NCLEX-RN | QB1 | Practice Exam #3 (50 questions)
1. A 78 year-old man presents to his care provider with persistent abdominal and back pain. He also occasionally has numbness and pain in the legs. On examination a palpable mass in the lower abdominal midline is palpated. On auscultation a blowing sound is heard over his mass. The nurse is concerned about possible rupture.Which additional finding most significantly indicates the patient is at an increased risk?
- Hypertension
- High blood sugar
- Constipation
- Decreased oxygen saturation
2. Situation: Mrs. Harper 50 y/o, teacher is affected with myasthenia gravis.Q. Looking at Mrs. Harper, your assessment would include the ff except:
- Nystagmus
- Difficulty of hearing
- Weakness of the levator palpebrae
- Weakness of the ocular muscle
3. In vaginal delivery done in the hospital setting, the doctor routinely orders an oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because:
- Oxytocin will prevent bleeding
- Oxytocin can make the cervix close and thus trap the placenta inside
- Oxytocin will facilitate placental delivery
- Giving oxytocin will ensure complete delivery of the placenta
4. In preparing a primigravida for breastfeeding, which of the following will you do?
- Tell her that lactation begins within a day after delivery
- Teach her nipple stretching exercises if her nipples are everted
- Instruct her to wash her nipples before and after each breastfeeding
- Explain to her that putting the baby to breast will lessen blood loss after delivery
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5. The client is scheduled to have surgical removal of the tumor on her left breast. Which of the following manifestation indicates that she is experiencing Mild Anxiety?
- She has increased awareness of her environmental details
- She focused on selected aspect of her illness
- She experiences incongruence of action, thoughts and feelings
- She experiences random motor activities
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6. A child is admitted with temperature of 38.5 C (101.3 F), loss of appetite and vomiting The nurse observes several joints are red, swollen, warm and tender to touch. A non pruritic rash is on the child's trunk. Laboratory test results include an elevate erythrocyte sedimentation rate (ESR), a positive creactive protein, and an elevated white blood cell count (WBC). The nurse should initiate the plan of care for:
- Congestive heart failure
- Meningitis
- Rotovirus
- Acute rheumatic fever
7. Situation: Mental Retardation is an increasingly common childhood disorder that impairs learnings Which of the following is true with regards to Mild Mental Retardation?
- Trainable, Can reach up to 2nd grade and can reach the maturity of a 7 year old
- Custodial and barely trainable
- Requires total care throughout life, Mental age of a young infant
- Educable, can reach up to grade 6 and has a maturity of a 12 year old
8. Which of the following can be use to determine if a prescribed pain management therapy is effective for a non verbal patient?
- Papanicolaoutest
- Faces rating scale
- Braden's scale
- Apgar assessment tool
9. Among the following people, who requires the greatest caloric intake?
- An individual in a long state of gluconeogenesis
- An individual in a long state of glycogenolysis
- A pregnant individual
- An adolescent with a BMI of 25
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10. The nurse is teaching a postpartum client about breast-feeding. Which instruction should the nurse include?
- The diet should include additional fluids.
- Prenatal vitamins should be discontinued.
- Soap should be used to cleanse the breasts.
- Birth control measures are unnecessary while breast-feeding.
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11. Normal body temperature is ranging from:
- 35.8- 37.4 C
- 34.5 - 36.5 C
- 35.0 - 38.0 C
- 36.5 - 38.5 C
12. Mr. Johnson is suspected to have malaria after a business trip. The most important diagnostic test in malaria is:
- WBC count
- Urinalysis
- ELISA
- Peripheral blood smear
13. A client who had an organ transplant is receiving cycloSPORINE (Gengraf). For what should the nurse monitor to identify a serious adverse effect of cycloSPORINE?
- Skin for hirsutism
- Stools for constipation
- Heart rhythm for dysrhythmias
- Creatinine level for an increase
14. Situation: - Nurse Lorena is a Family Planning and Infertility Nurse Specialist and is currently attending to a meeting. The following conditions pertain to meeting the nursing of this particular population group.Lilia's cousin on the other hand, knowing nurse Lorena's specialization asks what artificial insemination by donor entails. Which would be your best answer if you were Nurse Lorena?
- Donor sperm are introduced vaginally into the uterus or cervix
- Donor sperm are injected intra-abdominally into each ovary
- Artificial sperm are injected vaginally to test tubal patency
- The husband's sperm is administered intravenously weekly
15. The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child?
- Soccer
- Basketball
- Swimming
- Field hockey
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16. Situation: Valentina, 36 weeks gestation visits the hospital because the suspects that her bag of water was ruptured.Q. Few hours after, the nurse noted that her cervix is 2 cm dilated and 50% effaced. Which of the following would the priority assessment for this client?
- Red blood cell count
- Degree of Discomfort
- Urinary Output
- Temperature
17. A nurse is teaching an infertile couple about how the sperm travel through the man's body during ejaculation. Please put the following five major structures in or- der, beginning with the place where spermatogenesis occurs and continuing through the path that the sperm and semen travel until ejaculation. 1. Epididymis. 2. Prostate. 3. Testes. 4. Urethra.5. Vas deferens
- 3,1,5,2,4
- 4,2,3,1,5
- 1,2,4,3,5
- 1,3,4,5,2
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18. A woman's temperature has just risen 0.4°F and will remain elevated during the remainder of her cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the change?
- Estrogen.
- Progesterone.
- Luteinizing hormone (LH).
- Follicle-stimulating hormone (FSH).
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19. The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should tell the client to take which action?
- Freeze the insulin.
- Refrigerate the insulin.
- Store the insulin in a dark, dry place.
- Keep the insulin at room temperature.
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20. Which of the following foods would the nurse Trish eliminate from the diet of a client in alcohol withdrawal?
- Milk
- Orange Juice
- Soda
- Regular Coffee
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21. Within a few hours of alcohol withdrawal, nurse John should assess the male client for the presence of:
- Disorientation, paranoia, tachycardia
- Tremors, fever, profuse diaphoresis
- Irritability, heightened alertnessjerky movements
- Yawning, anxiety, convulsions
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22. A patient with pulmonary emboli complains of pain, dyspnea, and a fear of dying. Which of the following interventions would MOST likely help to reduce the patients anxiety level?
- Administer oxygen as ordered
- Administer pain medication as ordered
- Observe closely for signs of pain and discomfort
- Listen to the patient's concerns
23. The nurse enters the room of the client on airborne precaution due to tuberculosis. Which of the following are appropriate actions by the nurse? 1.She wears mask, covering the nose and mouth. 2.She washes her hands before and after removing gloves, after suctioning the client's secretion. 3.She removes gloves and hands before leaving the client's room. 4.She discards contaminated suction catheter tip in trashcan found in the clients room
- 1,2
- 1,2,3
- 1,2,3,4
- 1,3
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24. Which of the following is not true about sterilization, cleaning and disinfection?
- Equipment with small lumen are easier to clean
- Sterilization is the complete destruction of all viable microorganism including spores
- Some organism are easily destroyed, while other, with coagulated protein requires longer time
- The number of organism is directly proportional to the length of time required for sterilization
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25. Bethanechol chloride is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication?
- Gastric atony
- Urinary strictures
- Neurogenic atony
- Gastroesophageal reflux
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26. The nurse is caring for a four-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?
- Patching one of the eyes to help strengthen the ocular muscles
- Providing suckers and pinwheels to help strengthen tongue movement
- Providing musical tapes to provide auditory training
- Encouraging play with a video game to improve muscle coordination
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27. Nurse Evelyn reads about Path Goal theory. Which of the following behaviors is manifested by the leader who uses this theory?
- Recognizes staff for going beyond expectations by giving them citations
- Challenges the staff to take individual accountability fortheir own practice
- Admonishes staff for being laggards
- Reminds staff about the sanctions for non performance
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28. A child visits the clinic for a 6-week checkup after a tonsillectomy and adenoidectomy. In addition to assessing hearing, the nurse should include an assessment of the child's:
- Taste and smell
- Taste and speech
- Swallowing and smell
- Swallowing and speech
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29. A client with end stage renal disease is being managed with peritoneal dialysis. If the dialysate return is slowed the nurse should tell the client to:
- Irrigate the dialyzing catheter with saline.
- Skip the next scheduled infusion.
- Gently retract the dialyzing catheter.
- Change position or turn side to side.
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30. A client with vaginal cancer is being treated with a radioactive vaginal implant The clients husband asks the nurse if he can spend the night with his wife. The nurse should explain that:
- Overnight stays by family members is against hospital policy.
- There is no need for him to stay because staffing is adequate.
- His wife will rest much better knowing that he is at home.
- Visitation is limited to 30 minutes when the implant is in place.
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31. The nurse is caring for a client with systemic lupus erythematosus (SLE). The major complication associated with systemic lupus erythematosus is:
- Nephritis
- Cardiomegaly
- Desquamation
- Meningitis
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32. The nurse notes that a 6-year-old child does not recognize that objects exist even when the objects are outside of the visual field. Based on this observation, which action should the nurse take?
- Report the observation to the health care provider.
- Move the objects in the child's direct field of vision.
- Teach the child how to visually scan the environment.
- Provide additional lighting for the child during play activities.
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33. Chief complains includes:
- Immunization and childhood illness.
- Hoppies and sleep pattern.
- Risk factor for certain diseases.
- The answer given to question "what brought you to the hospital"
34. A client with terminal cancer arrives at the emergency department dead on arrival (DOA). After an autopsy is prescribed, the client's family requests that no autopsy be performed. Which response to the family is most appropriate?
- "The decision is made by the medical examiner."
- "An autopsy is mandatory for any client who is DOA."
- "I will contact the medical examiner regarding your request."
- "It is required by federal law. Tell me why you don't want the autopsy done"
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35. Situation: With the increasing documented cases of CANCER the best alternative to treatment still remains to be PREVENTION. The following conditions apply.Who among the following are recipients of the secondary level of care for cancer cases?
- Those under early case detection
- Those under supportive care
- Those scheduled for surgery
- Those under going treatment
36. The nurse is the first person to arrive at the scene of a motor vehicle accident. When rendering aid to the victim the nurse should give priority to:
- Establishing a patent airway
- Checking the quality of respirations
- Observing for signs of active bleeding
- Determining the level of consciousness
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37. Which of the following is the appropriate meaning of CBR?
- Cardiac Board Room
- Complete Bathroom
- Complete Bed Rest
- Complete Board Room
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38. Situation: As a nurse you are expected to participate in initiating or participating in the conduct of research students to improve nursing practice. You to be updated on the latest trends and issues affected the profession and the best practices arrived at by the profession.Q. You would like to compare the support system of patients with chronic illness to those with acute illness. Considering that the hypothesis was: "Clients with chronic illness have lesser support system than clients with acute illness.” What type of research is this?
- Descriptive
- Experimental
- Correlational, Non experimental
- Quasi Experimental
39. Three days ago a patient underwent an invasive surgery with an open wound. The patient is febrile with drop in biood pressure. Laboratory test results shows elevated WBC count. This could be possible presentation of:
- Sepsis
- Atelectasis
- Internal haemorrhaging
- Excess fluid volume
40. During a prenatal visit, a client at 36 weeks’ gestation tells a nurse that she has painful, irregular contractions. What should the nurse recommend?
- Lie down until they stop.
- Time them for at least 1 hour.
- Walk around until they subside.
- Take 1 over-the-counter analgesic.
41. Situation: You are assigned to take care of a group of patients across the lifespanJn conflict management, the win-win approach occurs when:
- There are two conflicts and the parties agree to each one
- Each party gives in on 50% of the disagreement making the conflict
- Both parties involved are committed in solving the conflict
- The conflict is settled out of court so the legal system mandates parties win.
42. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective?
- Muffled heart sounds
- A rise in blood pressure
- Jugular venous distention
- Client expressions of dyspnea
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43. Needles, scalpels, broken glass and lancets are considered as injurious wastes. As a nurse, it is correct to put them at disposal via a/an
- Puncture proof container
- Reused PET Bottles
- Black trashcan
- Yellow trashcan with a tag "INJURIOUS WASTES"
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44. A tentative diagnosis of opiate addiction. Nurse Ellen should assess a recently hospitalized client for signs of opiate withdrawal. These signs would include:
- Rhinorrhea, convulsions, subnormal temperature
- Nausea, dilated pupils, constipation
- Lacrimation, vomiting, drowsiness
- Muscle aches, papillary constriction, yawning
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45. An infant who weighs 8 pounds at birth would be expected to weigh how many pounds at one year?
- 14 pounds
- 16 pounds
- 18 pounds
- 24 pounds
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46. Situation: Adam 40 y/o married man, an electrical engineer was admitted with the diagnosis of paranoid disorders. He has became suspicious and distrustful 2 months before admission. Upon admission, he kept on saying, "my wife has been planning to kill me "Q. Most appropriate nursing intervention for a client with suspicious behaviour is one of the following:
- Talk to the client constantly to reinforce reality
- Involve him in competitive activities
- Project cheerfulness in interacting with the patient
- Use of Non Judgemental and Consistent approach
47. During a routine physical examination, a firm mass is palpated in the right breast of a 35- year-old woman. Which of the following findings or client history would suggest cancer of the breast as opposed to fibrocystic disease?
- History of early menarche
- Cyclic changes in mass size
- History of anovulatory cycles
- Increased vascularity of the breast
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48. A parent of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. Using Erikson's psychosocial development theory, which instructions should the nurse provide to the parent? Select all that apply. 1. Set limits on the child's behavior.2. Ignore the child when this behavior occurs.3. Allow the behavior, because this is normal at this age period.4. Provide a simple explanation of why the behavior is unacceptable.5. Punish the child every time the child says "no" to change the behavior.
- 2,3,5
- 1,2,4
- 1,3,5
- 1,4
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49. Objective data is also called:
- Covert
- Overt
- Inference
- Evaluation
50. Following a small-bowel resection, a client develops fever and anemia. The surface surrounding the surgical wound is warm to touch and necrotizing fasciitis is suspected. Another manifestation that would most suggest necrotizing fasciitis is:
- erythema
- leukocytosis
- pressure-like pain
- swelling
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NCLEX-RN | QB1 | Practice Exam #3 (50 questions)