NCLEX-RN | QB1 | Practice Exam #4 (50 questions)

 

1. SITUATION: Juan, a 40 year old construction worker developed cough, night sweats and fever He was brought to the nursing unit for diagnostic studies. He told the nurse he did not receive a BCG vaccine during childhood. Q. Susceptibility for tuberculosis is increased markedly in those with the following condition except

• 23 Year old athlete with diabetes insipidus
• 23 Year old athlete taking long term Decadron therapy and anabolic steroids
• 23 Year old athlete taking illegal drugs and abusing substances
• Undernourished and Underweight individual who undergone gastrectomy

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2. A client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate and contractions have stopped. If the client's labor can be inhibited for the next 48 hours, the nurse anticipates a prescription for which medication?

• Nalbuphine
• Betamethasone
• Rho(D) immune globulin
• Dinoprostone vaginal insert

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3. Nurse Emma should caution a female client who is sexually active in taking Isoniazid (INH) because the drug has which of the following side effects?

• Prevents ovulation
• Has a mutagenic effect on ova
• Decreases the effectiveness of oral contraceptives
• Increases the risk of vaginal infection

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4. Dennis has a lithium level of 2.4 mEq/L. The nurse immediately would assess the client for which of the following signs or symptoms?

• Weakness
• Diarrhea
• Blurred vision
• Fecal incontinence

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5. Situation: As a perioperative nurse, you are aware of the correct processing methods for preparing instruments and other devices for patient use to prevent infection.Q. Bronchoscope, Thermometer, Endoscope, ET tube, Cystoscope are all BEST sterilized using which of the following?

• Autoclaving at 121 degree Celsius in 15 minutes
• Flash sterilizer at 132 degree Celsius in 3 minutes
• Ethylene Oxide gas aeration for 20 hours
• 2% Glutaraldehyde immersion for 10 hours

6. What are the important considerations that the nurse must remember after the placenta is delivered? 1.Check if the placenta is complete including the membranes 2.Check if the cord is long enough for the baby 3.Check if the umbilical cord has 3 blood vessels 4.Check if the cord has a meaty portion and a shiny portion

• 1 and 3
• 2 and 4
• 1,3 and 4
• 2 and 3

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7. In what period of nursing does people believe in TREPHINING to drive evil forces away?

• Intuitive period
• Contemporary period
• Educative period
• Dark period

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8. Hemoptysis is:

• Cough with secretions.
• Cough without secretions.
• Difficult breathing.
• Blood in the sputum.

9. A male client is receiving total parenteral nutrition suddenly demonstrates signs and symptoms of an air embolism. What is the priority action by the nurse?

• Notify the physician.
• Place the client on the left side in the Trendelenburg position.
• Place the client in high-Fowlers position.
• Stop the total parenteral nutrition.

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10. Medication is instilled between the skin & the muscle and used to administer Heparin.

• Intravenous
• Intramuscular
• Intradermal
• Subcutaneous

11. During chemotherapy for lymphocytic leukemia, Mathew develops abdominal pain, fever, and "horse barn" smelling diarrhea. It would be most important for the nurse to advise the physician to order:

• enzyme-linked immunosuppressant assay (ELISA) test.
• electrolyte panel and hemogram.
• stool for Clostridium difficile test.
• flat plate X-ray of the abdomen.

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12. A health care provider has written a prescription to discontinue an intravenous (IV) line. The nurse should obtain which item from the unit supply area for applying pressure to the site after removing th e IV cath eter?

• Elastic wrap
• Povidone iodine swab
• Adhesive bandage
• Sterile 2 X 2 gauze

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13. A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed?

• Electrolyte levels
• Coagulation times
• Liver enzyme levels
• Serum creatinine level

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14. A client who has undergone a cholecystectomy asks the nurse whether there are any dietary restrictions that must be followed. Nurse Hilary would recognize that the dietary teaching was well understood when the client tells a family member that:

• "Most people need to eat a high protein diet for 12 months after surgery"
• "I should not eat those foods that upset me before the surgery"
• "I should avoid fatty foods as long as I live"
• "Most people can tolerate regular diet after this type of surgery"

15. The nurse performs a physical assessment on a client with type 2 diabetes mellitus. Findings include a fasting blood glucose level of 120mg/dL (6.8 mmol/L), temperature of 101 °F (38.3 °C), pulse of 102 beats/minute, respirations of 22 breaths/minute, and blood pressure of 142/72 mm Hg. Which finding would be the priority concern to the nurse?

• Pulse
• Respiration
• Temperature
• Blood pressure

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16. Situation: Transurethral resection prostatectomy, (TURP) is performed to Mr. Recto, 60 years old, due to prostate enlargement Post operatively he has continuous irrigation (Cystociysis).Q. Nursing assessment is vital to prevent and detect indications of postoperative complications. The following are the possible complications after prostatectomy except:

• Residual urine
• Urethral structure
• Erectile dysfunction
• The drainage has stopped

17. Situation: Developing countries such as the Philippines suffer from high infant and child mortality rates. Thus, as a management to the existing problem, the WHO and UNICEF launched the IMCILThe dosage of Vit. A supplement given to Baby Len would be:

• 100,000 IU
• 10,000 IU
• 200,000 IU
• 20,000 IU

18. Nurse Camila is administering the initial total parenteral nutrition solution to a client Which of the following assessments requires the nurse's immediate attention?

• Temperature of 37.5 degrees Celsius
• Urine output of 300 cc in 4 hours
• Poor skin turgor
• Blood glucose of 350 mg/dl

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19. When trying to communicate with a resident who speaks a different language than the nurse aide, the nurse aide should

• use pictures and gestures.
• face the resident and speak softly when talking.
• repeat words often if the resident does not understand.
• assume when the resident nods his/her head that the message is understood.

20. Which medication can control the extra pyramidal effects associated with antipsychotic agents?

• Clorazepate (Tranxene)
• Amantadine (Symmetrel)
• Doxepin (Sinequan)
• Perphenazine (Trilafon)

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21. A client with mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with giyburide daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL (10.2 to 11.4 mmol/L). Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?

• Prednisone
• Atenolol
• Phenelzine
• Allopurinol

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22. SITUATION: John Lloyd, a 27 basketball player sustained inhalation burn that required him to have tracheostomy due to massive upper airway edema.Q. Wilma was shocked to see that the Tracheostomy was dislodged. Both the inner and outer cannulas was removed and left hanging on John Lloyd' neck. What are the two (2) equipments at John Lloyd's bedside that could help Wilma deal with this situation?

• New set of tracheostomy tubes and Oxygen tank
• Theophylline and Epinephrine
• Obturator and Kelly clamp
• Sterile saline dressing

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23. Which criteria refer to the ability of the instrument to detect fine differences among the subjects being studied?

• Sensitivity
• Reliability
• Validity
• Objectivity

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24. While feeding a newborn with an unrepaired cardiac defect, the nurse keeps on assessing the condition of the client The nurse notes that the newborn's respiration is 72 breaths per minute. What would be the initial nursing action?

• Burp the newborn.
• Stop the feeding.
• Continue the feeding.
• Notify the physician.

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25. Situation: Mastery of research design determination is essential in passing the Nurse Licensure Examination.Q. Gen is conducting a research study on how mark, an AIDS client lives his life. A design suited for this is:

• Historical
• Case Study
• Phenomenological
• Ethnographic

26. Situation: The preoperative nurse collaborates with the client significant others, and healthcare providers.Q. Tess, the PACU nurse discovered that Malou, who weighs 110 lbs prior to surgery, is in severe pain 8 hours after cholecystectomy. Upon checking the chart, Malou found out that she has an order of Demerol 100 mg I.M. prn for pain. Tess should verify the order with:

• Nurse supervisor
• Anesthesiologist
• Surgeon
• Intern on duty

27. The nurse is caring for a client with epilepsy who is to receive phenytoin sodium (Dilantin) l00mg IV push. The client has an IV of D51/2NS infusing at 100mL/hr. When administering the Dilantin which is the appropriate initial nursing action?

• Obtain an ambu bag and put it at bedside.
• Insert a 16g IV catheter.
• Flush the IV line with normal saline.
• Premedicate with promethiazine (phenergan) IV push.

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28. A l-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition?

• Limited range of motion in the affected hip
• An apparent lengthened femur on the affected side
• Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed
• Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table

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29. A client who reportedly consumes 1 qt of vodka daily is admitted for alcohol detoxification. To try to prevent alcohol withdrawal symptoms, the physician is most likely to prescribe which drug?

• clozapine (Clozaril)
• thiothixene (Navane)
• lorazepam (Ativan)
• lithium carbonate (Eskalith)

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30. A child with P-Thalassemia is receiving therapy that includes multiple blood transfusions. This child is at risk for developing which complication?

• Serum hepatitis
• Allergic response
• Pulmonary edema
• Hemolytic reaction

31. During a unit card game a client with acute mania begins to sing loudly as she starts to undress. The nurse should:

• Ignore the clients behavior.
• Exchange the cards for a checker board.
• Send the other clients to their rooms.
• Cover the client and walk her to her room.

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32. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is:

• Allow the woman to exercise
• Let the woman walk for a while
• Let the woman lie down and dorsiflex the foot towards the knees
• Ask the woman to raise her legs

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33. Stage of GAS Characterized by adaptation

• Stage of Alarm
• Stage of Resistance
• Stage of Homeostasis
• Stage of Exhaustion

34. Isabella is the public health nurse in a municipality with a total population of about 20,000. There are 3 rural health midwives among the RHU personnel. How many more midwife items will the RHU need?

• 1
• 2
• 3
• The RHU does not need any more midwife item.

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35. The RN is making assignments for clients hospitalized on a neurological unit Which client should be assigned to the LPN?

• A client with a C3 injury immobilized by Crutchfield tongs
• A client with exacerbation of multiple sclerosis
• A client with a lumbar laminectomy
• A client with hemiplegia and a urinary tract infection

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36. Which of the following is true regarding the fontanels of the newborn?

• The anterior is triangular shaped; the posterior is diamond shaped.
• The posterior closes at 18 months; the anterior closes at 8 to 12 weeks.
• The anterior is large in size when compared to the posterior fontanel.
• The anterior is bulging; the posterior appears sunken.

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37. Which is the following is the most appropriate during the orientation phase?

• patients perception on the reason of her hospitalization
• identification of more effective ways of coping
• exploration of inadequate coping skills
• establishment of regular meeting of schedules

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38. Before formulating a plan of care for a 6 year old boy with attention deficit hyperactivity disorder (ADHD), nurse Kyla is aware that the Initial aim of therapy is to help the client to:

• Develop language skills
• Avoid his own regressive behavior
• Mainstream into a regular class in school
• Recognize himself as an independent person of worth

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39. A nurse is reviewing the laboratory report of a child with tetralogy of Fallot that indicates an elevated RBC count. What does the nurse identify as the cause of the polycythemia?

• Low blood pressure
• Tissue oxygen needs
• Diminished iron level
• Hypertrophic cardiac muscle

40. Before administering a clients morning dose of Lanoxin (digoxin) the nurse checks the apical pulse rate and finds a rate of 54. The appropriate nursing intervention is to:

• Record the pulse rate and administer the medication
• Administer the medication and monitor the heart rate
• Withhold the medication and notify the doctor
• Withhold the medication until the heart rate increases

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41. A patient who is scheduled for a tonsillectomy is in pre operative unit The nurse notes an order for pre anesthetic medication to be given "on call to operation roonT.The nurse should give this medication:

• Immediately upon being notified to prepare the patient fortransport
• When the operation room staff arrive to transport the patient
• Only if clearly needed after assessment
• Upon the patient's arrival in the operation room

42. The nurse cares for a 60 year-old woman has a history of hypertension, hypothyroidism and elevated cholesterol levels. She takes tablets daily for each of the health problems. The doctor orders a routine dual-energy X-ray absorptimetry test shows decreased bone density.Which medication most likely contributed to the test results?

• Statins
• Anti-hypertensive
• Synthetic thyroid hormones
• Cholesterol absorption inhibitors

43. Sofia with a histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner Nurse Trish would recommend which of the following activities for Sofia?

• Baking class
• Role playing
• Scrap book making
• Music group

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44. The nurse is monitoring the progress of a client in labor Which finding should be reported to the physician immediately?

• The presence of scant bloody discharge
• Frequent urination
• The presence of green-tinged amniotic fluid
• Moderate uterine contractions

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45. John is to be discharged on a regimen of lithium carbonate. In the teaching plan for discharge the nurse should include:

• Advising the client to watch the diet carefully
• Suggesting that the client take the pills with milk
• Reminding the client that a CBC must be done once a month.
• Encouraging the client to have blood levels checked as ordered.

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46. For a cognitively impaired client who cannot accurately report pain, what is the first action that you should take?

• Closely assess for nonverbal signs such as grimacing or rocking.
• Obtain baseline behavioral indicators from family members.
• Look at the MAR and chart, to note the time of the last dose and response.
• Give the maximum PRS dose within the minimum time frame for relief.

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47. A home care nurse reviews the laboratory results for a postpartum patient who had a caesarean section. Which of the following indicates possible wound infection?

• Increased WBC
• Decreased hematocrit level
• Increased hemoglobin
• Decreased platelet

48. The nurse is assisting a client with diverticulosis to select appropriate foods. Which food should be avoided?

• Bran
• Fresh peaches
• Cucumber salad
• Yeast rolls

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49. While pacing in the hall, a client with paranoid schizophrenia runs to the nurse and says, "Why are you poisoning me? I know you work for central thought control! You can keep my thoughts. Give me back my soul!" How should the nurse respond during the early stage of the therapeutic process?

• "I'm a nurse. I'm not poisoning you. It's against the nursing code of ethics."
• "I'm a nurse, and you're a client in the hospital. I'm not going to harm you.”
• "I'm not poisoning you. And how could I possibly steal your soul?"
• "I sense anger. Are you feeling angry today?"

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50. A client is suffering from low back pain. Which of the following exercises will strengthen the lower back muscle of the client?

• Tennis
• Basketball
• Diving
• Swimming

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NCLEX-RN | QB1 | Practice Exam #4 (50 questions)