NCLEX-RN Practice #1

I found these Qs on this nursing blog
geocity nursing blog
Practice NCLEX-RN #1
1. The nurse working with clients from many different cultures recognizes that it is a PRIORITY to
A Refer to experts from those countries
B Speak another language
C Recognize personal attitudes and biases
D Learn about all the cultures
2. A nurse assessing the newborn of a diabetic mother understands that hypoglycemia is related to
A Maternal insulin dependency
B Disruption of fetal glucose supply
C Reduced glycogen reserves
D Pancreatic insufficiency
3. The nurse is caring for a 2 year-old who is being treated with chelation therapy, calcium disodium edetate, for lead poisoning. The nurse should be alert for which of the following side effects?
A Nephrotoxicity
B Hepatomegaly
C Neurotoxicity
D Ototoxicity
4. A 16 year-old boy is admitted for Ewing's sarcoma of the tibia. In discussing his care with the parents, the nurse understands that the initial treatment MOST often includes
A Surgical excision of the mass
B Bone marrow graft in the affected leg
C Amputation just above the tumor
D Radiation and chemotherapy
5. A pregnant client who is at 34 weeks gestation is diagnosed with a pulmonary embolism (PE). The nurse would anticipate the physician ordering
A Heparin infusion to maintain the PTT at 1.5-2.5 times the control value
B Heparin by subcutaneous injection to maintain the PTT at 1.5 times the control value
C Oral Coumadin therapy
D Heparin 5000 units subcutaneously b.i.d.
6. The nurse is performing an assessment of the motor function in a client with a head injury. The BEST technique is
A A firm touch to the trapezius muscle or arm
B Pinching any body part
C Gentle pressure on eye orbit
D Sternal rub
7. The nurse is caring for a client with Hodgkin's disease who will be receiving radiation therapy. The nurse recognizes that, as a result of the radiation therapy, the client is MOST likely to experience
A High fever
B Nausea
C Face and neck edema
D Night sweats
8. The nurse admits a two year-old child who has had a seizure. Which of the following statement by the child's parent would be important in determining the etiology of the seizure?
A "He has had an ear infection for the past two days."
B "He has been taking long naps for a week."
C "He seems to be going to the bathroom more frequently."
D "He has been eating more red meat lately."
9. A 3 year-old child has tympanostomy tubes in place. The child's mother asks the nurse if he can swim in the family pool. The BEST response from the nurse is
A "Your child may swim anywhere."
B "Your child may swim in your own pool but not in a lake or ocean."
C "Your child should not swim at all while the tubes are in place."
D "Your child may swim if he wears ear plugs."
10. The nurse is preparing to take a toddler's blood pressure for the first time. Which of the following actions should the nurse do FIRST?
A Permit handling the equipment before putting the cuff in place
B Explain that the procedure will help him to get well
C Explain that the blood pressure checks the heart pump
D Show a cartoon character with a blood pressure cuff
11. The nurse is talking with the family of an 18 month-old newly diagnosed with retinoblastoma. A PRIORITY in communicating with the parents is
A Discussing the need for genetic counseling
B Informing them that combined therapy is seldom effective
C Preparing for the child's permanent disfigurement
D Suggesting that total blindness may follow surgery
12. A client with atrial fibrillation is receiving digoxin (Lanoxin). It is MOST important for the nurse to
A Measure apical pulse prior to administration
B Maintain accurate intake and output records
C Record an EKG strip after administration
D Monitor blood pressure every 4 hours
13. A newborn weighed 7 pounds 2 ounces at birth. The nurse assesses her at home two days later and finds the weight to be 6 pounds 7 ounces. When the parents question this loss, the nurse explains that
A The newborn needs additional assessments
B A change to formula is indicated
C The mother should breast feed more often
D The loss is within normal limits
14. The nurse is teaching a client about precautions with Coumadin. The nurse should instruct the client to avoid foods with excessive amounts of
A Calcium
B Iron
C Vitamin E
D Vitamin K
15. A 42 year-old male client refuses to take propranolol hydrochloride (Inderal) as prescribed. Which of the following client statements from the assessment data is likely to explain his noncompliance?
A "I have difficulty falling asleep."
B "I often feel jittery."
C "I have problems with diarrhea."
D "I have diminished sexual function."
16. The nurse is caring for a client with renal calculi. Which physician order would be a PRIORITY?
A Intravenous antibiotics
B Push oral fluids and keep vein open
C Continuous warm compresses to the flank area
D Morphine sulfate as client controlled analgesia
17. A client is brought to the emergency room following a motor vehicle accident. When assessing the client one-half hour after admission, the nurse notes several physical changes. Which of the following changes would require the nurse's IMMEDIATE attention?
A Tracheal deviation
B Tachycardia
C Tachypnea
D Increased restlessness
18. When managing a client's pain, which of the following statements BEST describes the ethical considerations of the nurse?
A Nurses should not prejudge a client's pain using their own values
B The client's self-report is the most important consideration
C Cultural sensitivity is fundamental to pain management
D Clients have the right to have their pain relieved
19. The nurse must know that the MOST accurate oxygen delivery system available is
A The venturi mask
B Nasal cannula
C Partial non-rebreather mask
D Simple face mask
20. The clinic nurse is counseling a substance-abusing post partum client on the risks of continued cocaine use. In order to provide continuity of care, which of the following is a PRIORITY nursing diagnosis?
A Social isolation
B Ineffective coping
C Sexual dysfunction
D Altered parenting
21. A nurse admits a client transferred from the emergency room. The client, diagnosed with a myocardial infarction, is complaining of substernal chest pain, diaphoresis and nausea. The FIRST action by the nurse should be
A Start an IV
B Measure vital signs
C Order an EKG
D Administer pain medication as ordered
22. An 18 month-old child is on peritoneal dialysis in preparation for a renal transplant in the near future. When the nurse obtains the child's health history, the mother indicates that the child has not had the first measles, mumps, rubella (MMR) immunization. The PRIORITY nursing action is based on the understanding that
A The MMR vaccine should be given now, prior to the transplant
B Live vaccines are withheld in children with renal chronic illness
C An inactivated form of the vaccine can be given at any time
D The risk of vaccine side effects precludes giving the vaccine
23. The nurse is assessing a comatose client receiving gastric tube feedings. Which of the following assessments requires an IMMEDIATE response from the nurse?
A Decreased breath sounds in right lower lobe
B Urine output of 250 cc in past eight hours
C Decrease in bowel sounds
D Aspiration of a residual of 100cc of formula
24. The nurse is instructing a client with moderate persistent asthma on the proper method for using MDI's (multi-dose inhalers). Which medication should be administered FIRST?
A Steroid
B Beta agonist
C Anticholinergic
D Mast cell stabilizer
25. The nurse is administering an intravenous piggyback infusion of penicillin. Which of the following client statements would require the nurse's IMMEDIATE attention?
A "I am itching all over."
B "I have soreness and aching in my muscles."
C "I have a burning sensation when I urinate."
D "I have cramping in my stomach."
26. A new nurse manager is responsible for interviewing applicants for a staff nurse position. Which of the following interview strategies is the BEST?
A Ask personal information of each applicant to assure meeting of job demands
B Develop an interview guide for consistency in interviewing each candidate
C Vary the interview style for each candidate to learn different techniques
D Use simple questions requiring "yes" and "no" answers to gain definitive information
27. The nurse is caring for a client who has altered cerebral tissue perfusion related to a subarachnoid hemorrhage. To reduce the risk of rebleeding, the nurse should plan to
A Restrict visitors to immediate family
B Arouse the client frequently
C Apply warming blankets
D Keep client's hips flexed at 120 degrees
28. A client is receiving dexamethasone (Decadron) therapy. The nurse plans to monitor the client's
A Oxygen saturation every eight hours
B Neurological signs every two hours
C Urine output every four hours
D Blood glucose levels every twelve hours
29. Decentralized scheduling is used on a nursing unit. A CHIEF advantage of this management strategy is that it
A Conserves time for planning
B Frees the nurse manager from this task
C Considers client and staff needs
D Allows for requests for special privileges
30. The nurse is preparing to administer a tube feeding to a post-operative client. To accurately assess for a gastostomy tube placement, the PRIORITY is to
A Place the end of the tube in water to check for air bubbles
B Auscultate the abdomen while instilling 10 cc of air into the tube
C Measure the length of tubing from nose to epigastrium
D Retract the tube several inches to check for resistance
31. The nurse manager informs the nursing staff at morning report that the clinical nurse specialist will be conducting a research study on staff attitudes toward client care. All staff are invited to participate in the study if they wish. This affirms the ethical principle of
A Anonymity
B Beneficence
C Autonomy
D Justice
32. Which of the following BEST describes the goal of total quality management or continuous quality improvement in a health care setting?
A Conducting chart audits to find common errors
B Creating a flow chart to organize daily tasks
C Observing reactive service and product problem solving
D Improving processes in a proactive, preventive mode
33. As a part of a 9 pound newborn's assessment, the nurse performs a dextro-stick at one hour. The blood glucose level is 45 mg/dl. What FIRST action by the nurse is appropriate?
A Give oral glucose
B Repeat the test in 2 hours
C Check other laboratory findings
D Notify the pediatrician
34. The nurse is planning care for an 8 year-old child. Which of the following should be included in the plan of care?
A Provide frequent reassurance and cuddling
B Talk with the child and allow him to express his opinions
C Encourage child to engage in activities in the playroom
D Promote independence in activities of daily living
35. You are caring for a client with Parkinson's disease who has developed hallucinations. Which of the following medications that the client is receiving may have been a contributing factor?
A Baclofen
B Benadryl
C Cogentin
D L-Dopa
36. A client with angina has been instructed about the use of sublingual nitroglycerin. Which of the following statements made to the nurse indicates a need for FURTHER teaching?
A "I will rest briefly right after taking one tablet."
B "I'll call the doctor if pain continues after 3 tablets 5 minutes apart."
C I understand that the medication should be kept in the dark bottle."
D "I can take 2-3 tablets at once if I have severe pain."
37. A five year-old has been rushed to the emergency room several hours after acetaminophen poisoning. Which of the following laboratory results should receive PRIORITY attention by the nurse?
A Bilirubin
B Profile 2
C Neutrophils
D Sedimentation rate
38. When teaching a client about the use of sublingual nitroglycerin, the nurse should emphasize that the MOST common side effect is
A Headache
B Depression
C Dry mouth
D Anorexia
39. While assessing the vital signs in children, the nurse should know that the apical heart rate is preferred until the radial pulse can be accurately assessed at about
A Three years of age
B One year of age
C Four years of age
D Two years of age
40. The nurse is teaching parents of a 7 month-old about adding table foods. Which of the following is an APPROPRIATE finger food?
A Sliced bananas
B Popcorn
C Whole grapes
D Hot dog pieces