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NCLEX RN Registered Nurses Quiz | Practice Test 04

1 >>An older adult attending a community health fair asks about receiving the necessary vaccines for the swine flu. The nurse tells the client that, to prevent the spread of swine flu, the client should receive: ?
  • (A) Just the seasonal flu and the pneumonia vaccines.
  • (B) The novel H1N1 vaccine instead of the seasonal vaccine.
  • (C) The seasonal and novel H1N1 vaccines the same day.
  • (D) The novel H1N1 and seasonal vaccines a week apart.
2 >>A client, who had been playing golf in 110°F outside temperature, is admitted to an emergency department with hyperthermia. A nursing assessment would reveal: Select all that apply. ?
  • (A) Absence of sweating.
  • (B) Decrease in body temperature.
  • (C) Increase in sweating.
  • (D) Increased blood pressure.
3 >>A nurse should recognize the signs of deep vein thrombosis (DVT) if a client reports: Select all that apply. ?
  • (A) Leg feeling cool with no pain.
  • (B) Numbness of legs with diaphoresis.
  • (C) Sudden swelling of one leg with dependent edema.
  • (D) Dizziness and blurred vision.
4 >>What nursing action is appropriate if a client has a K+ of 8 mEq/L? ?
  • (A) No change is required in treatment.
  • (B) Restrict intake of K+ and/or give sodium polystyrene sulfonate (Kayexalate).
  • (C) Restrict fluids to reduce K+ .
  • (D) Give insulin, glucose, calcium, and/or bicarbonate STAT, as ordered.
5 >>Which client has the greatest need for K+ replacement? ?
  • (A) A client in renal failure with a postdialysis serum K+ of 3.4.
  • (B) A client with a large NG output who is receiving Kayexalate with a serum K+ of 5.5.
  • (C) A client with cardiac disease who is about to receive furosemide with a K+ of 3.5.
  • (D) A client with cardiac disease who is about to receive spironolactone with a K+ of 3.5.
6 >>A nurse knows that the choice of a topical antimicrobial for a client with burns is most influenced by: ?
  • (A) The bactericidal and fungicidal effectiveness of the agent.
  • (B) The form of the agent, whether it is a liquid or cream.
  • (C) The presence and extent of eschar formation.
  • (D) The ability of the agent to deliver uniform absorption.
7 >>Which condition should a community health nurse report to the health department? ?
  • (A) Confirmation of acid-fast bacilli.
  • (B) Pruritic eruptions from Sarcoptes scabiei (scabies).
  • (C) Borrelia burgdorferi (Lyme disease).
  • (D) Microsporum species (ringworm) in a child who is in preschool.

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8 >>Which client can be safely discharged to make room for clients suffering from a salmonella outbreak from a local food chain? ?
  • (A) An 18-year-old diagnosed 1 day ago with type 1 diabetes, who lives in the college dormitory.
  • (B) A 61-year-old with osteoarthritis who lives in a nursing home.
  • (C) A client who is 48 hours post-MI, with a WBC of 9,000/mm3 and a CK-MB of 25 ng/mL.
  • (D) A 70-year-old man with anemia and a Hct of 39% and O2 saturation of 90%.
9 >>What should a nurse monitor first when caring for a client who is undergoing treatment for pheochromocytoma? ?
  • (A) Pulse rate.
  • (B) Blood sugar.
  • (C) Blood pressure.
  • (D) ECG changes
10 >>Which aspect of care is most important for a client with diabetic neuropathy? ?
  • (A) Teach the client to inspect the feet using a mirror.
  • (B) Teach the client to wash feet, then pat dry.
  • (C) Have client moisturize feet with lotion to prevent dryness.
  • (D) Teach the client to cut toenails straight across.
11 >>A client with diabetic ketoacidosis has been treated with an insulin drip for the past 3 hours. For which imbalance is this client at greatest risk? ?
  • (A) Hypovolemia.
  • (B) Hypokalemia.
  • (C) Hyponatremia.
  • (D) Hypoglycemia.
12 >>Which symptom would a nurse most likely observe in a client with cholecystitis? ?
  • (A) Black stools.
  • (B) Nausea after a high-fat meal.
  • (C) Temperature of 104°F.
  • (D) Colicky left upper quadrant pain.
13 >>If a client's bowel sounds are absent, a nurse should listen for at least: ?
  • (A) 30 seconds.
  • (B) 60 seconds.
  • (C) 2 minutes.
  • (D) 3 minutes.


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14 >>What should be the first nursing action if an NG tube is not draining? ?
  • (A) Irrigate the tube.
  • (B) Reposition the client.
  • (C) Determine tube placement.
  • (D) Remove the tube and reinsert.
15 >>A nurse is observing a client for possible complications of postoperative peritonitis. Which manifestations are most indicative of peritonitis? Select all that apply. ?
  • (A) Hyperactive bowel sounds.
  • (B) Localized or diffuse pain.
  • (C) Abdominal rigidity.
  • (D) Shallow respirations.
16 >>A nurse would know that a client was experiencing chronic renal failure (CRF) if which signs or symptoms were present? ?
  • (A) Nausea and vomiting.
  • (B) Asterixis and ascites.
  • (C) Kussmaul's breathing and drowsiness.
  • (D) Pruritus and anemia.
17 >>A client has returned to the unit from surgery after having an arteriovenous (A-V) fistula created in the left arm. The client's teaching should include: Select all that apply. ?
  • (A) Protecting site by wearing an elastic sleeve.
  • (B) Squeezing a ball to increase vessel size.
  • (C) Expecting fistula to be used for the next dialysis treatment.
  • (D) Avoiding BP or drawing of blood samples from left arm.
18 >>After a cystectomy and construction of an ileal conduit, which complication should a nurse instruct a client to take special precautions to prevent? ?
  • (A) Paralytic ileus.
  • (B) Urinary calculi.
  • (C) Pyelonephritis.
  • (D) Mucus in the urine.
19 >>A nurse should teach a client with a Kock pouch urinary diversion to prevent urinary tract infection by: ?
  • (A) Avoiding people with upper respiratory infections (URI).
  • (B) Maintaining a daily fluid intake of 2 liters.
  • (C) Using sterile technique to change the appliance.
  • (D) Irrigating the stoma daily.
20 >>A client who is scheduled for surgery to correct a retinal detachment should be positioned: ?
  • (A) On the side opposite of the retinal detachment.
  • (B) Upright with face down.
  • (C) On the side of the retinal detachment.
  • (D) Prone with face supported by pillow ring.

21 >>A client has been admitted with mild symptoms of novel H1N1. Which family member is at greatest risk for developing the infection? ?
  • (A) The elderly grandmother.
  • (B) A 6-year-old daughter.
  • (C) The healthy 45-year-old spouse.
  • (D) The 13-year-old son with asthma.
22 >>Which respiratory change would a nurse see most often in a client with increased intracranial pressure? ?
  • (A) Nasal flaring and retractions.
  • (B) Slow, irregular respirations.
  • (C) Rapid, deep respirations.
  • (D) Paradoxical chest movements.
23 >>Leakage of spinal fluid is a potential neurosurgical complication. How should a nurse assess for this complication? ?
  • (A) Check for urine specific gravity greater than 1.030.
  • (B) Monitor for urine output greater than 5-10 L/day.
  • (C) Test all nasal and ear drainage for glucose.
  • (D) Test all spinal fluid from lumbar punctures for glucose.
24 >>A client is admitted to an ICU with a possible brain attack (stroke). Assessment findings consistent with a brain attack include: Select all that apply. ?
  • (A) Pronator drift.
  • (B) Facial droop.
  • (C) Slurred speech.
  • (D) Weakness of affected extremity.


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25 >>Which is the most common treatment for a client in addisonian crisis? ?
  • (A) IV normal saline and glucocorticoids.
  • (B) IV lactated Ringer's and packed cells.
  • (C) IV 5% dextrose in normal saline and dopamine.
  • (D) IV total parenteral nutrition (TPN) and insulin coverage.
26 >>When a client is on chemotherapy, for which manifestations of bone marrow depression should a nurse continuously assess? ?
  • (A) Night sweats and fatigue.
  • (B) Loss of skin turgor and weight loss.
  • (C) Low urine output and elevated BUN levels.
  • (D) Ecchymosis, weakness, and fatigue.
27 >>A client is admitted to a hospital in the terminal stage of illness. At this time, a nurse, who is planning end-of-life care, should recognize that the client is most likely to fear: ?
  • (A) The terminal diagnosis.
  • (B) Further chemotherapy.
  • (C) Being socially inadequate.
  • (D) Dying alone and in pain.
28 >>A complication of Buck's extension traction would be noted by a nurse if: ?
  • (A) Redness and purulent drainage appeared at the pin site.
  • (B) Toes of affected leg became dusky in color.
  • (C) Skin over the fracture site was flushed.
  • (D) Dorsiflexion developed in the affected foot.
29 >>Due to the extent of a client's fracture, a hip prosthesis is inserted. A nurse knows that the most serious complication of implant surgery is: ?
  • (A) Infection.
  • (B) Phlebitis.
  • (C) Urinary retention.
  • (D) Narcotic addiction.
30 >>A client returns from an operating room. The client's IV is running at 150 mL/hr; pulse is 90 and full; respirations are moist and wheezy. A nurse's initial action should be to: ?
  • (A) Speed up the IV and call the physician.
  • (B) Check the electrolyte levels.
  • (C) Report the IV rate to the charge nurse.
  • (D) Slow down the IV and call the physician.
31 >>During the first 24 hours after an above-the-knee amputation for vascular disease, nursing priority for stump care would be: ?
  • (A) Inspecting for redness and pressure points.
  • (B) Elevating to reduce edema.
  • (C) Cleansing with soap and water.
  • (D) Initiating fitting for prosthesis.
32 >>What are the emergency nursing actions for a client with a head injury due to a fall from a third-floor roof? ?
  • (A) Assess respirations, assess circulation, and assess level of consciousness.
  • (B) Stabilize C-spine, determine responsiveness, and begin chest compressions.
  • (C) Stabilize C-spine, assess airway, and assess respirations.
  • (D) Assess airway, assess respirations, and assess circulation.
33 >>As a nurse is assisting a client out of bed, which objective sign should indicate to the RN that the client is experiencing hypotension? ?
  • (A) Pupil response is sluggish to light.
  • (B) Orientation level changes.
  • (C) Pulse rate increases 20 beats per minute.
  • (D) Increased muscle rigidity in legs.

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34 >>Which group is considered high risk for acquiring the human immunodeficiency virus (HIV)? ?
  • (A) Women in menopause.
  • (B) Men who are 65 plus years of age.
  • (C) People who engage in oral sex.
  • (D) Children of women with multiple partners.
35 >>Victims of a disastrous earthquake have been transported to an emergency department. Which victim should the nurse assess first? ?
  • (A) A victim with second-degree burns on 25% of the body.
  • (B) A victim with facial lacerations.
  • (C) A victim with a Glasgow Coma Scale score of 15 who is hyperventilating.
  • (D) A victim with no heartbeat.
36 >>A client with a tracheotomy just pulled out the tracheal tube. Which action by a RN is correct? ?
  • (A) Call the respiratory therapist to reinsert the tracheal tube.
  • (B) Get a hemostat to open the tracheotomy, and then try to reinsert the tube.
  • (C) Give 100% O2 by mask over the stomal opening.
  • (D) Place mouth to stoma and ventilate every 5 seconds.
37 >>A client with COPD is scheduled for abdominal surgery. Arterial blood gases before surgery were: pH 7.36, PCO2 54, PO2 70. After surgery the ABGs were pH 7.35, PCO2 60, PO2 65 on 2 L of O2. Which action should a nurse take? ?
  • (A) Suction the client.
  • (B) Have the client cough and deep breathe.
  • (C) Administer sodium bicarbonate, per order.
  • (D) Position the client in high Fowler's.
38 >>Which symptom(s) would be expected if a pacemaker suddenly malfunctioned? ?
  • (A) Pulse rate higher than set.
  • (B) Shortness of breath, dizziness.
  • (C) Atrial fibrillation, hypotension.
  • (D) Premature ventricular contractions (PVCs).
39 >>What signs will a nurse observe in a client who is experiencing right-sided heart failure? Select all that apply. ?
  • (A) Bilateral ankle edema.
  • (B) Jugular venous distention (JVD).
  • (C) Crackles on auscultation.
  • (D) Enlarged liver.
40 >>When assessing a client for signs of early septic shock, a nurse should observe for: ?
  • (A) Cool, clammy skin.
  • (B) Warm, flushed skin.
  • (C) Decreased systolic blood pressure.
  • (D) Disseminated intravascular coagulation (DIC).

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