Practice Tests: NCSBN Practice Exam #24 - 50 questions
The 50 questions in this test are randomized each time you start, ensuring a different order every time.
1. The nurse is performing discharge teaching to the parents of a 7-year-old who has been diagnosed with asthma. Which sports activity would be most appropriate for this client?
❍ A. Baseball
❍ B. Swimming
❍ C. Football
❍ D. Track
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2. The leukemic client is prescribed a low-bacteria diet. Which does the nurse expect to be included in this diet?
❍ A. Cooked spinach and sautéed celery
❍ B. Lettuce and alfalfa sprouts
❍ C. Fresh strawberries and whipped cream
❍ D. Raw cauliflower or broccoli
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3. A child is to receive heparin sodium 5 units per kilogram of body weight by subcutaneous route every 4 hours. The child weighs 52.8 lb. How many units should the child receive in a 24-hour period?
❍ A. 300
❍ B. 480
❍ C. 720
❍ D. 960
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4. A client with cancer is experiencing a common side effect of chemotherapy administration. Which laboratory assessment finding would cause the most concern?
❍ A. A sodium level of 50mg/dL
❍ B. A blood glucose of 110mg/dL
❍ C. A platelet count of 100,000/mm3
❍ D. A white cell count of 5,000/mm3
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5. A client’s admission history reveals complaints of fatigue, chronic sore throat, and enlarged lymph nodes in the axilla and neck. Which exam would assist the physician to make a tentative diagnosis of leukemia?
❍ A. A complete blood count
❍ B. An x-ray of the chest
❍ C. A bone marrow aspiration
❍ D. A CT scan of the abdomen
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6. A client is admitted with symptoms of vertigo and syncope. Diagnostic tests indicate left subclavian artery obstruction. What additional findings would the nurse expect?
❍ A. Memory loss and disorientation
❍ B. Numbness in the face, mouth, and tongue
❍ C. Radial pulse differences over 10bpm
❍ D. Frontal headache with associated nausea or emesis
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7. The nurse is performing discharge teaching on a client at high risk for the development of skin cancer. Which instruction should be included in the client teaching?
❍ A. “You should see the doctor every 6 months.”
❍ B. “Sunbathing should be done between the hours of noon and 3 p.m.”
❍ C. “If you have a mole, it should be removed and biopsied.”
❍ D. “You should wear sunscreen when going outside.”
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8. A client with pancreatitis has been transferred to the intensive care unit. The nurse assesses a pulmonary arterial wedge pressure (PAWP) of 14mmHg. Based on this finding, the nurse would want to further assess for:
❍ A. A drop in blood pressure
❍ B. Rales on chest auscultation
❍ C. Complaints of chest pain
❍ D. Dry mucous membranes
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9. The nurse is caring for a client with a diagnosis of hepatitis who is experiencing pruritis. Which would be the most appropriate nursing intervention?
❍ A. Suggest that the client take warm showers two times a day
❍ B. Add baby oil to the client’s bath water
❍ C. Apply powder to the client’s skin
❍ D. Suggest a hot-water rinse after bathing
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10. The school nurse assessed and referred a 14-year-old with scoliosis. An 18° curvature of the spine was diagnosed. Which treatment plan would the nurse expect?
❍ A. Application of a Milwaukee brace
❍ B. Electrical stimulation to the outward side of the curve
❍ C. Re-evaluation, with no treatment at this time
❍ D. Surgical realignment of the spine
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11. The physician has ordered a homocysteine blood level on a client. The nurse recognizes that the results will be increased in a client with a deficiency in:
❍ A. Vitamin B12
❍ B. Vitamin C
❍ C. Vitamin A
❍ D. Vitamin E
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12. The registered nurse is assigning staff for four clients on the 3–11 shift. Which client should be assigned to the LPN?
❍ A. A client with a diagnosis of adult respiratory distress syndrome (ARDS) who was transferred from the critical care unit at 1400
❍ B. A 1-hour post-operative colon resection
❍ C. A client with pneumonia expecting discharge in the morning
❍ D. A client with cirrhosis of the liver experiencing bleeding from esophageal varices
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13. A client with multiple sclerosis has an order to receive Solu Medrol 200mg IV push. The available dose is Solu Medrol 250mg per mL. How much medication will the nurse administer?
❍ A. 0.5 mL
❍ B. 0.8 mL
❍ C. 1.1 mL
❍ D. 1.4 mL
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14. The nurse is obtaining a history on a 74-year-old client. Which statement made by the client would alert the nurse to a possible fluid and electrolyte imbalance?
❍ A. “My skin is always so dry.”
❍ B. “I often use a laxative for constipation.”
❍ C. “I have always liked to drink a lot of water.”
❍ D. “I sometimes have a problem with dribbling urine.”
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15. The nurse is caring for a client in the acute care unit. Initial laboratory values reveal serum sodium of 156mEq/L. What behavior changes would the nurse expect the client to exhibit?
❍ A. Hyporeflexia
❍ B. Manic behavior
❍ C. Depression
❍ D. Muscle cramps
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16. The nurse is completing the preoperative checklist on a client scheduled for surgery and finds that the consent form has been signed, but the client is unclear about the surgery and possible complications. Which is the most appropriate action?
❍ A. Call the surgeon and ask him to come see the client to clarify the information
❍ B. Explain the procedure and complications to the client
❍ C. Check in the physician’s progress notes to see if understanding has been documented
❍ D. Check with the client’s family to see if they understand the procedure fully
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17. When preparing a client for admission to the surgical suite, the nurse recognizes that which one of the following items is most important to remove before sending the client to surgery?
❍ A. Hearing aid
❍ B. Contact lenses
❍ C. Wedding ring
❍ D. Dentures
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18. A client with cancer is to undergo a bone scan. The nurse should:
❍ A. Force fluids 24 hours before the procedure
❍ B. Ask the client to void immediately before the study
❍ C. Hold medication that affects the central nervous system for 12 hours pre- and post-test
❍ D. Cover the client’s reproductive organs with an x-ray shield
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19. A client with suspected leukemia is to undergo a bone marrow aspiration.
The nurse plans to include which statement in the teaching session?
❍ A. “You will be lying on your abdomen for the examination procedure.”
❍ B. “Portions of the procedure will cause pain or discomfort.”
❍ C. “You will be given some medication to cause amnesia of the test.”
❍ D. “You will not be able to drink fluids for 24 hours before the study.”
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20. The nurse is caring for a client scheduled for a surgical repair of an abdominal aortic aneurysm. Which assessment is most crucial during the preoperative period?
❍ A. Assessment of the client’s level of anxiety
❍ B. Evaluation of the client’s exercise tolerance
❍ C. Identification of peripheral pulses
❍ D. Assessment of bowel sounds and activity
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21. The nurse should carefully monitor the client for which common dysrhythmia that can occur during suctioning?
❍ A. Bradycardia
❍ B. Tachycardia
❍ C. Ventricular ectopic beats
❍ D. Sick sinus syndrome
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22. The nurse is performing discharge instruction for a client with an implantable permanent pacemaker. What discharge instruction is an essential part of the plan?
❍ A. “You cannot eat food prepared in a microwave.”
❍ B. “You should avoid moving the shoulder on the side of the pacemaker site for 6 weeks.”
❍ C. “You will have to learn to take your own pulse.”
❍ D. “You will not be able to fly on a commercial airliner with the pacemaker in place.”
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23. The nurse is completing admission on a client with possible esophageal cancer. Which finding would not be common for this diagnosis?
❍ A. Foul breath
❍ B. Dysphagia
❍ C. Diarrhea
❍ D. Chronic hiccups
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24. A client arrives from surgery following an abdominal perineal resection with a permanent illeostomy. What should be the priority nursing care during the post-op period?
❍ A. Teaching how to irrigate the illeostomy
❍ B. Stopping electrolyte loss through the stoma
❍ C. Encouraging a high-fiber diet
❍ D. Facilitating perineal wound drainage
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25. The nurse is making initial rounds on a client with a C5 fracture. The client is in a halo vest and is receiving O2 at 40% via mask to a tracheostomy. Assessment reveals a respiratory rate of 40 and O2 saturation of 88. The client is restless. Which initial nursing action is most indicated?
❍ A. Notifying the physician
❍ B. Performing tracheal suctioning
❍ C. Repositioning the client to the left side
❍ D. Rechecking the client’s O2 saturation
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26. A client has just finished her lunch, consisting of shrimp with rice, fruit salad, and a roll. The client calls for the nurse, stating, “My throat feels thick and I’m having trouble breathing.” What action should the nurse implement first?
❍ A. Place the bed in Trendelenburg position and call the physician
❍ B. Take the client’s vital signs and administer Benadryl 50mg PO
❍ C. Place the bed in high Fowler’s position and call the physician
❍ D. Start an Aminophylline drip and call the physician
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27. The nurse is caring for a client with cirrhosis of the liver. Which is the best method to use for determining that the client has ascites?
❍ A. Inspection of the abdomen for enlargement
❍ B. Bimanual palpation for hepatomegaly
❍ C. Daily measurement of abdominal girth
❍ D. Assessment for a fluid wave
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28. A client arrives in the emergency room after a motor vehicle accident. Witnesses tell the nurse that they observed the client’s head hit the side of the car door. Nursing assessment findings include BP 70/34, heart rate 130, and respirations 22. Which is the client’s most appropriate priority nursing diagnosis?
❍ A. Alteration in cerebral tissue perfusion
❍ B. Fluid volume deficit
❍ C. Ineffective airway clearance
❍ D. Alteration in sensory perception
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29. The home health nurse is visiting a 30-year-old with sickle cell disease. Assessment findings include spleenomegaly. What information obtained on the visit would cause the most concern? The client:
❍ A. Eats fast food daily for lunch
❍ B. Drinks a beer occasionally
❍ C. Sometimes feels fatigued
❍ D. Works as a furniture mover
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30. The nurse on the oncology unit is caring for a client with a WBC of 1500. During evening visitation, a visitor brings in a fruit basket. What action should the nurse take?
❍ A. Encourage the client to eat small snacks of the fruit
❍ B. Remove fruits that are not high in vitamin C
❍ C. Instruct the client to avoid the high-fiber fruits
❍ D. Remove the fruits from the client’s room
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31. The nurse is giving an end-of-shift report when a client with a chest tube is noted in the hallway with the tube disconnected. What is the most appropriate action?
❍ A. Clamp the chest tube immediately
❍ B. Put the end of the chest tube into a cup of sterile normal saline
❍ C. Assist the client back to the room and place him on his left side
❍ D. Reconnect the chest tube to the chest tube system
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32. A client with deep vein thrombosis is receiving a continuous heparin infusion and Coumadin PO. INR lab test result is 8.0. Which intervention would be most important to include in the nursing care plan?
❍ A. Assess for signs of abnormal bleeding
❍ B. Anticipate an increase in the heparin drip rate
❍ C. Instruct the client regarding the drug therapy
❍ D. Increase the frequency of vascular assessments
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33. Which breakfast selection by a client with osteoporosis indicates that the client understands the dietary management of the disease?
❍ A. Scrambled eggs, toast, and coffee
❍ B. Bran muffin with margarine
❍ C. Granola bar and half of a grapefruit
❍ D. Bagel with jam and skim milk
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34. A client with hepatitis C who has cirrhosis changes has just returned from a liver biopsy. The nurse will place the client in which position?
❍ A. Trendelenburg
❍ B. Supine
❍ C. Right side-lying
❍ D. Left Sim’s
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35. The nurse is caring for a client who was admitted to the burn unit 4 hours after the injury with second-degree burns to the trunk and head. Which finding would the nurse least expect to find during this time period?
❍ A. Hypovolemia
❍ B. Laryngeal edema
❍ C. Hypernatremia
❍ D. Hyperkalemia
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36. The nurse is evaluating nutritional outcomes for a client with anorexia nervosa. Which one of the following is the most objective favorable outcome for the client?
❍ A. The client eats all the food on her tray
❍ B. The client requests that family bring special foods
❍ C. The client’s weight has increased
❍ D. The client weighs herself each morning
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37. The client who is 2 weeks post-burn with a 40% deep partial-thickness injury still has open wounds. The nurse’s assessment reveals the following findings: temperature 96.5°F, BP 87/40, and severe diarrhea stools. What problem does the nurse most likely suspect?
❍ A. Findings are normal, not suspicious of a problem
❍ B. Systemic gram-positive infection
❍ C. Systemic gram-negative infection
❍ D. Systemic fungal infection
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38. The nurse assesses a new order for a blood transfusion. The order is to transfuse 1 unit of packed red blood cells (contains 250mL) in a 2-hour period. What will be the hourly rate of infusion?
❍ A. 50mL/hr
❍ B. 62mL/hr
❍ C. 125mL/hr
❍ D. 137mL/hr
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39. A client has signs of increased intracranial pressure. Which one of the following is an early indicator of deterioration in the client’s condition?
❍ A. Widening pulse pressure
❍ B. Decrease in the pulse rate
❍ C. Dilated, fixed pupils
❍ D. Decrease in level of consciousness
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40. Which of the following statements by a client with a seizure disorder who is taking topiramate (Topamax) indicates that the client has understood the nurse’s instruction?
❍ A. “I will take the medicine before going to bed.”
❍ B. “I will drink 8 to 10 ten-ounce glasses of water a day.”
❍ C. “I will eat plenty of fresh fruits.”
❍ D. “I must take the medicine with a meal or snack.”
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41. A client with terminal lung cancer is admitted to the unit. A family member asks the nurse, “How much longer will it be?” Which response by the nurse is most appropriate?
❍ A. “This must be a terrible situation for you.”
❍ B. “I don’t know. I’ll call the doctor.”
❍ C. “I cannot say exactly. What are your concerns at this time?”
❍ D. “Don’t worry, it will be very soon.”
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42. The nurse is administering a mantoux test. Which is a part of the correct technique for administering this test?
❍ A. Administer IM in the deltoid muscle
❍ B. Deposit the PPD subcutaneously in the upper arm
❍ C. Deposit the PPD subcutaneously with the needle bevel up
❍ D. Give the test subcutaneously in the inner aspect of the
forearm using a 1 1/2-inch needle
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43. The nurse is caring for a client with a closed head injury. Fluid is assessed leaking from the ear. The nurse’s first action will be to:
❍ A. Irrigate the ear canal gently
❍ B. Notify the physician
❍ C. Test the drainage for glucose
❍ D. Apply an occlusive dressing
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44. The nurse has inserted an NG tube for enteral feedings. Which assessment result is the best indicator of the tube’s stomach placement?
❍ A. Aspiration of tan-colored mucus
❍ B. Green aspirate with a pH of 3
❍ C. A swish auscultated with the injection of air
❍ D. Bubbling in a cup of NS when the end of the tube is placed in the cup
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45. The nurse would identify which one of the following assessment findings as a normal response in a craniotomy client post-operatively?
❍ A. A decrease in responsiveness the third post-op day
❍ B. Sluggish pupil reaction the first 24–48 hours
❍ C. Dressing changes 3 to 4 times a day for the first 3 days
❍ D. Temperature range of 98.8°F to 99.6°F the first 2–3 days
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46. A client with alcoholism has been instructed to increase his intake of thiamine. The nurse knows the client understands the instructions when he selects which food?
❍ A. Roast beef
❍ B. Broiled fish
❍ C. Baked chicken
❍ D. Sliced pork
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47. The nurse is caring for a client who abuses narcotics. The client is exhibiting a respiratory rate of 10 and dilated pupils. Which drug would the nurse expect to administer?
❍ A. Meperidine (Demerol)
❍ B. Naloxone (Narcan)
❍ C. Chlordiazepoxide (Librium)
❍ D. Haloperidol (Haldol)
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48. A client has a CVP monitor in place. Which would be included in the nursing care plan for this client?
❍ A. Notify the physician of readings less than 3cm or more than 8cm of water
❍ B. Use the clean technique to change the dressing at the insertion site
❍ C. Elevate the head of the bed to 90° to obtain CVP readings
❍ D. The 0 mark on the manometer should align with the client’s right clavicle for the readings
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49. A client is admitted to the chemical dependency unit for poly-drug abuse. The client states, “I don’t know why you are all so worried; I am in control. I don’t have a problem.” Which defense mechanism is being utilized?
❍ A. Rationalization
❍ B. Projection
❍ C. Dissociation
❍ D. Denial
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50. A client scheduled for a carotid endarterectomy requires insertion of an intra-arterial blood pressure-monitoring device. The nurse plans to perform the Allen test. Which observation indicates patency of the ulnar artery?
❍ A. Blanching of the hand on compression and release of the ulnar artery
❍ B. Muscular twitching of the bicep muscle with use of a tourniquet at the wrist
❍ C. Hand turning pink after the nurse releases the pressure on the ulnar artery
❍ D. Flexion of the wrist when tapping the ulnar artery with a reflex hammer
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