NCLEX Nursing Comprehensive Exam 300 Questions with Correct Answers Latest Update, Exams of Nursing

Download NCLEX Nursing Comprehensive Exam 300 Questions with Correct Answers Latest Update and more Exams Nursing in PDF only on Docsity! [Date] NCLEX Nursing Comprehensive Exam 300 Questions with Correct Answers Latest Update 1. An agitated, confused female client arrives in the emergency department. Her history includes type 1 diabetes mellitus, hypertension, and angina pectoris. Assessment reveals pallor, diaphoresis, headache, and intense hunger. A stat blood glucose sample measures 42 mg/dl, and the client is treated for an acute hypoglycemic reaction. After recovery, the nurse teaches the client to treat hypoglycemia by ingesting: A. 2 to 5 g of a simple carbohydrate. B. 10 to 15 g of a simple carbohydrate. C. 18 to 20 g of a simple carbohydrate. D. 25 to 30 g of a simple carbohydrate. 2. A female adult client with a history of chronic hyperparathyroidism admits to being noncompliant. Based on initial assessment findings, the nurse formulates the nursing diagnosis of Risk for injury. To complete the nursing diagnosis statement for this client, which “related-to” phrase should the nurse add? [Date] A. Related to bone demineralization resulting in pathologic fractures B. Related to exhaustion secondary to an accelerated metabolic rate C. Related to edema and dry skin secondary to fluid infiltration into the interstitial spaces D. Related to tetany secondary to a decreased serum calcium level 3. Nurse Joey is assigned to care for a postoperative male client who has diabetes mellitus. During the assessment interview, the client reports that he’s impotent and says he’s concerned about its effect on his marriage. In planning this client’s care, the most appropriate intervention would be to: A. Encourage the client to ask questions about personal sexuality. B. Provide time for privacy. C. Provide support for the spouse or significant other. D. Suggest referral to a sex counselor or other appropriate professional. 4. during a class on exercise for diabetic clients, a female client asks the nurse educator how often to exercise. The nurse educator advises the clients to exercise how often to meet the goals of planned exercise? A. At least once a week [Date] A. “The test needs to be repeated following a 12-hour fast.” B. “It looks like you aren’t following the prescribed diabetic diet.” C. “It tells us about your sugar control for the last 3 months.” D. “Your insulin regimen needs to be altered significantly.” 11. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia shown by which of the following? A. Muscle weakness B. Tremors C. Diaphoresis D. Constipation 12. Nurse Louie is developing a teaching plan for a male client diagnosed with diabetes insipidus. The nurse should include information about which hormone lacking in clients with diabetes insipidus? A. antidiuretic hormone (ADH). B. thyroid-stimulating hormone (TSH). C. follicle-stimulating hormone (FSH). D. luteinizing hormone (LH). 13. Early this morning, a female client had a subtotal thyroidectomy. During evening rounds, Nurse Tina assesses the client, who now has nausea, a temperature of 105° F [Date] (40.5° C), tachycardia, and extreme restlessness. What is the most likely cause of these signs? A. Diabetic ketoacidosis B. Thyroid crisis C. Hypoglycemia D. Tetany 14. For a male client with hyperglycemia, which assessment finding best supports a nursing diagnosis of Deficient fluid volume? A. Cool, clammy skin B. Distended neck veins C. Increased urine osmolarity D. Decreased serum sodium level 15. When assessing a male client with pheochromocytoma, a tumor of the adrenal medulla that secretes excessive catecholamine, Nurse April is most likely to detect: A. a blood pressure of 130/70 mm Hg. B. a blood glucose level of 130 mg/dl. C. bradycardia. D. a blood pressure of 176/88 mm Hg. 16. A male client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate? [Date] A. Infusing I.V. fluids rapidly as ordered B. Encouraging increased oral intake C. Restricting fluids D. Administering glucose-containing I.V. fluids as ordered 17. A female client has a serum calcium level of 7.2 mg/dl. During the physical examination, Nurse Noah expects to assess: A. Trousseau’s sign. B. Homans’ sign. C. Hegar’s sign. D. Goodell’s sign. 18. Which outcome indicates that treatment of a male client with diabetes insipidus has been effective? A. Fluid intake is less than 2,500 ml/day. B. Urine output measures more than 200 ml/hour. C. Blood pressure is 90/50 mm Hg. D. The heart rate is 126 beats/minute. 19. Jemma, who weighs 210 lb (95 kg) and has been diagnosed with hyperglycemia tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that she has large hands and a hoarse voice. Which of the following would the nurse suspect as a possible cause of the client’s hyperglycemia? [Date] B. Switch the client to a different oral antidiabetic agent. C. Prescribe an additional oral antidiabetic agent. D. Restrict carbohydrate intake to less than 30% of the total caloric intake. 25. During preoperative teaching for a female client who will undergo subtotal thyroidectomy, the nurse should include which statement? A. “The head of your bed must remain flat for 24 hours after surgery.” B. “You should avoid deep breathing and coughing after surgery.” C. “You won’t be able to swallow for the first day or two.” D. “You must avoid hyper extending your neck after surgery.” 26. Nurse Ronn is assessing a client with possible Cushing’s syndrome. In a client with Cushing’s syndrome, the nurse would expect to find: A. Hypotension. B. Thick, coarse skin. C. Deposits of adipose tissue in the trunk and dorsocervical area. D. Weight gain in arms and legs. [Date] 27. A male client with primary diabetes insipidus is ready for discharge on desmopressin (DDAVP). Which instruction should nurse Lina provide? A. “Administer desmopressin while the suspension is cold.” B. “Your condition isn’t chronic, so you won’t need to wear a medical identification bracelet.” C. “You may not be able to use desmopressin nasally if you have nasal discharge or blockage.”D. “You won’t need to monitor your fluid intake and output after you start taking desmopressin.” 28. Nurse Wayne is aware that a positive Chvostek’s sign indicate? A. Hypocalcaemia B. Hyponatremia C. Hypokalemia D. Hypermagnesemia 29. In a 29-year-old female client who is being successfully treated for Cushing’s syndrome, nurse Lyzette would expect a decline in: A. Serum glucose level. B. Hair loss. C. Bone mineralization. [Date] D. Menstrual flow. 30. A male client has recently undergone surgical removal of a pituitary tumor. Dr. Wong prescribes corticotropin (Acthar), 20 units I.M. q.i.d. as a replacement therapy. What is the mechanism of action of corticotropin? A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs. B. It interacts with plasma membrane receptors to inhibit enzymatic actions. C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism. D. It regulates the threshold for water reabsorption in the kidneys. 31. Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the doses: A. Onset to be at 2 p.m. and its peak to be at 3 p.m. [Date] D. felodipine (Plendil). 37. A male client with a history of hypertension is diagnosed with primary hyperaldosteronism. This diagnosis indicates that the client’s hypertension is caused by excessive hormone secretion from which of the following glands? A. Adrenal cortex B. Pancreas C. Adrenal medulla D. Parathyroid 38. Nurse Troy is aware that the most appropriate for a client with Addison’s disease? A. Risk for infection B. Excessive fluid volume C. Urinary retention D. Hypothermia 39. Acarbose (Precose), an alpha-glucosidase inhibitor, is prescribed for a female client with type 2 diabetes mellitus. During discharge planning, nurse Pauleen would be aware of the client’s need for additional teaching when the client states: A. “If I have hypoglycemia, I should eat some sugar, not dextrose.” [Date] B. “The drug makes my pancreas release more insulin.” C. “I should never take insulin while I’m taking this drug.” D. “It’s best if I take the drug with the first bite of a meal.” 40. A female client whose physical findings suggest a hyper pituitary condition undergoes an extensive diagnostic workup. Test results reveal a pituitary tumor, which necessitates a transsphenoidal hypophysectomy. The evening before the surgery, Nurse Jacob reviews preoperative and postoperative instructions given to the client earlier. Which postoperative instruction should the nurse emphasize? A. “You must lie flat for 24 hours after surgery.” B. “You must avoid coughing, sneezing, and blowing your nose.” C. “You must restrict your fluid intake.” D. “You must report ringing in your ears immediately.” 41. Dr. Kennedy prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a male client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide? A. “Be sure to take glipizide 30 minutes before meals.” B. “Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly.” [Date] C. “You won’t need to check your blood glucose level after you start taking glipizide.” D. “Take glipizide after a meal to prevent heartburn.” 42. For a diabetic male client with a foot ulcer, the physician orders bed rest, a wet-to-dry dressing change every shift, and blood glucose monitoring before meals and bedtime. Why are wet-to-dry dressings used for this client? A. They contain exudates and provide a moist wound environment. B. They protect the wound from mechanical trauma and promote healing. C. They debride the wound and promote healing by secondary intention. D. They prevent the entrance of microorganisms and minimize wound discomfort. 43. When instructing the female client diagnosed with hyperparathyroidism about diet, Nurse Gina should stress the importance of which of the following? A. Restricting fluids B. Restricting sodium C. Forcing fluids D. Restricting potassium [Date] D. “Discard the intermediate-acting insulin if it appears cloudy.” 49. Nurse Perry is caring for a female client with type 1 diabetes mellitus who exhibits confusion, light-headedness, and aberrant behavior. The client is still conscious. The nurse should first administer: A. I.M. or subcutaneous glucagon. B. I.V. bolus of dextrose 50%. C. 15 to 20 g of a fast-acting carbohydrate such as orange juice. D. 10 U of fast-acting insulin. 50. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following? A. Hypocalcaemia B. Hypercalcemia C. Hypokalemia D. Hyperkalemia 51) Knowing that gluconeogenesis helps to maintain blood levels, a nurse should: 1. Document weight changes because of fatty acid mobilization 2. Evaluate the patient’s sensitivity to low room temperatures because of decreased adipose tissue insulation [Date] 3. Protect the patient from sources of infection because of decreased cellular protein deposits4. Do all of the above 52. Clinical manifestations associated with a diagnosis of type 1 DM include all of the following except: 1. Hypoglycemia 2. Hyponatremia 3. Ketonuria 4. Polyphagia 53. The lowest fasting plasma glucose level suggestive of a diagnosis of DM is: 1. 90mg/dl 2. 115mg/dl 3. 126mg/dl 4. 180mg/dl 54. Rotation sites for insulin injection should be separated from one another by 2.5 cm (1 inch) and should be used only every: 1. Third day 2. Week 3. 2-3 weeks [Date] 4. 2-4 weeks 55. A clinical feature that distinguishes a hypoglycemic reaction from a ketoacidosis reaction is: 1. Blurred vision 2. Diaphoresis 3. Nausea 4. Weakness 56. Clinical nursing assessment for a patient with microangiopathy who has manifested impaired peripheral arterial circulation includes all of the following except: 1. Integumentary inspection for the presence of brown spots on the lower extremities 2. Observation for paleness of the lower extremities 3. Observation for blanching of the feet after the legs are elevated for 60 seconds 4. Palpation for increased pulse volume in the arteries of the lower extremities 57. The nurse expects that a type 1 diabetic may receive ____ of his or her morning dose of insulin preoperatively: 1. 10-20% 2. 25-40% [Date] the pump before each meal. 2. Is timed to release programmed doses of regular or NPH insulin into the bloodstream at specific intervals. 3. Is surgically attached to the pancreas and infuses regular insulin into the pancreas, which in turn releases the insulin into the bloodstream. 4. Continuously infuses small amounts of NPH insulin into the bloodstream while regularly monitoring blood glucose levels. 63. A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the ER. Which finding would a nurse expect to note as confirming this diagnosis? 1. Elevated blood glucose level and a low plasma bicarbonate 2. Decreased urine output 3. Increased respirations and an increase in pH 4. Comatose state 64. A client with DM demonstrates acute anxiety when first admitted for the treatment of hyperglycemia. The most appropriate intervention to decrease the client’s anxiety would be to: 1. Administer a sedative [Date] 2. Make sure the client knows all the correct medical terms to understand what is happening. 3. Ignore the signs and symptoms of anxiety so that they will soon disappear 4. Convey empathy, trust, and respect toward the client. 65. A nurse is preparing a plan of care for a client with DM who has hyperglycemia. The priority nursing diagnosis would be: 1. High risk for deficient fluid volume 2. Deficient knowledge: disease process and treatment 3. Imbalanced nutrition: less than body requirements 4. Disabled family coping: compromised. 66. A nurse is caring for a client admitted to the ER with DKA. In the acute phase the priority nursing action is to prepare to: 1. Administer regular insulin intravenously 2. Administer 5% dextrose intravenously 3. Correct the acidosis 4. Apply an electrocardiogram monitor. 67. A nurse performs a physical assessment on a client with type 2 DM. Findings include a fasting blood glucose of [Date] 120mg/dl, temperature of 101, pulse of 88, respirations of 22, and a bp of 140/84. Which finding would be of most concern of the nurse? 1. Pulse 2. BP 3. Respiration 4. Temperature 68. A client with type 1 DM calls the nurse to report recurrent episodes of hypoglycemia with exercise. Which statement by the client indicated an inadequate understanding of the peak action of NPH insulin and exercise? 1. “The best time for me to exercise is every afternoon.” 2. “The best time for me to exercise is right after I eat.” 3. “The best time for me to exercise is after breakfast.” 4. “The best time for me to exercise is after my morning snack.” 69. A client with diabetes mellitus visits a health care clinic. The client’s diabetes previously had been well controlled with glyburide (Diabeta), 5 mg PO daily, but recently the fasting blood glucose has been running 180-200mg/dl. Which medication, if added to the clients regimen, may have contributed to the hyperglycemia? [Date] 3. “I have to make sure that my current glucose monitor can be used at an alternate site.” 4. “Alternate site testing is unsafe if I am experiencing a rapid change in glucose levels.” 75. Which adaptations should the nurse caring for a client with diabetic ketoacidosis expect the client to exhibit? Select all that apply: 1. Sweating 2. Low PCO2 3. Retinopathy 4. Acetone breath 5. Elevated serum bicarbonate 76. All of the following statements about Hashimoto's disease are true accept: a. Many patients are entirely asymptomatic b. Not all patients become hypothyroid c. Most cases of obesity are attributable to Hashimoto's disease d. Hypothyroidism may be subclinical 77. The most common benign tumor of the pituitary gland is a: a. Glioma b [Date] Prolactin oma c. Carcinoid tumor d. Islet cell tumor . 78.12. Symptoms of polycystic ovarian syndrome (PCOS) may include all of the following except: a. Pelvic pain b. Acne, oily skin, and dandruff c. Infertility d. Weight Loss 79. Women with PCOS are at increased risk for all of the following except: a. Pregnancy b. Diabetes c. Cardiovascular disease d. Metabolic syndrome 80. All of the following organs may be affected by multiple endocrine neoplasia type 1 except: a. Parathyroid glands b. Kidneys c. Pancreas and Duodenum d. Pituitary gland 81. What is the treatment for hyperparathyroidism? a. Synthetic thyroid hormone b. Desiccated thyroid hormone [Date] c. Surgical removal of the glands d. Calcium and phosphate 82. The most common causes of death in people with cystic fibrosis is: a. Dehydration b. Opportunistic infection c. Lung cancer d. Respiratory failure 83. Untreated hyperthyroidism during pregnancy may result in all of the following except: a. Premature birth and miscarriage b. Low birth weight c. Autism d. Preeclampsia 84. Short stature and undeveloped ovaries suggest which of the following disorders: a. Polycystic ovarian syndrome b. Prolactinoma c. Grave's disease d. Turner syndrome 85. Endocrine disorders may be triggered by all of the following except: a. Stress b. Infection c. Chemicals in the food chain and environment [Date] c. ensuring the client is adequately hydrated d. explaining that the client will need lifelong hormone therapy 94. A nurse is caring for a client in the late stage of Ketoacidosis. The nurse notices that the clients’ breath has a characteristic fruity odor. Which of the following substances is responsible for the fruity smell in the breath? a. iodine b. acetone c.alcohol d. glucose 95. A nurse is caring for a client with Addison's disease. Which of the following nursing considerations should be employed when caring for this client? a. avoid sodium in the clients diet b. monitor and protect skin integrity c. document the specific gravity of urine d. monitor increases in blood pressure 96. A nurse is assigned to care for and monitor any complications in a 40 yr client with chronic diabetes. Which of the following is a macrovascular complication of diabetes? a. neuropathy b. retinopathy c. nephropathy d. Arteriosclerosis [Date] 97. A nurse is instructing a 50yr diabetic client about the steps to be followed for self admin of insulin. Which of the following instructions should be included in the client teaching? a. instruct client to avoid injections to the abdomen b. encourage client to always inject insulin in the same site c. inform client about the type of syringe to use d. encourage client to do active exercise after injection 98. A nurse is preparing a diet plan for a 50yr with simple goiter. Which of the following should be included in the client’s diet to decrease the enlargement of the thyroid gland? a. iodine b. sodium c. potassium d. calcium 99. A nurse is caring for a 60yr client affected with hypoparathyroidism. When checking the lab report, the nurse finds the clients’ calcium level was very low. Which of the following vitamins regulates the calcium level in the body? a. A b. D c. E d. K 100. A client presents to the emergency room with a history of Graves' disease. The client reports having symptoms for a few [Date] days, but has not previously sought or received any additional treatment. The client also reports having had a cold a few days back. Which of the following interventions would be appropriate to implement for this client, based on the history and current symptoms? Select all that apply. A. Administer aspirin B. Replace intravenous fluids C. Induce shivering D. Relieve respiratory distress E. Administer a cooling blanket 101. Select the member of the healthcare team that is paired with one of the main functions of this team member. A. Occupational therapist: Gait exercises B. Physical therapist: The provision of assistive devices to facilitate the activities of daily living C. Speech and language therapist: The treatment of swallowing disorders D. Case manager: Ordering medications and treatments 102. The recommended daily caloric intake for sedentary older men, active adult women and children is: A. 2400 calories [Date] A. Intramuscular medication administration B. Central line intravenous medication administration C. Donning gloves in the operating room D. Neonatal bathing E. Foley catheter insertion F. Emptying a urinary drainage bag 110. What is the ultimate purpose and goal of performance improvement activities? A. To increase efficiency B. To contain costs C. To improve processes D. To improve policies 111. The primary difference between practical nursing licensure and a nursing certification in an area of practice is that nursing licensure is: A. Insures competency and a nursing certification validates years of experience. B. Mandated by the American Nurses Association and a nursing certification are not. C. Is legally mandated by the states and a nursing certification is not. [Date] D. Renewed every two years and a nursing certification is renewed every five years. 112. What intervention is the best to relieve constipation during pregnancy? A. Increasing the consumption of fruits and vegetables B. Taking a mild over-the-counter laxative C. Lying flat on back when sleeping D. Reduction of iron intake by half or more 113. You are the RN working on 2 easts with adult medical surgical patients. Your unit has been instructed to perform a horizontal evacuation of your patients because there is a fire on 1 east. Where will you evacuate your patients to? A. 3 west B. 3 east C. 2 west D. 1 west 114. Which electrolyte is essential for enzyme and neurochemical activities? A. Chloride B. Magnesium C. Potassium D. Phosphate [Date] 115. Number the choices below to reflect the correct sequence for using a fire extinguisher: A. Aim at the base of the fire (2) B. Squeeze the handle (3) C. Sweep back and forth (4) D. Pull the pin (1) 116. As you are working you suspect that another licensed practical nurse is verbally and physically abusing a patient. What is the first thing that you will do? A. Nothing because you are not certain that it is occurring B. Nothing because you only suspect the abuse C. Call the police or the security department D. Report your suspicions to the charge nurse 117. Which of the following is the World Health Organization’s (WHO) definition of health? A. The absence of all illness and disease B. The absence of any comorbidity C. A holistic state of wellbeing D. A use of health promotion activities 118. Which nursing theorist believes that most patients are capable of performing self-care? [Date] A. The problem oriented medical system has a centralized part of the chart for interdisciplinary progress notes and the source oriented medical record has separate areas for each profession’s progress notes. B. The problem oriented medical system consists of narrative progress notes and the source oriented medical record uses SOAP. C. The source oriented medical system uses charting by exception and the source oriented medical record system does not. D. The source oriented medical system has a centralized part of the chart for interdisciplinary progress notes and the problem oriented medical record has separate areas for each profession’s progress notes. 125. Which of the following are necessary elements of malpractice? Select all that apply. A. A breach of duty B. An intentional act C. A nonintentional act D. Forseeability E. Patient harm F. Causation [Date] 126. Select the following fire emergency interventions in correct sequential order. A. Pull the fire alarm. (2) B. Contain the fire. (3) C. Rescue patients in danger.(1) D. Extinguish the fire. (4) 127. After your patient has been told that they have Cushing’s syndrome, the patient asks you what Cushing’s syndrome is. How would you respond to this patient’s question? A. “Cushing’s syndrome is a type of irritable bowel syndrome.” B. “Cushing’s syndrome is a disorder of the adrenal gland.” C. “Cushing’s syndrome often occurs among patients who are getting radiation therapy.” D. “Cushing’s syndrome often occurs among patients who are chemotherapy.” 128. You are preparing a sterile field for a operating room surgical procedure. When should you stop the preparation of this sterile field? A. When you have placed a sterile item only 1 inch and not 2 inches from the edge of the sterile field [Date] B. When you have completely finished the field. You cannot stop the set up until it is all done. C. When you have accidentally poured a sterile liquid into a container that was on the sterile field D. When you turn your upper body only away from the field because the surgeon calls your name 129. Avulsed teeth should be placed in: A. Normal saline. B. Cold water. C. Milk. D. Warm water. 130. You are working in a pediatric unit of the hospital and caring for a six year old boy who is hospitalized with cystic fibrosis and respiratory compromise. Which developmental task is the challenge for this boy at his age? A. To cough, deep breathe and improve respiratory status B. To establish industry and self confidence C. To develop autonomy and self-control D. To develop initiative and a sense of purpose [Date] Which statements about these states to state differences are accurate? Select all that apply. A. Nursing assistants can change catheter tubing’s but not catheters B. Nursing assistants can change sterile dressings C. Nursing assistants have an expanding role in many states. D. Nursing assistants cannot assess the physical status of the patients. E. Nursing assistants can apply topical medication lotions to intact skin. F. The trend is moving toward nurses only staffing patterns. 138. A cesarean mode of delivery, often utilized for various reasons, is the most common mode for females with which pelvic type? A. Android B. Anthropoid C. Gynecoid D. Platypelloid 139. How many bones make up a newborn’s skull? A. 8 B. 4 C. 6 [Date] D. 5 140. Your patient has just returned from the diagnostic imaging department and the doctor has told the patient that they have a Mallory-Weiss tear. The patient asks you what a MalloryWeiss tear is. How should you respond to this patient? A. “A Mallory-Weiss tear is a kind of diverticulitis.” B. “A Mallory-Weiss tear is an esophageal tear” C. “A Mallory-Weiss tear is a lacrimal gland disorder.” D. “A Mallory-Weiss tear is a tear that results from a peptic ulcer.” 141. You have been asked to speak at a new nursing assistants' orientation class about infection control and hand washing techniques. What would you include in this teaching? A. Demonstrate the correct one minute hand washing procedure using soap and running water. B. Demonstrate the correct 2 minute hand washing procedure using soap and running water. C. Using hot water so that the natural fats on the skins are emulsified with the soap. D. Using cold water so that the natural fats on the skins are emulsified with the soap. 142. How many minims are contained in 1 milliliter? [Date] Between 10-11 12 20 Between 15 or 16 143. Peri wound maceration occurs when: A. The skin around the wound softens and is damaged. B. Selecting a dressing individualized to the type of wound. C. Negative-pressure to “air out” the wound is used. D. The skin around the wound dries out and hardens. 144. Which patient is at greatest risk for cholelithiasis and choledocholithiasis? A. A 70-year-old male patient who has liver disease B. A 70-year-old female patient who has liver disease C. A 50-year-old male patient who is Asian D. A 50-year-old female patient who is Asian 145. Select the method of special precautions that is accurately paired with the personal protective equipment that is minimally required in order to prevent the spread of infection. A. Contact precautions: Gowns, gloves and mask [Date] 151. Which cardiac arrhythmia can be either acquired or congenital and can spontaneously disappear on its own or lead to ventricular fibrillation? A. Wenckebach B. Premature arterial contractions C. Torsade de pointes D. Premature ventricular contractions 152. Which quality assurance or performance improvement technique is used to identify underlying process flaws? A. Small group process B. Root cause analysis C. People at fault process D. Cause and effect 153. Which legal document will most likely contain the patient’s decision to not get cardiopulmonary resuscitation? A. Healthcare surrogacy B. Healthcare proxy C. Advance directives D. Durable power of attorney [Date] 154. Select the stage of a pressure ulcer that is accurately pair with its characteristics.A. Stage I: Only slight blanching when pressure is applied to the skin. B. Stage II: The epidermis and part of the dermis is damaged or lost. C. Stage III: The wound has slough and eschar. D. Stage IV: The loss of skin usually exposes some fat. 155. You have been assigned to care for a neonate who has been diagnosed with the Tetralogyof Fallot. The mother asks you what the Tetralogy of Fallot is. How should you respond to this mother? A. “The Tetralogy of Fallot is a congenital gastrointestinal disorder” B. “The Tetralogy of Fallot is a congenital cardiac disorder” C. “The Tetralogy of Fallot will affect the baby’s reflexes” D. “The Tetralogy of Fallot will affect the baby’s ability to breastfeed” 156. The protrusion of an internal organ through a wound or surgical incision is referred to as: A. Serosanguineous. B. Dehiscence. [Date] C . Eviscera tion. D. Exuded. 157. Which pain assessment scale is used exclusively for infants and neonates from 32 weeks of gestation to six months of age? A. The PEPPS pain scale B. The FLACC pain scale C. The Faces pain scale D. The CRIES pain scale 158. Which of the following is a hazard of immobility? A. Loss of bone calcium B. Increased vital capacity C. Venous vasoconstriction D. A positive nitrogen balances 159. How many daily feedings are considered normal for a newborn? A. 8 to 10 B. 10 to 12 C. 6 to 8 [Date] A. A liquid diet. B. Tilting the head back when swallowing. C. Tucking the chin in when swallowing. D. Following each bite with a drink of water. 167. How long can women lactate for? A. Indefinitely B. 12 to 18 months C. 18 to 24 months D. 30 to 36 months 168. Which anatomic malformations are associated with the Tetralogy of Fallot? A. A sub-aortic septal defect, an overriding aorta, left ventricular hypertrophy, and right ventricular outflow B. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and left ventricular outflow C. A sub-aortic septal defect, an overriding aorta, pulmonary atresia, and right ventricular outflow D. A sub-aortic septal defect, an overriding aorta, right ventricular hypertrophy, and right ventricular outflow 169. Your 32-year-old female patient has erythema marginatum, Sydenham chorea, epistaxis, abdominal pain, [Date] fever, cardiac problems and skin nodules. What disorder would you most likely suspect based on these signs and symptoms? A. Leukemia B. Histoplasmosis C. Pneumocystis jirovec D. Rheumatoid arthritis 170. Select the cranial nerve that is accurately paired with its name. A. The first cranial nerve: The trochlear nerve B. The twelfth cranial nerve: The hypoglossal nerve C. The tenth cranial nerve: The olfactory nerve D. The thirteenth cranial nerve: The auditory nerve 171. Round off these numbers to the nearest tenth: A. 5.5778 = _5.6________ B.1.027 = ___1______ C.62.999 = ____63_____ D. 55.123 = _55.1________ [Date] 96.676 = _96.7________ 172. The doctor has ordered 500 mg of a medication po once a day. The tablets on hand are labeled as 1 tablet = 250 mg. How many tablets will you administer to your patient? A. 1 Tablet B . 2 Tablet s C. 3 Tablets D. 4 Tablets 173. Which patient is exercising their right to autonomy in the context of patient rights? A. An 86-year-old female who remains independent in terms of the activities of daily living. B. An unemancipated 16-year-old who chooses to not have an intravenous line. C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves. D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful. 174. The mnemonic “PERLA” is useful for the assessment of the eyes. What does PERLA stand for? [Date] 180. How many calories per kilogram does an average full-term infant require when the infants is around 1-2 months old? A. 140 calories per kilogram per day B. 120 calories per kilogram per day C. 100 calories per kilogram per day D. 160 calories per kilogram per day 181. What are the six levels of consciousness from the most to the least responsive level of consciousness? Number all six using 1 as the most conscious and 6 as the least conscious. A. Obtunded B. Confused C. Lethargic D. Comatose E. Stuporous F . Aler t 182. Select the stage of shock that is accurately paired with its characteristic. A. The initial stage of shock: Hyperventilation occurs and the blood pH rises. B. The compensatory stage of shock: Hypoxia occurs and lactic acid rises. [Date] C. The progressive stage of shock: Histamine is released; fluid and proteins leak into surrounding tissues and the blood thickens. D. The refractory stage of shock: Potassium ions leak out; sodium ions build up and metabolic acidosis increases. 183. The doctor has ordered 1,000 cc of intravenous fluid every 8 hours. You will be using intravenous tubing that delivers 20 cc/drop. At what rate will you adjust the intravenous fluid flow? _____ gtts per minute. A. 38 gtts/min B . 42 gtts/mi n C. 50 gtts/min D. 40 gtts/min 184. During which stage of anesthesia is a patient most likely to experience involuntary motoractivity? A. Stage I B . Stag e II C. Stage III D. Stage VI [Date] 185. Select all of the risk factors that are associated with deep vein thrombosis. A. The use of oral contraceptives B. Type B and O blood C. Rh negative blood D. Obesity E. Nulliparity F. Leukemia 186. Most water leaves the body by way of the: A. Lungs. B. Intestines. C. Skin. D. Kidneys. 187. Which statement about glaucoma is true and accurate? A. Acute angle-closure glaucoma is an ocular emergency. B. Acute angle-closure glaucoma leads to the loss of peripheral vision and tunnel vision. C. Primary open-angle glaucoma leads to eye pain, nausea and vomiting, blurry vision and halos. D. Bubbles are implanted to protect the retina from the glaucoma. [Date] 194. As you are administering penicillin intravenously, you determine that the patient becomes hypotensive and with a bounding, rapid pulse rate. What is the first thing that you would do? A. Decrease the rate of the intravenous medication flow. B. Increase the rate of the intravenous medication flow. C. Call the doctor. D. Stop the intravenous flow. 195. Your patient has a blood potassium level of 9.2 mEq/L. What intervention should you anticipate for this patient? A. Intravenous potassium supplementation B. Intravenous calcium supplementation C. Kidney dialysis D. Parenteral nutrition 196. Which of the following foods enhances the absorption of an iron supplement? A. Orange juice B. Green beans C. Fortified Milk D. Baked potato [Date] 197. Select a myth or falsehood relating to pain, pain management and addiction.A. Addiction can be accurately predicted. B. Withdrawal, drug tolerance and physical dependence do not indicate addiction. C. Pain medications can be used with patients who have a substance abuse history. D. Addiction is signaled when the client employs deception and stockpiling. 198. What is the expected date of delivery for the woman who has had their last menstrual period on April 20th? A. January 20th B. January 27th C. January 29th D. January 31st 199. Clumsiness, difficulty running, climbing, and riding a bicycle are some of the earliest signs and symptoms of: A. Duchenne’s muscular dystrophy B. Osteomyelitis C. Talipes or clubfoot D. Septic joint, supportive arthritis [Date] 200. Which statement about adjuvant medications is true and accurate? A. Licensed practical nurses cannot administer adjuvant medications. B. Adjuvant medications are schedule 2 narcotics. C. Adjuvant medications are schedule 1 narcotics. D. Adjuvant medications can be purchased over the counter. 201. Which nonpharmacological technique entails the use of electronic monitoring equipmentwhile the patient controls basic bodily mechanisms? A. Meditation B. Visualization C . Biofeedb ack D. Chiropractic 202. Which of the following is considered normal for the neonate? A. Chest Circumference: 10 to 13 inches B. Length: 16 to 22 inches C. Weight: 1,500 to 4,000 g D. Head Circumference: 12.6 to 14.5 inches [Date] C. A greenstick fracture: This bends but does not fracture the bone. D. An avulsion fracture: A fracture that pulls a part of the bone from the tendon or ligament 209. Select the criteria that is accurately paired with its indication of birth weight or gestational age. A. Low birth weight: The neonate’s weight is less than 1,500 g at the time of delivery. B. Appropriate for gestational age: The neonate’s weight ranges from the 10th to the 90th percentile. C. Large for gestational age: The neonate’s weight is above the 99th percentile. D. Small for gestational age: The neonate’s weight is below the 20th percentile. 210. Diabetes insipidus is the result of: A. A diet high in sugar and carbohydrates. B. A complicated pregnancy. C. A disorder of the pancreas. D. A disorder of the pituitary gland. [Date] 211. Which position will you place your patient in when they are demonstrating the signs and symptoms of hypovolemic shock? A. The Trendelenburg positions B. The supine position C. The left lateral position D. The right lateral position 212. the fine, down-like hairs on the newborn’s ears, shoulders, lower back, and/or forehead are known as: A. Vernix. B . Lanug o. C. Milia. D. Vibrissae. 213. What is the softening and thinning of the cervix during labor known as? A. Dilation B. Symphysis C . Effacem ent D. Hyperplasia [Date] 214. Which of the following joints normally has 360-degree circumflexion? A. The knee B. The shoulder C. The elbow D. The finger tips 215. Which healthcare associated infection is the greatest risk for patients? A. Pneumonia B. Catheter related infections C. Intravenous line infections D. C. difficile 216. Select the nursing theorist who is accurately paired with the theory or model of nursing that they are credited with. A. The Twelve Nursing Problems: Faye Glenn Abdullah B. The Nature of Nursing: Imogene King C. The Goal Attainment Theory: Virginia Henderson D. The Interpersonal Relations Model: Hildegard Peplau [Date] C. Locked in syndrome D. Brain death 223.A client with diabetes experiences Somogyi's effect. To prevent this complication, the nurse should instruct the client to: A. Take his insulin each day at 1400 hours B. Engage in physical activity daily C. Increase the amount of regular insulin D. Eat a protein and carbohydrate snack at bedtime 224. A client with type 1 DM has a finger stick glucose level of 258mg/dl at bedtime. An order for sliding scale insulin exists. The nurse should: 1. Call the physician 2. Encourage the intake of fluids 3. Administer the insulin as ordered 4. Give the client ½ c. of orange juice 225. The physician orders 36 units of NPH and 12 units of regular insulin. The nurse plans to administer these drugs in 1 [Date] syringe. Identify the steps in this procedure by listing them in priority order. ANS: 1324 1. Inject air equal to NPH dose into NPH vial 2. Invert regular insulin bottle and withdraw regular insulin dose 3. Inject air equal to regular dose into regular dose 4. Invert NPH vial and withdraw NPH dose. 226. The insulin that has the most rapid onset of action would be: 1. Lente 2. Lispro 3. Ultralente 4. Humulin N 227. A client with DM states, “I cannot eat big meals; I prefer to snack throughout the day.” The nurse should carefully explain that the: 1. Regulated food intake is basic to control 2. Salt and sugar restriction is the main concern 3. Small, frequent meals are better for digestion 4. Large meals can contribute to a weight problem [Date] 228. A client with DM has an above-knee amputation because of severe peripheral vascular disease, Two days following surgery, when preparing the client for dinner, it is the nurse’s primary responsibility to: 1. Check the client’s serum glucose level 2. Assist the client out of bed to the chair 3. Place the client in a high-Fowlers position 4. Ensure that the client’s residual limb is elevated. 229. Which of the following nursing interventions should be taken for a client who complains of nausea and vomits one hour after taking his glyburide (DiaBeta)? 1. Give glyburide again 2. Give subcutaneous insulin and monitor blood glucose 3. Monitor blood glucose closely, and look for signs of hypoglycemia. 4. Monitor blood glucose, and assess for signs of hyperglycemia. 230. Which of the following chronic complications is associated with diabetes? 1. Dizziness, dyspnea on exertion, and coronary artery disease. 2. Retinopathy, neuropathy, and coronary artery disease 3. Leg ulcers, cerebral ischemic events, and pulmonary infarcts [Date] 237. Marlisa has been diagnosed with diabetes mellitus type 1. She asks Nurse Errol what this means. What is the best response by the nurse? Select all that apply. A. “Your alpha cells should be able to secrete insulin, but cannot.” B. “The exocrine function of your pancreas is to secrete insulin.” C. “Without insulin, you will develop ketoacidosis (DKA).” D. “The endocrine function of your pancreas is to secrete insulin.” E. “It means your pancreas cannot secrete insulin.” 238. Dr. Shrunk orders intravenous (IV) insulin for Rita, a client with a blood sugar of 563. Nurse AJ administers insulin lispro (Humalog) intravenously (IV). What does the best evaluation of the nurse reveal? Select all that apply. A. The nurse could have given the insulin subcutaneously. B. The nurse should have contacted the physician. C. The nurse should have used regular insulin (Humulin R). D. The nurse used the correct insulin. 239. Ben injects his insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal? A. The client will be very thirsty. B. The client will complain of nausea. [Date] C. The client will need to urinate. D. The client will have moist skin. 240. A clinical instructor teaches a class for the public about diabetes mellitus. Which individual does the nurse assess as being at highest risk for developing diabetes? A. The 50-year-old client who does not get any physical exercise B. The 56-year-old client who drinks three glasses of wine each evening C. The 42-year-old client who is 50 pounds overweight D. The 38-year-old client who smokes one pack of cigarettes per day 241. Steven John has type 1 diabetes mellitus and receives insulin. Which laboratory test will the nurse assess? A. Potassium B. AST (aspartate aminotransferase) C. Serum amylase D. Sodium 242. Jansen is receiving metformin (Glucophage). What will be the best plan of the nurse with regard to patient education with this drug? Select all that apply. A. It stimulates the pancreas to produce more insulin. B. It must be taken with meals. [Date] C. It decreases sugar production in the liver. D. It inhibits absorption of carbohydrates. E. It reduces insulin resistance. 243. Serafica who has diabetes mellitus type 1 is found unresponsive in the clinical setting. Which nursing action is a priority? Arrange from 1 to 4. 1. Treat the client for hypoglycemia. 2. Call the physician STAT. 3. Assess the vital signs. 4. Call a code. A. 1, 2, 3, 4 B. 1, 3, 2, 4 C. 3, 1, 2, 4 D. 4, 3, 2, 1 244. Serge who has diabetes mellitus is taking oral agents, and is scheduled for a diagnostic test that requires him to be NPO. What is the best plan of the nurse with regard to giving the client his oral medications? A. Administer the oral agents immediately after the test. B. Notify diagnostic department and request orders. [Date] B. A bivalve cast for a skeletal fracture C. A cerebral diuretic to decease intracranial pressure after a head injuryD. A chest tube to restore normal intrathoracic pressure after a pneumothorax 250. Which patient is at greatest risk for papilledema? A. An elderly patient with cataracts and macular degeneration B. A male patient with hypothyroidism C. A male patient with hyperthyroidism D. An adolescent with a closed head injury 251. Low birth weight is defined as a newborn’s weight of: A. 2500 grams or less at birth, regardless of gestational age. B. 1500 grams or less at birth, regardless of gestational age. C. 2500 grams or less at birth, according to gestational age. D. 1500 grams or less at birth, according to gestational age. 252. You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is: A. 8 to 12 months of age. B. 20 to 24 months of age. C. [Date] 16 to 20 months of age. D. 12 to 16 months of age. 253. What percentage of term newborns has a congenital heart disease due to environmental risk factors such as maternal alcoholism or drug ingestion? A. 2% to 4% B. 10% to 20% C. 5% to 10% D. 7% to 9% 254. Who should document care? A. The LPNs should document the care that they provided and the care that was given by unlicensed assistive staff. B. The registered nurse must document all of the care that is provided by the nursing assistants because they are accountable for all care. C. All staff members should document all of the care that they have provided. D. All staff should document all of the care that they have provided but the registered nurse, as the only independent practitioner, signs it. [Date] 555. Your 54-year-old male HIV positive patient has just expired. How should you care for this deceased patient? A. Bathe the patient but it is no longer necessary to use standard precautions because the patient is deceased. B. Place the patient in an negative pressure isolated area of the morgue. C. Double shroud the patient to prevent the spread of infection. D. Bathe the patient using the same standard precautions you used when he was alive. 256. Select the types of pain that are accurately coupled with an example of it. Select all that are correct. A. Radicular pain: A broken bone B. Central neuropathic pain: A spinal cord injury C. Peripheral neuropathic pain: A fractured leg bone D. Chronic pain: A stab wound to the chest E. Nocicetive pain: A laceration F. Radicular pain: A herniated spinal disc 257. Select the stage of viral hepatitis that is accurately paired with its characteristic(s). A. The prodromal stage: Jaundice begins B. The icteric stage: Flu like symptoms occur C. The prehistoric stage: Elevated urine bilirubin levels [Date] 263. The normal sodium level in the body is: A. 135 to 145 milliequivalents. B. 3 to 5 milliequivalents. C. 135 to 145 micro equivalents. D. 3 to 5 micro equivalents. 264. Which type of practice is most similar toresearch-based practice? A. Best practices B. Evidence based practice C. Benchmark practices D. Standard based practice 265. Select the ethical principles that are paired with their description. Select all that apply. A. Justice: Being honest and fair B. Beneficence: Do no harm C. Veracity: Treating all patients equally D. Self-determination: Facilitating patient choices E. Beneficence: Do good G. Nonmaleficence: Do no harm [Date] H. Self-determination: Accountability 266. You are caring for a patient with multiple-trauma. Of all of these injuries and conditions, it the most serious? A. A deviated trachea B. Gross deformity of a lower extremity C. Hematuria D. Decreased bowel sounds 267. Which statement about appendicitis is accurate and true? A. Appendicitis is more common among females than males. B. A high fiber diet is a risk factor associated with appendicitis. C. Left lower quadrant pain is suggestive of appendicitis. D. Mc Burney’s point tenderness is suggestive of appendicitis. 268. Which skin disorder most closely resembles and mimics dandruff? A. Lice infestation B. Scabies C. Dermatitis D. Acne vulgaris [Date] 269. You have just learned that another nurse was fired for taking photographs of patients without their permission using a cell phone and posting them on Face book. This nurse was fired because the nurse has: A. Violated the law B. Acted in a negligent manner C. Not completed the proper documentation D. Violated an ethical principle 270. Which of the following differentiates ulcerative colitis from Crohn’s disease? A. Crohn’s disease primarily affects the left colon and rectum and ulcerative colitis most often affects the right colon and distal ileum. B. Crohn’s disease presents with shallow ulcerations and ulcerative colitis presents with a cobblestone appearance of the mucosal lining. C. The extent of involvement is noncontiguous and segmented with Crohn’s disease and it is contiguous and diffuse with ulcerative colitis. D. Crohn’s disease has primarily mucosal involvement and it is transmural with ulcerative colitis. 271. Which atrioventricular heart block is also referred to as Mobitz II?