Practice Tests: NCSBN Practice Exam #25 - 50 questions

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

1. The chest tube drainage system has continuous bubbling in the water seal chamber. When the nurse clamps different areas of the tube to find out where the bubbling stops, he is checking for:
❍ A. An air leak
❍ B. The suction being too high
❍ C. The suction being too low
❍ D. A tension pneumothorax

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2. The nurse should be particularly alert for which one of the following problems in a client with barbiturate overdose?
❍ A. Oliguria
❍ B. Cardiac tamponade
❍ C. Apnea
❍ D. Hemorrhage

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3. A client taking the drug disulfiram (Antabuse) is admitted to the ER. Which clinical manifestations are most indicative of recent alcohol ingestion?
❍ A. Vomiting, heart rate 120, chest pain
❍ B. Nausea, mild headache, bradycardia
❍ C. Respirations 16, heart rate 62, diarrhea
❍ D. Temp 101°F, tachycardia, respirations 20

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4. The nurse caring for clients with coronary artery disease recognizes which one of the following as a modifiable risk factor?
❍ A. History of heart disease in family
❍ B. African American race
❍ C. An LDL blood level of 180mg/dL
❍ D. Gender

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5. A client with cocaine addiction would most likely be placed on which medication?
❍ A. Amantidine (Symmetrel)
❍ B. Methadone
❍ C. THC
❍ D. Disulfiram (Antabuse)

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6. Which laboratory test is used to identify injury to the myocardium and can remain elevated for up to 3 weeks?
❍ A. Total CK
❍ B. CK-MB
❍ C. Myoglobulin
❍ D. Troponin T or I

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7. A client with newly diagnosed epilepsy tells the nurse, “If I keep having seizures, I’m scared my husband will feel differently toward me.” Which response by the nurse would be most appropriate?
❍ A. “You don’t know if you’ll ever have another seizure. Why don’t you wait and see what happens?”
❍ B. “You seem to be concerned that there could be a change in the relationship with your husband.”
❍ C. “You should focus on your children. They need you.”
❍ D. “Let’s see how your husband reacts before getting upset.”

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8. While interviewing a client who abuses alcohol, the nurse learns that the client has experienced “blackouts.” The wife asks what this means. The best response at this time is:
❍ A. “Your husband has experienced short-term memory amnesia.”
❍ B. “Your husband has experienced loss of remote memory.”
❍ C. “Your husband has experienced loss of consciousness due to drinking alcohol.”
❍ D. “Your husband has experienced a fainting spell.”

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9. Which would be included in the nursing care plan of a client experiencing severe delirium tremens?
❍ A. Placing the client in a darkened room
❍ B. Keeping the closet and bathroom doors closed
❍ C. Administering a diuretic to decrease fluid excess
❍ D. Checking vital signs every 8 hours

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10. The nurse is caring for a client admitted with a diagnosis of epilepsy. The client begins to have a seizure. Which action by the nurse is contraindicated?
❍ A. Turning the client to the side-lying position
❍ B. Inserting a padded tongue blade and oral airway
❍ C. Loosening restrictive clothing
❍ D. Removing the pillow and raising padded side rails

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11. A client has been placed on the drug valproic acid (Depakene). Which would indicate to the nurse that the client is experiencing an adverse reaction to this medication?
❍ A. Photophobia
❍ B. Poor skin turgor
❍ C. Lethargy
❍ D. Visual disturbances

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12. The nurse is caring for a 16-year-old female with second- and thirddegree burns to the face, neck, chest, and arms. The client’s wounds are almost healed. The nurse would expect rehabilitation to focus on problems related to:
❍ A. Body image disturbance
❍ B. Risk for infection
❍ C. Sensory perceptual alterations
❍ D. Activity intolerance

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13. The nurse is performing fluid resuscitation on a burn client. Which piece of assessment data is the best indicator that it is effective?
❍ A. Respirations 24, unlabored
❍ B. Urine output of 30ml/hr
❍ C. Capillary refill < 4 seconds
❍ D. Apical pulse of 110/min

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14. A client diagnosed with COPD is receiving theophylline. Morning laboratory values reveal a theophylline level of 38mcg/mL. The most appropriate action by the nurse would be to:
❍ A. Take no action; this is within normal range
❍ B. Notify the physician of the level results
❍ C. Administer Narcan 2mg IV push stat
❍ D. Give the client a double dose of Theodur at the next time due

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15. A client has suffered a severe electrical burn. Which medication would the nurse expect to have ordered for application to the burned area?
❍ A. Mafenide acetate (Sulfamylon)
❍ B. Silver nitrate
❍ C. Providone-iodine ointment
❍ D. Silver sulfadiazine (Silvadene)

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16. A client with a head injury develops syndrome of inappropriate antidiuretic hormone (SIADH). Which physician prescription would the nurse question?
❍ A. D5W at 200mL/hr
❍ B. Demeclocycline (Declomycin) 150mg Q6h
❍ C. Daily weights
❍ D. Intake and output Q4h

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17. The nurse is caring for a postpartum client. Which of the following assessment findings would be a reason for concern during the client’s postpartum stay?
❍ A. Pulse rate of 70–90 the third postpartum day
❍ B. Diuresis her second and third postpartum days
❍ C. Vaginal discharge of rubra, serosa, then rubra
❍ D. Diaphoresis her third postpartum day

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18. The nurse is caring for a postpartum client 2 hours post-delivery who is unable to void. Which of the following nursing interventions should be considered initially?
❍ A. Insert a straight catheter for residual
❍ B. Encourage oral intake of fluids
❍ C. Check perineum for swelling or hematoma
❍ D. Palpate bladder for distention and position

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19. A client is admitted to the intensive care unit after falling on an icy sidewalk and striking the right side of the head. An MRI revealed a rightsided epidural hematoma. Which physical force explains the location of the client’s injury?
❍ A. Coup
❍ B. Contrecoup
❍ C. Deceleration
❍ D. Acceleration

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20. The nurse is preparing to teach a client about phenytoin sodium (Dilantin). Which fact would be most important to teach the client regarding why the drug should not be stopped suddenly?
❍ A. Physical dependence can develop over time.
❍ B. Status epilepticus can develop.
❍ C. A hypoglycemic reaction can develop.
❍ D. Heart block can develop.

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21. One week after discharge of a postpartum client, the client’s husband calls the postpartum unit and asks the nurse, “Is it normal for my wife to cry at the drop of a hat? I’m worried I’ve done something to upset her.”
The nurse’s best initial response would be:
❍ A. “Have you noticed any pattern to her periods of crying?”
❍ B. “Try not to worry about it. I’m sure it’s just the postpartum blues.”
❍ C. “Can you think of something you might have done to upset her?”
❍ D. “Let’s consider some of the ways you can decrease her depression.”

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22. A client is admitted with suspected Guillain-Barre syndrome. The nurse would expect the cerebrospinal fluid (CSF) analysis to reveal which of the following to confirm the diagnosis?
❍ A. CSF protein 10mg/dL and WBC 2 cells/mm3
❍ B. CSF protein of 60mg/dL and WBC 0 cells/mm3
❍ C. CSF protein of 50mg/dL and WBC 20 cells/mm3
❍ D. CSF protein of 5mg/dL and WBC 20 cells/mm3

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23. A client with burns is admitted and fluid resuscitation has begun. Central venous pressure (CVP) readings are ordered every 4 hours; the client’s CVP reading is 14cm/H2O. Which evaluation by the nurse would be most accurate?
❍ A. The client has received enough fluid.
❍ B. The client’s fluid status is unaltered.
❍ C. The client has inadequate fluids.
❍ D. The client has a volume excess.

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24. The nurse is working on a neurological unit. If the following events occur simultaneously, which would receive RN priority?
❍ A. A client with a cerebral aneurysm complains of sudden weakness on the right side.
❍ B. A client with a suspected brain tumor complains of a headache.
❍ C. A client post-op lumbar laminectomy vomits.
❍ D. A client with Guillain-Barre syndrome has a temp of 99.6°F.

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25. The nurse assesses a client’s fundal height every 15 minutes during the first hour postpartum. The height of the fundus during this hour should be:
❍ A. 1–2 fingerbreadths under the umbilicus
❍ B. 4 fingerbreadths under the umbilicus
❍ C. 1 fingerbreadth above the umbilicus
❍ D. 4 fingerbreadths above the umbilicus

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26. The nurse assesses a client complaining of a headache. When the nurse shines a light on the frontal and maxillary sinuses, the light does not penetrate the tissues. What is the best interpretation of this finding?
❍ A. This is a normal finding indicating no problem in the sinuses.
❍ B. Inflammation is present in the sinuses.
❍ C. The cavity likely contains fluid or pus.
❍ D. The client has a sinus infection.

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27. A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?
❍ A. O2 at 5L/min by nasal cannula
❍ B. Solu Medrol 125mg IV push every 6 hours
❍ C. Ceftriaxone (Rocephin) 1gram IVPB daily
❍ D. Darvocet N 100 po prn pain

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28. A burn client begins treatments with silver sulfadiazine (Silvadene) applied to the wounds. The nurse should carefully monitor for which adverse affect associated with this drug?
❍ A. Hypokalemia
❍ B. Leukopenia
❍ C. Hyponatremia
❍ D. Thrombocytopenia

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29. The nurse is caring for clients on the postpartum unit. Which of the following should the nurse assess first?
❍ A. A primapara who has delivered an 8-pound baby boy
❍ B. A gravida IV para IV who experienced 1 hour of labor
❍ C. A gravida II para II whose placenta was delivered 10 minutes after the infant
❍ D. A primapara receiving 100mg of meperidine (Demerol) during her labor

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30. The nurse is assessing a client for tactile fremitus. Which client would most likely exhibit a decrease in tactile fremitus? A client with:
❍ A. Emphysema
❍ B. Pneumonia
❍ C. Tuberculosis
❍ D. A lung tumor

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31. A client who has been diagnosed with lung cancer is starting a smokingcessation program. Which of the following drugs would the nurse expect to be included in the program’s plan?
❍ A. Bupropion SR (Zyban)
❍ B. Metoproterenol (Alupent)
❍ C. Oxitropuim (Oxivent)
❍ D. Alprazolam (Xanax)

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32. A client delivered a 9-pound infant 2 hours ago. The client has an IV of D5W with oxytocin. The nurse determines that the medication is achieving the desired effect when she observes:
❍ A. A rise in blood pressure
❍ B. A decrease in pain
❍ C. An increase in lochia rubra
❍ D. A firm uterine fundus

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33. The nurse is evaluating cerebral perfusion outcomes for a client with a subdural hematoma. The nurse evaluates which of the following as a favorable outcome for this client?
❍ A. Arterial blood gas PO 2 of 98
❍ B. Increase in lethargy
❍ C. Pupils slow to react to light
❍ D. Temperature of 101°F

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34. The nurse is caring for a client with COPD. Which of the associated disorders has changes that are reversible?
❍ A. Bronchiectasis
❍ B. Emphysema
❍ C. Asthma
❍ D. Chronic bronchitis

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35. A client experienced a major burn over 55% of his body 36 hours ago. The client is restless and anxious, and states, “I am in pain.” There is a physician prescription for intravenous morphine. The nurse’s first action would be to:
❍ A. Administer the morphine
❍ B. Assess respirations
❍ C. Assess urine output
❍ D. Check serum potassium levels

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36. The nurse is caring for a client 7 days post-burn injury with 60% body surface area involved. The nursing care of this client would primarily focus on:
❍ A. Meticulous infection-control measures
❍ B. Fluid-replacement evaluation
❍ C. Psychological adjustment to the wound
❍ D. Measurement and application of a pressure garment

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37. The nurse is caring for a child 4 days after a tracheostomy tube insertion. The child’s mother calls the desk and states, “He pulled out his trach tube and threw it on the floor; it’s closing—come quick, he can’t breathe.” What is the best action for the nurse to take?
❍ A. Cover the stoma with a sterile 4×4
❍ B. Keep the stoma open using sterile technique, and call for help
❍ C. Retrieve the tracheostomy tube and reinsert it
❍ D. Apply O2 at 4L/min by nasal cannula

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38. The nurse is performing discharge teaching for a client after a cardiac catheterization. Which statement by the client indicates a need for further teaching?
❍ A. “I should not bend, strain, or lift heavy objects for 1 day.”
❍ B. “If bleeding occurs, I should place an ice bag on the site for 10 minutes.”
❍ C. “I need to call the doctor if my temperature goes above 101°F.”
❍ D. “I should talk to the doctor to find out when I can go back to work.”

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39. A burn client is in the acute phase of burn care. The nurse assesses jugular vein distention, edema, urine output of 20cc in 2 hours, and crackles on auscultation. Which order would the nurse anticipate from the physician?
❍ A. Furosemide (Lasix) IV push
❍ B. Irrigate the Foley catheter
❍ C. Increase the IV fluids to 200mL/hr
❍ D. Place the client in Trendelenburg position

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40. When performing suctioning of a tracheostomy, the nurse would know that the suction pressure should not exceed:
❍ A. 120mmHg
❍ B. 145mmHg
❍ C. 160mmHg
❍ D. 185mmHg

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41. A client admitted with transient ischemia attacks has returned from a cerebral arteriogram. The nurse performs an assessment and finds a newly formed hematoma in the right groin area. What is the nurse’s initial action?
❍ A. Apply direct pressure to the site
❍ B. Check the pedal pulses on the right leg
❍ C. Notify the physician
❍ D. Turn the client to the prone position

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42. The nurse is assessing an ECG strip of a 42-year-old client and finds a regular rate greater than 100, a normal QRS complex, a normal P wave in front of each QRS, a PR interval between 0.12 and 0.20 seconds, and a P: QRS ratio of 1:1. What is the nurse’s interpretation of this rhythm?
❍ A. Premature atrial complex
❍ B. Sinus tachycardia
❍ C. Atrial flutter
❍ D. Supraventricular tachycardia

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43. A client is complaining of chest pain. Nursing assessment reveals a BP of 78/40, shortness of breath, and third-degree AV block on the heart monitor. What medication would the nurse prepare for initial administration?
❍ A. Atropine
❍ B. Verapamil (Calan)
❍ C. Lidocaine (Xylocaine)
❍ D. Procainamide (Pronestyl)

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44. The nurse is discussing cigarette smoking with an emphysema client. The client states, “I don’t know why I should worry about cancer.” The nurse’s response is based on the fact that the most important reason for a client with emphysema to avoid smoking is that it:
❍ A. Affects peripheral blood vessels
❍ B. Causes vasoconstriction
❍ C. Destroys the lung parenchyma
❍ D. Paralyzes ciliary activity

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45. The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:
❍ A. Chronic fatigue syndrome
❍ B. Normal aging
❍ C. Sundowning
❍ D. Delusions

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46. A client with chest pain is scheduled for a heart catheterization. Which of the following would the nurse include in the client’s care plan?
❍ A. Keep the client NPO for 12 hours after the procedure
❍ B. Inform the client that general anesthesia will be administered
❍ C. Assess the site for bleeding or hematoma once per shift
❍ D. Instruct the client that he might be asked to cough and
breathe deeply during the procedure

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47. The nurse is caring for a COPD client who is discharged on p.o. Theophylline. Which of the following statements by the client would indicate a correct understanding of discharge instructions?
❍ A. “A slow, regular pulse could be a side effect.”
❍ B. “Take the pill with antacid or milk and crackers.”
❍ C. “The doctor might order it intravenously if symptoms worsen.”
❍ D. “Hold the drug if symptoms decrease.”

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48. The nurse has just admitted a client with emphysema. Arterial blood gas results indicate hypoxia. Which physician prescription would the nurse implement for the best improvement in the client’s hypoxia?
❍ A. Elevate the head of the bed 45°
❍ B. Encourage diaphragmatic breathing
❍ C. Initiate an Alupent nebulizer treatment
❍ D. Start O2 at 2L/min

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49. The nurse is assessing the chart of a client with a stroke. MRI results reveal a hemorrhagic stroke to the brain. Which physician prescription would the nurse question?
❍ A. Normal saline IV at 50mL/hr
❍ B. O2 at 3L/min by nasal cannula
❍ C. Heparin infusion per pharmacist protocol
❍ D. Insert a Foley catheter

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50. The nurse is caring for a client admitted with congestive heart failure. Which finding would the nurse expect if the failure was on the right side of the heart?
❍ A. Jugular vein distention
❍ B. Dry, nonproductive cough
❍ C. Orthopnea
❍ D. Crackles on chest auscultation

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NCSBN Practice Exam #25 - 50 questions