Practice Tests: NCSBN Practice Exam #7 - 50 questions
The 50 questions in this test are randomized each time you start, ensuring a different order every time.
1. The nurse is admitting a client with a suspected duodenal ulcer. The client will most likely report that his abdominal discomfort decreases when he:
❍ A. Avoids eating
❍ B. Rests in a recumbent position
❍ C. Eats a meal or snack
❍ D. Sits upright after eating
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2. The nurse is assessing a newborn in the well-baby nursery. Which finding should alert the nurse to the possibility of a cardiac anomaly?
❍ A. Diminished femoral pulses
❍ B. Harlequin’s sign
❍ C. Circumoral pallor
❍ D. Acrocyanosis
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3. A 2-year-old is hospitalized with a diagnosis of Kawasaki’s disease. A severe complication of Kawasaki’s disease is:
❍ A. The development of Brushfield spots
❍ B. The eruption of Hutchinson’s teeth
❍ C. The development of coxa plana
❍ D. The creation of a giant aneurysm
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4. The charge nurse is formulating a discharge teaching plan for a client with mild preeclampsia. The nurse should give priority to:
❍ A. Teaching the client to report a nosebleed
❍ B. Instructing the client to maintain strict bed rest
❍ C. Telling the client to notify the doctor of pedal edema
❍ D. Advising the client to avoid sodium sources in the diet
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5. The nurse is preparing to discharge a client who is taking an MAOI. The nurse should instruct the client to:
❍ A. Wear protective clothing and sunglasses when outside
❍ B. Avoid over-the-counter cold and hayfever preparations
❍ C. Drink at least eight glasses of water a day
❍ D. Increase his intake of high-quality protein
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6. Which of the following meal selections is appropriate for the client with celiac disease?
❍ A. Toast, jam, and apple juice
❍ B. Peanut butter cookies and milk
❍ C. Rice Krispies bar and milk
❍ D. Cheese pizza and Kool-Aid
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7. A client with hyperthyroidism is taking lithium carbonate to inhibit thyroid hormone release. Which complaint by the client should alert the nurse to a problem with the client’s medication?
❍ A. The client complains of blurred vision.
❍ B. The client complains of increased thirst and increased urination.
❍ C. The client complains of increased weight gain over the past year.
❍ D. The client complains of rhinorrhea.
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8. The physician has ordered intravenous fluid with potassium for a client admitted with gastroenteritis and dehydration. Before adding potassium
to the intravenous fluid, the nurse should:
❍ A. Assess the urinary output
❍ B. Obtain arterial blood gases
❍ C. Perform a dextrostick
❍ D. Obtain a stool culture
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9. A 2-month-old infant has just received her first Tetramune injection. The nurse should tell the mother that the immunization:
❍ A. Will need to be repeated when the child is 4 years of age
❍ B. Is given to determine whether the child is susceptible to pertussis
❍ C. Is one of a series of injections that protects against diphtheria, pertussis, tetanus and H.influenza b
❍ D. Is a one-time injection that protects against measles, mumps, rubella and varicella
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10. A client with Addison’s disease has been receiving glucocorticoid therapy. Which finding indicates a need for dosage adjustment?
❍ A. Dryness of the skin and mucus membranes
❍ B. Dizziness when rising to a standing position
❍ C. A weight gain of 6 pounds in the past week
❍ D. Difficulty in remaining asleep
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11. The nurse is caring for an obstetrical client in early labor. After the rupture of membranes, the nurse should give priority to:
❍ A. Applying an internal monitor
❍ B. Assessing fetal heart tones
❍ C. Assisting with epidural anesthesia
❍ D. Inserting a Foley catheter
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12. The physician has prescribed Synthroid (levothyroxine) for a client with myxedema. Which statement indicates that the client understands the nurse’s teaching regarding the medication?
❍ A. “I will take the medication each morning after breakfast.”
❍ B. “I will check my heart rate before taking the medication.”
❍ C. “I will report visual disturbances to my doctor.”
❍ D. “I will stop the medication if I develop gastric upset.”
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13. The nurse is caring for a client with a radium implant for the treatment of cervical cancer. While caring for the client with a radioactive implant, the nurse should:
❍ A. Provide emotional support by spending additional time with the client
❍ B. Stand at the foot of the bed when talking to the client
❍ C. Avoid handling items used by the client
❍ D. Wear a badge to monitor the amount of time spent in the client’s room
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14. The nurse is caring for a client hospitalized with bipolar disorder, manic phase who is taking lithium. Which of the following snacks would be best for the client with mania?
❍ A. Potato chips
❍ B. Diet cola
❍ C. Apple
❍ D. Milkshake
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15. The physician has prescribed imipramine (ToFranil) for a client with depression. The nurse should continue to monitor the client’s affect because the maximal effects of tricyclic antidepressant medication do not occur for:
❍ A. 48–72 hours
❍ B. 5–7 days
❍ C. 2–4 weeks
❍ D. 3–6 months
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16. An elderly client with glaucoma has been prescribed Timoptic eyedrops. Timoptic should be used with caution in clients with a history of:
❍ A. Diabetes
❍ B. Gastric ulcers
❍ C. Emphysema
❍ D. Pancreatitis
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17. A 2-year-old is hospitalized with suspected intussusception. Which finding is associated with intussusception?
❍ A. “Currant jelly” stools
❍ B. Projectile vomiting
❍ C. “Ribbonlike” stools
❍ D. Palpable mass over the flank
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18. Which of the following findings would be expected in the infant with biliary atresia?
❍ A. Rapid weight gain and hepatomegaly
❍ B. Dark stools and poor weight gain
❍ C. Abdominal distention and poor weight gain
❍ D. Abdominal distention and rapid weight gain
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19. A client is being treated for cancer with linear acceleration radiation. The physician has marked the radiation site with a blue marking pen. The nurse should:
❍ A. Remove the unsightly markings with acetone or alcohol
❍ B. Cover the radiation site with loose gauze dressing
❍ C. Sprinkle baby powder over the radiated area
❍ D. Refrain from using soap or lotion on the marked area
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20. The blood alcohol concentration of a client admitted following a motor vehicle accident is 460mg/dL. The nurse should give priority to monitoring the client for:
❍ A. Loss of coordination
❍ B. Respiratory depression
❍ C. Visual hallucinations
❍ D. Tachycardia
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21. The nurse is caring for a client with acromegaly. Following a transphenoidal hypophysectomy, the nurse should:
❍ A. Monitor the client’s blood sugar
❍ B. Suction the mouth and pharynx every hour
❍ C. Place the client in low Trendelenburg position
❍ D. Encourage the client to cough
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22. A client newly diagnosed with diabetes is started on Precose (acarbose). The nurse should tell the client that the medication should be taken:
❍ A. 1 hour before meals
❍ B. 30 minutes after meals
❍ C. With the first bite of a meal
❍ D. Daily at bedtime
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23. A client with a deep decubitus ulcer is receiving therapy in the hyperbaric oxygen chamber. Before therapy, the nurse should:
❍ A. Apply a lanolin-based lotion to the skin
❍ B. Wash the skin with water and pat dry
❍ C. Cover the area with a petroleum gauze
❍ D. Apply an occlusive dressing to the site
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24. The physician has ordered DDAVP (desmopressin acetate) for a client with diabetes insipidus. Which finding indicates that the medication is having its intended effect?
❍ A. The client’s appetite has improved.
❍ B. The client’s morning blood sugar was 120mg/dL.
❍ C. The client’s urinary output has decreased.
❍ D. The client’s activity level has increased.
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25. A client with pregnancy-induced hypertension is scheduled for a C-section. Before surgery, the nurse should keep the client:
❍ A. On her right side
❍ B. Supine with a small pillow
❍ C. On her left side
❍ D. In knee chest position
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26. The physician has prescribed Coumadin (sodium warfarin) for a client having transient ischemic attacks. Which laboratory test measures the therapeutic level of Coumadin?
❍ A. Prothrombin time
❍ B. Clot retraction time
❍ C. Partial thromboplastin time
❍ D. Bleeding time
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27. An adolescent client with cystic acne has a prescription for Accutane (isotretinoin). Which lab work is needed before beginning the medication?
❍ A. Complete blood count
❍ B. Clean-catch urinalysis
❍ C. Liver profile
❍ D. Thyroid function test
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28. Twenty-four hours after an uncomplicated labor and delivery, a client’s WBC is 12,000 cu/mm. The elevation in the client’s WBC is most likely an indication of:
❍ A. A normal response to the birth process
❍ B. An acute bacterial infection
❍ C. A sexually transmitted virus
❍ D. Dehydration from being NPO during labor
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29. The home health nurse is visiting a client who plans to deliver her baby at home. Which statement by the client indicates an understanding regarding screening for phenylketonuria (PKU)?
❍ A. “I will need to take the baby to the clinic within 24 hours of delivery to have blood drawn.”
❍ B. “I will need to schedule a home visit for PKU screening when the baby is 3 days old.”
❍ C. “I will remind the midwife to save a specimen of cord blood for the PKU test.”
❍ D. “I will have the PKU test done when I take her for her first immunizations.”
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30. The physician has ordered intubation and mechanical ventilation for a client with periods of apnea following a closed head injury. Arterial blood gases reveal a pH of 7.47, PCO2 of 28, and HCO3 of 23. These findings indicate that the client has:
❍ A. Respiratory acidosis
❍ B. Respiratory alkalosis
❍ C. Metabolic acidosis
❍ D. Metabolic alkalosis
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31. A client is diagnosed with emphysema and cor pulmonale. Which findings are characteristic of cor pulmonale?
❍ A. Hypoxia, shortness of breath, and exertional fatigue
❍ B. Weight loss, increased RBC, and fever
❍ C. Rales, edema, and enlarged spleen
❍ D. Edema of the lower extremities and distended neck veins
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32. 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:
❍ A. Prevent swelling and dysphagia
❍ B. Decompress the stomach
❍ C. Prevent contamination of the suture line
❍ D. Promote healing of the oral mucosa
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33. The physician orders the removal of an in-dwelling catheter the second postoperative day for a client with a prostatectomy. The client complains of pain and dribbling of urine the first time he voids. The nurse should tell the client that:
❍ A. Using warm compresses over the bladder will lessen the discomfort.
❍ B. Perineal exercises will be started in a few days to help relieve his symptoms.
❍ C. If the symptoms don’t improve, the catheter will have to be reinserted.
❍ D. His complaints are common and will improve over the next few days.
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34. A client with a right lobectomy is being transported from the intensive care unit to a medical unit. The nurse understands that the client’s chest drainage system:
❍ A. Can be disconnected from suction if the chest tube is clamped
❍ B. Can be disconnected from suction, but the chest tube should remain unclamped
❍ C. Must remain connected by means of a portable suction
❍ D. Must be kept even with the client’s shoulders during the transport
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35. A nurse is caring for a client with a myocardial infarction. The nurse recognizes that the most common complication in the client following a myocardial infarction is:
❍ A. Right ventricular hypertrophy
❍ B. Cardiac dysrhythmia
❍ C. Left ventricular hypertrophy
❍ D. Hyperkalemia
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36. A client develops a temperature of 102°F following coronary artery bypass surgery. The nurse should notify the physician immediately because elevations in temperature:
❍ A. Increase cardiac output
❍ B. Indicate cardiac tamponade
❍ C. Decrease cardiac output
❍ D. Indicate graft rejection
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37. The chart indicates that a client has expressive aphasia following a stroke. The nurse understands that the client will have difficulty with:
❍ A. Speaking and writing
❍ B. Comprehending spoken words
❍ C. Carrying out purposeful motor activity
❍ D. Recognizing and using an object correctly
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38. 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?
❍ A. Processed cheese
❍ B. Cottage cheese
❍ C. Cream cheese
❍ D. Cheddar cheese
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39. To prevent deformities of the knee joints in a client with an exacerbation of rheumatoid arthritis, the nurse should:
❍ A. Tell the client to remain on bed rest until swelling subsides
❍ B. Discourage passive range of motion because it will cause further swelling
❍ C. Encourage motion of the joint within the limits of pain
❍ D. Tell the client she will need joint immobilization for 2–3 weeks
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40. The nurse is assessing a trauma client in the emergency room when she notes a penetrating abdominal wound with exposed viscera. The nurse should:
❍ A. Apply a clean dressing to protect the wound
❍ B. Cover the exposed visera with a sterile saline gauze
❍ C. Gently replace the abdominal contents
❍ D. Cover the area with a petroleum gauze
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41. A client is admitted to the emergency room with multiple injuries. What is the proper sequence for managing the client?
❍ A. Assess for head injuries, control hemorrhage, establish an airway, prevent hypovolemic shock
❍ B. Control hemorrhage, prevent hypovolemic shock, establish an airway, assess for head injuries
❍ C. Establish an airway, control hemorrhage, prevent hypovolemic shock, assess for head injuries
❍ D. Prevent hypovolemic shock, assess for head injuries, establish an airway, control hemorrhage
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42. The nurse is teaching the mother of a child with attention deficit disorder regarding the use of Ritalin (methylphenidate). The nurse recognizes that the mother understands her teaching when she states the importance of:
❍ A. Offering high-calorie snacks
❍ B. Watching for signs of infection
❍ C. Observing for signs of oversedation
❍ D. Using a sunscreen with an SPF of 30
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43. A home health nurse has several elderly clients in her case load. Which of the following clients is most likely to be a victim of elder abuse?
❍ A. A 76-year-old female with Alzheimer’s disease
❍ B. A 70-year-old male with diabetes mellitus
❍ C. A 64-year-old female with a hip replacement
❍ D. A 72-year-old male with Parkinson’s disease
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44. A camp nurse is applying sunscreen to a group of children enrolled in swim classes. Chemical sunscreens are most effective when applied:
❍ A. Just before sun exposure
❍ B. 5 minutes before sun exposure
❍ C. 15 minutes before sun exposure
❍ D. 30 minutes before sun exposure
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45. The physician has made a diagnosis of “shaken child” syndrome for a 13-month-old who was brought to the emergency room after a reported fall from his highchair. Which finding supports the diagnosis of “shaken child” syndrome?
❍ A. Fracture of the clavicle
❍ B. Periorbital bruising
❍ C. Retinal hemorrhages
❍ D. Fracture of the humerus
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46. A post-operative client has an order for Demerol (meperidine) 75mg and Phenergan (promethazine) 25mg IM every 3–4 hours as needed for pain. The combination of the two medications produces a/an:
❍ A. Agonist effect
❍ B. Synergistic effect
❍ C. Antagonist effect
❍ D. Excitatory effect
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47. Which obstetrical client is most likely to have an infant with respiratory distress syndrome?
❍ A. A 28-year-old with a history of alcohol use during the pregnancy
❍ B. A 24-year-old with a history of diabetes mellitus
❍ C. A 30-year-old with a history of smoking during the pregnancy
❍ D. A 32-year-old with a history of pregnancy-induced hypertension
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48. A client with a C4 spinal cord injury has been placed in traction with cervical tongs. Nursing care should include:
❍ A. Releasing the traction for 5 minutes each shift
❍ B. Loosening the pins if the client complains of headache
❍ C. Elevating the head of the bed 90°
❍ D. Performing sterile pin care as ordered
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49. The nurse is assessing a client following a coronary artery bypass graft (CABG). The nurse should give priority to reporting:
❍ A. Chest drainage of 150mL in the past hour
❍ B. Confusion and restlessness
❍ C. Pallor and coolness of skin
❍ D. Urinary output of 40mL per hour
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50. Before administering a client’s morning dose of Lanoxin (digoxin), the nurse checks the apical pulse rate and finds a rate of 54. The appropriate nursing intervention is to:
❍ A. Record the pulse rate and administer the medication
❍ B. Administer the medication and monitor the heart rate
❍ C. Withhold the medication and notify the doctor
❍ D. Withhold the medication until the heart rate increases
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