Practice Tests: NCSBN Practice Exam #20 - 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 teaching a client with an orthotopic bladder replacement. The nurse should tell the client to:
❍ A. Place a gauze pad over the stoma
❍ B. Lie on her side while evacuating the pouch
❍ C. Bear down with each voiding
❍ D. Wear a well-fitting drainage bag

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2. A client is receiving a blood transfusion following surgery. In the event of a transfusion reaction, any unused blood should be:
❍ A. Sealed and discarded in a red bag
❍ B. Flushed down the client’s commode
❍ C. Sealed and discarded in the sharp’s container
❍ D. Returned to the blood bank

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3. The physician has ordered a trivalent botulism antitoxin for a client with botulism poisoning. Before administering the medication, the nurse should assess the client for a history of allergies to:
❍ A. Eggs
❍ B. Horses
❍ C. Shellfish
❍ D. Pork

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4. The physician has ordered increased oral hydration for a client with renal calculi. Unless contraindicated, the recommended oral intake for helping with the removal of renal calculi is:
❍ A. 75mL per hour
❍ B. 100mL per hour
❍ C. 150mL per hour
❍ D. 200mL per hour

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5. The nurse is caring for a client with acquired immunodeficiency syndrome who has oral candidiasis. The nurse should clean the client’s mouth using:
❍ A. A toothbrush
❍ B. A soft gauze pad
❍ C. Antiseptic mouthwash
❍ D. Lemon and glycerin swabs

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6. A client taking anticoagulant medication has developed a cardiac tamponade. Which finding is associated with cardiac tamponade?
❍ A. A decrease in systolic blood pressure during inspiration
❍ B. An increase in diastolic blood pressure during expiration
❍ C. An increase in systolic blood pressure during inspiration
❍ D. A decrease in diastolic blood pressure during expiration

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7. The nurse is preparing a client for discharge following the removal of a cataract. The nurse should tell the client to:
❍ A. Take aspirin for discomfort
❍ B. Avoid bending over to put on his shoes
❍ C. Remove the eye shield before going to sleep
❍ D. Continue showering as usual

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8. The physician has ordered Pentam (pentamidine) IV for a client with pneumocystis carinii. While receiving the medication, the nurse should carefully monitor the client’s:
❍ A. Blood pressure
❍ B. Temperature
❍ C. Heart rate
❍ D. Respirations

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9. Intra-arterial chemotherapy primarily benefits the client by applying greater concentrations of medication directly to the malignant tumor. An additional benefit of intra-arterial chemotherapy is:
❍ A. Prevention of nausea and vomiting
❍ B. Treatment of micro-metastasis
❍ C. Eradication of bone pain
❍ D. Prevention of therapy-induced anemia

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10. A client with rheumatoid arthritis is receiving injections of Myochrysine (gold sodium thiomalate). Before administering the client’s medication, the nurse should:
❍ A. Check the lab work
❍ B. Administer an antiemetic
❍ C. Obtain the blood pressure
❍ D. Administer a sedative

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11. The nurse is caring for a client following a Whipple procedure. The nurse notes that the drainage from the nasogastric tube is bile tinged in appearance and has increased in the past hour. The nurse should:
❍ A. Document the finding and continue to monitor the client
❍ B. Irrigate the drainage tube with 10mL of normal saline
❍ C. Decrease the amount of intermittent suction
❍ D. Notify the physician of the findings

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12. A client with AIDS tells the nurse that he regularly takes echinacea to boost his immune system. The nurse should tell the client that:
❍ A. Herbals can interfere with the action of antiviral medication
❍ B. Supplements have proven effective in prolonging life
❍ C. Herbals have been shown to decrease the viral load
❍ D. Supplements appear to prevent replication of the virus

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13. A client with rheumatoid arthritis has Sjogren’s syndrome. The nurse can help relieve the symptoms of Sjogren’s syndrome by:
❍ A. Providing heat to the joints
❍ B. Instilling eyedrops
❍ C. Administering pain medication
❍ D. Providing small, frequent meals

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14. Which one of the following symptoms is common in the client with duodenal ulcers?
❍ A. Vomiting shortly after eating
❍ B. Epigastric pain following meals
❍ C. Frequent bouts of diarrhea
❍ D. Presence of blood in the stools

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15. A client with end-stage renal failure receives hemodialysis via an arteriovenous fistula (AV) placed in the right arm. When caring for the client, the nurse should:
❍ A. Take the blood pressure in the right arm above the AV fistula
❍ B. Flush the AV fistula with IV normal saline to keep it patent
❍ C. Auscultate the AV fistula for the presence of a bruit
❍ D. Perform needed venopunctures distal to the AV fistula

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16. The nurse is reviewing the lab results of four clients. Which finding should be reported to the physician?
❍ A. A client with chronic renal failure with a serum creatinine of 5.6mg/dL
❍ B. A client with rheumatic fever with a positive C reactive protein
❍ C. A client with gastroenteritis with a hematocrit of 52%
❍ D. A client with epilepsy with a white cell count of 3,800 mm3

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17. The physician has prescribed a Becloforte (beclomethasone) inhaler two puffs twice a day for a client with asthma. The nurse should tell the client to report:
❍ A. Increased weight
❍ B. A sore throat
❍ C. Difficulty in sleeping
❍ D. Changes in mood

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18. A client treated for depression has developed signs of serotonin syndrome. The nurse recognizes that serotonin syndrome is caused by:
❍ A. Concurrent use of an MAO inhibitor and a SSRI
❍ B. Eating foods that are high in tyramine
❍ C. Drastic decreases in the dopamine level
❍ D. Use of medications containing pseudoephedrine

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19. The nurse is caring for a client following a transphenoidal hypophysectomy. Post-operatively, the nurse should:
❍ A. Provide the client a toothbrush for mouth care
❍ B. Check the nasal dressing for the “halo sign”
❍ C. Tell the client to cough forcibly every 2 hours
❍ D. Ambulate the client when he is fully awake

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20. The physician has inserted an esophageal balloon tamponade in a client with bleeding esophageal varices. The nurse should maintain the esophageal balloon at a pressure of:
❍ A. 5–10mmHg
❍ B. 10–15mmHg
❍ C. 15–20mmHg
❍ D. 20–25mmHg

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21. The nurse is caring for a client with Lyme’s disease. The nurse should carefully monitor the client for signs of neurological complications, which include:
❍ A. Complaints of a “drawing” sensation and paralysis on one side of the face
❍ B. Presence of an unsteady gait, intention tremor, and facial weakness
❍ C. Complaints of excruciating facial pain brought on by talking, smiling, or eating
❍ D. Presence of fatigue when talking, dysphagia, and involuntary facial twitching

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22. When caring for the child with autistic disorder, the nurse should:
❍ A. Take the child to the playroom to be with peers
❍ B. Assign a consistent caregiver
❍ C. Place the child in a ward with other children
❍ D. Assign several staff members to provide care

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23. A client is admitted with suspected pernicious anemia. Which findings support the diagnosis of pernicious anemia?
❍ A. The client complains of feeling tired and listless.
❍ B. The client has waxy, pale skin.
❍ C. The client exhibits loss of coordination and position sense.
❍ D. The client has a rapid pulse rate and a detectable heart murmur.

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24. The physician has prescribed Cyclogel (cyclopentolate hydrochloride) drops for a client following a scleral buckling. The nurse knows that the purpose of the medication is to:
❍ A. Rest the muscles of accommodation
❍ B. Prevent post-operative infection
❍ C. Constrict the pupils
❍ D. Reduce the production of aqueous humor

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25. Which finding is associated with secondary syphilis?
❍ A. Painless, papular lesions on the perineum, fingers, and eyelids
❍ B. Absence of lesions
❍ C. Deep asymmetrical granulomatous lesions
❍ D. Well-defined generalized lesions on the palms, soles, and perineum

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❍ A. Urine output of 50ml in the past hour
❍ B. Temperature of 99°F
❍ C. Strong pedal pulses bilaterally
❍ D. Central venous pressure 15mm H2O

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27. Which symptom is not associated with glaucoma?
❍ A. Veil-like loss of vision
❍ B. Foggy loss of vision
❍ C. Seeing halos around lights
❍ D. Complaints of eye pain

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28. When caring for a ventilator-dependent client who is receiving tube feedings, the nurse can help prevent aspiration of gastric secretions by:
❍ A. Keeping the head of the bed flat
❍ B. Elevating the head of the bed 30–45°
❍ C. Placing the client on his left side
❍ D. Raising the foot of the bed 10–20°

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29. When gathering evidence from a victim of rape, the nurse should place the victim’s clothing in a:
❍ A. Plastic zip-lock bag
❍ B. Rubber tote
❍ C. Paper bag
❍ D. Padded manila envelope

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30. The nurse on an orthopedic unit is assigned to care for four clients with displaced bone fractures. Which client will not be treated with the use of traction?
❍ A. A client with fractures of the femur
❍ B. A client with fractures of the cervical spine
❍ C. A client with fractures of the humerus
❍ D. A client with fractures of the ankle

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31. A client is hospitalized with an acute myocardial infarction. Which nursing diagnosis reflects an understanding of the cause of acute myocardial infarction?
❍ A. Decreased cardiac output related to damage to the myocardium
❍ B. Impaired tissue perfusion related to an occlusion in the coronary vessels
❍ C. Acute pain related to cardiac ischemia
❍ D. Ineffective breathing patterns related to decreased oxygen to the tissues

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32. The nurse in the emergency department is responsible for the triage of four recently admitted clients. Which client should the nurse send directly to the treatment room?
❍ A. A 23-year-old female complaining of headache and nausea
❍ B. A 76-year-old male complaining of dysuria
❍ C. A 56-year-old male complaining of exertional shortness of breath
❍ D. A 42-year-old female complaining of recent sexual assault

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33. The physician has ordered an injection of morphine for a client with post-operative pain. Before administering the medication, it is essential that the nurse assess the client’s:
❍ A. Heart rate
❍ B. Respirations
❍ C. Temperature
❍ D. Blood pressure

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34. The nurse is caring for a client with a closed head injury. A late sign of increased intracranial pressure is:
❍ A. Changes in pupil equality and reactivity
❍ B. Restlessness and irritability
❍ C. Complaints of headache
❍ D. Nausea and vomiting

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35. The newly licensed nurse has been asked to perform a procedure that he feels unqualified to perform. The nurse’s best response at this time is to:
❍ A. Attempt to perform the procedure
❍ B. Refuse to perform the procedure and give a reason for the refusal
❍ C. Request to observe a similar procedure and then attempt to complete the procedure
❍ D. Agree to perform the procedure if the client is willing

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36. A client admitted to the emergency department with complaints of crushing chest pain that radiates to the left jaw. After obtaining a stat electrocardiogram the nurse should:
❍ A. Obtain a history of prior cardiac problems
❍ B. Begin an IV using a large-bore catheter
❍ C. Administer oxygen at 2L per minute via nasal cannula
❍ D. Perform pupil checks for size and reaction to light

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37. Which of the following techniques is recommended for removing a tick from the skin?
❍ A. Grasping the tick with a tissue and quickly jerking it away from the skin
❍ B. Placing a burning match close the tick and watching for it to release
❍ C. Using tweezers, grasp the tick close to the skin and pull the tick free using a steady, firm motion
❍ D. Covering the tick with petroleum jelly and gently rubbing the area until the tick releases

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38. A nurse is observing a local softball game when one of the players is hit in the nose with a ball. The player’s nose is visibly deformed and bleeding. The best way for the nurse to control the bleeding is to:
❍ A. Tilt the head back and pinch the nostrils
❍ B. Apply a wrapped ice compress to the nose
❍ C. Pack the nose with soft, clean tissue
❍ D. Tilt the head forward and pinch the nostrils

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39. What is the responsibility of the nurse in obtaining an informed consent for surgery?
❍ A. Describing in a clear and simply stated manner what the surgery will involve
❍ B. Explaining the benefits, alternatives, and possible risks and complications of surgery
❍ C. Using the nurse/client relationship to persuade the client to sign the operative permit
❍ D. Providing the informed consent for surgery and witnessing the client’s signature


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40. During the change of shift report, the nurse states that the client’s last pulse strength was a 1+. The oncoming nurse recognizes that the client’s pulse was:
❍ A. Bounding
❍ B. Full
❍ C. Normal
❍ D. Weak

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41. The RN is making assignments for the day. Which one of the following duties can be assigned to the unlicensed assistive personnel?
❍ A. Notifying the physician of an abnormal lab value
❍ B. Providing routine catheter care with soap and water
❍ C. Administering two aspirin to a client with a headache
❍ D. Setting the rate of an infusion of normal saline

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42. The nurse is observing the respirations of a client when she notes that the respiratory cycle is marked by periods of apnea lasting from 10 seconds to 1 minute. The apnea is followed by respirations that gradually increase in depth and frequency. The nurse should document that the client is experiencing:
❍ A. Cheyne-Stokes respirations
❍ B. Kussmaul respirations
❍ C. Biot respirations
❍ D. Diaphragmatic respirations

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43. A client seen in the doctor’s office for complaints of nausea and vomiting is sent home with directions to follow a clear-liquid diet for the next 24–48 hours. Which of the following is not permitted on a clear-liquid diet?
❍ A. Sweetened tea
❍ B. Chicken broth
❍ C Ice cream
❍ D. Orange gelatin

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44. When administering a tuberculin skin test, the nurse should insert the needle at a:
❍ A. 15° angle
❍ B. 30° angle
❍ C. 45° angle
❍ D. 90° angle

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45. The nurse is preparing to discharge a client following a trabeculoplasty for the treatment of glaucoma. The nurse should instruct the client to:
❍ A. Wash her eyes with baby shampoo and water twice a day
❍ B. Take only tub baths for the first month following surgery
❍ C. Begin using her eye makeup again 1 week after surgery
❍ D. Wear eye protection for several months after surgery

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46. Which type of endotracheal tube is recommended by the Centers for Disease Control (CDC) for reducing the risk of ventilator-associated pneumonia?
❍ A. Uncuffed
❍ B. CASS
❍ C. Fenestrated
❍ D. Nasotracheal

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47. Which client is at greatest risk for complications following abdominal surgery?
❍ A. A 68-year-old obese client with noninsulin-dependent diabetes
❍ B. A 27-year-old client with a recent history of urinary tract infections
❍ C. A 16-year-old client who smokes a half-pack of cigarettes per day
❍ D. A 40-year-old client who exercises regularly, with no history of medical conditions

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48. The nurse is preparing a client for surgery. Which lab finding should be reported to the physician?
❍ A. Potassium 2.5mEq/L
❍ B. Hemoglobin 14.5g/dL
❍ C. Blood glucose 75mg/dL
❍ D. White cell count 8,000mm3

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49. A client is diagnosed with bleeding from the upper gastrointestinal system. The nurse would expect the client’s stools to be:
❍ A. Brown
❍ B. Black
❍ C. Clay colored
❍ D. Green

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50. The physician has prescribed Chloromycetin (chloramphenicol) for a client with bacterial meningitis. Which lab report should the nurse monitor most carefully?
❍ A. Serum creatinine
❍ B. Urine specific gravity
❍ C. Complete blood count
❍ D. Serum sodium

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NCSBN Practice Exam #20 - 50 questions