Practice Tests: NCSBN Practice Exam #13 - 50 questions

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

1. Which observation would the nurse expect to make after an amniotomy?
❍ A. Dark yellow amniotic fluid
❍ B. Clear amniotic fluid
❍ C. Greenish amniotic fluid
❍ D. Red amniotic fluid

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2. The client taking Glyburide (Diabeta) should be cautioned to:
❍ A. Avoid eating sweets
❍ B. Report changes in urinary pattern
❍ C. Allow 3 hours for onset
❍ D. Check the glucose daily

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3. The obstetric client’s fetal heart rate is 80–90 during the contractions. The first action the nurse should take is:
❍ A. Reposition the monitor
❍ B. Turn the client to her left side
❍ C. Ask the client to ambulate
❍ D. Prepare the client for delivery

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4. Arterial ulcers are best described as ulcers that:
❍ A. Are smooth in texture
❍ B. Have irregular borders
❍ C. Are cool to touch
❍ D. Are painful to touch

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5. A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?
❍ A. Anticipate the need for a Caesarean section
❍ B. Apply an internal fetal monitor
❍ C. Place the client in Genu Pectoral position
❍ D. Perform an ultrasound

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6. A vaginal exam reveals that the cervix is 4cm dilated, with intact membranes and a fetal heart tone rate of 160–170bpm. The nurse decides to apply an external fetal monitor. The rationale for this implementation is:
❍ A. The cervix is closed.
❍ B. The membranes are still intact.
❍ C. The fetal heart tones are within normal limits.
❍ D. The contractions are intense enough for insertion of an internal monitor.

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7. The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labor. Which one would be most appropriate for the primagravida as she completes the early phase of labor?
❍ A. Impaired gas exchange related to hyperventilation
❍ B. Alteration in placental perfusion related to maternal position
❍ C. Impaired physical mobility related to fetal-monitoring equipment
❍ D. Potential fluid volume deficit related to decreased fluid intake

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8. As the client reaches 6cm dilation, the nurse notes late decelerations on the fetal monitor. What is the most likely explanation of this pattern?
❍ A. The baby is sleeping.
❍ B. The umbilical cord is compressed.
❍ C. There is head compression.
❍ D. There is uteroplacental insufficiency.

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9. The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:
❍ A. Notify her doctor
❍ B. Start an IV
❍ C. Reposition the client
❍ D. Readjust the monitor

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10. Which of the following is a characteristic of an ominous periodic change in the fetal heart rate?
❍ A. A fetal heart rate of 120–130bpm
❍ B. A baseline variability of 6–10bpm
❍ C. Accelerations in FHR with fetal movement
❍ D. A recurrent rate of 90–100bpm at the end of the contractions.

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11. The rationale for inserting a French catheter every hour for the client with epidural anesthesia is:
❍ A. The bladder fills more rapidly because of the medication used for the epidural.
❍ B. Her level of consciousness is such that she is in a trancelike state.
❍ C. The sensation of the bladder filling is diminished or lost.
❍ D. She is embarrassed to ask for the bedpan that frequently.

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12. A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:
❍ A. Estrogen levels are low.
❍ B. Lutenizing hormone is high.
❍ C. The endometrial lining is thin.
❍ D. The progesterone level is low.

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13. A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:
❍ A. Age of the client
❍ B. frequency of intercourse
❍ C. Regularity of the menses
❍ D. Range of the client’s temperature

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14. A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?
❍ A. Intrauterine device
❍ B. Oral contraceptives
❍ C. Diaphragm
❍ D. Contraceptive sponge

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15. The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of a ruptured ectopic pregnancy?
❍ A. Painless vaginal bleeding
❍ B. Abdominal cramping
❍ C. Throbbing pain in the upper quadrant
❍ D. Sudden, stabbing pain in the lower quadrant

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16. The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?
❍ A. Hamburger pattie, green beans, French fries, and iced tea
❍ B. Roast beef sandwich, potato chips, baked beans, and cola
❍ C. Baked chicken, fruit cup, potato salad, coleslaw, yogurt, and iced tea
❍ D. Fish sandwich, gelatin with fruit, and coffee

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17. The client with hyperemesis gravidarum is at risk for developing:
❍ A. Respiratory alkalosis without dehydration
❍ B. Metabolic acidosis with dehydration
❍ C. Respiratory acidosis without dehydration
❍ D. Metabolic alkalosis with dehydration

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18. A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:
❍ A. Elevated human choronic gonadatropin
❍ B. The presence of fetal heart tones
❍ C. Uterine enlargement
❍ D. Breast enlargement and tenderness

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19. The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:
❍ A. Hypoglycemic, small for gestational age
❍ B. Hyperglycemic, large for gestational age
❍ C. Hypoglycemic, large for gestational age
❍ D. Hyperglycemic, small for gestational age

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20. Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?
❍ A. Weight gain should be reported to the physician.
❍ B. An alternate method of birth control is needed when taking antibiotics.
❍ C. If the client misses one or more pills, two pills should be taken per day for 1 week.
❍ D. Changes in the menstrual flow should be reported to the physician.

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21. The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:
❍ A. Diabetes
❍ B. HIV
❍ C. Hypertension
❍ D. Thyroid disease

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22. A client is admitted to the labor and delivery unit complaining of vaginal bleeding with very little discomfort. The nurse’s first action should be to:
❍ A. Assess the fetal heart tones
❍ B. Check for cervical dilation
❍ C. Check for firmness of the uterus
❍ D. Obtain a detailed history

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23. A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:
❍ A. Her contractions are 2 minutes apart.
❍ B. She has back pain and a bloody discharge.
❍ C. She experiences abdominal pain and frequent urination.
❍ D. Her contractions are 5 minutes apart.

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24. The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development. Which characteristic is associated with babies born to mothers who smoked during pregnancy?
❍ A. Low birth weight
❍ B. Large for gestational age
❍ C. Preterm birth, but appropriate size for gestation
❍ D. Growth retardation in weight and length

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25. The physician has ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is O positive. To provide postpartum prophylaxis, RhoGam should be administered:
❍ A. Within 72 hours of delivery
❍ B. Within 1 week of delivery
❍ C. Within 2 weeks of delivery
❍ D. Within 1 month of delivery

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26. After the physician performs an amniotomy, the nurse’s first action should be to assess the:
❍ A. Degree of cervical dilation
❍ B. Fetal heart tones
❍ C. Client’s vital signs
❍ D. Client’s level of discomfort

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27. A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client’s cervix is 5cm dilated with 75% effacement. Based on the nurse’s assessment the client is in which phase of labor?
❍ A. Active
❍ B. Latent
❍ C. Transition
❍ D. Early

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28. A newborn with narcotic abstinence syndrome is admitted to the nursery. Nursing care of the newborn should include:
❍ A. Teaching the mother to provide tactile stimulation
❍ B. Wrapping the newborn snugly in a blanket
❍ C. Placing the newborn in the infant seat
❍ D. Initiating an early infant-stimulation program

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29. A client elects to have epidural anesthesia to relieve the discomfort of labor. Following the initiation of epidural anesthesia, the nurse should give priority to:
❍ A. Checking for cervical dilation
❍ B. Placing the client in a supine position
❍ C. Checking the client’s blood pressure
❍ D. Obtaining a fetal heart rate

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30. The nurse is aware that the best way to prevent post-operative wound infection in the surgical client is to:
❍ A. Administer a prescribed antibiotic
❍ B. Wash her hands for 2 minutes before care
❍ C. Wear a mask when providing care
❍ D. Ask the client to cover her mouth when she coughs

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31. The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit?
❍ A. Pain
❍ B. Disalignment
❍ C. Cool extremity
❍ D. Absence of pedal pulses

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32. The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:
❍ A. Lack of exercise
❍ B. Hormonal disturbances
❍ C. Lack of calcium
❍ D. Genetic predisposition

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33. A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse indicates that the traction is working properly?
❍ A. The infant no longer complains of pain.
❍ B. The buttocks are 15° off the bed.
❍ C. The legs are suspended in the traction.
❍ D. The pins are secured within the pulley.

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34. Which statement is true regarding balanced skeletal traction? Balanced skeletal traction:
❍ A. Utilizes a Steinman pin
❍ B. Requires that both legs be secured
❍ C. Utilizes Kirschner wires
❍ D. Is used primarily to heal the fractured hips

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35. The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery, the nurse should give priority to assessing the:
❍ A. Serum collection (Davol) drain
❍ B. Client’s pain
❍ C. Nutritional status
❍ D. Immobilizer

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36. Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates understanding of the nurse’s teaching?
❍ A. “I must flush the tube with water after feedings and clamp the tube.”
❍ B. “I must check placement four times per day.”
❍ C. “I will report to the doctor any signs of indigestion.”
❍ D. “If my father is unable to swallow, I will discontinue the feeding and call the clinic.”

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37. The nurse is assessing the client with a total knee replacement 2 hours post-operative. Which information requires notification of the doctor?
❍ A. Scant bleeding on the dressing.
❍ B. Low-grade temperature.
❍ C. Hemoglobin of 7gm
❍ D. The urinary output has been 120ml during the last hour.

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38. The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?
❍ A. The client has traveled out of the country in the last 6 months.
❍ B. The client’s parents are skilled stained-glass artists.
❍ C. The client lives in a house built in 1990.
❍ D. The client has several brothers and sisters.

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39. A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?
❍ A. High-seat commode
❍ B. Recliner
❍ C. TENS unit
❍ D. Abduction pillow

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40. An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration, the nurse should:
❍ A. Administer oxygen via nasal cannula
❍ B. Have narcan (naloxane) available
❍ C. Prepare to administer blood products
❍ D. Prepare to do cardioresuscitation

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41. Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell’s traction?
❍ A. 16-year-old female with scoliosis
❍ B. 12-year-old male with a fractured femur
❍ C. 10-year-old male with sarcoma
❍ D. 6-year-old male with osteomylitis

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42. A client with osteoarthritis has a prescription for Celebrex (celecoxib). Which instruction should be included in the discharge teaching?
❍ A. Take the medication with milk.
❍ B. Report chest pain.
❍ C. Remain upright after taking for 30 minutes.
❍ D. Allow 6 weeks for optimal effects.

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43. A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates understanding of a plaster-of-Paris cast?
The nurse:
❍ A. Handles the cast with the fingertips
❍ B. Petals the cast
❍ C. Dries the cast with a hair dryer
❍ D. Allows 24 hours before bearing weight

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44. The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?
❍ A. “It will be alright for your friends to autograph the cast.”
❍ B. “Because the cast is made of plaster, autographing can weaken the cast.”
❍ C. “If they don’t use chalk to autograph, it is okay.”
❍ D. “Autographing or writing on the cast in any form will harm the cast.”

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45. The nurse is assigned to care for the client with a Steinmen pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?
❍ A. Assisting the LPN with opening sterile packages and peroxide
❍ B. Telling the LPN that clean gloves are allowed
❍ C. Telling the LPN that the registered nurse should perform pin care
❍ D. Asking the LPN to clean the weights and pulleys with peroxide

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46. A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?
❍ A. Check the bowel sounds
❍ B. Assess the blood pressure
❍ C. Offer pain medication
❍ D. Check for swelling

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47. The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?
❍ A. Russell’s traction
❍ B. Buck’s traction
❍ C. Halo traction
❍ D. Crutchfield tong traction

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48. A client with a total knee replacement has a CPM (continuous passive motion device) applied during the post-operative period. Which statement made by the nurse indicates understanding of the CPM machine?
❍ A. “Use of the CPM will permit the client to ambulate during the therapy.”
❍ B. “The CPM machine controls should be positioned distal to the site.”
❍ C. “If the client complains of pain during the therapy, I will turn off the machine and call the doctor.”
❍ D. “Use of the CPM machine will alleviate the need for physical therapy after the client is discharged.”

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49. A client with a fractured hip is being taught correct use of the walker. The nurse is aware that the correct use of the walker is achieved if the:
❍ A. Palms rest lightly on the handles
❍ B. Elbows are flexed 0°
❍ C. Client walks to the front of the walker
❍ D. Client carries the walker

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50. When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should:
❍ A. Attempt to replace the cord
❍ B. Place the client on her left side
❍ C. Elevate the client’s hips
❍ D. Cover the cord with a dry, sterile gauze

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NCSBN Practice Exam #13 - 50 questions