NCLEX-RN Quiz Part 1 (1-50)

NO.1 A depressed client is seen at the mental health center for follow-up after an attempted suicide 1 week ago. She has taken phenelzine sulfate (Nardil), a monoamine oxidase

(MAO) inhibitor, for 7 straight days. She states that she is not feeling any better. The nurse explains that the drug must accumulate to an effective level before symptoms are totally relieved. Symptom relief is expected to occur within:

A.            10 days

B.            2-4 weeks

C.            2 months

D.            3 months

NO.2 Cystic fibrosis is transmitted as an autosomal recessive trait. This means that:

A.            Mothers carry the gene and pass it to their sons

B.            Fathers carry the gene and pass it to their daughters

C.            Both parents must have the disease for a child to have the disease

D.            Both parents must be carriers for a child to have the disease

NO.3 A 24-year-old client presents to the emergency department protesting “I am God.” The nurse identifies this as a:

A.            Delusion

B.            Illusion

C.            Hallucination

D.            Conversion

NO.4 In acute episodes of mania, lithium is effective in 1-2 weeks, but it may take up to 4 weeks, or even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during the first few days or weeks of an acute episode to manage severe behavioral excitement and acute psychotic symptoms. In addition to the lithium, which one of the following medications might the physician prescribe?

A.            Diazepam (Valium)

B.            Haloperidol (Haldol)

C.            Sertraline (Zoloft)

D.            Alprazolam (Xanax)

NO.5 A violent client remains in restraints for several hours. Which of the following interventions is most appropriate while he is in restraints?

A.            Give fluids if the client requests them.

B.            Assess skin integrity and circulation of extremities before applying restraints and as they are removed.

C.            Measure vital signs at least every 4 hours.

D.            Release restraints every 2 hours for client to exercise.

NO.6 The pediatrician has diagnosed tinea capitis in an 8- year-old girl and has placed her on oral griseofulvin. The nurse should emphasize which of these instructions to the mother and/or child?

A.            Administer oral griseofulvin on an empty stomach for best results.

B.            Discontinue drug therapy if food tastes funny.

C.            May discontinue medication when the child experiences symptomatic relief.

D.            Observe for headaches, dizziness, and anorexia.

NO.7 A client with cirrhosis of the liver becomes comatose and is started on neomycin 300 mg q6h via nasogastric tube. The rationale for this therapy is to:

A.            Prevent systemic infection

B.            Promote diuresis

C.            Decrease ammonia formation

D.            Acidify the small bowel

NO.8 A 5-year-old has just had a tonsillectomy and adenoidectomy. Which of these nursing measures should be included in the postoperative care?

A.            Encourage the child to cough up blood if present.

B.            Give warm clear liquids when fully alert.

C.            Have child gargle and do toothbrushing to remove old blood.

D.            Observe for evidence of bleeding.

NO.9 An 80-year-old male client with a history of arteriosclerosis is experiencing severe pain in his left leg that started approximately 20 minutes ago. When performing the admission assessment, the nurse would expect to observe which of the following:

A.            Both lower extremities warm to touch with 2_pedal pulses

B.            Both lower extremities cyanotic when placed in a dependent position

 C.           Decreased or absent pedal pulse in the left leg

D.            The left leg warmer to touch than the right leg

NO.10 A 16-month-old infant is being prepared for tetralogy of Fallot repair. In the nursing assessment, which lab value should elicit further assessment and requires notification of physician?

A.            pH 7.39

B.            White blood cell (WBC) count 10,000 WBCs/mm3

C.            Hematocrit 60%

D.            Bleeding time of 4 minutes

NO.11 A male client is experiencing extreme distress. He begins to pace up and down the corridor. What nursing intervention is appropriate when communicating with the pacing client?

A.            Ask him to sit down. Speak slowly and use short, simple sentences.

B.            Help him to recognize his anxiety.

C.            Walk with him as he paces.

D.            Increase the level of his supervision.

NO.12 Prior to an amniocentesis, a fetal ultrasound is done in order to:

A.            Evaluate fetal lung maturity

B.            Evaluate the amount of amniotic fluid

C.            Locate the position of the placenta and fetus

D.            Ensure that the fetus is mature enough to perform the amniocentesis

NO.13 A 25-year-old client believes she may be pregnant with her first child. She schedules an obstetric examination with the nurse practitioner to determine the status of her possible pregnancy. Her last menstrual period began May 20, and her estimated date of confinement using Nagele’s rule is:

A.            March 27

B.            February 1

C.            February 27

D.            January 3

NO.14 A client is now pregnant for the second time. Her first child weighed 4536 g at delivery. The client’s glucose tolerance test shows elevated blood sugar levels. Because she only shows signs of diabetes when she is pregnant, she is classified as having:

A.            Insulin-dependent diabetes

B.            Type II diabetes mellitus

C.            Type I diabetes mellitus

D.            Gestational diabetes mellitus

NO.15 A 44-year-old female client is receiving external radiation to her scapula for metastasis of breast cancer.

Teaching related to skin care for the client would include which of the following?

A.            Teach her to completely clean the skin to remove all ointments and markings after each treatment

.B.           Teach her to cover broken skin in the treated area with a medicated ointment.

C.            Encourage her to wear a tight-fitting vest to support her scapula.

D.            Encourage her to avoid direct sunlight on the area being treated.

NO.16 The nurse is assisting a 4th-day postoperative cholecystectomy client in planning her meals for tomorrow’s menu. Which vitamin is the most essential in promoting tissue healing?

A.            Vitamin C

B.            Vitamin B1

C.            Vitamin D

D.            Vitamin A

NO.17 A 10-year-old client with a pin in the right femur is immobilized in traction. He is exhibiting behavioral changes including restlessness, difficulty with problem solving, inability to concentrate on activities, and monotony. Which of the following nursing implementations would be most effective in helping him cope with immobility?

A.            Providing him with books, challenging puzzles, and games as diversionary activities

B.            Allowing him to do as much for himself as he is able, including learning to do pin-site care under supervision

C.            Having a volunteer come in to sit with the client and to read him stories

D.            Stimulating rest and relaxation by gentle rubbing with lotion and changing the client’s position frequently

NO.18 In client teaching, the nurse should emphasize that fetal damage occurs more frequently with ingestion of drugs during:

A.            First trimester

B.            Second trimester

C.            Third trimester

D.            Every trimester

NO.19 On admission, the client has signs and symptoms of pulmonary edema. The nurse places the client in the most appropriate position for a client in pulmonary edema, which is:

A.            High Fowler

B.            Lying on the left side

C.            Sitting in a chair

D.            Supine with feet elevated

NO.20 A client has returned to the unit from the recovery room after having a thyroidectomy. The nurse knows that a major complication after a thyroidectomy is:

A.            Respiratory obstruction

B.            Hypercalcemia

C.            Fistula formation

D.            Myxedema

 NO.21 The nurse should facilitate bonding during the postpartum period. What should the nurse expect to observe in the taking-hold phase?

A.            Mother is concerned about her recovery.

B.            Mother calls infant by name.

C.            Mother lightly touches infant.

D.            Mother is concerned about her weight gain.

NO.22 A female client has just died. Her family is requesting that all nursing staff leave the room. The family’s religious leader has arrived and is ready to conduct a ceremony for the deceased in the room, requesting that only family members be present. The nurse assigned to the client should perform the appropriate nursing action, which might include:

A.            Inform the family that it is the hospital’s policy not to conduct religious ceremonies in client rooms

.B.           Refuse to leave the room because the client’s body is entrusted in the nurse’s care until it can be brought to the morgue.

C.            Tell the family that they may conduct their ceremony in the client’s room; however, the nurse must attend.

D.            Respect the client’s family’s wishes.

NO.23 A woman diagnosed with multiple sclerosis is disturbed with diplopia. The nurse will teach her to:

A.            Limit activities which require focusing (close vision)

B.            Take more frequent naps

C.            Use artificial tears

D.            Wear a patch over one eye

NO.24 One of the most reliable assessment tools for adequacy of fluid resuscitation in burned children is:

A.            Blood pressure

B.            Level of consciousness

C.            Skin turgor

D.            Fluid intake Answer: B Explanation:

NO.25 Which one of the following is considered a reliable indicator for assessing the adequacy of fluid resuscitation in a 3-year-old child who suffered partial- and fullthickness burns to 25% of her body?

A.            Urine output

B.            Edema

C.            Hypertension

D.            Bulging fontanelle

NO.26 A client with a diagnosis of C-4 injury has been stabilized and is ready for discharge. Because this client is at risk for autonomic dysreflexia, he and his family should be instructed to assess for and report:

A.            Dizziness and tachypnea

B.            Circumoral pallor and lightheadedness

C.            Headache and facial flushing

D.            Pallor and itching of the face and neck

NO.27 A client states to his nurse that “I was told by the doctor not to take one of my drugs because it seems to have caused decreasing blood cells.” Based on this information, which drug might the nurse expect to be discontinued?

A.            Prednisone

B.            Timolol maleate (Blocadren)

C.            Garamycin (Gentamicin)

D.            Phenytoin (Dilantin)

NO.28 A client has been taking lithium 300 mg po bid for the past two weeks. This morning her lithium level was 1 mEq/L. The nurse should:

A.            Notify the physician immediately

B.            Hold the morning lithium dose and continue to observe the client

C.            Administer the morning lithium dose as scheduled

D.            Obtain an order for benztropine (Cogentin)

NO.29 The primary focus of nursing interventions for the child experiencing sickle cell crisis is aimed toward:

A.            Maintaining an adequate level of hydration

B.            Providing pain relief

C.            Preventing infection

D.            O2 therapy

NO.30 Three weeks following discharge, a male client is readmitted to the psychiatric unit for depression. His wife stated that he had threatened to kill himself with a handgun. As the nurse admits him to the unit, he says, “I wish I were dead because I am worthless to everyone; I guess I am just no good.” Which response by the nurse is most appropriate at this time?

A.            “I don’t think you are worthless. I’m glad to see you, and we will help you.”

B.            “Don’t you think this is a sign of your illness?”

C.            “I know with your wife and new baby that you do have a lot to live for.”

D.            “You’ve been feeling sad and alone for some time now?”

NO.31 A 52-year-old client is scheduled for a small-bowel resection in the morning. In conjunction with other preoperative preparation, the nurse is teaching her diaphragmatic breathing exercises.

 She will teach the client to:

A.            Inhale slowly and deeply through the nose until the lungs are fully expanded, hold the breath a couple of seconds, and then exhale slowly through the mouth. Repeat 2-3 more times to complete the series every 1-2 hours while awake

B.            Purse the lips and take quick, short breaths approximately 18-20 times/min

C.            Take a large gulp of air into the mouth, hold it for 10-15 seconds, and then expel it through the nose. Repeat 4-5 times to complete the series

D.            Inhale as deeply as possible and then immediately exhale as deeply as possible at a rate of approximately 20-24 times/min

NO.32 The nurse enters the playroom and finds an 8-year-old child having a grand mal seizure. Which one of the following actions should the nurse take?

A.            Place a tongue blade in the child’s mouth.

B.            Restrain the child so he will not injure himself.

C.            Go to the nurses station and call the physician.

D.            Move furniture out of the way and place a blanket under his head.

NO.33 An 11-year-old boy has received a partial-thickness burn to both legs. He presents to the emergency room approximately 15 minutes after the accident in excruciating pain with charred clothing to both legs. What is the first nursing action?

A.            Apply ice packs to both legs.

B.            Begin debridement by removing all charred clothing from wound.

C.            Apply Silvadene cream (silver sulfadiazine).

D.            Immerse both legs in cool water.

NO.34 The nurse notes scattered crackles in both lungs and 1+ pitting edema when assessing a cardiac client. The physician is notified and orders furosemide (Lasix) 80 mg IV push stat. Which of the following diagnostic studies is monitored to assess for a major complication of this therapy?

A.            Serum electrolytes

B.            Arterial blood gases

C.            Complete blood count

D.            12-Lead ECG

NO.35 A psychiatric client has been stabilized and is to be discharged. The nurse will recognize client insight and behavioral change by which of the following client statements?

A.            “When I get home, I will need to take my medicines and call my therapist if I have any side effects or begin to hear voices.”

B.            “If I have any side effects from my medicines, I will take an extra dose of Cogentin.”

C.            “When I get home, I should be able to taper myself off the Haldol because the voices are gone now.”

D.            “As soon as I leave here, I’m throwing away my medicines. I never thought I needed them anyway.”

NO.36 A mother brings a 6-month-old infant and a 4-year-old child to the nursing clinic for routine examination and screening. Which of these plans by the nurse would be most successful?

A.            Examine the 4 year old first.

B.            Provide time for play and becoming acquainted.

C.            Have the mother leave the room with one child, and examine the other child privately.

D.            Examine painful areas first to get them “over with.”

NO.37 Diagnostic assessment findings for an infant with possible coarctation of the aorta would include:

A.            A third heart sound

B.            A diastolic murmur

C.            Pulse pressure difference between the upper extremities

D.            Diminished or absent femoral pulses

NO.38 During a client’s first postpartum day, the nurse assessed that the fundus was located laterally to the umbilicus.

This may be due to:

A.            Endometritis

B.            Fibroid tumor on the uterus

C.            Displacement due to bowel distention

D.            Urine retention or a distended bladder

NO.39 An 80-year-old widow is living with her son and daughter- in-law. The home health nurse

has been making weekly visits to draw blood for a prothrombin time test. The client is taking 5 mg of coumadin per day. She appears more debilitated, and bruises are noted on her face. Elder abuse is suspected. Which of the following are signs of persons who are at risk for abusing an elderly person?

A.            A family member who is having marital problems and is regularly abusing alcohol

B.            A person with adequate communication and coping skills who is employed by the family

C.            A friend of the family who wants to help but is minimally competent

D.            A lifelong friend of the client who is often confused

NO.40 A 32-year-old female client is being treated for Guillain- Barre syndrome. She complains of gradually increasing muscle weakness over the past several days. She has noticed an increased difficulty in ambulating and fell yesterday. When conducting a nursing assessment, which finding would indicate a need for immediate further evaluation?

A.            Complaints of a headache

B.            Loss of superficial and deep tendon reflexes

C.            Complaints of shortness of breath

D.            Facial paralysis

NO.41 Plans for the care of a client with an ulcer caused by emotional problems need to take into consideration that:

A.            His priority needs are limited to medical management

 B.           There is no real psychological basis for his illness

C.            The disorder is a threat to his physical well-being

D.            He is unable to participate in planning his care

NO.42 A 55-year-old man has recently been diagnosed with hypertension. His physician orders a low- sodium diet for him. When he asks, “What does salt have to do with high blood pressure?” the nurse’s initial response would be:

A.            “The reason is not known why hypertension is associated with a high-salt diet.”

B.            “Large amounts of salt in your diet can cause you to retain fluid, which increases your blood pressure.”

C.            “Salt affects your blood vessels and causes your blood pressure to be high.”

D.            “Salt is needed to maintain blood pressure, but too much causes hypertension.”

NO.43 A client is medically cleared for ECT and is tentatively scheduled for six treatments over a 2- week period. Her husband asks, “Isn’t that a lot?” The nurse’s best response is:

A.            “Yes, that does seem like a lot.”

B.            “You’ll have to talk to the doctor about that. The physician knows what’s best for the client.”

C.            “Six to 10 treatments are common. Are you concerned about permanent effects?”

D.            “Don’t worry. Some clients have lots more than that.”

NO.44 A client with IDDM is given IV insulin for a blood glucose level of 520 mg/dL. Life-threatening complications may occur initially, so the nurse will monitor him closely for serum:

A.            Chloride level of 99 mEq/L

B.            Sodium level of 136 mEq/L

C.            Potassium level of 3.1 mEq/L

D.            Potassium level of 6.3 mEq/L

NO.45 A 27-year-old primigravida at 32 weeks’ gestation has been diagnosed with complete placenta previa. Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:

A.            Dinitrophenylhydrazine

B.            Metachromatic stain

C.            Blood serum phenylalanine test

D.            Lecithin-sphingomyelin ratio

NO.46 One week ago, a 21-year-old client with a diagnosis of bipolar disorder was started on lithium 300 mg po qid. A lithium level is ordered. The client’s level is 1.3 mEq/L. The nurse recognizes that this level is considered to be:

A.            Within therapeutic range

B.            Below therapeutic range

C.            Above therapeutic range

D.            At a level of toxic poisoning

NO.47 When discussing the relationship between exercise and insulin requirements, a 26-year-old client with IDDM should be instructed that:

A.            When exercise is increased, insulin needs are increased

B.            When exercise is increased, insulin needs are decreased

C.      &nb