Practice Tests: NCSBN Practice Exam #4 - 50 questions

All 50 questions are randomized each time you take the test, and do not appear in the same order here.

 

1. The nurse employed in the emergency room is responsible for triage of four clients injured in a motor vehicle accident. Which of the following clients should receive priority in care?
 A. A 10-year-old with lacerations of the face
 B. A 15-year-old with sternal bruises
 C. A 34-year-old with a fractured femur
 D. A 50-year-old with dislocation of the elbow
 
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2. Which of the following roommates would be most suitable for the client with myasthenia gravis?
 A. A client with hypothyroidism
 B. A client with Crohn’s disease
 C. A client with pylonephritis
 D. A client with bronchitis
 
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3. The nurse is observing a graduate nurse as she assesses the central venous pressure. Which observation would indicate that the graduate needs further teaching?
 A. The graduate places the client in a supine position to read the manometer.
 B. The graduate turns the stop-cock to the off position from the IV fluid to the client.
 C. The graduate instructs the client to perform the Valsalva maneuver during the CVP reading.
 D. The graduate notes the level at the top of the meniscus.
 
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4. The nurse is working with another nurse and a patient care assistant. Which of the following clients should be assigned to the registered nurse?
 A. A client 2 days post-appendectomy
 B. A client 1 week post-thyroidectomy
 C. A client 3 days post-splenectomy
 D. A client 2 days post-thoracotomy
 
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5. Which of the following roommates would be best for the client newly admitted with gastric resection?
 A. A client with Crohn’s disease
 B. A client with pneumonia
 C. A client with gastritis
 D. A client with phlebitis
 
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6. The nurse is preparing a client for mammography. To prepare the client for a mammogram, the nurse should tell the client:
 A. To restrict her fat intake for 1 week before the test
 B. To omit creams, powders, or deodorants before the exam
 C. That mammography replaces the need for self-breast exams
 D. That mammography requires a higher dose of radiation than x-rays
 
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7. Which action by the novice nurse indicates a need for further teaching?
 A. The nurse fails to wear gloves to remove a dressing.
 B. The nurse applies an oxygen saturation monitor to the ear lobe.
 C. The nurse elevates the head of the bed to check the blood pressure.
 D. The nurse places the extremity in a dependent position to acquire a peripheral blood sample.
 
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8. The graduate nurse is assigned to care for the client on ventilator support, pending organ donation. Which goal should receive priority?
 A. Maintaining the client’s systolic blood pressure at 70mmHg or greater
 B. Maintaining the client’s urinary output greater than 300cc per hour
 C. Maintaining the client’s body temperature of greater than 33°F rectal
 D. Maintaining the client’s hematocrit at less than 30%
 
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9. The nurse is assigned to care for an infant with physiologic jaundice. Which action by the nurse would facilitate elimination of the bilirubin?
 A. Increasing the infant’s fluid intake
 B. Maintaining the infant’s body temperature at 98.6°F
 C. Minimizing tactile stimulation
 D. Decreasing caloric intake
 
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10. A home health nurse is planning for her daily visits. Which client should the home health nurse visit first?
 A. A client with AIDS being treated with Foscarnet
 B. A client with a fractured femur in a long leg cast
 C. A client with laryngeal cancer with a laryngectomy
 D. A client with diabetic ulcers to the left foot
 
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11. The charge nurse overhears the patient care assistant speaking harshly to the client with dementia. The charge nurse should:
 A. Change the nursing assistant’s assignment
 B. Explore the interaction with the nursing assistant
 C. Discuss the matter with the client’s family
 D. Initiate a group session with the nursing assistant
 
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12. The nurse notes the patient care assistant looking through the personal items of the client with cancer. Which action should be taken by the registered nurse?
 A. Notify the police department as a robbery
 B. Report this behavior to the charge nurse
 C. Monitor the situation and note whether any items are missing
 D. Ignore the situation until items are reported missing
 
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13. Which client can best be assigned to the newly licensed nurse?
 A. The client receiving chemotherapy
 B. The client post–coronary bypass
 C. The client with a TURP
 D. The client with diverticulitis
 
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14. The nurse has an order for medication to be administered intrathecally. The nurse is aware that medications will be administered by which method?
 A. Intravenously
 B. Rectally
 C. Intramuscularly
 D. Into the cerebrospinal fluid
 
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15. The client is admitted to the unit after a cholescystectomy. Montgomery straps are utilized with this client. The nurse is aware that Montgomery straps are utilized on this client because:
 A. The client is at risk for evisceration.
 B. The client will require frequent dressing changes.
 C. The straps provide support for drains that are inserted into the incision.
 D. No sutures or clips are used to secure the incision.
 
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16. A client with pancreatitis has been transferred to the intensive care unit. Which order would the nurse anticipate?
 A. Blood pressure every 15 minutes
 B. Insertion of a Levine tube
 C. Cardiac monitoring
 D. Dressing changes two times per day
 
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17. The nurse is caring for a client with a diagnosis of hepatitis who is experiencing pruritis. Which would be the most appropriate nursing intervention?
 A. Suggest that the client take warm showers two times per day
 B. Add baby oil to the client’s bath water
 C. Apply powder to the client’s skin
 D. Suggest a hot-water rinse after bathing
 
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18. The nurse recognizes that which of the following would be most appropriate to wear when providing direct care to a client with a cough?
 A. Mask
 B. Gown
 C. Gloves
 D. Shoe covers
 
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19. A client visits the clinic after the death of a parent. Which statement made by the client’s sister signifies abnormal grieving?
 A. “My sister still has episodes of crying, and it’s been three months since Daddy died.”
 B. “Sally seems to have forgotten the bad things that Daddy did in his lifetime.”
 C. “She really had a hard time after Daddy’s funeral. She said that she had a sense of longing.”
 D. “She has not been saddened at all by Daddy’s death. She acts like nothing has happened.”
 
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20. The nurse is obtaining a history on an 80-year-old client. Which statement made by the client might indicate a potential for fluid and electrolyte imbalance?
 A. “My skin is always so dry.”
 B. “I often use laxatives.”
 C. “I have always liked to drink a lot of ice tea.”
 D. “I sometimes have a problem with dribbling urine.”
 
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21. A client is admitted to the acute care unit. Initial laboratory values reveal serum sodium of 170meq/L. What behavior changes would be most common for this client?
 A. Anger
 B. Mania
 C. Depression
 D. Psychosis
 
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22. When assessing a client for risk of hyperphosphatemia, which piece of information is most important for the nurse to obtain?
 A. A history of radiation treatment in the neck region
 B. Any history of recent orthopedic surgery
 C. A history of minimal physical activity
 D. A history of the client’s food intake
 
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23. The nurse on the 3–11 shift is assessing the chart of a client with an abdominal aneurysm scheduled for surgery in the morning and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action?
 A. Call the surgeon and ask him or her to see the client to clarify the information
 B. Explain the procedure and complications to the client
 C. Check in the physician’s progress notes to see if understanding has been documented
 D. Check with the client’s family to see if they understand the procedure fully
 
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24. The nurse is preparing a client for surgery. Which item is most important to remove before sending the client to surgery?
 A. Hearing aid
 B. Contact lenses
 C. Wedding ring
 D. Artificial eye
 
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25. A client is 2 days post-operative colon resection. After a coughing episode, the client’s wound eviscerates. Which nursing action is most appropriate?
 A. Reinsert the protruding organ and cover with 4×4s
 B. Cover the wound with a sterile 4×4 and ABD dressing
 C. Cover the wound with a sterile saline-soaked dressing
 D. Apply an abdominal binder and manual pressure to the wound
 
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26. The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:
 A. That cannot be assessed
 B. That is in situ
 C. With increasing lymph node involvement
 D. With distant metastasis
 
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27. A client with cancer is to undergo an intravenous pyelogram. The nurse should:
 A. Force fluids 24 hours before the procedure
 B. Ask the client to void immediately before the study
 C. Hold medication that affects the central nervous system for 12 hours pre- and post-test
 D. Cover the client’s reproductive organs with an x-ray shield.
 
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28. A client arrives in the emergency room with a possible fractured femur. The nurse should anticipate an order for:
 A. Trendelenburg position
 B. Ice to the entire extremity
 C. Buck’s traction
 D. An abduction pillow
 
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29. The nurse is performing an assessment on a client with possible pernicious anemia. Which data would support this diagnosis?
 A. A weight loss of 10 pounds in 2 weeks
 B. Complaints of numbness and tingling in the extremities
 C. A red, beefy tongue
 D. A hemoglobin level of 12.0gm/dL
 
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30. A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session?
 A. “You will be sitting for the examination procedure.”
 B. “Portions of the procedure will cause pain or discomfort.”
 C. “You will be asleep during the procedure.”
 D. “You will not be able to drink fluids for 24 hours following the study.”
 
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31. The nurse is caring for a client scheduled for a surgical repair of a sacular abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?
 A. Assessment of the client’s level of anxiety
 B. Evaluation of the client’s exercise tolerance
 C. Identification of peripheral pulses
 D. Assessment of bowel sounds and activity
 
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32. A client in the cardiac step-down unit requires suctioning for excess mucous secretions. The dysrhythmia most commonly seen during suctioning is:
 A. Bradycardia
 B. Tachycardia
 C. Premature ventricular beats
 D. Heart block
 
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33. The nurse is performing discharge instruction to a client with an implantable defibrillator. What discharge instruction is essential?
 A. “You cannot eat food prepared in a microwave.”
 B. “You should avoid moving the shoulder on the side of the pacemaker site for 6 weeks.”
 C. “You should use your cell phone on your right side.”
 D. “You will not be able to fly on a commercial airliner with the defibrillator in place.”
 
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34. Six hours after birth, the infant is found to have an area of swelling over the right parietal area that does not cross the suture line. The nurse should chart this finding as:
 A. A cephalhematoma
 B. Molding
 C. Subdural hematoma
 D. Caput succedaneum
 
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35. A removal of the left lower lobe of the lung is performed on a client with lung cancer. Which post-operative measure would usually be included in the plan?
 A. Closed chest drainage
 B. A tracheostomy
 C. A Swan Ganz Monitor
 D. Percussion vibration and drainage
 
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36. The nurse is caring for a client with laryngeal cancer. Which finding ascertained in the health history would not be common for this diagnosis?
 A. Foul breath
 B. Dysphagia
 C. Diarrhea
 D. Chronic hiccups
 
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37. The nurse is caring for a new mother. The mother asks why her baby has lost weight since he was born. The best explanation of the weight loss is:
 A. The baby is dehydrated.
 B. The baby is hypoglycemic.
 C. The baby is allergic to the formula the mother is giving him.
 D. A loss of 10% is normal in the first week due to meconium stools.
 
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38. The nurse is performing discharge teaching on a client with diverticulitis who has been placed on a low-roughage diet. Which food would have to be eliminated from this client’s diet?
 A. Roasted chicken
 B. Noodles
 C. Cooked broccoli
 D. Custard
 
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39. A client has rectal cancer and is scheduled for an abdominal perineal resection. What should be the priority nursing care during the post-op period?
 A. Teaching how to irrigate the illeostomy
 B. Stopping electrolyte loss in the incisional area
 C. Encouraging a high-fiber diet
 D. Facilitating perineal wound drainage
 
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40. The nurse is assisting a client with diverticulosis to select appropriate foods. Which food should be avoided?
 A. Bran
 B. Fresh peaches
 C. Cucumber salad
 D. Yeast rolls
 
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41. A 6-month-old client is admitted with possible intussuception. Which question during the nursing history is least helpful in obtaining information regarding this diagnosis?
 A. “Tell me about his pain.”
 B. “What does his vomit look like?”
 C. “Describe his usual diet.”
 D. “Have you noticed changes in his abdominal size?”
 
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42. The nurse is caring for a client with epilepsy who is being treated with carbamazepine (Tegretol). Which laboratory value might indicate a serious side effect of this drug?
 A. Uric acid of 5mg/dL
 B. Hematocrit of 33%
 C. WBC 2000 per cubic millimeter
 D. Platelets 150,000 per cubic millimeter
 
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43. A client is admitted with a Ewing’s sarcoma. Which symptoms would be expected due to this tumor’s location?
 A. Hemiplegia
 B. Aphasia
 C. Nausea
 D. Bone pain

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44. A infant weighs 7 pounds at birth. The expected weight by 1 year should be:
 A. 10 pounds
 B. 12 pounds
 C. 18 pounds
 D. 21 pounds
 
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45. The nurse is making initial rounds on a client with a C5 fracture and crutchfield tongs. Which equipment should be kept at the bedside?
 A. A pair of forceps
 B. A torque wrench
 C. A pair of wire cutters
 D. A screwdriver
 
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46. The nurse is visiting a home health client with osteoporosis. The client has a new prescription for alendronate (Fosamax). Which instruction should be given to the client?
 A. Rest in bed after taking the medication for at least 30 minutes.
 B. Avoid rapid movements after taking the medication.
 C. Take the medication with water only.
 D. Allow at least 1 hour between taking the medicine and taking other medications.
 
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47. The nurse is working in the emergency room when a client arrives with severe burns of the left arm, hands, face, and neck. Which action should receive priority?
 A. Starting an IV
 B. Applying oxygen
 C. Obtaining blood gases
 D. Medicating the client for pain
 
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48. A 24-year-old female client is scheduled for surgery in the morning. Which of the following is the primary responsibility of the nurse?
 A. Taking the vital signs
 B. Obtaining the permit
 C. Explaining the procedure
 D. Checking the lab work
 
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49. A client with cancer is admitted to the oncology unit. Stat lab values reveal Hgb 12.6, WBC 6500, K+ 1.9, uric acid 7.0, Na+ 136, and platelets 178,000. The nurse evaluates that the client is experiencing which of the following?
 A. Hypernatremia
 B. Hypokalemia
 C. Myelosuppression
 D. Leukocytosis
 
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50. The nurse is caring for a client scheduled for removal of the pituitary gland. The nurse should be particularly alert for:
 A. Nasal congestion
 B. Abdominal tenderness
 C. Muscle tetany
 D. Oliguria
 
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NCSBN Practice Exam #4 - 50 questions