Practice Tests: NCSBN Practice Exam #12 - 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 is admitted to the labor and delivery unit in active labor. During examination, the nurse notes a papular lesion on the perineum. Which initial action is most appropriate?
❍ A. Document the finding
❍ B. Report the finding to the doctor
❍ C. Prepare the client for a C-section
❍ D. Continue primary care as prescribed

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2. A client with a diagnosis of HPV is at risk for which of the following?
❍ A. Hodgkin’s lymphoma
❍ B. Cervical cancer
❍ C. Multiple myeloma
❍ D. Ovarian cancer

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3. During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:
❍ A. Syphilis
❍ B. Herpes
❍ C. Gonorrhea
❍ D. Condylomata

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4. A client visiting a family planning clinic is suspected of having an STI. The best diagnostic test for treponema pallidum is:
❍ A. Venereal Disease Research Lab (VDRL)
❍ B. Rapid plasma reagin (RPR)
❍ C. Florescent treponemal antibody (FTA)
❍ D. Thayer-Martin culture (TMC)

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5. A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP syndrome. Which laboratory finding is associated with HELLP syndrome?
❍ A. Elevated blood glucose
❍ B. Elevated platelet count
❍ C. Elevated creatinine clearance
❍ D. Elevated hepatic enzymes

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6. The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex?
❍ A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer.
❍ B. The nurse loosely suspends the client’s arm in an open hand while tapping the back of the client’s elbow.
❍ C. The nurse instructs the client to dangle her legs as the nurse strikes the area below the patella with the blunt side of the reflex hammer.
❍ D. The nurse instructs the client to place her arms loosely at her side as the nurse strikes the muscle insert just above the wrist.

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7. A primigravida with diabetes is admitted to the labor and delivery unit at 34 weeks gestation. Which doctor’s order should the nurse question?
❍ A. Magnesium sulfate 4gm (25%) IV
❍ B. Brethine 10mcg IV
❍ C. Stadol 1mg IV push every 4 hours as needed prn for pain
❍ D. Ancef 2gm IVPB every 6 hours

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8. A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse’s assessment of this data is:
❍ A. The infant is at low risk for congenital anomalies.
❍ B. The infant is at high risk for intrauterine growth retardation.
❍ C. The infant is at high risk for respiratory distress syndrome.
❍ D. The infant is at high risk for birth trauma.

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9. Which observation in the newborn of a diabetic mother would require immediate nursing intervention?
❍ A. Crying
❍ B. Wakefulness
❍ C. Jitteriness
❍ D. Yawning

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10. The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is:
❍ A. Decreased urinary output
❍ B. Hypersomnolence
❍ C. Absence of knee jerk reflex
❍ D. Decreased respiratory rate

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11. The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension, the nurse would:
❍ A. Place her in Trendelenburg position
❍ B. Decrease the rate of IV infusion
❍ C. Administer oxygen per nasal cannula
❍ D. Increase the rate of the IV infusion

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12. A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?
❍ A. Alteration in nutrition
❍ B. Alteration in bowel elimination
❍ C. Alteration in skin integrity
❍ D. Ineffective individual coping

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13. The nurse is caring for a client with uremic frost. The nurse is aware that uremic frost is often seen in clients with:
❍ A. Severe anemia
❍ B. Arteriosclcrosis
❍ C. Liver failure
❍ D. Parathyroid disorder

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14. The client arrives in the emergency department after a motor vehicle accident. Nursing assessment findings include BP 80/34, pulse rate 120, and respirations 20. Which is the client’s most appropriate priority nursing diagnosis?
❍ A. Alteration in cerebral tissue perfusion
❍ B. Fluid volume deficit
❍ C. Ineffective airway clearance
❍ D. Alteration in sensory perception

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15. The home health nurse is visiting an 18-year-old with osteogenesis imperfecta. Which information obtained on the visit would cause the most concern? The client:
❍ A. Likes to play football
❍ B. Drinks carbonated drinks
❍ C. Has two sisters
❍ D. Is taking acetaminophen for pain

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16. The nurse working the organ transplant unit is caring for a client with a white blood cell count of 450. During evening visitation, a visitor brings a basket of fruit. What action should the nurse take?
❍ A. Allow the client to keep the fruit
❍ B. Place the fruit next to the bed for easy access by the client
❍ C. Offer to wash the fruit for the client
❍ D. Ask the family members to take the fruit home

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17. The nurse is caring for the client following a laryngectomy when suddenly the client becomes nonresponsive and pale, with a BP of 90/40. The initial nurse’s action should be to:
❍ A. Place the client in Trendelenburg position
❍ B. Increase the infusion of normal saline
❍ C. Administer atropine intravenously
❍ D. Move the emergency cart to the bedside

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18. The client admitted 2 days earlier with a lung resection accidentally pulls out the chest tube. Which action by the nurse indicates understanding of the management of chest tubes?
❍ A. Order a chest x-ray
❍ B. Reinsert the tube
❍ C. Cover the insertion site with a Vaseline gauze
❍ D. Call the doctor

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19. A client being treated with sodium warfarin (Coumadin) has a Protime of 120 seconds. Which intervention would be most important to include in the nursing care plan?
❍ A. Assess for signs of abnormal bleeding
❍ B. Anticipate an increase in the Coumadin dosage
❍ C. Instruct the client regarding the drug therapy
❍ D. Increase the frequency of neurological assessments

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20. Which selection would provide the most calcium for the client who is 4 months pregnant?
❍ A. A granola bar
❍ B. A bran muffin
❍ C. A cup of yogurt
❍ D. A glass of fruit juice

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21. The client with preeclampsia is admitted to the unit with an order for magnesium sulfate. Which action by the nurse indicates the understanding of magnesium toxicity?
❍ A. The nurse performs a vaginal exam every thirty minutes.
❍ B. The nurse places a padded tongue blade at the bedside.
❍ C. The nurse inserts a Foley catheter.
❍ D. The nurse darkens the room.

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22. The best size cathlon for administration of a blood transfusion to a six year old is:
❍ A. 18 gauge
❍ B. 19 gauge
❍ C. 22 gauge
❍ D. 20 gauge

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23. A client is admitted to the unit 2 hours after an explosion causes burns to the face. The nurse would be most concerned with the client developing which of the following?
❍ A. Hypovolemia
❍ B. Laryngeal edema
❍ C. Hypernatremia
❍ D. Hyperkalemia

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24. The client has recently been diagnosed with diabetes. Which of the following indicates understanding of the management of diabetes?
❍ A. The client selects a balanced diet from the menu.
❍ B. The client can tell the nurse the normal blood glucose level.
❍ C. The client asks for brochures on the subject of diabetes.
❍ D. The client demonstrates correct insulin injection technique.

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25. The client is admitted following cast application for a fractured ulna. Which finding should be reported to the doctor?
❍ A. Pain at the site
❍ B. Warm fingers
❍ C. Pulses rapid
❍ D. Paresthesia of the fingers

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26. The client with AIDS should be taught to:
❍ A. Avoid warm climates.
❍ B. Refrain from taking herbals.
❍ C. Avoid exercising.
❍ D. Report any changes in skin color.

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27. Which action by the healthcare worker indicates a need for further teaching?
❍ A. The nursing assistant ambulates the elderly client using a gait belt.
❍ B. The nurse wears goggles while performing a venopuncture.
❍ C. The nurse washes his hands after changing a dressing.
❍ D. The nurse wears gloves to monitor the IV infusion rate.

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28. The client is having electroconvulsive therapy for treatment of severe depression. Prior to the ECT the nurse should:
❍ A. Apply a tourniquet to the client’s arm.
❍ B. Administer an anticonvulsant medication.
❍ C. Ask the client if he is allergic to shell fish.
❍ D. Apply a blood pressure cuff to the arm.

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29. The 5-year-old is being tested for enterobiasis (pinworms). Which symptom is associated with enterobiasis?
❍ A. Rectal itching
❍ B. Nausea
❍ C. Oral ulcerations
❍ D. Scalp itching

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30. The nurse is teaching the mother regarding treatment for pedicalosis capitis. Which instruction should be given regarding the medication?
❍ A. Treatment is not recommended for children less than 10 years of age.
❍ B. Bed linens should be washed in hot water.
❍ C. Medication therapy will continue for 1 year.
❍ D. Intravenous antibiotic therapy will be ordered.

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31. The registered nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?
❍ A. The client with HIV
❍ B. The client with a radium implant for cervical cancer
❍ C. The client with RSV (respiratory synctial virus)
❍ D. The client with cytomegalovirus

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32. The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?
❍ A. The client with methcillin resistant-staphylococcus aureas (MRSA)
❍ B. The client with diabetes
❍ C. The client with pancreatitis
❍ D. The client with Addison’s disease

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33. The doctor accidently cuts the bowel during surgery. As a result of this action, the client develops an infection and suffers brain damage. The doctor can be charged with:
❍ A. Negligence
❍ B. Tort
❍ C. Assault
❍ D. Malpractice

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34. Which assignment should not be performed by the nursing assistant?
❍ A. Feeding the client
❍ B. Bathing the client
❍ C. Obtaining a stool
❍ D. Administering a fleet enema

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35. The mother calls the clinic to report that her newborn has a rash on his forehead and face. Which action is most appropriate?
❍ A. Tell the mother to wash the face with soap and apply powder.
❍ B. Tell her that 30% of newborns have a rash that will go away by one month of life.
❍ C. Report the rash to the doctor immediately.
❍ D. Ask the mother if anyone else in the family has had a rash in the last six months.

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36. Which nurse should not be assigned to care for the client with a radium implant for vaginal cancer?
❍ A. The LPN who is 6 months postpartum
❍ B. The RN who is pregnant
❍ C. The RN who is allergic to iodine
❍ D. The RN with a 3 year old at home

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37. Which information should be reported to the state Board of Nursing?
❍ A. The facility fails to provide literature in both Spanish and English.
❍ B. The narcotic count has been incorrect on the unit for the past 3 days.
❍ C. The client fails to receive an itemized account of his bills and services received during his hospital stay.
❍ D. The nursing assistant assigned to the client with hepatitis fails to feed the client and give the bath.

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38. The nurse is suspected of charting medication administration that he did not give. After talking to the nurse, the charge nurse should:
❍ A. Call the Board of Nursing
❍ B. File a formal reprimand
❍ C. Terminate the nurse
❍ D. Charge the nurse with a tort

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39. The home health nurse is planning for the day’s visits. Which client should be seen first?
❍ A. The 78-year-old who had a gastrectomy 3 weeks ago and has a PEG tube
❍ B. The 5-month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension
❍ C. The 50-year-old with MRSA being treated with Vancomycin via a PICC line
❍ D. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

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40. The emergency room is flooded with clients injured in a tornado. Which clients can be assigned to share a room in the emergency department during the disaster?
❍ A. A client having auditory hallucinations and the client with ulcerative colitis
❍ B. The client who is pregnant and the client with a broken arm
❍ C. A child who is cyanotic with severe dypsnea and a client with a frontal head injury
❍ D. The client who arrives with a large puncture wound to the abdomen and the client with chest pain

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41. Before administering eardrops to a toddler, the nurse should recognize that it is essential to consider which of the following?
❍ A. The age of the child.
❍ B. The child’s weight.
❍ C. The developmental level of the child.
❍ D. The IQ of the child.

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42. The nurse is discussing meal planning with the mother of a 2-year-old. Which of the following statements, if made by the mother, would require a need for further instruction?
❍ A. “It is okay to give my child white grape juice for breakfast.”
❍ B. “My child can have a grilled cheese sandwich for lunch.”
❍ C. “We are going on a camping trip this weekend, and I have bought hot dogs to grill for his lunch.”
❍ D. “For a snack, my child can have ice cream.”

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43. A client with AIDS has a viral load of 200 copies per ml. The nurse should interpret this finding as:
❍ A. The client is at risk for opportunistic diseases.
❍ B. The client is no longer communicable.
❍ C. The client’s viral load is extremely low so he is relatively free of circulating virus.
❍ D. The client’s T-cell count is extremely low.

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44. The client has an order for sliding scale insulin at 1900 hours and Lantus insulin at the same hour. The nurse should:
❍ A. Administer the two medications together.
❍ B. Administer the medications in two injections.
❍ C. Draw up the Lantus insulin and then the regular insulin and administer them together.
❍ D. Contact the doctor because these medications should not be given to the same client.

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45. A priority nursing diagnosis for a child being admitted from surgery following a tonsillectomy is:
❍ A. Altered nutrition
❍ B. Impaired communication
❍ C. Risk for injury/aspiration
❍ D. Altered urinary elimination

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46. What would the nurse expect the admitting assessment to reveal in a client with glomerulonephritis?
❍ A. Hypertension
❍ B. Lassitude
❍ C. Fatigue
❍ D. Vomiting and diarrhea

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47. Which action is contraindicated in the client with epiglottis?
❍ A. Ambulation
❍ B. Oral airway assessment using a tongue blade
❍ C. Placing a blood pressure cuff on the arm
❍ D. Checking the deep tendon reflexes.

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48. A 25-year-old client with a goiter is admitted to the unit. What would the nurse expect the admitting assessment to reveal?
❍ A. Slow pulse
❍ B. Anorexia
❍ C. Bulging eyes
❍ D. Weight gain

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49. Which of the following foods, if selected by the mother with a child with celiac, would indicate her understanding of the dietary instructions?
❍ A. Whole-wheat toast
❍ B. Angel hair pasta
❍ C. Reuben on rye
❍ D. Rice cereal

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50. The first action that the nurse should take if she finds the client has an O saturation of 68% is:
❍ A. Elevate the head
❍ B. Recheck the O2 saturation in 30 minutes
❍ C. Apply oxygen by mask
❍ D. Assess the heart rate

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NCSBN Practice Exam #12 - 50 questions