Practice Tests: NCSBN Practice Exam #18 - 50 questions

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

1. If the school-age child is not given the opportunity to engage in tasks and activities he can carry through to completion, he is likely to develop feelings of:
❍ A. Guilt
❍ B. Shame
❍ C. Stagnation
❍ D. Inferiority

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2. The physician has ordered 2 units of whole blood for a client following surgery. To provide for client safety, the nurse should:
❍ A. Obtain a signed permit for each unit of blood
❍ B. Use a new administration set for each unit transfused
❍ C. Administer the blood using a Y connector
❍ D. Check the blood type and Rh factor three times before initiating the transfusion

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3. A client with B positive blood is scheduled for a transfusion of whole blood. Which finding requires nursing intervention?
❍ A. The available blood has been banked for 2 weeks.
❍ B. The blood available for transfusion is Rh negative.
❍ C. The client has a peripheral IV of D5 1/ 2 normal saline.
❍ D. The blood available for transfusion is type O positive.

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4. The nurse is reviewing the lab results of a client’s arterial blood gases. The PaCO2 indicates effective functioning of the:
❍ A. Kidneys
❍ B. Pancreas
❍ C. Lungs
❍ D. Liver

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5. The autopsy results in SIDS-related death will show the following consistent findings:
❍ A. Abnormal central nervous system development
❍ B. Abnormal cardiovascular development
❍ C. Intraventricular hemorrhage and cerebral edema
❍ D. Pulmonary edema and intrathoracic hemorrhages

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6. The nurse is caring for a newborn who is on strict intake and output. The used diaper weighs 73.5gm. The diaper’s dry weight was 62gm. The newborn’s urine output is:
❍ A. 10ml
❍ B. 11.5ml
❍ C. 10gm
❍ D. 12gm

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7. The nurse is teaching the parents of an infant with osteogenesis imperfecta. The nurse should explain the need for:
❍ A. Additional calcium in the infant’s diet
❍ B. Careful handling to prevent fractures
❍ C. Providing extra sensorimotor stimulation
❍ D. Frequent testing of visual function

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8. A newborn is diagnosed with respiratory distress syndrome (RDS). Which position is best for maintaining an open airway?
❍ A. Prone, with his head turned to one side
❍ B. Side-lying, with a towel beneath his shoulders
❍ C. Supine, with his neck slightly flexed
❍ D. Supine, with his neck slightly extended

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9. A client with bipolar disorder is discharged with a prescription for Depakote (divalproex sodium). The nurse should remind the client of the need for:
❍ A. Frequent dental visits
❍ B. Frequent lab work
❍ C. Additional fluids
❍ D. Additional sodium

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10. The physician’s notes state that a client with cocaine addiction has formication. The nurse recognizes that the client has:
❍ A. Tactile hallucinations
❍ B. Irregular heart rate
❍ C. Paranoid delusions
❍ D. Methadone tolerance

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11. The nurse is preparing a client with gastroesophageal reflux disease (GERD) for discharge. The nurse should tell the client to:
❍ A. Eat a small snack before bedtime
❍ B. Sleep on his right side
❍ C. Avoid carbonated beverages
❍ D. Increase his intake of citrus fruits

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12. A client with a C3 spinal cord injury experiences autonomic hyperreflexia. After placing the client in high Fowler’s position, the nurse’s next action should be to:
❍ A. Notify the physician
❍ B. Make sure the catheter is patent
❍ C. Administer an antihypertensive
❍ D. Provide supplemental oxygen

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13. A client is to receive Dilantin (phenytoin) via a nasogastric (NG) tube. When giving the medication, the nurse should:
❍ A. Flush the NG tube with 2–4mL of water before giving the medication
❍ B. Administer the medication, flush with 5mL of water, and clamp the NG tube
❍ C. Flush the NG tube with 5mL of normal saline and administer the medication
❍ D. Flush the NG tube with 2–4oz of water before and after giving the medication

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14. When assessing the client with acute arterial occlusion, the nurse would expect to find:
❍ A. Peripheral edema in the affected extremity
❍ B. Minute blackened areas on the toes
❍ C. Pain above the level of occlusion
❍ D. Redness and warmth over the affected area

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15. The nurse is assessing a client following the removal of a pituitary tumor. The nurse notes that the urinary output has increased and that the urine is very dilute. The nurse should give priority to:
❍ A. Notifying the doctor immediately
❍ B. Documenting the finding in the chart
❍ C. Decreasing the rate of IV fluids
❍ D. Administering vasopressive medication

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16. The physician has ordered Coumadin (sodium warfarin) for a client with a history of clots. The nurse should tell the client to avoid which of the following vegetables?
❍ A. Lettuce
❍ B. Cauliflower
❍ C. Beets
❍ D. Carrots

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17. The nurse is caring for a child in a plaster-of-Paris hip spica cast. To facilitate drying, the nurse should:
❍ A. Use a small hand-held hair dryer set on medium heat
❍ B. Place a small heater near the child’s bed
❍ C. Turn the child at least every 2 hours
❍ D. Allow one side to dry before changing positions

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18. The local health clinic recommends vaccination against influenza for all its employees. The influenza vaccine is given annually in:
❍ A. November
❍ B. December
❍ C. January
❍ D. February

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19. A client is admitted with suspected Hodgkin’s lymphoma. The diagnosis is confirmed by the:
❍ A. Overproliferation of immature white cells
❍ B. Presence of Reed-Sternberg cells
❍ C. Increased incidence of microcytosis
❍ D. Reduction in the number of platelets

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20. The nurse is caring for a client following a laryngectomy. The nurse can
best help the client with communication by:
❍ A. Providing a pad and pencil
❍ B. Checking on him every 30 minutes
❍ C. Telling him to use the call light
❍ D. Teaching the client simple sign language

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21. A client has recently been diagnosed with open-angle glaucoma. The nurse should tell the client to avoid taking:
❍ A. Aleve (naprosyn)
❍ B. Benadryl (diphenhydramine)
❍ C. Tylenol (acetaminophen)
❍ D. Robitussin (guaifenesin)

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22. The nurse is caring for a client with an endemic goiter. The nurse recognizes that the client’s condition is related to:
❍ A. Living in an area where the soil is depleted of iodine
❍ B. Eating foods that decrease the thyroxine level
❍ C. Using aluminum cookware to prepare the family’s meals
❍ D. Taking medications that decrease the thyroxine level

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23. A client with a history of schizophrenia is seen in the local health clinic for medication follow-up. To maintain a therapeutic level of medication, the nurse should tell the client to avoid:
❍ A. Taking over-the-counter allergy medication
❍ B. Eating cheese and pickled foods
❍ C. Eating salty foods
❍ D. Taking over-the-counter pain relievers

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24. The nurse is formulating a plan of care for a client with a goiter. The priority nursing diagnosis for the client with a goiter is:
❍ A. Body image disturbance related to swelling of neck
❍ B. Anxiety-related changes in body image
❍ C. Altered nutrition, less than body requirements, related to difficulty in swallowing
❍ D. Risk for ineffective airway clearance related to pressure on the trachea

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25. Upon arrival in the nursery, erythomycin eyedrops are applied to the newborn’s eyes. The nurse understands that the medication will:
❍ A. Make the eyes less sensitive to light
❍ B. Help prevent neonatal blindness
❍ C. Strengthen the muscles of the eyes
❍ D. Improve accommodation to near objects

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26. A client has a diagnosis of discoid lupus erythematosus (DLE). The nurse recognizes that discoid lupus differs from systemic lupus erythematosus because it:
❍ A. Produces changes in the kidneys
❍ B. Is confined to changes in the skin
❍ C. Results in damage to the heart and lungs
❍ D. Affects both joints and muscles

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27. A client sustained a severe head injury to the occipital lobe. The nurse should carefully assess the client for:
❍ A. Changes in vision
❍ B. Difficulty in speaking
❍ C. Impaired judgment
❍ D. Hearing impairment

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28. The nurse observes a group of toddlers at daycare. Which of the following play situations exhibits the characteristics of parallel play?
❍ A. Ava and Eloise sharing clay to make cookies
❍ B. Larry and Nick playing beside each other with trucks
❍ C. Aurora working a puzzle with Eleanor and Matt
❍ D. Olivia playing with a busy box while sitting in her crib

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29. Which of the following statements is true regarding language development of young children?
❍ A. Infants can discriminate speech from other patterns of sound.
❍ B. Boys are more advanced in language development than girls of the same age.
❍ C. Second-born children develop language earlier than first-born or only children.
❍ D. Using single words for an entire sentence suggests delayed speech development.

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30. A mother tells the nurse that her daughter has become quite a collector, filling her room with Beanie babies, dolls, and stuffed animals. The nurse recognizes that the child is developing:
❍ A. Object permanence
❍ B. Post-conventional thinking
❍ C. Concrete operational thinking
❍ D. Pre-operational thinking

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31. According to Erikson, the developmental task of the infant is to establish trust. Parents and caregivers foster a sense of trust by:
❍ A. Holding the infant during feedings
❍ B. Speaking quietly to the infant
❍ C. Providing sensory stimulation
❍ D. Consistently responding to needs

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32. The nurse is preparing to walk the postpartum client for the first time since delivery. Before walking the client, the nurse should:
❍ A. Give the client pain medication
❍ B. Assist the client in dangling her legs
❍ C. Have the client breathe deeply
❍ D. Provide the client additional fluids

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33. To minimize confusion in the elderly hospitalized client, the nurse should:
❍ A. Provide sensory stimulation by varying the daily routine
❍ B. Keep the room brightly lit and the television on to provide orientation to time
❍ C. Encourage visitors to limit visitation to phone calls to avoid overstimulation
❍ D. Provide explanations in a calm, caring manner to minimize anxiety

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34. A client diagnosed with tuberculosis asks the nurse when he can return to work. The nurse should tell the client that:
❍ A. He can return to work when he has three negative sputum cultures.
❍ B. He can return to work as soon as he feels well enough.
❍ C. He can return to work after a week of being on the medication.
❍ D. He should think about applying for disability because he will no longer be able to work.

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35. The physician has ordered lab work for a client with suspected disseminated intravascular coagulation (DIC). Which lab finding would provide a definitive diagnosis of DIC?
❍ A. Elevated erythrocyte sedimentation rate
❍ B. Prolonged clotting time
❍ C. Presence of fibrin split compound
❍ D. Elevated white cell count

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36. The nurse is caring for a client with rheumatoid arthritis. The nurse knows that the client’s symptoms will be most improved by:
❍ A. Taking a warm shower upon awakening
❍ B. Applying ice packs to the joints
❍ C. Taking two aspirin before going to bed
❍ D. Going for an early morning walk

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37. A client with schizophrenia has been taking Clozaril (clozapine) for the past 6 months. This morning the client’s temperature was elevated to 102°F. The nurse should give priority to:
❍ A. Placing a note in the chart for the doctor
❍ B. Rechecking the temperature in 4 hours
❍ C. Notifying the physician immediately
❍ D. Asking the client if he has been feeling sick

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38. Which one of the following clients is most likely to develop acute respiratory distress syndrome?
❍ A. A 20-year-old with fractures of the tibia
❍ B. A 36-year-old who is HIV positive
❍ C. A 40-year-old with duodenal ulcers
❍ D. A 32-year-old with barbiturate overdose

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39. The complete blood count of a client admitted with anemia reveals that the red blood cells are hypochromic and microcytic. The nurse recognizes that the client has:
❍ A. Aplastic anemia
❍ B. Iron-deficiency anemia
❍ C. Pernicious anemia
❍ D. Hemolytic anemia

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40. While performing a neurological assessment on a client with a closed head injury, the nurse notes a positive Babinski reflex. The nurse should:
❍ A. Recognize that the client’s condition is improving
❍ B. Reposition the client and check reflexes again
❍ C. Do nothing because the finding is an expected one
❍ D. Notify the physician of the finding

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41. The doctor has ordered neurological checks every 30 minutes for a client injured in a biking accident. Which finding indicates that the client’s condition is satisfactory?
❍ A. A score of 13 on the Glascow coma scale
❍ B. The presence of doll’s eye movement
❍ C. The absence of deep tendon reflexes
❍ D. Decerebrate posturing

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42. The nurse is developing a plan for bowel and bladder retraining for a client with paraplegia. The primary goal of a bowel and bladder retraining program is:
❍ A. Optimal restoration of the client’s elimination pattern
❍ B. Restoration of the client’s neurosensory function
❍ C. Prevention of complications from impaired elimination
❍ D. Promotion of a positive body image

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43. When checking patellar reflexes, the nurse is unable to elicit a knee-jerk response. To facilitate checking the patellar reflex, the nurse should tell the client to:
❍ A. Pull against her interlocked fingers
❍ B. Shrug her shoulders and hold for a count of five
❍ C. Close her eyes tightly and resist opening
❍ D. Cross her legs at the ankles

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44. The nurse is performing a physical assessment on a newly admitted client. The last step in the physical assessment is:
❍ A. Inspection
❍ B. Auscultation
❍ C. Percussion
❍ D. Palpation

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45. A client with schizophrenia spends much of his time pacing the floor, rocking back and forth, and moving from one foot to another. The client’s behaviors are an example of:
❍ A. Dystonia
❍ B. Tardive dyskinesia
❍ C. Akathisia
❍ D. Oculogyric crisis

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46. The nurse is assessing a recently admitted newborn. Which finding should be reported to the physician?
❍ A. The umbilical cord contains three vessels.
❍ B. The newborn has a temperature of 98°F.
❍ C. The feet and hands are bluish in color.
❍ D. A large, soft swelling crosses the suture line.

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47. Which statement is true regarding the infant’s susceptibility to pertussis?
❍ A. If the mother had pertussis, the infant will have passive immunity.
❍ B. Most infants and children are highly susceptible from birth.
❍ C. The newborn will be immune to pertussis for the first few months of life.
❍ D. Infants under 1 year of age seldom get pertussis.

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48. A client in labor has been given epidural anesthesia with Marcaine (bupivacaine). To reverse the hypotension associated with epidural anesthesia, the nurse should have which medication available?
❍ A. Narcan (naloxone)
❍ B. Dobutrex (dobutamine)
❍ C. Romazicon (flumazenil)
❍ D. Adrenalin (epinephrine)

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49. The physician has prescribed Gantrisin (sulfasoxazole) 1g in divided doses for a client with a urinary tract infection. The nurse should administer the medication:
❍ A. With meals or a snack
❍ B. 30 minutes before meals
❍ C. 30 minutes after meals
❍ D. At bedtime

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50. A client with a history of depression is treated with Parnate (tranylcypromine), an MAO inhibitor. Ingestion of foods containing tyramine while taking an MAO inhibitor can result in:
❍ A. Extreme elevations in blood pressure
❍ B. Rapidly rising temperature
❍ C. Abnormal movement and muscle spasms
❍ D. Damage to the eighth cranial nerve

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NCSBN Practice Exam #18 - 50 questions