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NCLEX RN Registered Nurses Quiz | Practice Test 05

1 >>An indicator of a worsening hypovolemic shock related to GI bleeding would be: ?
  • (A) Decreased level of consciousness (LOC).
  • (B) Complaints of abdominal pain with hematemesis.
  • (C) Deepening, rapid respirations.
  • (D) Increasingly rapid, thready pulse.
2 >>A 50-year-old client is being seen in the outpatient clinic with complaints of a fever, cough, muscle soreness, and fatigue. The nurse would be concerned that the client had novel H1N1 flu if the complaints included: Select all that apply. ?
  • (A) Persistent cough.
  • (B) Shortness of breath.
  • (C) Persistent vomiting.
  • (D) Temperature of 104°F.
3 >>A client's vital signs are: BP 80/60 mm Hg, P 120, R 30, T 100.4°F. A nurse should know that these findings most likely indicate: ?
  • (A) Neurogenic shock from increased intracranial pressure.
  • (B) Hypovolemic shock from fluid volume deficits.
  • (C) Septic shock from gram-negative sepsis.
  • (D) Cardiogenic shock from MI.
4 >>A nurse should expect that a client with a severe loss of potassium (hypokalemia) from diarrhea will have: ?
  • (A) Fatigue, tetany, cardiac standstill.
  • (B) Kussmaul's respirations, thirst, furrowed tongue.
  • (C) Muscle weakness, cramps, cardiac irritability.
  • (D) Confusion, pitting edema, irregular pulse.
5 >>Which finding should indicate to a nurse that a client has recovered from respiratory acidosis? ?
  • (A) Increasing respiratory rate.
  • (B) Increasing serum creatinine.
  • (C) Decreasing respiratory rate.
  • (D) Increasing serum bicarbonate.
6 >>The goal of care for a client with liver failure is to lower the blood ammonia level. Which actions would prevent increased ammonia? Select all that apply. ?
  • (A) Prevent gastrointestinal bleeding.
  • (B) Reduce dietary protein intake.
  • (C) Avoid diarrhea and vomiting.
  • (D) Decrease bacterial flora in the intestines.

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7 >>If a bowel obstruction occurs from inflammatory bowel disease at the transverse colon, a nurse will initially hear bowel sounds that are: ?
  • (A) Increased RLQ; decreased LLQ.
  • (B) Decreased RLQ; decreased LLQ.
  • (C) Absent RLQ; absent LLQ.
  • (D) Decreased RLQ; increased LLQ.
8 >>Identify the appropriate actions in the prevention of thrombophlebitis in a client on bedrest. Select all that apply. ?
  • (A) Elevate the knee gatch of the bed.
  • (B) Encourage exercises that dorsiflex and plantar flex the ankle.
  • (C) Apply sequential compression devices bilaterally.
  • (D) Prevent dehydration.
9 >>Which nursing actions should be completed before a physician performs a thoracentesis? Select all that apply. ?
  • (A) Assessing the client for any allergy to local anesthetics.
  • (B) Teaching the client to do pursed-lip breathing during the procedure.
  • (C) Placing the client in an upright sitting position leaning forward, if able.
  • (D) Placing the client in a prone position with the affected lung on a pillow.
10 >>A nurse should evaluate the effects of coumadin, used in the treatment of deep vein thrombosis, by looking at the results of which laboratory tests? ?
  • (A) Prothrombin time (PT).
  • (B) Lee-White clotting time.
  • (C) Partial thromboplastin time (PTT).
  • (D) Fibrinogen clotting time (FCT).
11 >>Which client should be the first priority for a telephone advice RN? A client who reports: ?
  • (A) Headache, vomiting, and fever.
  • (B) Ankle swelling and shortness of breath.
  • (C) Productive cough.
  • (D) Palpitations.
12 >>To promote maximum ventilation in a client who is postoperative, a nurse should: ?
  • (A) Auscultate breath sounds bilaterally.
  • (B) Give humidified oxygen via cannula.
  • (C) Maintain placement of airway until the client is awake.
  • (D) Position the client on the side, with the neck extended.

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13 >>A nurse gets a report that a client will be admitted with an ejection fraction of 58%. Which history and physical finding should the nurse anticipate? ?
  • (A) Inspiratory wheezing in upper lobes, bilaterally.
  • (B) O2 saturation that increases from 90% to 99% when head of bed is lowered to a flat position.
  • (C) Crackles in the lung bases that clear with deep breathing.
  • (D) A client is unable to walk up two flights of stairs without dyspnea.
14 >>Management of a BUN of 71 and a creatinine of 2.7 in a client with diabetic ketoacidosis (DKA) is correctly accomplished with: ?
  • (A) Rehydration.
  • (B) Fluid restriction.
  • (C) Dialysis.
  • (D) Bladder catheterization.
15 >>A nurse notes that a client has a total bilirubin of 1.0 mg/dL. The nurse should: ?
  • (A) Record this normal finding.
  • (B) Check urine for blood.
  • (C) Check the stool for guaiac.
  • (D) Assess the sclerae for yellow coloration.
16 >>Ten hours after beginning an insulin drip on a client with diabetic ketoacidosis, the following laboratory results are returned: Na+ 130, K+ 4.4, Cl- 100, bicarb 15, BUN 60, creatinine 2.5, glucose 100. Which action should a nurse take? ?
  • (A) Administer potassium.
  • (B) Continue the insulin.
  • (C) Administer salt tablets.
  • (D) Restrict fluids.
17 >>A client is admitted with diabetic ketoacidosis (DKA). Five months ago, the hemoglobin A1c (HgbA1c) was 9.4%; currently it is 10.3%. Based on this information, a nurse should: ?
  • (A) Record this expected finding.
  • (B) Recheck the HgbA1c after the DKA is resolved.
  • (C) Provide diabetic teaching.
  • (D) Ask the physician about longer-acting insulin.
18 >>Seizure precautions should be applied to clients who have: ?
  • (A) A serum sodium of less than 125 mg/dL.
  • (B) An HgbA1c over 8%.
  • (C) An anion gap less than 12.
  • (D) Chronic peripheral neuropathies.
19 >>Which techniques are effective in communicating with a client who has complete loss of vision? Select all that apply. ?
  • (A) Raise the voice when talking.
  • (B) Avoid using the words "see" and "look."
  • (C) Talk very softly, since hearing is overly sensitive.
  • (D) Face the client when talking.
20 >>A client with mild hypertension asks a nurse for suggestions to control blood pressure. What should a nurse recommend? ?
  • (A) Follow a regular exercise program.
  • (B) Attend a stress-reduction support group.
  • (C) Avoid use of tobacco and limit alcohol intake.
  • (D) Increase intake of fruits and vegetables.

21 >>A nurse is checking a client's third cranial nerve. How should physical assessment be performed? ?
  • (A) Sweep a piece of cotton briskly across the cornea.
  • (B) Ask the client to follow the examiner's finger with the eyes.
  • (C) Use a Snellen chart to check visual acuity.
  • (D) Check pupillary reaction using a penlight.
22 >>A nurse should assess for hypercalcemia by checking a client for: ?
  • (A) Chvostek's sign.
  • (B) Trousseau's sign.
  • (C) Deep tendon reflex.
  • (D) Babinski reflex.


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23 >>The mother of a 2-year-old child is concerned her child may have novel H1N1. The nurse tells the mother that she should immediately report: ?
  • (A) Loss of appetite.
  • (B) Fever for 2 days.
  • (C) Vomiting
  • (D) Lack of alertness.
24 >>Which nursing intervention should a nurse complete first for a client experiencing addisonian crisis? ?
  • (A) Maintain a quiet, nonstressful environment.
  • (B) Take measures to avoid exertion by the client.
  • (C) Administer hormone replacement as prescribed.
  • (D) IV administration of fluid, glucose, and electrolytes.
25 >>A nurse knows that the serum sodium level of a client with a head trauma should be above 140 to: ?
  • (A) Keep cerebral perfusion pressure up.
  • (B) Prevent cerebral vasodilation.
  • (C) Lower the seizure threshold.
  • (D) Prevent cerebral edema.
26 >>A client is admitted with diabetic ketoacidosis. A nurse's first priority should be to give: ?
  • (A) IV bicarbonate.
  • (B) IV normal saline.
  • (C) IV albumin.
  • (D) Insulin subcutaneously.
27 >>A client with diabetic ketoacidosis (DKA) has been receiving IV insulin for 6 hours. Laboratory findings are: Na+ 131, K+ 3.7, Cl- 102, HCO3 22, and glucose 170. Which action should a nurse take? ?
  • (A) Administer 3% sodium chloride at 200 mL/hr.
  • (B) Expect the insulin drip to be discontinued.
  • (C) Give potassium IV.
  • (D) Administer D5 1 /4 NS with the insulin drip.
28 >>A client, who is malnourished, is admitted with a serum calcium of 7.5. A nurse should: ?
  • (A) Administer glucocorticoids, as ordered.
  • (B) Check urine for ketones.
  • (C) Check the serum albumin lab result.
  • (D) Administer Neutra-Phos, as ordered.
29 >>Following a thyroidectomy, a nurse assesses for complications related to damage or removal of the parathyroid. The nurse should assess for: ?
  • (A) Hypertension.
  • (B) Numbness around the mouth.
  • (C) Polyuria.
  • (D) Muscle weakness.

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30 >>A 19-year-old victim of trauma is admitted to an emergency department with a blood pressure of 80/50 mm Hg, and a heart rate of 130 bpm. Which action should a nurse take first? ?
  • (A) Give 1 liter of D5W IV as fast as possible.
  • (B) Give 1 liter NS IV as fast as possible.
  • (C) Start an additional large-bore IV as saline lock.
  • (D) Calculate the anion gap before selecting IV fluid.
31 >>A client with CHF has: 2+ pedal edema, jugular venous distention (JVD), bilateral basilar crackles, urine output of 1.2 L/24 hr, blood pressure of 145/88 mm Hg, Na+ of 129. A nurse should plan to: ?
  • (A) Restrict fluids.
  • (B) Give salt tablets PO.
  • (C) Change IV to NS.
  • (D) Give 3% sodium chloride IV.
32 >>A client is scheduled for outpatient bariatric surgery. Deep vein thrombosis (DVT) is best prevented by: ?
  • (A) Early ambulation.
  • (B) Postoperative low-dose heparin.
  • (C) Alternating compression leg wraps.
  • (D) Range-of-motion exercises to wrist.
33 >>Following general anesthesia for a hip replacement, an elderly client's vital signs are: P 80, R 14, blood pressure 110/78 mm Hg; O2 Sat 100% on 40% mask; pain 2/10. The client is shivering and complains of being cold. The first nursing priority should be to: ?
  • (A) Remove the oxygen.
  • (B) Check the temperature.
  • (C) Apply warm blankets.
  • (D) Give pain medication.
34 >>Which finding is consistent with a client developing fluid overload? ?
  • (A) Pulse over 100.
  • (B) Pulmonary crackles that clear with deep breathing.
  • (C) Concentrated urine.
  • (D) Oxygen saturation less than 92% on 40% O2 via facemask.
35 >>What is the best nursing action to prevent pressure sores during a long surgical procedure? ?
  • (A) Pad bony prominences before surgery begins.
  • (B) Turn the client every 2 hours.
  • (C) Perform range of motion on the affected joints.
  • (D) Provide an alternating pressure mattress.
36 >>A client with diabetes and hypertension has returned from surgery. Which nursing intervention will most likely reduce the risk of wound infection? ?
  • (A) Monitor blood sugar and keep it under 200 postoperatively.
  • (B) Place the client in contact isolation postoperatively.
  • (C) Administer prophylactic antibiotics 48 hours preoperatively, as ordered.
  • (D) Administer glucocorticoid stress hormone replacements postoperatively, as ordered.
37 >>A client asks a nurse what to expect with a condition of uncomplicated gallstones. The best response would be: ?
  • (A) "There may be blood in the stools, with increased mucus."
  • (B) "There may be RLQ cramping, with pain relieved after eating a fatty meal."
  • (C) "You may feel fatigue because of low hemoglobin level."
  • (D) "Most clients do not notice any effects."
38 >>A nurse is caring for a 32-year-old client who is 1 day post-gastric bypass. Vital signs are: T 37.9�C, P 100, R 18, BP 130/80 mm Hg, pain 2/10, O2 Sat 92% on room air. The nurse should first: ?
  • (A) Notify the physician for antibiotic orders.
  • (B) Have the client use the incentive spirometer.
  • (C) Increase intravenous fluids.
  • (D) Administer pain medication.
39 >>One day after surgery for intestinal resection, a client has no bowel sounds. Which action should a nurse take? ?
  • (A) Take the vital signs and notify the physician.
  • (B) Record this expected finding.
  • (C) Check rectally for impacted stool.
  • (D) Perform abdominal massage.
40 >>A client with gallstones asks a nurse what might have caused the condition. The nurse knows the risk of developing this condition is greater in: ?
  • (A) African Americans.
  • (B) Men.
  • (C) Significant recent weight loss.
  • (D) Drinking a lot of coffee.

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