Practice Tests: NCSBN Practice Exam #17 - 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 tells the nurse that she takes St. John’s wort (hypericum perforatum) three times a day for mild depression. The nurse should tell the client that:
❍ A. St. John’s wort seldom relieves depression.
❍ B. She should avoid eating aged cheese.
❍ C. Skin reactions increase with the use of sunscreen.
❍ D. The herbal is safe to use with other antidepressants.

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2. The physician has ordered a low-purine diet for a client with gout. Which protein source is high in purine?
❍ A. Dried beans
❍ B. Nuts
❍ C. Cheese
❍ D. Eggs

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3. The nurse is observing the ambulation of a client recently fitted for crutches. Which observation requires nursing intervention?
❍ A. Two finger widths are noted between the axilla and the top of the crutch.
❍ B. The client bears weight on his hands when ambulating.
❍ C. The crutches and the client’s feet move alternately.
❍ D. The client bears weight on his axilla when standing.

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4. During the change of shift report, a nurse writes in her notes that she suspects illegal drug use by a client assigned to her care. During the shift, the notes are found by the client’s daughter. The nurse could be sued for:
❍ A. Libel
❍ B. Slander
❍ C. Malpractice
❍ D. Negligence

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5. The nurse is caring for an adolescent with a 5-year history of bulimia. A common clinical finding in the client with bulimia is:
❍ A. Extreme weight loss
❍ B. Dental caries
❍ C. Hair loss
❍ D. Decreased temperature

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6. A client hospitalized for treatment of congestive heart failure is to be discharged with a prescription for Digitek (digoxin) 0.25mg daily. Which of the following statements indicates that the client needs further teaching?
❍ A. “I will need to take the medication at the same time each day.”
❍ B. “I can prevent stomach upset by taking the medication with an antacid.”
❍ C. “I can help prevent drug toxicity by eating foods containing fiber.”
❍ D. “I will need to report visual changes to my doctor.”

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7. A client with paranoid schizophrenia has an order for Thorazine (chlorpromazine) 400mg orally twice daily. Which of the following symptoms should be reported to the physician immediately?
❍ A. Fever, sore throat, weakness
❍ B. Dry mouth, constipation, blurred vision
❍ C. Lethargy, slurred speech, thirst
❍ D. Fatigue, drowsiness, photosensitivity

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8. When caring for a client with an anterior cervical discectomy, the nurse should give priority to assessing for post-operative bleeding. The nurse should pay particular attention to:
❍ A. Drainage on the surgical dressing
❍ B. Complaints of neck pain
❍ C. Bleeding from the mouth
❍ D. Swelling in the posterior neck

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9. The initial assessment of a newborn reveals a chest circumference of 34cm and an abdominal circumference of 31cm. The chest is asymmetrical and breath sounds are diminished on the left side. The nurse should give priority to:
❍ A. Providing supplemental oxygen by a ventilated mask
❍ B. Performing auscultation of the abdomen for the presence of active bowel sounds
❍ C. Inserting a nasogastric tube to check for esophageal patency
❍ D. Positioning on the left side with head and chest elevated

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10. The physician has ordered Eskalith (lithium carbonate) 500mg three times a day and Risperdal (risperidone) 2mg twice daily for a client admitted with bipolar disorder, acute manic episodes. The best explanation for the client’s medication regimen is:
❍ A. The client’s symptoms of acute mania are typical of undiagnosed schizophrenia.
❍ B. Antipsychotic medication is used to manage behavioral excitement until mood stabilization occurs.
❍ C. The client will be more compliant with a medication that allows some feelings of hypomania.
❍ D. Antipsychotic medication prevents psychotic symptoms commonly associated with the use of mood stabilizers.

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11. During a unit card game, a client with acute mania begins to sing loudly as she starts to undress. The nurse should:
❍ A. Ignore the client’s behavior
❍ B. Exchange the cards for a checker board
❍ C. Send the other clients to their rooms
❍ D. Cover the client and walk her to her room

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12. A child with Down syndrome has a developmental age of 4 years. According to the Denver Developmental Assessment, the 4-year-old should be able to:
❍ A. Draw a man in six parts
❍ B. Give his first and last name
❍ C. Dress without supervision
❍ D. Define a list of words

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13. A client with paranoid schizophrenia is brought to the hospital by her elderly parents. During the assessment, the client’s mother states, “Sometimes she is more than we can manage.” Based on the mother’s statement, the most appropriate nursing diagnosis is:
❍ A. Ineffective family coping related to parental role conflict
❍ B. Care-giver role strain related to chronic situational stress
❍ C. Altered family process related to impaired social interaction
❍ D. Altered parenting related to impaired growth and development

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14. An adolescent client hospitalized with anorexia nervosa is described by her parents as “the perfect child.” When planning care for the client, the nurse should:
❍ A. Allow her to choose what foods she will eat
❍ B. Provide activities to foster her self-identity
❍ C. Encourage her to participate in morning exercise
❍ D. Provide a private room near the nurse’s station

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15. The nurse is assigning staff to care for a number of clients with emotional disorders. Which facet of care is suitable to the skills of the nursing assistant?
❍ A. Obtaining the vital signs of a client admitted for alcohol withdrawal
❍ B. Helping a client with depression with bathing and grooming
❍ C. Monitoring a client who is receiving electroconvulsive therapy
❍ D. Sitting with a client with mania who is in seclusion

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16. A client with angina is being discharged with a prescription for Transderm Nitro (nitroglycerin) patches. The nurse should tell the client to:
❍ A. Shave the area before applying the patch
❍ B. Remove the old patch and clean the skin with alcohol
❍ C. Cover the patch with plastic wrap and tape it in place
❍ D. Avoid cutting the patch because it will alter the dose

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17. A client with myasthenia gravis is admitted in a cholinergic crisis. Signs of of cholinergic crisis include:
❍ A. Decreased blood pressure and constricted pupils
❍ B. Increased heart rate and increased respirations
❍ C. Increased respirations and increased blood pressure
❍ D. Anoxia and absence of the cough reflex

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18. The nurse is providing dietary teaching for a client with hypertension. Which food should be avoided by the client on a sodium-restricted diet?
❍ A. Dried beans
❍ B. Swiss cheese
❍ C. Peanut butter
❍ D. Colby cheese

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19. A client is admitted to the emergency room with partial-thickness burns to his right arm and full-thickness burns to his trunk. According to the Rule of Nines, the nurse calculates that the total body surface area (TBSA) involved is:
❍ A. 20%
❍ B. 35%
❍ C. 45%
❍ D. 60%

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20. The physician has ordered a paracentesis for a client with severe abdominal ascites. Before the procedure, the nurse should:
❍ A. Provide the client with a urinal
❍ B. Prep the area by shaving the abdomen
❍ C. Encourage the client to drink extra fluids
❍ D. Request an ultrasound of the abdomen

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21. Which of the following combinations of foods is appropriate for a 6-month-old?
❍ A. Cocoa-flavored cereal, orange juice, and strained meat
❍ B. Graham crackers, strained prunes, and pudding
❍ C. Rice cereal, bananas, and strained carrots
❍ D. Mashed potatoes, strained beets, and boiled egg

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22. The mother of a 9-year-old with asthma has brought an electric CD player for her son to listen to while he is receiving oxygen therapy. The nurse should:
❍ A. Explain that he does not need the added stimulation
❍ B. Allow the player, but ask him to wear earphones
❍ C. Tell the mother that he cannot have items from home
❍ D. Ask the mother to bring a battery-operated CD instead

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23. Which one of the following situations represents a maturational crisis for the family?
❍ A. A 4-year-old entering nursery school
❍ B. Development of preeclampsia during pregnancy
❍ C. Loss of employment and health benefits
❍ D. Hospitalization of a grandfather with a stroke

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24. A client with a history of phenylketonuria is seen at the local family planning clinic. After completing the client’s intake history, the nurse provides literature for a healthy pregnancy. Which statement indicates that the client needs further teaching?
❍ A. “I can help control my weight by switching from sugar to Nutrasweet.”
❍ B. “I need to resume my old diet before becoming pregnant.”
❍ C. “Fresh fruits and raw vegetables will make excellent betweenmeal snacks.”
❍ D. “I need to eliminate most sources of phenylalanine from my diet.”

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25. Parents of a toddler are dismayed when they learn that their child has Duchenne’s muscular dystrophy. Which statement describes the inheritance pattern of the disorder?
❍ A. An affected gene is located on 1 of the 21 pairs of autosomes.
❍ B. The disorder is caused by an over-replication of the X chromosome in males.
❍ C. The affected gene is located on the Y chromosome of the father.
❍ D. The affected gene is located on the X chromosome of the mother.

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26. A client with obsessive compulsive personality disorder annoys his coworkers with his rigid-perfectionistic attitude and his preoccupation with trivial details. An important nursing intervention for this client would be:
❍ A. Helping the client develop a plan for changing his behavior
❍ B. Contracting with him for the time he spends on a task
❍ C. Avoiding a discussion of his annoying behavior because it will only make him worse
❍ D. Encouraging him to set a time schedule and deadlines for himself

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27. The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching?
❍ A. Zovirax (acyclovir)
❍ B. Varivax (varicella vaccine)
❍ C. VZIG (varicella-zoster immune globulin)
❍ D. Periactin (cyproheptadine)

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28. One of the most important criteria for the diagnosis of physical abuse is inconsistency between the appearance of the injury and the history of how the injury occurred. Which one of the following situations should alert the nurse to the possibility of abuse?
❍ A. An 18-month-old with sock and mitten burns from a fall into the bathtub
❍ B. A 6-year-old with a fractured clavicle following a fall from her bike
❍ C. An 8-year-old with a concussion from a skateboarding accident
❍ D. A 2-year-old with burns to the scalp and face from a grease spill

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29. A patient refuses to take his dose of oral medication. The nurse tells the patient that if he does not take the medication that she will administer it by injection. The nurse’s comments can result in a charge of:
❍ A. Malpractice
❍ B. Assault
❍ C. Negligence
❍ D. Battery

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30. During morning assessments, the nurse finds that a client’s nephrostomy tube has been clamped. The nurse’s first action should be to:
❍ A. Assess the drainage bag
❍ B. Check for bladder distention
❍ C. Unclamp the tubing
❍ D. Irrigate the tubing

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31. The nurse caring for a client with chest tubes notes that the Pleuravac’s collection chambers are full. The nurse should:
❍ A. Add more water to the suction-control chamber
❍ B. Remove the drainage using a 60mL syringe
❍ C. Milk the tubing to facilitate drainage
❍ D. Prepare a new unit for continuing collection

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32. A client with severe anemia is to receive a unit of whole blood. In the event of a transfusion reaction, the first action by the nurse should be to:
❍ A. Notify the physician and the nursing supervisor
❍ B. Stop the transfusion and maintain an IV of normal saline
❍ C. Call the lab for verification of type and cross match
❍ D. Prepare an injection of Benadryl (diphenhydramine)

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33. A new mother tells the nurse that she is getting a new microwave so that her husband can help prepare the baby’s feedings. The nurse should:
❍ A. Explain that a microwave should never be used to warm the baby’s bottles
❍ B. Tell the mother that microwaving is the best way to prevent bacteria in the formula
❍ C. Tell the mother to shake the bottle vigorously for 1 minute after warming in the microwave
❍ D. Instruct the parents to always leave the top of the bottle open while microwaving so heat can escape

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34. A client with HELLP syndrome is admitted to the labor and delivery unit for observation. The nurse knows that the client will have elevated:
❍ A. Serum glucose levels
❍ B. Liver enzymes
❍ C. Pancreatic enzymes
❍ D. Plasma protein levels

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25. To reduce the possibility of having a baby with a neural tube defect, the client should be told to increase her intake of folic acid. Dietary sources of folic acid include:
❍ A. Meat, liver, eggs
❍ B. Pork, fish, chicken
❍ C. Spinach, beets, cantaloupe
❍ D. Dried beans, sweet potatoes, Brussels sprouts

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36. The nurse is making room assignments for four obstetrical clients. If only one private room is available, it should be assigned to:
❍ A. A multigravida with diabetes mellitus
❍ B. A primigravida with preeclampsia
❍ C. A multigravida with preterm labor
❍ D. A primigravida with hyperemesis gravidarum

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37. A client has a tentative diagnosis of myasthenia gravis. The nurse recognizes that myasthenia gravis involves:
❍ A. Loss of the myelin sheath in portions of the brain and spinal cord
❍ B. An interruption in the transmission of impulses from nerve endings to muscles
❍ C. Progressive weakness and loss of sensation that begins in the lower extremities
❍ D. Loss of coordination and stiff “cogwheel” rigidity

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38. The physician has ordered an infusion of Osmitrol (mannitol) for a client with increased intracranial pressure. Which finding indicates the direct effectiveness of the drug?
❍ A. Increased pulse rate
❍ B. Increased urinary output
❍ C. Decreased diastolic blood pressure
❍ D. Increased pupil size

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39. The nurse has just received the change of shift report. Which client should the nurse assess first?
❍ A. A client with a supratentorial tumor awaiting surgery
❍ B. A client admitted with a suspected subdural hematoma
❍ C. A client recently diagnosed with akinetic seizures
❍ D. A client transferring to the neuro rehabilitation unit

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40. The physician has ordered an IV bolus of Solu-Medrol (methylprednisolone sodium succinate) in normal saline for a client admitted with a spinal cord injury. Solu-Medrol has been shown to be effective in:
❍ A. Preventing spasticity associated with cord injury
❍ B. Decreasing the need for mechanical ventilation
❍ C. Improving motor and sensory functioning
❍ D. Treating post injury urinary tract infections

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41. The physician has ordered a lumbar puncture for a client with suspected Guillain-Barre syndrome. The spinal fluid of a client with Guillain-Barre syndrome typically shows:
❍ A. Decreased protein concentration with a normal cell count
❍ B. Increased protein concentration with a normal cell count
❍ C. Increased protein concentration with an abnormal cell count
❍ D. Decreased protein concentration with an abnormal cell count

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42. An 18-month-old is admitted to the hospital with acute laryngotracheobronchitis. When assessing the respiratory status, the nurse should expect to find:
❍ A. Inspiratory stridor and harsh cough
❍ B. Strident cough and drooling
❍ C. Wheezing and intercostal retractions
❍ D. Expiratory wheezing and nonproductive cough

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43. The school nurse is assessing an elementary student with hemophilia who fell during recess. Which symptoms indicate hemarthrosis?
❍ A. Pain, coolness, and blue discoloration in the affected joint
❍ B. Tingling and pain without loss of movement in the affected joint
❍ C. Warmth, redness, and decreased movement in the affected joint
❍ D. Stiffness, aching, and decreased movement in the affected joint

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44. The physician has ordered aerosol treatments, chest percussion, and postural drainage for a client with cystic fibrosis. The nurse recognizes that the combination of therapies is to:
❍ A. Decrease respiratory effort and mucous production
❍ B. Increase efficiency of the diaphragm and gas exchange
❍ C. Dilate the bronchioles and help remove secretions
❍ D. Stimulate coughing and oxygen consumption

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45. The nurse is assessing a 6-year-old following a tonsillectomy. Which one of the following signs is an early indication of hemorrhage?
❍ A. Drooling of bright red secretions
❍ B. Pulse rate of 90
❍ C. Vomiting of dark brown liquid
❍ D. Infrequent swallowing while sleeping

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46. A client is admitted for suspected bladder cancer. Which one of the following factors is most significant in the client’s diagnosis?
❍ A. Smoking a pack of cigarettes a day for 30 years
❍ B. Use of nonsteroidal anti-inflammatories
❍ C. Eating foods with preservatives
❍ D. Past employment involving asbestos

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47. The nurse is teaching a client with peritoneal dialysis how to manage exchanges at home. The nurse should tell the client to notify the doctor immediately if:
❍ A. The dialysate returns become cloudy in appearance.
❍ B. The return of the dialysate is slower than usual.
❍ C. A “tugging” sensation is noted as the dialysate drains.
❍ D. A feeling of fullness is felt when the dialysate is instilled.

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48. The physician has prescribed nitroglycerin sublingual tablets as needed for a client with angina. The nurse should tell the client to take the medication:
❍ A. After engaging in strenuous activity
❍ B. Every 4 hours to prevent chest pain
❍ C. As soon as he notices signs of chest pain
❍ D. At bedtime to prevent nocturnal angina

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49. The nurse is caring for a client following a myocardial infarction. Which of the following enzymes are specific to cardiac damage?
❍ A. SGOT and LDH
❍ B. SGOT and CK BB
❍ C. LDH and CK MB
❍ D. LDH and CK BB

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50. Which of the following characterizes peer group relationships in 8-and 9-year-olds?
❍ A. Activities organized around competitive games
❍ B. Loyalty and strong same-sex friendships
❍ C. Informal socialization between boys and girls
❍ D. Shared activities with one best friend

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NCSBN Practice Exam #17 - 50 questions