Practice Tests: NCSBN Practice Exam #21 - 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 caring for a client who is of the Islam religious group. Which food selection might this client want to avoid?
❍ A. Jello
❍ B. Chicken
❍ C. Milk
❍ D. Broccoli

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2. A 65-year-old client is admitted after a stroke. The nurse is concerned about skin breakdown and decubitus ulcer development. Which nursing intervention would best improve tissue perfusion to prevent skin problems?
❍ A. Assessing the skin daily
❍ B. Massaging any erythematous areas on the skin
❍ C. Changing incontinence pads as soon as they become soiled
❍ D. Performing range-of-motion exercises and turning and repositioning the client

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3. The nurse is performing discharge diet teaching to a client with a stage 1 decubitus ulcer on the coccyx. Which diet selection by this client would indicate that the client has a clear understanding of the proper diet for healing of a decubitus ulcer?
❍ A. Tossed salad, milk, and a slice of caramel cake
❍ B. Vegetable soup and crackers, and a glass of tea
❍ C. Baked chicken breast, broccoli, wheat roll, and an orange
❍ D. Hamburger, French fries, and corn on the cob

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4. The nurse is assessing elderly clients at a community center. Which of the following findings would be the most cause for concern?
❍ A. Complaint of dry mouth
❍ B. Loss of 1 inch of height in the last year
❍ C. Stiffened joints
❍ D. Rales bilaterally on chest auscultation

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5. A client with chronic pain is being treated with opioid administration via epidural route. Which medication would it be most important to have available due to a possible complication of this pain relief procedure?
❍ A. (Ketorolac) Toradol
❍ B. (Naloxone) Narcan
❍ C. (Diphenhydramine) Benadryl
❍ D. (Promethazine) Phenergan

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6. The nurse is assessing a client for hypovolemia. Which laboratory result would help the nurse in confirming a volume deficit?
❍ A. Hematocrit 55%
❍ B. Potassium 5.0mEq/L
❍ C. Urine specific gravity 1.016
❍ D. BUN 18mg/dL

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7. A nurse is triaging in the emergency room when a client enters complaining of muscle cramps and a feeling of exhaustion after a running competition. Which of the following would the nurse suspect?
❍ A. Hypernatremia
❍ B. Hyponatremia
❍ C. Syndrome of inappropriate antidiuretic hormone (SIADH)
❍ D. Decreased potassium

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8. A client was transferred to the hospital unit as a direct admit from a small community hospital. While the nurse is obtaining part of the admission history information, the client suddenly becomes semiconscious. Assessment reveals a systolic BP of 70, heart rate of 130, and respiratory rate of 24. What is the nurse’s initial action?
❍ A. Lower the head of the bed
❍ B. Initiate an IV with a large bore needle
❍ C. Notify the physician
❍ D. Call for the cardiopulmonary resuscitation team

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9. The nurse is caring for a client post-myocardial infarction on the cardiac unit. The client is exhibiting symptoms of shock. Which clinical manifestation is the best indicator that the shock is cardiogenic rather than anaphylactic?
❍ A. BP 90/60
❍ B. Chest pain
❍ C. Anxiety
❍ D. Temp 98.6°F

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10. While reading the progress notes on a client with cancer, the nurse notes a TNM classification of T1, N1, M0. What does this classification indicate?
❍ A. The tumor is in situ, no regional lymph nodes, and no metastasis.
❍ B. No evidence of primary tumor exists, lymph nodes can’t be assessed, and metastasis can’t be assessed.
❍ C. The tumor is extended, with regional lymph node involvement and distant metastasis.
❍ D. The tumor is extended and regional lymph nodes are involved, but there is no metastasis.

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11. The nurse is caring for a client with leukemia who has received the drug (daunorubicin) Cerubidine. Which of the following common side effects would cause the most concern?
❍ A. Nausea
❍ B. Vomiting
❍ C. Cardiotoxicity
❍ D. Alopecia

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12. The nurse is caring for an organ donor client with a severe head injury from an MVA. Which of the following is most important when caring for the organ donor client?
❍ A. Maintenance of the BP at 90mmHg or greater
❍ B. Maintenance of a normal temperature
❍ C. Keeping the hematocrit at less than 28%
❍ D. Ensuring a urinary output of at least 300mL/hr

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13. The nurse is constructing a nursing care plan for a client post-operative open cholecystectomy. Which nursing diagnosis would be the priority for this client?
❍ A. Risk for ineffective airway clearance
❍ B. Activity intolerance
❍ C. Risk for urinary retention
❍ D. Acute pain

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14. A client with a fractured leg is exhibiting shortness of breath, pain upon deep breathing, and hemoptysis. The nurse would determine that these clinical manifestations are indicative of:
❍ A. Congestive heart failure
❍ B. Pulmonary embolus
❍ C. Adult respiratory distress syndrome
❍ D. Tension pneumothorax

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15. A nurse is preparing to mix and administer chemotherapy. What equipment would be unnecessary to obtain?
❍ A. Surgical gloves
❍ B. Luer lok fitting IV tubing
❍ C. Surgical hat cover
❍ D. Disposable long-sleeve gown

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16. The charge nurse is assigning staff for the day. Staff consists of an RN, an LPN, and two certified nursing assistants. Which client assignment should be given to the nursing assistants?
❍ A. Emergency exploratory laparotomy with a colon resection the previous shift
❍ B. Client with a stroke who has been hospitalized for 2 days
❍ C. A client with metastatic cancer on PCA morphine
❍ D. New admission with diverticulitis

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17. The registered nurse is making shift assignments. Which client should be assigned to the licensed practical nurse (LPN)?
❍ A. A diabetic with a foot ulcer
❍ B. A client with a deep vein thrombosis receiving intravenous heparin
❍ C. A client being weaned from a tracheostomy
❍ D. A post-operative cholecystectomy with a T-tube

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18. A client with metastatic cancer of the lung has just been told the prognosis by the oncologist. The nurse hears the client state, “I don’t believe the doctor; I think he has me confused with another patient.” This is an example of which of Kubler-Ross’ stages of dying?
❍ A. Denial
❍ B. Anger
❍ C. Depression
❍ D. Bargaining

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19. The surgical nurse is preparing a patient for surgery on the lower abdomen. In which position would the nurse most likely place the client for surgery on this area?
❍ A. Lithotomy
❍ B. Sim’s
❍ C. Prone
❍ D. Trendelenburg

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20. The nurse is performing a history on a client admitted for surgery in the morning. Which long-term medication in the client’s history would be most important to report to the physician?
❍ A. Prednisone
❍ B. Lisinopril (Zestril)
❍ C. Docusate (Colace)
❍ D. Oscal D

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21. A nurse is working in an endoscopy recovery area. Many of the clients are administered midazolam (Versed) to provide conscious sedation. Which medication is important to have available as an antidote for Versed?
❍ A. Diazepam (Valium)
❍ B. Naloxone (Narcan)
❍ C. Flumazenil (Romazicon)
❍ D. Florinef (Fludrocortisone)

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22. The nurse is caring for a client with a cerebrovascular accident (CVA) who is complaining of being nauseated and is requesting an emesis basin. Which action would the nurse take first?
❍ A. Administer an ordered antiemetic
❍ B. Obtain an ice bag and apply to the client’s throat
❍ C. Turn the client to one side
❍ D. Notify the physician

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23. The nurse is assessing a client who had a colon resection 2 days ago. The client states, “I feel like my stitches have burst loose.” Upon further assessment, dehiscence of the wound is noted. The nurse should:
❍ A. Place the client in the prone position
❍ B. Apply a sterile, saline-moistened dressing to the wound
❍ C. Administer atropine to decrease abdominal secretions
❍ D. Wrap the abdomen with an ACE bandage

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24. A client with hepatitis C is scheduled for a liver biopsy. Which would the nurse include in the teaching plan for this client?
❍ A. The client should lie on the left side after the procedure.
❍ B. Cleansing enemas should be given the morning of the procedure.
❍ C. Blood coagulation studies might be done before the biopsy.
❍ D. The procedure is noninvasive and causes no pain.

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25. The nurse is caring for a client after a laryngectomy. The client is anxious, with a respiratory rate of 32 and an oxygen saturation of 88. The nurse’s first action should be to:
❍ A. Suction the client
❍ B. Increase the oxygen flow rate
❍ C. Notify the physician
❍ D. Recheck the O2 saturation

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26. The nurse is performing discharge teaching to a client who is on isoniazid (INH). Which diet selection would let the nurse know that the teaching has been ineffective?
❍ A. Tuna casserole
❍ B. Ham salad sandwich
❍ C. Baked potato
❍ D. Broiled beef roast

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27. A client with a head injury has an intracranial pressure (ICP) monitor in place. Cerebral perfusion pressure calculations are ordered. If the client’s ICP is 22 and the mean pressure reading is 70, what is the client’s cerebral perfusion pressure?
❍ A. 92
❍ B. 72
❍ C. 58
❍ D. 48

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28. A student nurse is observing a neurological nurse perform an assessment. When the nurse asks the client to “stick out his tongue,” the nurse is assessing the function of which cranial nerve?
❍ A. II optic
❍ B. I olfactory
❍ C. X vagus
❍ D. XII hypoglossal

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29. Which set of vital signs would best indicate an increase in intracranial pressure?
❍ A. BP 180/70, pulse 50, respirations 16, temperature 101°F
❍ B. BP 100/70, pulse 64, respirations 20, temperature 98.6°F
❍ C. BP 96/70, pulse 132, respirations 20, temperature 98.6°F
❍ D. BP 130/80, pulse 50, respirations 18, temperature 99.6°F

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30. The nurse is assessing the laboratory results of a client scheduled to receive phenytoin (Dilantin). The Dilantin level, drawn 2 hours ago, is 30mcg/mL. What is the appropriate nursing action?
❍ A. Administer the Dilantin as scheduled
❍ B. Hold the scheduled dose and notify the physician
❍ C. Decrease the dosage from 100mg to 50mg
❍ D. Increase the dosage to 200mg from 100mg

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31. A client with sickle cell disease is admitted in active labor. Which nursing intervention would be most helpful in preventing a sickling crisis?
❍ A. Obtaining blood pressures every 2 hours
❍ B. Administering pain medication every 3–4 hours as ordered
❍ C. Monitoring arterial blood gas results
❍ D. Administering IV fluids at ordered rate of 200mL/hr

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32. A client is admitted with a diagnosis of pernicious anemia. Which of the following signs or symptoms would indicate that the client has been noncompliant with ordered B12 injections?
❍ A. Hyperactivity in the evening hours
❍ B. Weight gain of 5 pounds in 1 week
❍ C. Paresthesia of hands and feet
❍ D. Diarrhea stools several times a day

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33. The nurse has performed nutritional teaching on a client with gout who is placed on a low-purine diet. Which selection by the client would indicate that teaching has been ineffective?
❍ A. Cabbage
❍ B. Apple
❍ C. Peach cobbler
❍ D. Spinach

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34. The nurse is caring for a 70-year-old client with hypovolemia who is receiving a blood transfusion. Assessment findings reveal crackles on chest auscultation and distended neck veins. What is the nurse’s initial action?
❍ A. Slow the transfusion
❍ B. Document the finding as the only action
❍ C. Stop the blood transfusion and turn on the normal saline
❍ D. Assess the client’s pupils

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35. The orthopedic nurse should be particularly alert for a fat embolus in which of the following clients having the greatest risk for this complication after a fracture?
❍ A. A 50-year-old with a fractured fibula
❍ B. A 20-year-old female with a wrist fracture
❍ C. A 21-year-old male with a fractured femur
❍ D. An 8-year-old with a fractured arm

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36. The nurse has performed discharge teaching to a client in need of a high-iron diet. The nurse recognizes that teaching has been effective when the client selects which meal plan?
❍ A. Hamburger, French fries, and orange juice
❍ B. Sliced veal, spinach salad, and whole-wheat roll
❍ C. Vegetable lasagna, Caesar salad, and toast
❍ D. Bacon, lettuce, and tomato sandwich; potato chips; and tea

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37. An elderly female is admitted with a fractured right femoral neck. Which clinical manifestation would the nurse expect to find?
❍ A. Free movement of the right leg
❍ B. Abduction of the right leg
❍ C. Internal rotation of the right hip
❍ D. Shortening of the right leg

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38. The nurse is performing the skill of intramuscular injection by the Z track method. Which technique would the nurse utilize to prevent tracking of the medication?
❍ A. Inject the medication in the deltoid muscle
❍ B. Use a 22-gauge needle
❍ C. Omit aspirating for blood before injecting
❍ D. Draw up 0.2mL of air after the proper medication dose

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39. A client is admitted to the surgical unit following a transurethral prostactectomy (TURP). The nurse administers a B&O suppository to help prevent bladder spasms. The nurse would observe the client for:
❍ A. Insomnia and hyperactivity
❍ B. Physiological dependence on the drug
❍ C. Nausea and vomiting
❍ D. Diarrhea and abdominal cramping

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40. The nurse caring for a client with anemia recognizes which clinical manifestation as the one that is specific for a hemolytic type of anemia?
❍ A. Jaundice
❍ B. Anorexia
❍ C. Tachycardia
❍ D. Fatigue

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41. A client with cancer who is receiving chemotherapeutic drugs has been given injections of (pegfilgastrin) Neulasta. Which laboratory value reveals that the drug is producing the desired effect?
❍ A. Hemoglobin of 13.5g/dL
❍ B. White blood cells count of 6,000/mm
❍ C. Platelet count of 300,000/mm
❍ D. HCT 39%

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42. The nurse is performing discharge teaching on a client with polycythemia vera. Which would be included in the teaching plan?
❍ A. Avoid large crowds
❍ B. Keep the head of the bed elevated at night
❍ C. Wear socks and gloves when going outside
❍ D. Recognize clinical manifestations of thrombosis

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43. A client is being discharged after lithotripsy for removal of a kidney stone. Which statement by the client indicates understanding of the nurse’s instructions?
❍ A. “I’ll need to strain my urine the first thing in the morning.”
❍ B. “I will need to save all urine for the next 2 days and take it to the laboratory to be examined and strained.”
❍ C. “I will be careful to strain all the urine and save the stone.”
❍ D. “I won’t need to strain my urine now that the procedure is complete.”

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44. The nurse is caring for a client with osteoporosis who is being discharged on (alendronate) Fosamax. Which statement would indicate a need for further teaching?
❍ A. “I should take the medication immediately before bedtime.”
❍ B. “I should remain in an upright position for 30 minutes after taking the medication.”
❍ C. “The medication should be taken by mouth with water.”
❍ D. “I should not have any food with this medication.”

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45. A client is being evaluated for carpel tunnel syndrome. The nurse is observed tapping over the median nerve in the wrist and asking the client if there is pain or tingling. Which assessment is the nurse performing?
❍ A. Phalen’s maneuver
❍ B. Tinel’s sign
❍ C. Kernig’s sign
❍ D. Brudzinski’s sign

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46. The nurse is caring for a client who is recovering from a fractured femur. Which diet selection would be best for this client?
❍ A. Loaded baked potato, fried chicken, and tea
❍ B. Dressed cheeseburger, French fries, and Coke
❍ C. Tuna fish salad on sourdough bread, potato chips, and skim milk
❍ D. Mandarin orange salad, broiled chicken, and milk

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47. The nurse working in the emergency department realizes that it would be contraindicated to induce vomiting if someone had ingested which of the following?
❍ A. Ibuprofen
❍ B. Aspirin
❍ C. Vitamins
❍ D. Gasoline

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48. A client with AIDS has impaired nutrition because of diarrhea. Which diet selection by the client would indicate a need for further teaching of foods that can worsen the diarrhea?
❍ A. Tossed salad
❍ B. Baked chicken
❍ C. Broiled fish
❍ D. Steamed rice

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49. The nurse has just received a report from the previous shift. Which of the following clients should the nurse visit first?
❍ A. A 50-year-old COPD client with a PCO2 of 50
❍ B. A 24-year-old admitted after an MVA complaining of shortness of breath
❍ C. A client with cancer requesting pain medication
❍ D. A 1-day post-operative cholecystectomy with a temperature of 100°F

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50. The nurse is performing a breast exam on a client when she discovers a mass. Which characteristic of the mass would most indicate a reason for concern?
❍ A. Tender to touch
❍ B. Regular shape
❍ C. Moves easily
❍ D. Firm to the touch

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NCSBN Practice Exam #21 - 50 questions