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NCLEX RN Registered Nurses Quiz | Practice Test 01

The NCSBN i.e. National Council of State Boards of Nursing, Inc. authority is developed NCLEX test. These test are designed for those candidates who want to serve their duties in field of medical nurse and this test also evaluate the knowledge, skills and abilities essential for the safe and effective practice of nursing at the entry level. The NCLEX exam is a computerized adaptive testing (CAT) format. In this exam the computer selects which question you are asked based on how you answered the previous question. The NCLEX covers a wide range of material. The individual will be scored by their ability to think critically about decisions involving nursing care.

1 >>A client presents to an emergency department at 8 weeks' gestation. A physician suspects that the client has an ectopic (tubal) pregnancy. When performing an initial assessment, which symptom should a nurse recognize as consistent with a diagnosis of ectopic (tubal) pregnancy? ?
  • (A) Painless vaginal bleeding.
  • (B) Abdominal cramping.
  • (C) Throbbing pain in the upper quadrant.
  • (D) Sudden, stabbing pain in the lower quadrant.
2 >>A client, who is 10 weeks' gestation, has been having severe nausea for the past 3 weeks. She tells a nurse that she cannot eat anything. She has been diagnosed with hyperemesis gravidarum and is at risk for developing: ?
  • (A) Respiratory alkalosis without dehydration.
  • (B) Metabolic acidosis with dehydration.
  • (C) Respiratory acidosis without dehydration.
  • (D) Metabolic alkalosis with dehydration.
3 >>A client presents to a prenatal clinic and tells a physician that she thinks she might be pregnant because she has not has a period for about 5 months. Which is the most definitive sign of pregnancy? ?
  • (A) Elevated human chorionic gonadotropin.
  • (B) The presence of fetal heart tones.
  • (C) Uterine enlargement.
  • (D) Breast enlargement and tenderness.
4 >>A client, who is gravida 3, para 2 at 39 weeks' gestation with poorly controlled gestational diabetes, has just given birth via cesarean section. A nurse will expect that the neonate will most likely be: ?
  • (A) Hypoglycemic, small for gestational age.
  • (B) Hyperglycemic, large for gestational age.
  • (C) Hypoglycemic, large for gestational age.
  • (D) Hyperglycemic, small for gestational age.
5 >>A client, who is 44 years old, gravida 3, para 2, has just delivered a newborn suspected of having trisomy 21. Which characteristics should a nurse observe in an infant with this condition? Select all that apply. ?
  • (A) Simian creases.
  • (B) Increased muscle tone.
  • (C) Flat appearance of the face.
  • (D) Small tongue.
6 >>A nursing student is performing an initial newborn assessment. The newborn is observed to have a cephalohematoma. What are the likely causes of this condition? Select all that apply. ?
  • (A) Scheduled cesarean delivery.
  • (B) Prolonged latent phase of labor.
  • (C) Prolonged second stage of labor.
  • (D) Vacuum-assisted vaginal delivery.
7 >>A client, who is 24 years old, gravida 4, para 3, has had no prenatal care and does not know when her last menstrual period was. She presents to labor and delivery completely dilated and crowning. She precipitously delivers a 5-pound, 6-ounce infant. The client's urine toxicology screen shows methamphetamines. The client admits that she uses methamphetamine daily. Which observations should a nurse expect in the neonate that would be consistent with methamphetamine exposure in utero? Select all that apply. ?
  • (A) Cleft lip.
  • (B) Irritability.
  • (C) Clubfoot.
  • (D) Hyperbilirubinemia.

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8 >>An 18-year-old client chooses oral contraceptives as her method of birth control. Which instruction should be included in a nurse's teaching regarding oral contraceptives? ?
  • (A) Weight gain should be reported to the physician.
  • (B) An alternate method of birth control is needed when taking antibiotics.
  • (C) If the client misses one or more pills, two pills should be taken per day for 1 week.
  • (D) Nausea or stomach upset should be reported to the physician.
9 >>A 27-year-old client, who is gravida 3, para 1, presents to a labor and delivery unit at 33 weeks' gestation. She tells a nurse that she woke up this morning in a pool of blood about the size of an orange, but she has no abdominal cramping or pain. The nurse's first action should be to: ?
  • (A) Assess the fetal heart tones.
  • (B) Check for cervical dilation.
  • (C) Check for firmness of the uterus.
  • (D) Obtain maternal vital signs.
10 >>A nurse is caring for a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory test would the nurse be least likely to obtain? ?
  • (A) Urine specific gravity.
  • (B) Blood glucose.
  • (C) Serum sodium.
  • (D) Urine osmolality.
11 >>A physician prescribes digoxin (Lanoxin) for a toddler with congestive heart failure (CHF). Before administering the medication, it is most important for the nurse to: ?
  • (A) First obtain an apical heart rate.
  • (B) Determine the serum potassium.
  • (C) Review the child's admission electrocardiogram (ECG).
  • (D) Mix the medication with a pleasant-tasting food.
12 >>A nurse prepares to administer spironolactone (Aldactone) to an infant with congenital heart disease. The nurse understands that the main purpose of this medication is to: ?
  • (A) Preserve the patent ductus arteriosus.
  • (B) Cause vasodilation of the blood vessels.
  • (C) Prevent the secretion of potassium.
  • (D) Block aldosterone, which leads to diuresis.
13 >>Which symptom(s), if present in a child, should a nurse recognize as being characteristic of Kawasaki disease? Select all that apply. ?
  • (A) Strawberry tongue.
  • (B) High fever.
  • (C) Irritability.
  • (D) Cough.


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14 >>Which orders should a nurse question for a 5-month-old infant with hypoplastic left heart syndrome who is hospitalized awaiting the second stage of surgical repair? Select all that apply. ?
  • (A) Call physician for oxygen saturations below 85%.
  • (B) Daily weights.
  • (C) Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute.
  • (D) Enfamil formula ad lib.
15 >>A nurse would be most correct in withholding digoxin (Lanoxin) prescribed to an infant if the heart rate falls below which parameter? ?
  • (A) Below 100 beats per minute.
  • (B) Below 120 beats per minute.
  • (C) Below 140 beats per minute.
  • (D) Below 160 beats per minute.
16 >>A hospitalized child is experiencing sickle cell vasoocclusive crisis. The child is currently receiving an intravenous (IV) fluid bolus, pain medication every 4 hours, and warm compresses to the extremities per physician orders. During the midday assessment, the child reports no pain. Which action should a nurse take? ?
  • (A) Continue to apply warm compresses per physician order.
  • (B) Hold the next dosage of pain medication.
  • (C) Hold the next round of warm compresses.
  • (D) Contact the physician for a change in orders.
17 >>What should be the expected weight of an infant at 12 months of age whose birth weight was 3600 grams? ?
  • (A) 5600 grams.
  • (B) 7200 grams.
  • (C) 11 kilograms.
  • (D) 15 kilograms.
18 >>An infant in a newborn nursery is identified as having phenylketonuria (PKU). What is the best initial source of nutrients for an infant with this diagnosis? ?
  • (A) Maternal breast milk.
  • (B) Pregestimil.
  • (C) Lofenalac.
  • (D) Isomil.
19 >>In assessing the reflexes of a 15-month-old child, which finding would indicate that the child is experiencing normal development? ?
  • (A) Positive Babinski reflex.
  • (B) Asymmetric tonic neck reflex.
  • (C) Positive patellar reflex.
  • (D) Presence of doll's eye reflex.
20 >>A nurse is caring for a child with acute glomerulonephritis. Which nursing assessment should be the nurse's first priority when caring for this child? ?
  • (A) Obtaining a daily weight.
  • (B) Palpating extremities frequently for edema.
  • (C) Assessing urine for hematuria.
  • (D) Obtaining the child's blood pressure every shift.

21 >>In developing a plan of care for a hospitalized preschooler, a nurse recognizes that it is most essential to consider: ?
  • (A) That the child may believe the hospitalization is a punishment.
  • (B) Ways to provide visitation from peers.
  • (C) How to incorporate play activities with other children.
  • (D) Ways to promote privacy and independence.








22 >>A nurse assesses a child who is 12 hours status post- tonsillectomy and adenoidectomy. The child reports feeling nauseated and shows the nurse a moderate amount of red-tinged vomitus in the emesis basin. Which action should the nurse take first? ?
  • (A) Administer an antiemetic as ordered.
  • (B) Offer the child ice chips as tolerated.
  • (C) Report the findings to the physician.
  • (D) Apply bilateral pressure to the child's neck.
23 >>The parents of a 2-year-old child ask a nurse how to best assist the child to accomplish developmental tasks at this age. What is the best response by the nurse? ?
  • (A) "Make sure that the child's siblings insist that the child share toys at playtime."
  • (B) "Since the child understands the word �no,' use this word frequently to establish house rules."
  • (C) "Ask grandparents and other child care providers to follow your home schedule as much as possible."
  • (D) "Attend to the child quickly during temper tantrums by hugging and offering reassurance."
24 >>An infant is hospitalized following a febrile seizure. When a nurse teaches the infant's family about the prevention of future seizures, what would be the nurse's best recommendation? ?
  • (A) Place the child in a tepid bath during the next febrile illness.
  • (B) Administer antipyretics around the clock the next time the child has a fever.
  • (C) Contact the physician for antibiotics if the child becomes feverish again.
  • (D) Take the child's temperature frequently during the next illness.
25 >>A toddler with Kawasaki disease is being evaluated by a primary care clinic nurse 1 week following discharge. The nurse understands that it is a priority to instruct the parents to contact the clinic immediately if the child: ?
  • (A) Throws frequent temper tantrums.
  • (B) Is exposed to someone with chickenpox.
  • (C) Experiences night terrors.
  • (D) Develops a low-grade fever.
26 >>A child arrives in an emergency department with a chief complaint of asthma exacerbation. Which assessment information is most important for the nurse to obtain first? ?
  • (A) Whether the child has been taking asthma medications as prescribed.
  • (B) When the child began having symptoms.
  • (C) Whether the child is able to speak in full sentences.
  • (D) The child's ABG levels.
27 >>A child is seen in an emergency department following the ingestion of lighter fluid. Which nursing action is of the highest priority at this time? ?
  • (A) Induce vomiting.
  • (B) Determine the amount of poison ingested.
  • (C) Assess the respiratory system.
  • (D) Administer Mucomyst as ordered.
28 >>A nurse prepares to administer a chelating agent to a child with lead poisoning. Which laboratory tests should be obtained prior to the administration of this agent? ?
  • (A) BUN and creatinine.
  • (B) PT, PTT.
  • (C) Urine specific gravity.
  • (D) CBC.
29 >>A nurse is caring for a child with meningococcemia who is on a ventilator. This morning, the nurse finds the child's mother sitting at the bedside, crying. The mother tells the nurse, "I thought it was the flu. This is my fault because I should have come to the hospital earlier." What is the best action by the nurse in response to the mother's statements? ?
  • (A) Tell the mother not to worry since many parents and even physicians frequently mistake meningitis symptoms for other infectious conditions.
  • (B) Make a referral to social services.
  • (C) Call the child's father and explain that the mother needs emotional support from him.
  • (D) Remind the mother that she did seek proper treatment as soon as she became concerned, and review the special care the child is receiving now.





30 >>An infant is admitted for probable pyloric stenosis. A physician orders IV fluids and makes the infant NPO pending a surgical consult. The infant is crying vigorously and the parents express frustration that they cannot feed their baby even though the surgery is not yet definite. Which is the best action for the nurse to take now? ?
  • (A) Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting.
  • (B) Offer the parents a pacifier for the infant.
  • (C) Place a call to the surgeon to find out how long it will be before the consult.
  • (D) Feed the infant a small amount of Pedialyte since the surgical repair for this condition will most likely not occur until the following day.
31 >>A 1-day-old infant, born at 39 weeks' gestation, weighs 4 pounds, 7 ounces at birth. A pediatrician diagnoses the neonate with intrauterine growth restriction (IGR). An RN observes the newborn to be irritable, difficult to console, restless, fist-sucking, and demonstrating a highpitched, shrill cry. Based on these assessment data, the RN should: ?
  • (A) Increase stimulation of the baby by handling the infant as much as possible.
  • (B) Schedule routine feeding times every 3 to 4 hours.
  • (C) Encourage stimulation by rubbing the infant's back and head.
  • (D) Tightly swaddle the infant in a flexed position.
32 >>A nurse performs a scoliosis screening at a local school. Which assessment finding by the nurse would least likely result in a scoliosis referral? ?
  • (A) Unilateral rib hump noted when the child is bent forward.
  • (B) Asymmetrical hip height noted when the child is standing erect.
  • (C) Uneven wear noted on the bottom of the child's pant legs.
  • (D) Rounded shoulders noted when the child is standing erect.
33 >>Which conditions in children and/or adolescents should a nurse identify as being associated with metabolic alkalosis? Select all that apply. ?
  • (A) Pyloric stenosis.
  • (B) Diabetes.
  • (C) Renal failure.
  • (D) Bulimia nervosa.
34 >>A child is admitted for treatment of lead poisoning. A nurse recognizes that the priority nursing diagnosis for this child is: ?
  • (A) Alteration in comfort related to abdominal pain.
  • (B) Alteration in nutrition related to pica.
  • (C) Pain related to chelation therapy.
  • (D) Alteration in neurologic functioning.
35 >>A newborn arrives in a neonatal intensive care unit with a myelomeningocele. A physician writes orders to keep the infant in the prone position. A nurse should know that the most important rationale behind this order is to: ?
  • (A) Prevent infection.
  • (B) Promote circulation in the lower extremities.
  • (C) Prevent trauma to the meningeal sac.
  • (D) Promote comfort.
36 >>A child, hospitalized with nephrotic syndrome, has been receiving corticosteroids for a week. What should the nurse recognize as early evidence that the child is responding well to treatment? ?
  • (A) Decreased general edema.
  • (B) Increased urinary output.
  • (C) Improved general appetite.
  • (D) Hemoglobin and hematocrit within normal limits.
37 >>A nurse is performing discharge teaching with the parents of a preschooler diagnosed with cystic fibrosis. What part of the teaching plan will best assist the parents to prevent future pulmonary infections in this child? ?
  • (A) Teaching the parents proper administration of pancreatic enzymes.
  • (B) Emphasizing the need for regular and consistent chest physiotherapy.
  • (C) Stressing the need to seek prompt medical attention for increased work of breathing.
  • (D) Instructing the parents to monitor the child's daily fluid intake for adequacy.
38 >>The mother of a child asks a clinic nurse how to safetyproof the home. What should the nurse recognize as the most effective means to prevent accidental poisoning? ?
  • (A) Keep the Poison Control Center phone number near the phone.
  • (B) Store poisons in the garage rather than in the home.
  • (C) Scan the home from the child's eye level and remove accessible toxins.
  • (D) Tell children where toxic substances are kept and instruct them not to go there.
39 >>A nurse visits the home of a toddler. With what aspect of the home environment would the nurse be most concerned? ?
  • (A) Power cords plugged into capped electrical outlets.
  • (B) Presence of a television in the child's bedroom.
  • (C) A swimming pool located in the backyard.
  • (D) Cooking pot handle turned toward the front of the stove.
40 >>An infant is admitted to a pediatric unit with labored breathing and moderate amounts of thick nasal secretions. What nursing intervention is most likely to improve the infant's oxygenation? ?
  • (A) Frequent suctioning of the nares with a nasal olive.
  • (B) Providing supplemental oxygen via nasal cannula.
  • (C) Strict monitoring of oxygen saturation levels.
  • (D) Placing the child in an infant seat.

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