen at 2 L/minute per NC then begin intravenous line
- Administering oxygen 12 l/minute per oxygen face mask and obtain a portable chest radiograph
39. A patient receives intravenous therapy of 1000 cc normal saline with 20mEq potassium chloride at a rate of 75cc per hour Upon evaluation of the site, there is no edema, the vein appears slightly red, and the patient complains of pain. What should the nurse do?
- Slow the rate to prevent burning from the solution and continue to monitor
- Discontinue the intravenousline and restart in another site
- Monitor at least every half-hour for edema but continueas the order state
- Notify the doctor that the patient is having an adverse reaction to the medication
40. A 3-year old child was brought by his mother to the health center because of fever of 4-day duration. The child had a positive tourniquet test result. In the absence of other signs, which of the most appropriate measure that the PHN may carry out to prevent Dengue shock syndrome?
- Insert an NGT and give fluids per NGT
- Instruct the mother to give the child Oresol
- Start the patient on IV Stat
- Refer the client to the physician for appropriate management
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41. Situation: A client is brought into the emergency department with brain stem contusionQ. Which of the following method of insulin administration would be used in the initial treatment of hyperglycemia in a client with diabetic ketoacidosis.
- Subcutaneous
- Intramuscular
- IV bolus only
- I.V bolus followed by continuous infusion
42. The nurse is performing an assessment on a client diagnosed with placenta previa. Which assessment findings should the nurse expect to note? Select all that apply. 1. Uterine rigidity 2. Uterine tenderness 3. Severe abdominal pain 4. Bright red vaginal bleeding 5. Soft, relaxed, nontender uterus 6. Fundal height may be greater than expected for gestational age
- 2,4,6
- 1,3,4,5,6
- 4,5,6
- 3,4,5
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43. The nurse is caring for a client in labor. Which assessment findings indicate to the nurse that the client is beginning the second stage of labor? Select all that apply. 1. The contractions are regular.2. The membranes have ruptured.3. The cervix is dilated completely.4. The client begins to expel clear vaginal fluid. 5. The spontaneous urge to push is initiated from perineal pressure.
- 3,5
- 1,4,5
- 2,3,5
- 1,2,3,4
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44. A schizophrenic client with delusions tells the nurse, "There is a man wearing a red coat who's out to get me" The client exhibits increasing anxiety when focusing on the delusions. Which of the following would be the best response?
- "This subject seems to be troubling you. Let's walk to the activity room."
- "Describe the man who's out to get you. What does he look like?"
- "There is no reason to be afraid of that man. This hospital is very secure"
- "There is no need to be concerned with a man who isn't even real"
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45. A physician orders Lactated Ringer Solution to infuse at 125 cc/hour. This is an example of which type of solution?
- Hypotonic
- Isotonic
- Hypertonic
- Hyper alimentation
46. A client with a laryngectomy returns from surgery with a nasogastric tube in place. The primary reason for placement of the nasogastric tube is to:
- Prevent swelling and dysphagia
- Decompress the stomach
- Prevent contamination of the suture line
- Promote healing of the oral mucosa
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47. A female patient needs a whole blood transfusion. In order for transfusion services (the blood bank) to prepare the correct product a sample of the patient's blood must be obtained for:
- A complete blood count and differential.
- A blood type and crossmatch.
- A blood culture and sensitivity.
- A blood type and antibody screen.
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48. The nurse is discussing the human immunodeficiency virus (HIV) with a group of high - risk patients. The nurse should state that this virus is found MOST commonly in which of the following body fluids?
- Blood
- Saliva
- Breast milk
- vaginal secretions
49. The nurse is preparing to discharge a client following a trabeculoplasty for the treatment of glaucoma. The nurse should instruct the client to:
- Wash her eyes with baby shampoo and water twice a day
- Take only tub baths for the first month following surgery
- Begin using her eye makeup again one week after surgery
- Wear eye protection for several months after surgery
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50. SITUATION : John Smith was diagnosed with Acute Close Angle Glaucoma. He is being seen by Nurse JetQ. Nurse jet performed a TONOMETRY test to Mr. Smith. What does this test measures
- It measures the peripheral vision remaining on the client
- Measures the Intra Ocular Pressure
- Measures the Client's Visual Acuity
- Determines the Tone of the eye in response to the sudden increase in IOP
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NCLEX-RN | QB1 | Practice Exam #6 (50 questions)