Practice Tests: NCSBN Practice Exam #9 - 50 questions

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

 

1. A client with breast cancer is returned to the room following a right total mastectomy. The nurse should:
❍ A. Elevate the client’s right arm on pillows
❍ B. Place the client’s right arm in a dependent sling
❍ C. Keep the client’s right arm on the bed beside her
❍ D. Place the client’s right arm across her body

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2. The physician has ordered nitroglycerin buccal tablets for a client with stable angina. The nurse knows that nitroglyerin:
❍ A. Slows contractions of the heart
❍ B. Dilates coronary blood vessels
❍ C. Increases the ventricular fill time
❍ D. Strengthens contractions of the heart

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3. A trauma client is admitted to the emergency room following a motor vehicle accident. Examination reveals that the left side of the chest moves inward when the client inhales. The finding is suggestive of:
❍ A. Pneumothorax
❍ B. Mediastinal shift
❍ C. Pulmonary contusion
❍ D. Flail chest

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4. A neurological consult has been ordered for a pediatric client with suspected absence seizures. The client with absence seizures can be expected to have:
❍ A. Short, abrupt muscle contractions
❍ B. Quick, severe bilateral jerking movements
❍ C. Abrupt loss of muscle tone
❍ D. Brief lapse in consciousness

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5. To decrease the likelihood of seizures and visual hallucinations in a client with alcohol withdrawal, the nurse should:
❍ A. Keep the room darkened by pulling the curtains
❍ B. Keep the light over the bed on at all times
❍ C. Keep the room quiet and dim the lights
❍ D. Keep the television or radio turned on

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6. A client with schizoaffective disorder is exhibiting Parkinsonian symptoms. Which medication is responsible for the development of Parkinsonian symptoms?
❍ A. Zyprexa (olanzapine)
❍ B. Cogentin (benzatropine mesylate)
❍ C. Benadryl (diphenhydramine)
❍ D. Depakote (divalproex sodium)

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7. Which activity is best suited to the 12-year-old with juvenile rheumatoid arthritis?
❍ A. Playing video games
❍ B. Swimming
❍ C. Working crossword puzzles
❍ D. Playing slow-pitch softball

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8. The home health nurse is scheduled to visit four clients. Which client should she visit first?
❍ A. A client with acquired immunodeficiency syndrome with a cough and reported temperature of 101°F
❍ B. A client with peripheral vascular disease with an ulcer on the left lower leg
❍ C. A client with diabetes mellitus who needs a diabetic control index drawn
❍ D. A client with an autograft to burns of the chest and trunk

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9. The glycosylated hemoglobin of a 40-year-old client with diabetes mellitus is 2.5%. The nurse understands that:
❍ A. The client can have a higher-calorie diet.
❍ B. The client has good control of her diabetes.
❍ C. The client requires adjustment in her insulin dose.
❍ D. The client has poor control of her diabetes.

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10. A dexamethasone-suppression test has been ordered for a client with severe depression. The purpose of the dexamethasone suppression test is to:
❍ A. Determine which social intervention will be best for the client
❍ B. Help diagnose the seriousness of the client’s clinical symptoms
❍ C. Determine whether the client will benefit from electroconvulsive therapy
❍ D. Reverse the depressive symptoms the client is experiencing

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11. The physician has ordered Stadol (butorphanol) for a post-operative client. The nurse knows that the medication is having its intended effect if the client:
❍ A. Is asleep 30 minutes after the injection
❍ B. Asks for extra servings on his meal tray
❍ C. Has an increased urinary output
❍ D. States that he is feeling less nauseated

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12. The mother of a child with cystic fibrosis tells the nurse that her child makes “snoring” sounds when breathing. The nurse is aware that many children with cystic fibrosis have:
❍ A. Choanal atresia
❍ B. Nasal polyps
❍ C. Septal deviations
❍ D. Enlarged adenoids

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13. The nurse is caring for a client with full thickness burns to the lower half of the torso and lower extremities. During the emergent phase of injury, the primary nursing diagnosis would focus on:
❍ A. Ineffective airway clearance
❍ B. Impaired gas exchange
❍ C. Fluid volume deficit
❍ D. Pain

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14. A client is hospitalized with hepatitis A. Which of the client’s regular medications is contraindicated due to the current illness?
❍ A. Prilosec (omeprazole)
❍ B. Synthroid (levothyroxine)
❍ C. Premarin (conjugated estrogens)
❍ D. Lipitor (atorvastatin)

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15. Which activity is suitable for a client who suffered an uncomplicated myocardial infarction (MI) 2 days ago?
❍ A. Sitting in the bedside chair for 15 minutes three times a day
❍ B. Remaining on strict bed rest with bedside commode privileges
❍ C. Ambulating in the room and hall as tolerated
❍ D. Sitting on the bedside for 5 minutes three times a day with assistance

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16. The nurse has been teaching the role of diet in regulating blood pressure to a client with hypertension. Which meal selection indicates the client understands his new diet?
❍ A. Cornflakes, whole milk, banana, and coffee
❍ B. Scrambled eggs, bacon, toast, and coffee
❍ C. Oatmeal, apple juice, dry toast, and coffee
❍ D. Pancakes, ham, tomato juice, and coffee

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17. An 18-month-old is being discharged following hypospadias repair. Which instruction should be included in the nurse’s discharge teaching?
❍ A. The child should not play on his rocking horse.
❍ B. Applying warm compresses will decrease pain.
❍ C. Diapering should be avoided for 1–2 weeks.
❍ D. The child will need a special diet to promote healing.

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18. An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to:
❍ A. Keep crackers at the bedside for eating before she arises
❍ B. Drink a glass of whole milk before going to sleep at night
❍ C. Skip breakfast but eat a larger lunch and dinner
❍ D. Drink a glass of orange juice after adding a couple of teaspoons of sugar

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19. The nurse is making assignments for the day. The staff consists of an RN, a novice RN, an LPN, and a nursing assistant. Which client should be assigned to the RN?
❍ A. A client with peptic ulcer disease
❍ B. A client with skeletal traction for a fractured femur
❍ C. A client with an abdominal cholecystectomy
❍ D. A client with an esophageal tamponade

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20. A child with Tetralogy of Fallot is scheduled for a modified Blalock Taussig procedure. The nurse understands that the surgery will:
❍ A. Reverse the direction of the blood flow
❍ B. Allow better blood supply to the lungs
❍ C. Relieve pressure on the ventricles
❍ D. Prevent the need for further correction

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21. The nurse has taken the blood pressure of a client hospitalized with methicillin-resistant staphylococcus aureus (MRSA). Which action by the nurse indicates an understanding regarding the care of clients with MRSA?
❍ A. The nurse leaves the stethoscope in the client’s room for future use.
❍ B. The nurse cleans the stethoscope with alcohol and returns it to the exam room.
❍ C. The nurse uses the stethoscope to assess the blood pressure of other assigned clients.
❍ D. The nurse cleans the stethoscope with water, dries it, and returns it to the nurse’s station.

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22. The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician’s teaching by telling the parents that:
❍ A. The medication will be needed only during times of rapid growth.
❍ B. The medication will be needed throughout the child’s lifetime.
❍ C. The medication schedule can be arranged to allow for drug holidays.
❍ D. The medication is given one time daily every other day.

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23. A client with diabetes mellitus has a prescription for Glucotrol XL (glipizide). The client should be instructed to take the medication:
❍ A. At bedtime
❍ B. With breakfast
❍ C. Before lunch
❍ D. After dinner

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24. The nurse is caring for a client admitted with suspected myasthenia gravis. Which finding is usually associated with a diagnosis of myasthenia gravis?
❍ A. Visual disturbances, including diplopia
❍ B. Ascending paralysis and loss of motor function
❍ C. Cogwheel rigidity and loss of coordination
❍ D. Progressive weakness that is worse at the day’s end

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25. A preterm infant with sepsis is receiving Gentamycin (garamycin). Which physiological alteration places the preterm infant at increased risk for toxicity related to aminoglycoside therapy?
❍ A. Lack of subcutaneous fat deposits
❍ B. Immature central nervous system
❍ C. Presence of fetal hemoglobin
❍ D. Immaturity of the renal system

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26. The nurse is teaching the parents of an infant with osteogenesis imperfecta. The nurse should tell the parents:
❍ A. That the infant will need daily calcium supplements
❍ B. That it is best to lift the infant by the buttocks when diapering
❍ C. That the condition is a temporary one
❍ D. That only the bones of the infant are affected by the disease

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27. The home health nurse is visiting an elderly client following a hip replacement. Which finding requires further teaching?
❍ A. The client shares her apartment with a cat.
❍ B. The client has a grab bar near the commode.
❍ C. The client usually sits on a soft, low sofa.
❍ D. The client wears supportive shoes with nonskid soles.

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28. Physician’s orders for a client with acute pancreatitis include the following: strict NPO and nasogastric tube to low intermittent suction. The nurse recognizes that witholding oral intake will:
❍ A. Reduce the secretion of pancreatic enzymes
❍ B. Decrease the client’s need for insulin
❍ C. Prevent the secretion of gastric acid
❍ D. Eliminate the need for pain medication

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29. A client with diverticulitis is admitted with nausea, vomiting, and dehydration. Which finding suggests a complication of diverticulitis?
❍ A. Pain in the left lower quadrant
❍ B. Boardlike abdomen
❍ C. Low-grade fever
❍ D. Abdominal distention

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30. The physician has ordered Vancocin (vancomycin) 500mg IV every 6 hours for a client with MRSA. The medication should be administered:
❍ A. IV push
❍ B. Over 15 minutes
❍ C. Over 30 minutes
❍ D. Over 60 minutes

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31. The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirm a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is:
❍ A. Prostigmine (neostigmine)
❍ B. Atropine (atropine sulfate)
❍ C. Didronel (etidronate)
❍ D. Tensilon (edrophonium)

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32. A client with AIDS complains of a weight loss of 20 pounds in the past month. Which diet is suggested for the client with AIDS?
❍ A. High calorie, high protein, high fat
❍ B. High calorie, high carbohydrate, low protein
❍ C. High calorie, low carbohydrate, high fat
❍ D. High calorie, high protein, low fat

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33. The nurse is caring for a 4-year-old with cerebral palsy. Which nursing intervention will help ready the child for rehabilitative services?
❍ A. Patching one of the eyes to help strengthen the ocular muscles
❍ B. Providing suckers and pinwheels to help strengthen tongue movement
❍ C. Providing musical tapes to provide auditory training
❍ D. Encouraging play with a video game to improve muscle coordination

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34. A client is admitted with a diagnosis of duodenal ulcer. A common complaint of the client with a duodenal ulcer is:
❍ A. Epigastric pain that is relieved by eating
❍ B. Weight loss
❍ C. Epigastric pain that is worse after eating
❍ D. Vomiting after eating

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35. A client with otosderosis is scheduled for a stapedectomy. Which finding suggests a complication involving the seventh cranial nerve?
❍ A. Diminished hearing
❍ B. Sensation of fullness in the ear
❍ C. Inability to move the tongue side to side
❍ D. Changes in facial sensation

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36. At the 6-week check-up, the mother asks when she can expect the baby to sleep all night. The nurse should tell the mother that most infants begin to sleep all night by age:
❍ A. 1 month
❍ B. 2 months
❍ C. 3–4 months
❍ D. 5–6 months

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37. A client with emphysema has been receiving oxygen at 3L per minute by nasal cannula. The nurse knows that the goal of the client’s oxygen therapy is achieved when the client’s PaO2 reading is:
❍ A. 50–60mm Hg
❍ B. 70–80mm Hg
❍ C. 80–90mm Hg
❍ D. 90–98mm Hg

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38. A client with diabetes insipidus is receiving DDAVP (desmopressin acetate). Which lab finding indicates that the medication is having its intended effect?
❍ A. Blood glucose 92mg/dL
❍ B. Urine specific gravity 1.020
❍ C. White blood count of 7,500
❍ D. Glycosylated hemoglobin 3.5mg/dL

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39. Which of the following pediatric clients is at greatest risk for latex allergy?
❍ A. The child with a myelomeningocele
❍ B. The child with epispadias
❍ C. The child with coxa plana
❍ D. The child with rheumatic fever

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40. The physician has ordered a serum aminophylline level for a client with chronic obstructive lung disease. The nurse knows that the therapeutic range for aminophylline is:
❍ A. 1–3 micrograms/mL
❍ B. 4–6 micrograms/mL
❍ C. 7–9 micrograms/mL
❍ D. 10–20 micrograms/mL

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41. The nurse is developing a plan of care for a client with acromegaly. Which nursing diagnosis should receive priority?
❍ A. Alteration in body image related to change in facial features
❍ B. Risk for immobility related to joint pain
❍ C. Risk for ineffective airway clearance related to obstruction of airway by tongue
❍ D. Sexual dysfunction related to altered hormone secretion

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42. A client with acute respiratory distress syndrome (ARDS) is placed on mechanical ventilation. To increase ventilation and perfusion to all areas of the lungs, the nurse should:
❍ A. Tell the client to inhale deeply during the inspiratory cycle
❍ B. Increase the positive end expiratory pressure (PEEP)
❍ C. Turn the client every hour
❍ D. Administer medication to prevent the client from fighting the ventilator

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43. The nurse is teaching the mother of a child with cystic fibrosis how to do chest percussion. The nurse should tell the mother to:
❍ A. Use the heel of her hand during percussion
❍ B. Change the child’s position every 20 minutes during percussion sessions
❍ C. Do percussion after the child eats and at bedtime
❍ D. Use cupped hands during percussion

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44. A client with Addison’s disease asks the nurse what he needs to know to manage his condition. The nurse should give priority to:
❍ A. Emphasizing the need for strict adherence to his medication regimen
❍ B. Teaching the client to avoid lotions and skin preparations containing alcohol
❍ C. Explaining the need to avoid extremes of temperature
❍ D. Assisting the client to choose a diet that contains adequate protein, fat, and carbohydrates

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45. The nurse is caring for a client following the removal of a central line catheter when the client suddenly develops dyspnea and complains of substernal chest pain. The client is noticeably confused and fearful. Based on the client’s symptoms, the nurse should suspect which complication of central line use?
❍ A. Myocardial infarction
❍ B. Air embolus
❍ C. Intrathoracic bleeding
❍ D. Vagal response

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46. The nurse calculates the amount of an antibiotic for injection to be given to an infant. The amount of medication to be administered is 1.25mL. The nurse should:
❍ A. Divide the amount into two injections and administer in each vastus lateralis muscle
❍ B. Give the medication in one injection in the dorsogluteal muscle
❍ C. Divide the amount in two injections and give one in the ventrogluteal muscle and one in the vastus lateralis muscle
❍ D. Give the medication in one injection in the ventrogluteal muscle

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47. A client with schizophrenia is receiving depot injections of Haldol Deconate (haloperidol decanoate). The client should be told to return for his next injection in:
❍ A. 1 week
❍ B. 2 weeks
❍ C. 4 weeks
❍ D. 6 weeks

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48. The physician is preparing to remove a central line. The nurse should tell the client to:
❍ A. Breathe normally
❍ B. Take slow, deep breaths
❍ C. Take a deep breath and hold it
❍ D. Breathe as quickly as possible

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49. Cystic fibrosis is an exocrine disorder that affects several systems of the body. The earliest sign associated with a diagnosis of cystic fibrosis is:
❍ A. Steatorrhea
❍ B. Frequent respiratory infections
❍ C. Increased sweating
❍ D. Meconium ileus

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50. A 3-year-old is immobilized in a hip spica cast. Which discharge instruction should be given to the parents?
❍ A. Keep the bed flat, with a small pillow beneath the cast.
❍ B. Provide crayons and a coloring book for play activity.
❍ C. Increase her intake of high-calorie foods for healing.
❍ D. Tuck a disposable diaper beneath the cast at the perineal opening.

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NCSBN Practice Exam #9 - 50 questions