Practice Tests: NCSBN Practice Exam #24 - 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 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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NCSBN Practice Exam #24 - 50 questions