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NCLEX PRACTICE

Total questions: 66

Worksheet time: 1hrs 6mins

Name
Class
Date
1.

While assessing a one-month old infant, which of the findings warrants further investigation by the nurse? Select all that apply.

a)

Abdominal respirations

b)

Cyanosis

c)

Increased heart rate with crying

d)

Asymmetric chest movement

e)

Nasal flaring

2.

Which individual is at the greatest risk for developing hypertension?

a)

45-year-old African America attorney

b)

60-year-old Asian American shop owner

c)

40-year-old Caucasian nurse

d)

55-year-old Hispanic teacher

3.

15-year-old female who ingested 15 tablets of maximum strength acetaminophen 45 minutes ago is rushed to the emergency department. Which of these orders should the nurse do first?

a)

Gastric Lavage

b)

Administer acetylcysteine (Mucomyst) orally

c)

Start IV D5 with 0.33% normal saline to keep vein open

d)

Have patient drink activated charcoal mixed with water

4.

Which complication of cardiac catheterization should the nurse monitor for in the initial 24 hours after the procedure?

a)

Angina at rest

b)

Thrombus formation

c)

Dizziness

d)

Falling blood pressure

5.

A client is admitted to the emergency room with renal calculi and is complaining of moderate to severe flank pain and nausea. The client’s temperature is 100.8 degrees Fahrenheit. The priority nursing goal for this client is:

a)

Maintain fluid and electrolyte balance

b)

Control nausea

c)

Manage pain

d)

Prevent UTI

6.

What would the nurse expect to see while assessing the growth of children during their school-age years?

a)

Decreasing amounts of body fat and muscle mass

b)

Little change in body appearance from year to year

c)

Progressive height increase of 4 inches per year

d)

Yearly weight gain of about 5.5lbs per year

7.

At a community health fair, the blood pressure of a 62-year-old client is 160/96 mmHg. The client states “My blood pressure is usually much lower.” The nurse should tell the client to:

a)

Go get a BP check within the next 15 minutes

b)

Check BP again in 2 months

c)

See healthcare provider immediately

d)

Visit healthcare provider within 1 week for a BP check

8.

The hospital has sounded the call for a disaster drill on the evening shift. Which of these clients would the nurse put first on the list to be discharged in order to make a room available for a new admission?

a)

Middle-aged client w/ history of being ventilator dependent for over 7 years and admitted with bacterial PNA 5 days ago

b)

Young adult with DM2 for over 10 years and admitted with antibiotic-induced diarrhea 24 hours ago

c)

Elderly client with history of HTN, hypercholesterolemia, and lupus, and was admitted with SJS that morning

d)

Adolescent with positive HIV test and admitted for acute cellulitis of lower leg 48 hours ago.

9.

A 25-year-old male client has been newly diagnosed with hypothyroidism and will take levothyroxine (Synthroid) 50 mcg/day by mouth. As part of the teaching plan, the nurse emphasizes that this medication:

a)

Should be taken in the morning

b)

May decrease the client's energy level

c)

Must be store in a dark container

d)

Will decrease the client's heart rate

10.

A 3-year-old child was brought to the pediatric clinic after the sudden onset of findings that include irritability, thick muffled voice, croaking on inspiration, hot to touch, sit leaning forward, tongue protruding, drooling, and suprasternal retractions. What should the nurse do first?

a)

Prepare the child for x-ray of upper airways

b)

Examine the child's throat

c)

Collect a sputum specimen

d)

Notify the healthcare provider of the child's status

11.

In children suspected to have a diagnosis of diabetes, which one of the following complaints would be most likely to prompt parents to take their school-age child for evaluation?

a)

Polyphagia

b)

Dehydration

c)

Bedwetting

d)

Weight loss

12.

A client comes to the clinic for treatment of recurrent pelvic inflammatory disease. The nurse recognizes that this condition most frequently follows which type of infection?

a)

Trichomoniasis

b)

Chlamydia

c)

Staphylococcus

d)

Streptococcus

13.

A registered nurse who usually works in a spinal rehabilitation unit is floated to the emergency department. Which of these clients should the charge nurse assign to this RN?

a)

Middle aged client who says "I took too many diet pills" and "my heart is racing".

b)

Young adult who says "I hear songs from heaven, need money for beer. I quit drinking 2 days ago and my arms and legs are jerking."

c)

Adolescent who has been on pain meds for terminal cancer with an initial assessment finding pinpoint pupils and relaxed respiratory rate of 11.

d)

Elderly patient who reports taken a "large crack hit" 10 minutes prior to walking into the ER.

14.

When teaching a client with coronary artery disease about nutrition, the nurse should emphasize:

a)

Eating 3 balanced meals a day

b)

Adding complex carbohydrates

c)

Avoiding very heavy meals

d)

Limiting sodium to 7 gms per day

15.

Which of these findings indicate that a pump to deliver a basal rate of 10 ml per hour plus PRN for pain breakthrough for morphine drip is not working?

a)

Client complains of discomfort at the IV insertion site

b)

Client states "I just can't get relief from pain"

c)

The level of the drug is 100ml at 8am and 80ml at noon

d)

The level of drug is 100ml at 8am and 50ml at noon

16.

The nurse is speaking at a community meeting about personal responsibility for health promotion. A participant asks about chiropractic treatment for illnesses. What should be the focus of the nurse’s response?

a)

Electrical energy fields

b)

Spinal column manipulation

c)

Mind-body balance

d)

Exercise of joints

17.

The nurse is performing a neurological assessment on a client post right cerebrovascular accident. Which finding, if observed by the nurse, would warrant immediate attention?

a)

Decrease in LOC

b)

Loss of bladder control

c)

Altered sensation to stimuli

d)

Emotional lability

18.

A child who has recently been diagnosed with cystic fibrosis is in a pediatric clinic where a nurse is performing an assessment. Which later finding of this disease would the nurse not expect to see at this time?

a)

Positive sweat test

b)

Bulky greasy stools

c)

Moist, productive cough

d)

Meconium ileus

19.

The home health nurse visits a male client to provide wound care and finds the client lethargic and confused. His wife states he fell down the stairs two (2) hours ago. The nurse should...

a)

Place a call to client's health care provider for instructions

b)

Send him to emergency room for evaluation

c)

Reassure client's wife that the symptoms are transient

d)

Instruct the client's wife to call doctor if symptoms become worse

20.

Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiography test?

a)

Client must be NPO before

b)

Enema to be administered prior

c)

Medicate client with Lasix 20mg IV 30 min prior

d)

No special orders necessary

21.

The nurse is giving discharge teaching to a client seven (7) days post-myocardial infarction. He asks the nurse why he must wait six (6) weeks before having sexual intercourse. What is the best response by the nurse to this question?

a)

"You need to regain your strength before attempting such exertion"

b)

"When you can climb 2 flights of stairs without problems, it is generally safe"

c)

"Have a glass of wine to relax you, then you can try to have sex"

d)

"You can have sex when you have an active walking program"

22.

A triage nurse has these four (4) clients arrive in the emergency department within 15 minutes. Which client should the triage nurse send back to be seen first?

a)

2-month-old infant with history of rolling off bed and has bulging fontanelle with crying

b)

Teenager who got a singed beard while camping

c)

Elderly client with complaints of frequent liquid brown colored stools

d)

Middle-aged client with intermittent pain behind right scapula

23.

While planning care for a toddler, the nurse teaches the parents about the expected developmental changes for this age which includes developing autonomy. Which statement by the mother shows that she understands the child’s developmental needs?

a)

"I want to protect my child from any falls"

b)

"I will set limits on exploring the house"

c)

"I understand the need to use those new skills"

d)

"I intend to keep control over our child"

24.

The nurse is preparing to administer an enteral feeding to a client via a nasogastric feeding tube. The most important action of the nurse is:

a)

Verify correct placement of the tube

b)

Check that the feeding solution matches the dietary order

c)

Aspirate abdominal contents to determine the amount of last feeding remaining stomach

d)

Ensure that feeding solution is at room temperature

25.

The nurse is caring for a client with a serum potassium level of 3.5 mEq/L. The client is placed on a cardiac monitor and receives 40 mEq potassium chloride in 1000 ml of 5% dextrose in water IV. Which of the following EKG patterns indicates to the nurse that the infusions should be discontinued?

a)

Narrowed QRS complex

b)

Shortened "PR" interval

c)

Tall peaked "T" waves

d)

Prominent "U" waves

26.

A nurse prepares to care for a 4-year-old newly admitted for rhabdomyosarcoma. The nurse should alert the staff to pay more attention to the function of which area of the body?

a)

All striated muscles

b)

The cerebellum

c)

The kidneys

d)

The leg bones

27.

During an assessment of a client with cardiomyopathy, the nurse finds that the systolic blood pressure has decreased from 145 to 110 mm Hg and the heart rate has risen from 72 to 96 beats per minute and the client complains of periodic dizzy spells. The nurse instructs the client to:

a)

Increase fluids that are high in protein

b)

Restrict fluids

c)

Increase fluids and reassess blood pressure

d)

Limit fluids to non-caffeine

28.

The nurse prepares the client for the insertion of a pulmonary artery catheter (Swan-Ganz catheter). The nurse teaches the client that the catheter will be inserted to provide information about:

a)

Stroke Volume

b)

Cardiac Output

c)

Venous Pressure

d)

Left Ventricular Functioning

29.

A nurse enters a client’s room to discover that the client has no pulse or respirations. After calling for help, the first action the nurse should take is:

a)

Start peripheral IV

b)

Initiate high quality chest compressions

c)

Establish an airway

d)

Obtain the crash cart

30.

A client is receiving digoxin (Lanoxin) 0.25 mg daily. The health care provider has written a new order to give metoprolol (Lopressor) 25 mg B.I.D. In assessing the client prior to administering the medications, which of the following should the nurse report immediately to the health care provider?

a)

BP pressure 94/60mmHg

b)

HR 76 BPM

c)

Urine output 50ml/hour

d)

RR 16 BMP

31.

The nurse practicing in a maternity setting recognizes that the postmature fetus is at risk due to:

a)

Excessive fetal weight

b)

Low blood sugar levels

c)

Depletion of subcutaneous fat

d)

Progressive placental insufficiency

32.

The nurse is caring for a client who had a total hip replacement seven (7) days ago. Which statement by the client requires the nurse’s immediate attention?

a)

"I have bad muscle spasms in my lower leg of the affected extremity"

b)

"I just can't catch my breath over the past few minutes and I think I am in grave danger"

c)

"I have to use the bedpan to pass my water at least every 1-2 hours"

d)

"It seems that the pain medication is not working as well today"

33.

A 33-year-old male client with heart failure has been taking furosemide for the past week. Which of the following assessment cues below may indicate the client is experiencing a negative side effect from the medication?

a)

Weight gain of 5 pounds

b)

Edema of ankles

c)

Gastric irritability

d)

Decreased appetite

34.

The nurse is caring for a 27-year-old female client with venous stasis ulcer. Which nursing intervention would be most non-invasive and effective in promoting healing?

a)

Apply dressing using sterile technique

b)

Improve client's nutrition status

c)

Initiate limb compression therapy

d)

Begin proteolytic debridement

35.

The nurse is providing information to a client with multiple sclerosis on performing exercises and physical activities. The nurse determines the client needs additional teaching if the client makes which statements? Select all that apply.

a)

"I can lift weights and do resistance training"

b)

"I should exercise to the point of exaustion"

c)

"I should exercise continuously without rest"

d)

"Proper stretching should be done before starting my routine"

e)

"I can include aerobic exercise in my routine"

36.

During the evaluation of the quality of home care for a client with Alzheimer’s disease, the priority for the nurse is to reinforce which statement by a family member?

a)

"At least two full meals a day are eaten"

b)

"We go to a group discussion every week at our community center"

c)

"We have safety bars installed in the bathroom and have 24 hour alarms on doors"

d)

"The medication is not a problem to have it taken three times a day"

37.

A nurse is reviewing a patient’s medication during shift change. Which of the following medications would be contraindicated if the patient were pregnant? Select all that apply.

a)

Warfarin (Coumadin)

b)

Finasteride (Propecia, Proscar)

c)

Celecoxib (Celebrex)

d)

Clonidine (Catapres)

e)

Nicotine Gum

38.

A nurse is reviewing a patient’s past medical history (PMH). The history indicates the patient has photosensitive reactions to medications. Which of the following drugs is associated with photosensitive reactions? Select all that apply.

a)

Ciprofloxacin

b)

Sulfonamide

c)

Norfloxacin (Noroxin)

d)

Sulfmethoxazole and Trimethorprim (Bactrim)

e)

Isotretinoin (Accutane)

39.

A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following of the patient’s medication does not cause urine discoloration?

a)

Sulfasalazine

b)

Levodopa

c)

Phenolphthalein

d)

Aspirin

40.

You are responsible for reviewing the nursing unit’s refrigerator. Which of the following drugs, if found inside the fridge, should be removed?

a)

Nadolol (Corgard)

b)

Opened (in use) Humulin N injection

c)

Urokinase (Kinlytic)

d)

Epoetin alfa IV (Epogen)

41.

A 34-year-old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?

a)

IgA

b)

IgD

c)

IgE

d)

IgG

42.

A second-year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most significant action that the nursing student should take?

a)

Immediately see social worker

b)

Start prophylactic AZT treatment

c)

Start prophylactic Pentamidine treatment

d)

Seek counseling

43.

A thirty-five-year-old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?

a)

Atherosclerosis

b)

Diabetic Nephropathy

c)

Autonomic Neuropathy

d)

Somatic Neuropathy

44.

You are taking the history of a 14-year-old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?

a)

Multiple sclerosis

b)

Anorexia nervosa

c)

Bulimia nervosa

d)

Systemic sclerosis

45.

A 24-year-old female is admitted to the ER due to confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Based on the presenting signs and symptoms, which of the following would you most likely suspect?

a)

Diverticulosis

b)

Hypercalcemia

c)

Hypocalcemia

d)

Irritable Bowel Syndrome

46.

Rhogam is most often used to treat____ mothers that have a ____ infant.

a)

RH +, RH+

b)

RH +, RH-

c)

RH-, RH+

d)

RH-, RH-

47.

A new mother has some questions about phenylketonuria (PKU). Which of the following statements made by a nurse is not correct regarding PKU?

a)

A Guthrie test can check the necessary lab values

b)

The urine has a high concentration of phenyl pyruvic acid

c)

Mental deficits are often present with PKU

d)

The effects of PKU are reversible

48.

A patient has taken an overdose of aspirin. Which of the following should a nurse must closely monitor for during acute management of this patient?

a)

Onset of pulmonary edema

b)

Metabolic alkalosis

c)

Respiratory alkalosis

d)

Parkinson's Disease type tremors

49.

A 50-year-old blind and deaf patient has been admitted to your floor. As the charge nurse, your primary responsibility for this patient is?

a)

Let others know about the patient's deficits

b)

Communicate with your supervisor your safety concerns

c)

Continuously update the patient on the social environment

d)

Provide a secure environment for the patient

50.

A patient is getting discharged from a skilled nursing facility (SNF). The patient has a history of severe COPD and PVD. The patient is primarily concerned about his ability to breathe easily. Which of the following would be the best instruction for this patient?

a)

Deep breathing techniques to increase oxygen levels

b)

Cough regularly and deeply to clear airway passages

c)

Cough following bronchodilator utilization

d)

Decrease CO2 levels by increased oxygen during meals

51.

A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?

a)

Slow pulse rate

b)

Weight gain

c)

Decreased systolic pressure

d)

Irregular WBC values

52.

A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?

a)

Simian Crease

b)

Brachycephaly

c)

Oily skin

d)

Hypotonicity

53.

A client with myocardial infarction is receiving tissue plasminogen activator, alteplase (Activase, tPA). While on the therapy, the nurse plans to prioritize which of the following?

a)

Observe for neurological changes

b)

Monitor for any signs of renal failure

c)

Check a food diary

d)

Observe for signs of bleeding

54.

A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?”

a)

Green vegetables and liver

b)

Yellow vegetables and red meat

c)

Carrots

d)

Milk

55.

A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans?

a)

S. pneumoniae

b)

H.influenzae

c)

N.meningitidis

d)

C. difficile

56.

A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long do red blood cells live in my body? The correct response is:

a)

45 days

b)

60 days

c)

90 days

d)

120 days

57.

A 5-year-old child and has been recently admitted to the hospital. According to Erik Erikson’s psychosocial development stages, the child is in which stage?

a)

Trust vs Mistrust

b)

Initiative vs Guilt

c)

Autonomy vs Shame & Guilt

d)

Intimacy vs Isolation

58.

A toddler is 26 months old and has been recently admitted to the hospital. According to Erikson, which of the following stages is the toddler in?

a)

Trust vs Mistrust

b)

Initiative vs Guilt

c)

Autonomy vs Shame & Guilt

d)

Intimacy vs Isolation

59.

When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?

a)

Amitriptyline

b)

Calcitonin

c)

Pergolide mesylate

d)

Verapamil

60.

Which of the following conditions would a nurse not administer erythromycin?

a)

Campylobacteriosis infection

b)

Legionnaires disease

c)

Pneumonia

d)

Multiple Sclerosis

61.

A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?

a)

Decreased HR

b)

Parasthesias

c)

Muscle weakness of extremities

d)

Migraines

62.

A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?

a)

Vomiting

b)

Extreme thirst

c)

Weight gain

d)

Acetone breath

63.

A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?

a)

Increased appetite

b)

Vomiting

c)

Fever

d)

Poor tolerance of light

64.

A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?

a)

Yersinia pestis

b)

Helicobacter pylori

c)

Vibrio cholerae

d)

Haemophilus aegyptius

65.

A nurse is reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition?

a)

Borrelia burgdorferi

b)

Streptococcus pyogenes

c)

Bacillus anthracis

d)

Enterococcus faecalis

66.

A fragile 87-year-old female has recently been admitted to the hospital with increased confusion and falls over the last two (2) weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?

a)

CBC (Complete blood count)

b)

ECG (electrocardiogram)

c)

Thyroid function tests

d)

CT scan