NCLEX RN Registered Nurses Quiz | Practice Test 08
1 >>A nurse should teach a client with angina about the common side effects of nitroglycerin, including: Select all that apply. ?
(A) Headache.
(B) Hypotension.
(C) Shock.
(D) Flushing.
2 >>The cardiac glycosides are essential in the therapy of a client with a myocardial infarction (MI). What should indicate to a nurse that a therapeutic response to this medication has been achieved? ?
(A) A 15% increase in apical pulse rate.
(B) A rise in CVP from 12 to 15 cm.
(C) Urine output 30 mL/hr (previously 40 to 50 mL/hr).
(D) Diminished crackles in the lungs.
3 >>To prevent a common adverse effect of prolonged use of phenytoin sodium (Dilantin), a client should be instructed to: ?
(A) Obtain an annual influenza vaccination.
(B) Drink at least 8 to 10 glasses of water daily.
(C) Eat a diet low in sodium and high in potassium.
(D) Report gum swelling or bleeding to the physician.
4 >>A client is being discharged and instructed to take furosemide (Lasix) every morning. A nurse tells the client to notify the health provider in the event of: ?
(A) Increased appetite.
(B) Disruption in sleep patterns.
(C) Increased urinary frequency.
(D) Leg cramps.
5 >>A client is planning a cruise and wants to use the scopolamine patch. Which frequent side effect should a nurse tell the client to expect? ?
(A) Irregular pulse.
(B) Dry mouth.
(C) Drop in blood pressure.
(D) Slurred speech.
6 >>A nurse instructs a client about taking an angiotensinconverting enzyme (ACE). The client should be warned to continue therapy even when which common side effect occurs? ?
(A) A dry, persistent cough.
(B) Exacerbation of heart failure.
(C) Sedation.
(D) Urinary incontinence.
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7 >>Which solution will a client most likely receive for fluid replacement in the first 24 hours after a burn injury that covers a large area? ?
(A) D5W.
(B) Lactated Ringer's.
(C) Dextran.
(D) Normal saline with added K+ .
8 >>A client is to receive oxycodone for acute pain. Adverse effects of opioid analgesics include: Select all that apply. ?
(A) Agitation.
(B) Constipation.
(C) Diarrhea.
(D) Vomiting
9 >>The treatment for a client suffering from hypovolemic shock following extensive burns will focus on controlling fluid loss and replacing fluid volume. A nurse should expect the client with burns to receive solutions that expand volume. To pull fluid from the interstitial spaces, which solutions should the nurse prepare? Select all that apply. ?
(A) A unit of whole blood.
(B) Hespan (hetastarch).
(C) Albumin.
(D) Lactated Ringer's.
10 >>During a blood transfusion, a client reports a throbbing headache, chills, and nausea. What ordered drugs should a nurse prepare for administration? Select all that apply. ?
(A) Epinephrine.
(B) Sodium bicarbonate.
(C) Theophylline.
(D) Solu-Cortef.
11 >>Upon discharge from a hospital, teaching for a client with osteoporosis about proper administration of calcium supplements should include: ?
(A) Taking calcium with vitamin D to increase absorption.
(B) Taking calcium citrate at meal time.
(C) Taking a calcium carbonate on an empty stomach.
(D) Taking calcium once a day.
12 >>A common symptom for Sjogren's syndrome, an autoimmune disorder in women, is dry eyes. A client asks a nurse what she can do for relief. Which suggestion given by the nurse would be correct for initial treatment? ?
(A) Use artificial tears 3 to 4 times a day.
(B) Use cyclosporine A (Restasis) ophthalmic drops.
(C) Schedule punctal occlusion.
(D) Use pilocarpine drops 3 times a day.
13 >>Epidural analgesia has been started for a client who is experiencing chronic pain that is unrelieved by other methods. Proper positioning of the client should include: Select all that apply. ?
(A) Side-lying, semi-Fowler's.
(B) Supine, head of bed flat, thin pillow.
(C) Side-lying, head of bed flat.
(D) High Fowler's, supine.
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14 >>The correct nursing actions when administering a vesicant chemotherapeutic agent are to: Select all that apply. ?
(A) Assess the site for swelling, redness, or presence of vesicles.
(B) Administer the drug by IV push.
(C) Give the drug slowly to minimize cardiac toxicity.
(D) Apply ice to the site if infiltration occurs.
15 >>A client reports unexplained weight loss and palpitations. Assessment findings include: exophthalmos, tachycardia, decreased thyroid-stimulating hormone (TSH), and increased triiodothyronine (T3) and thyroxine (T4). Which treatments would be most appropriate for this client? Select all that apply. ?
(A) Levothyroxine (Synthroid).
(B) Radioactive iodine.
(C) Propylthiouracil (PTU).
(D) Methimazole (Tapazole).
16 >>A client with diabetes is admitted with symptoms of diabetic ketoacidosis. Which type of insulin IV should a nurse expect to administer? ?
(A) NPH.
(B) Regular.
(C) Lantus.
(D) Intermediate- and short-acting mix.
17 >>Which combination of insulins, if ordered, should a nurse question? ?
(A) Regular and NPH.
(B) Regular and Humulin-N.
(C) Lantus and Lispro.
(D) Humulin-R and Lente.
18 >>When drawing up two different insulins in one syringe, which insulin should a nurse draw up first? ?
(A) Lispro.
(B) NPH.
(C) Lantus.
(D) Novolin 70/30.
19 >>When administering nitroglycerin to a client for chest pain, a nurse knows that a second dose can be safely given in: ?
(A) 5 minutes.
(B) 10 minutes.
(C) 15 minutes.
(D) 20 minutes.
20 >>A client is to start on an enteral tube feeding. What should a nurse do to make this as comfortable as possible for the client? ?
(A) Keep the head of the bed flat.
(B) Give the feeding as quickly as possible.
(C) Chill the feeding to improve the taste.
(D) Start the tube feeding slowly.
21 >>A physician orders furosemide (Lasix) for a client. What should a nurse tell the client to expect if the medication is having the desired effect? ?
(A) Elevated blood pressure.
(B) Elevated heart rate.
(C) More frequent urination.
(D) Nighttime urination will decrease.
22 >>When administering a beta blocker, a nurse should first: ?
(A) Take the client's temperature and heart rate.
(B) Place the client in an upright position before the client swallows the drug.
(C) Take the client's blood pressure and heart rate.
(D) Ask the client if there have been any adverse effects.
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23 >>Maintaining the infusion rate of total parenteral nutrition (TPN) is a nursing responsibility. If the infusion rate is too rapid, which side effects would the nurse observe? ?
(A) Serum sodium and potassium excess.
(B) Increased blood pressure and hyperglycemia.
(C) Hypoglycemia and low blood pressure.
(D) Potassium excess and congestive heart failure.
24 >>An older client complains that, in the past, some analgesics have caused urinary retention and constipation. Which analgesic should a nurse tell the client would not cause those problems? ?
(A) Lomotil.
(B) Morphine.
(C) Meperidine.
(D) Fentanyl.
25 >>A client weighing 70 kg has received 10 mg of morphine sulfate (MS) IM for pain rated at 5/10 postappendectomy. Which outcome should a nurse expect? ?
(A) Blood pressure and pulse will increase.
(B) Moderate pain will be relieved for 4 hours.
(C) Dose is insufficient for the client's size.
(D) Another dose will be needed in 2 hours.
26 >>A nursing student asks an RN why clients who have had myocardial infarctions (MIs) should receive medications intravenously rather than intramuscularly. The best response by the RN would be: ?
(A) "A larger dose of medication would be required to bring relief from chest pain."
(B) "The trauma from more frequent needle sticks would cause stress and increase the serum enzymes."
(C) "Tissue perfusion is poor and venous return is diminished following an MI, which affects results."
(D) "Intramuscular injections should be avoided if the client is also receiving an anticoagulant drug post-MI."
27 >>A client with a history of alcohol abuse returns to a postanesthesia care unit (PACU) following abdominal surgery. A nurse knows pain management may be more difficult because of: ?
(A) Potential diminished drug effects related to impaired liver blood flow.
(B) Possible drug tolerance requiring higher dosages to produce desired effects.
(C) The need for higher dosages of medications because of accelerated liver detoxification.
(D) Increased sensitivity to the anesthetic agents used, requiring higher dosages than normal.
28 >>A client, who is gravida 6, para 4, has blood drawn for routine prenatal first-trimester laboratory work. Upon reviewing the client's laboratory results, which result should a nurse consider within normal limits for this stage of pregnancy? ?
(A) Hemoglobin of 11 gm/dL.
(B) Hemoglobin of 18 gm/dL.
(C) Fasting serum glucose of 110 mg/dL.
(D) White blood cell count of 18,000/mL.
29 >>A client, who is gravida 1, para 0, is admitted with a diagnosis of severe preeclampsia. A nurse starts the client on intravenous magnesium sulfate. For which expected side effect should the nurse closely observe the client? ?
(A) Decreased urinary output.
(B) Hypersomnolence.
(C) Absence of knee jerk reflex.
(D) Decreased respiratory rate.
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30 >>A client, who is gravida 5, para 3, requests epidural anesthesia to relieve the discomfort of labor. After placement of her epidural and a loading dose of medication, which assessment should be a nurse's priority? ?
(A) Checking for cervical dilation.
(B) Placing the client in a supine position.
(C) Obtaining a fetal heart rate.
(D) Checking the client's blood pressure.
31 >>A client, who is gravida 2, para 1, is at 42 weeks' gestation with gestational diabetes that is controlled with diet. A physician orders an intravenous infusion of oxytocin for the induction of labor due to postdates pregnancy. When caring for the client who is receiving intravenous oxytocin, the nurse should monitor for: ?
(A) Maternal hypoglycemia.
(B) Fetal movement.
(C) Maternal hyperreflexia.
(D) Fetal bradycardia.
32 >>A client, who is gravida 2, para 1 at 14 weeks gestation, has a routine ultrasound that shows no fetal cardiac motion. Which medication should a nurse anticipate being ordered for this client? ?
(A) Magnesium sulfate.
(B) Clomiphene citrate (Clomid).
(C) Calcium gluconate.
(D) Misoprostol (Cytotec).
33 >>A client, who is gravida 1, para 0 with severe preeclampsia, has been on a magnesium sulfate infusion at 2 gm/hr for the past 6 hours. Her recent assessment reveals a blood pressure 150/88 mm Hg, pulse 88, respirations 16, 1+ deep tendon reflexes, with 80 mL of urinary output during the past hour. Which action should a nurse take? ?
(A) Decrease the infusion rate to 1 gm/hr and turn the client on her left side.
(B) Continue the infusion of magnesium sulfate and monitor the client's blood pressure.
(C) Stop the infusion of magnesium sulfate and notify the physician.
(D) Administer calcium gluconate IV push and notify the physician.
34 >>A client is having severe pain in the lower back and left leg. The client has sensation in all extremities, but is not moving the left leg. While waiting for a diagnostic x-ray, the client asks for pain medication. The correct response by the nurse would be to: ?
(A) Tell the client nothing can be given until a diagnosis is made.
(B) Give half of the usual dose of analgesic to minimize pain.
(C) Request order for an opioid to achieve maximum relief.
(D) Offer two acetaminophen tablets.
35 >>A 35-year-old man has been experiencing low back pain for 2 days with no relief from ibuprofen 400 mg 4 times daily. His pain is 7 on a scale of 1 to 10. An opioid is prescribed by a physician for pain. A nurse should know that the most important barrier to the use of opioids for pain is: ?
(A) Clients fear becoming addicted.
(B) Physicians' concern about drug abuse.
(C) Possible side effects of the drug.
(D) Lack of accurate pain screening tools.
36 >>A nurse enters a client's room to administer an IV medication and finds that the IV site is swollen, cool, and pale. The client reports discomfort at the insertion site. The nurse recognizes that this may be: ?
(A) Infiltration.
(B) Phlebitis.
(C) Sepsis.
(D) An allergic reaction.
37 >>Medications are absorbed differently with aging. A nurse should expect the dosage for an older adult to be: ?
(A) Doubled to achieve the same effectiveness.
(B) Reduced to prevent excessive systemic levels.
(C) Increased slightly to make up for diminished liver function.
(D) Monitored for reduced clinical effectiveness.
38 >>A client is scheduled for an inguinal herniorrhaphy in the morning and wants to know when to take the blood pressure pill before surgery. The best response by a nurse would be: ?
(A) "No medications are taken by mouth the morning of surgery."
(B) "Since you will not be taking anything by mouth after midnight, your drug won't be absorbed as well in the stomach."
(C) "You will probably take your medicine with a small amount of water in the morning as usual."
(D) "Your medication will be given to you intravenously just before surgery."
39 >>A client, who is newly diagnosed with tuberculosis, is being seen in a clinic. Current treatment includes isoniazid (INH) and rifampin (Rifadia). During the assessment, the client states that there has been blood in the urine since starting treatment. The best response by a nurse would be: ?
(A) "One of your medications changes the color of body fluids."
(B) "This is expected. There is nothing to worry about."
(C) "I will send a urine specimen to the lab for analysis."
(D) "Have you had any pain on urination or more frequent urination?"
40 >>A child is hospitalized for moderate respiratory distress caused by asthma. A physician orders a corticosteroid. A nurse knows that the main rationale for this medication is to: ?
