Practice Tests: NCSBN Practice Exam #10 - 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 is caring for a client following the reimplantation of the thumb and index finger. Which finding should be reported to the physician immediately?
❍ A. Temperature of 100°F
❍ B. Coolness and discoloration of the digits
❍ C. Complaints of pain
❍ D. Difficulty moving the digits

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2. Which client is at greatest risk for a caesarean section due to cephalopelvic disproportion (CPD)?
❍ A. A 25-year-old gravida 2, para 1
❍ B. A 30-year-old gravida 3, para 2
❍ C. A 17-year-old gravida 1, para 0
❍ D. A 32-year-old gravida 1, para 0

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3. The nurse is caring for a client with amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease). The nurse should give priority to:
❍ A. Assessing the client’s respiratory status
❍ B. Providing an alternate means of communication
❍ C. Referring the client and family to community support groups
❍ D. Instituting a routine of active range-of-motion exercises

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4. The physician has ordered Claforan (cefotaxime) 1g every 6 hours. The pharmacy sends the medication premixed in 100mL of D5W with instructions to infuse the medication over 1 hour. The IV set delivers 20 drops per milliliter. The nurse should set the IV rate at:
❍ A. 50 drops per minute
❍ B. 33 drops per minute
❍ C. 25 drops per minute
❍ D. 12 drops per minute

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5. When assessing the urinary output of a client who has had extracorporeal lithotripsy, the nurse can expect to find:
❍ A. Cherry-red urine that gradually becomes clearer
❍ B. Orange-tinged urine containing particles of calculi
❍ C. Dark red urine that becomes cloudy in appearance
❍ D. Dark, smoky-colored urine with high specific gravity

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6. A client scheduled for an atherectomy asks the nurse about the procedure. The nurse understands that:
❍ A. Plaque will be removed by rotational or directional catheters.
❍ B. Plaque will be destroyed by a laser.
❍ C. A balloon-tipped catheter will compress fatty lesions against the vessel wall.
❍ D. Medication will be used to dissolve the build-up of plaque.

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7. An elderly client has a stage II pressure ulcer on her sacrum. During assessment of the client’s skin, the nurse would expect to find:
❍ A. A deep crater with a nonpainful wound base
❍ B. A craterous area with a nonpainful wound base
❍ C. Cracks and blisters with redness and induration
❍ D. Nonblanchable redness with tenderness and pain

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8. The physician has prescribed Cognex (tacrine) for a client with dementia. The nurse should monitor the client for adverse reactions, which include:
❍ A. Hypoglycemia
❍ B. Jaundice
❍ C. Urinary retention
❍ D. Tinnitus

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9. The suggested diet for a child with cystic fibrosis is one that contains:
❍ A. High calories, high protein, moderate fat
❍ B. High calories, moderate protein, low fat
❍ C. Moderate calories, moderate protein, moderate fat
❍ D. Low calories, high protein, low fat

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10. The physician has ordered a low-potassium diet for a client with acute glomerulonephritis. Which snack is suitable for the client with potassium restrictions?
❍ A. Raisins
❍ B. Oranges
❍ C. Apricots
❍ D. Bananas

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11. A client with increased intracranial pressure is placed on mechanical ventilation with hyperventilation. The nurse knows that the purpose of the hyperventilation is to:
❍ A. Prevent the development of acute respiratory failure
❍ B. Decrease cerebral blood flow
❍ C. Increase systemic tissue perfusion
❍ D. Prevent cerebral anoxia

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12. The physician has ordered a blood test for H. pylori. The nurse should prepare the client by:
❍ A. Withholding oral intake after midnight
❍ B. Telling the client that no special preparation is needed
❍ C. Explaining that a small dose of radioactive isotope will be used
❍ D. Giving an oral suspension of glucose 1 hour before the test

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13. The nurse is preparing to give an oral potassium supplement. The nurse should give the medication:
❍ A. Without diluting it
❍ B. With 4oz. of juice
❍ C. With water only
❍ D. On an empty stomach

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14. A client with acute alcohol intoxication is being treated for hypomagnesemia. During assessment of the client, the nurse would expect to find:
❍ A. Bradycardia
❍ B. Negative Chvostek’s sign
❍ C. Hypertension
❍ D. Positive Trousseau’s sign

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15. The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true of the collection of cultures for cytomegalovirus?
❍ A. Stool cultures are preferred for definitive diagnosis.
❍ B. Pregnant caregivers may obtain cultures.
❍ C. Collection of one specimen is sufficient.
❍ D. Accurate diagnosis depends on fresh specimens.

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16. A home health nurse has four clients assigned for morning visits. The nurse should give priority to visiting the client with:
❍ A. Diabetes mellitus with a nongranulated ulcer of the right foot
❍ B. Congestive heart failure who reports coughing up frothy sputum
❍ C. Hemiplegia with tenderness in the right flank and cloudy urine
❍ D. Rheumatoid arthritis with soft tissue swelling behind the right knee

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17. Four clients are admitted to a medical unit. If only one private room is available, it should be assigned to:
❍ A. The client with ulcerative colitis
❍ B. The client with neutropenia
❍ C. The client with cholecystitis
❍ D. The client with polycythemia vera

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18. The RN is making assignments for the morning staff. Which client should be cared for by the RN?
❍ A. A client with hemianopsia
❍ B. A client with asterixis
❍ C. A client with akathesia
❍ D. A client with hemoptysis

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19. The nurse is reviewing the lab reports on several clients. Which one should be reported to the physician immediately?
❍ A. A serum creatinine of 5.2mg/dL in a client with chronic renal failure
❍ B. A positive C reactive protein in a client with rheumatic fever
❍ C. A hematocrit of 52% in a client with gastroenteritis
❍ D. A white cell count of 2,200cu/mm in a client taking Dilantin phenytoin

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20. The following clients are to be assigned for daily care. The newly licensed nurse should not be assigned to provide primary care for the client with:
❍ A. Full-thickness burns of the abdomen and upper thighs
❍ B. A fractured hip scheduled for hip replacement
❍ C. Ileal reservoir following a cystectomy
❍ D. Noncardiogenic pulmonary edema (ARDS)

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21. The RN is making assignments for clients hospitalized on a neurological unit. Which client should be assigned to the LPN?
❍ A. A client with a C3 injury immobilized by Crutchfield tongs
❍ B. A client with exacerbation of multiple sclerosis
❍ C. A client with a lumbar laminectomy
❍ D. A client with hemiplegia and a urinary tract infection

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22. The nurse has just received the change of shift report. The nurse should give priority to assessing the client with:
❍ A. A thoracotomy with 110mL of drainage in the past hour
❍ B. A cholecystectomy with an oral temperature of 100°F
❍ C. A transurethral prostatectomy who complains of urgency to void
❍ D. A stapedectomy who reports diminished hearing in the past hour
 
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23. A client with primary sclerosing cholangitis has received a liver transplant. The nurse should give priority to assessing the client for complications. Which findings are associated with an acute rejection of the new liver?
❍ A. Increased jaundice and prolonged prothrombin time
❍ B. Fever and foul-smelling bile drainage
❍ C. Abdominal distention and clay-colored stools
❍ D. Increased uric acid and increased creatinine

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24. The nurse is planning care for a client with adrenal insufficiency. Which nursing diagnosis should receive priority?
❍ A. Fluid volume deficit
❍ B. Sleep pattern disturbance
❍ C. Altered nutrition
❍ D. Alterations in body image

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25. A pediatric client with burns to the hands and arms has dressing changes with Sulfamylon (mafenide acetate) cream. The nurse is aware that the medication:
❍ A. Will cause dark staining of the surrounding skin
❍ B. Produces a cooling sensation when applied
❍ C. Can alter the function of the thyroid
❍ D. Produces a burning sensation when applied

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26. The physician has ordered Dilantin (phenytoin) for a client with generalized seizures. When planning the client’s care the nurse should:
❍ A. Maintain strict intake and output
❍ B. Check the pulse before giving the medication
❍ C. Administer the medication 30 minutes before meals
❍ D. Provide oral hygiene and gum care every shift

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27. The nurse is caring for a client receiving Capoten (captopril). The nurse should be alert for adverse reactions to the drug, which include:
❍ A. Increased red cell count
❍ B. Decreased sodium level
❍ C. Decreased white cell count
❍ D. Increased calcium level

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28. A client receiving chemotherapy for breast cancer has an order for Zofran (ondansetron) 8mg PO to be given 30 minutes before induction of the chemotherapy. The purpose of the medication is to:
❍ A. Prevent anemia
❍ B. Promote relaxation
❍ C. Prevent nausea
❍ D. Increase neutrophil counts

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29. The physician has ordered cortisporin ear drops for a 2-year-old. To administer the ear drops, the nurse should:
❍ A. Pull the ear down and back
❍ B. Pull the ear straight out
❍ C. Pull the ear up and back
❍ D. Leave the ear undisturbed

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30. A client with Lyme’s disease is being treated with Achromycin (tetracycline HCl). The nurse should tell the client that the medication will be rendered ineffective if taken with:
❍ A. Antacids
❍ B. Salicylates
❍ C. Antihistamines
❍ D. Sedative-hypnotics

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31. A client with schizophrenia has been taking Thorazine (chlorpromazine) 200mg four times a day. Which finding should be reported to the doctor immediately?
❍ A. The client complains of thirst.
❍ B. The client has gained 4 pounds in the past 2 months.
❍ C. The client complains of a sore throat.
❍ D. The client naps throughout the day.

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32. The doctor has prescribed Claratin (loratidine) for a client with seasonal allergies. The feature that separates Claratin from other antihistamines such as diphenhydramine is that the medication:
❍ A. Is nonsedating
❍ B. Stimulates appetite
❍ C. Is used for motion sickness
❍ D. Is less expensive

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33. A 6-month-old is being treated for thrush with Nystatin (mycostatin) oral suspension. The nurse should administer the medication by:
❍ A. Placing it in a small amount of applesauce
❍ B. Using a cotton-tipped swab
❍ C. Adding it to the infant’s formula
❍ D. Placing it in 2–3oz. of water

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34. A client with iron-deficiency anemia is taking an oral iron supplement. The nurse should tell the client to take the medication with:
❍ A. Orange juice
❍ B. Water only
❍ C. Milk
❍ D. Apple juice

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35. A child is admitted to the emergency room following ingestion of a bottle of Children’s Tylenol. The nurse is aware that Tylenol poisoning is treated with:
❍ A. Acetylcysteine
❍ B. Deferoximine
❍ C. Edetate calcium disodium
❍ D. Activated charcoal

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36. The nurse knows that a client with right-sided hemiplegia understands teaching regarding ambulation with a cane if she states:
❍ A. “I will hold the cane in my right hand.”
❍ B. “I will advance my cane and my right leg at the same time.”
❍ C. “I will be able to walk only by using a walker.”
❍ D. “I will hold the cane in my left hand.”

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37. A nursing assistant assigned to care for a client receiving linear accelerator radium therapy for laryngeal cancer states, “I don’t want to be assigned to that radioactive patient.” The best response by the nurse is to:
❍ A. Tell the nursing assistant that the client is not radioactive
❍ B. Tell the nursing assistant to wear a radiation badge to detect the amount of radiation that she is receiving
❍ C. Instruct her regarding the use of a lead-lined apron
❍ D. Ask a co-worker to care for the client

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38. The nurse caring for a client scheduled for an angiogram should prepare the client for the procedure by telling him to expect:
❍ A. Dizziness as the dye is injected
❍ B. Nausea and vomiting after the procedure is completed
❍ C. A decreased heart rate for several hours after the procedure is completed
❍ D. A warm sensation as the dye is injected

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39. A client with Parkinson’s disease complains of “choking” when he swallows. Which intervention will improve the client’s ability to swallow?
❍ A. Withholding liquids until after meals
❍ B. Providing semiliquid foods when possible
❍ C. Providing a fully liquid diet
❍ D. Offering small, more frequent meals

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40. Which of the following statements best explains the rationale for placing the client in Trendelenburg position during the insertion of a central line catheter?
❍ A. It will facilitate catheter insertion.
❍ B. It will make the client more comfortable during the insertion.
❍ C. It will prevent the occurrence of ventricular tachycardia.
❍ D. It will prevent the development of pulmonary emboli.

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41. The doctor has ordered the removal of a Davol drain. Which of the following instructions should the nurse give to the client before removing the drain?
❍ A. The client should be told to breathe normally.
❍ B. The client should be told to take two or three deep breaths as the drain is being removed.
❍ C. The client should be told to hold his breath as the drain is being removed.
❍ D. The client should breathe slowly as the drain is being removed.

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42. Which of the following findings is associated with right-sided heart failure?
❍ A. Shortness of breath
❍ B. Nocturnal polyuria
❍ C. Daytime oliguria
❍ D. Crackles in the lungs

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43. A client returns from surgery with a total knee replacement. Which of the following findings requires immediate nursing intervention?
❍ A. Bloody drainage of 30mL from the Davol drain is present.
❍ B. The CPM is set on 90° flexion.
❍ C. The client is unable to ambulate to the bathroom.
❍ D. The client is complaining of muscle spasms.

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44. Which of the following postpartal clients is at greatest risk for hemorrhage?
❍ A. A gravida 1 para 1 with an uncomplicated delivery of a 7-pound infant
❍ B. A gravida 1 para 0 with a history of polycystic ovarian disease
❍ C. A gravida 3 para 3 with a history of low–birth weight infants
❍ D. A gravida 4 para 3 with a Caesarean section

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45. An infant with a ventricular septal defect is discharged with a prescription for lanoxin elixir 0.01mg PO q 12hrs. The bottle is labeled 0.10mg per 1/2 tsp. The nurse should instruct the mother to:
❍ A. Administer the medication using a nipple
❍ B. Administer the medication using the calibrated dropper in the bottle
❍ C. Administer the medication using a plastic baby spoon
❍ D. Administer the medication in a baby bottle with 1oz. of water

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46. An elderly client with glaucoma is scheduled for a cholecystectomy. Which medication order should the nurse question?
❍ A. Meperidine
❍ B. Cimetadine
❍ C. Atropine
❍ D. Promethazine

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47. Which instruction would not be included in the discharge teaching of the client receiving chlorpromazine (Thorazine)?
❍ A. “You will need to wear protective clothing or a sunscreen when you are outside.”
❍ B. “You will need to avoid eating aged cheese.”
❍ C. “You should carry hard candy with you to decrease dryness of the mouth.”
❍ D. “You should report a sore throat immediately.”

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48. An elderly client who experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help with decreasing the client’s confusion by:
❍ A. Assigning a nursing assistant to sit with him until he falls asleep
❍ B. Allowing the client to room with another elderly client
❍ C. Administering a bedtime sedative
❍ D. Leaving a nightlight on during the evening and night shifts

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49. A 4-year-old is scheduled for a routine tonsillectomy. Which of the following lab findings should be reported to the doctor?
❍ A. A hemoglobin of 12Gm
❍ B. A platelet count of 200,000
❍ C. A white blood cell count of 16,000
❍ D. A urine specific gravity of 1.010

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50. A client with psychotic depression is receiving haloperidol (Haldol). Which of the following adverse effects is associated with haloperidol?
❍ A. Akathisia
❍ B. Cataracts
❍ C. Diaphoresis
❍ D. Polyuria

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NCSBN Practice Exam #10 - 50 questions