Thursday, August 11, 2016

NCLEX Practice Exam 2 (40 Items)

Another set of 40-item NCLEX exam. These questions can help you sharpen your critical thinking skills and prepare you for the big exam day!



Guidelines

Follow the guidelines below to make the most out of this exam:
  • Read each question carefully and choose the best answer.
  • Answers and rationales are given below. Be sure to read them.
NCLEX Practice Exam 2 (40 Items)
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1. A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct.

1. Coumadin
2. Finasteride
3. Celebrex
4. Catapres
5. Habitrol
6. Clofazimine


2. A nurse is reviewing a patient’s PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct.

1. Cipro
2. Sulfonamide
3. Noroxin
4. Bactrim
5. Accutane
6. Nitro-dur


3. A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient’s medication does not cause urine discoloration?

1. Sulfasalazine
2. Levodopa
3. Phenolphthalein
4. Aspirin


4. You are responsible for reviewing the nursing unit’s refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator’s contents?

1. Corgard
2. Humulin (injection)
3. Urokinase
4. Epogen (injection)


5. A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?

1. IgA
2. IgD
3. IgE
4. IgG

6. A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?

1. Immediately see a social worker
2. Start prophylactic AZT treatment
3. Start prophylactic Pentamidine treatment
4. Seek counseling


7. A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?

1. Atherosclerosis
2. Diabetic nephropathy
3. Autonomic neuropathy
4. Somatic neuropathy


8. You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?

1. Multiple sclerosis
2. Anorexia nervosa
3. Bulimia
4. Systemic sclerosis


9. A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?

1. Diverticulosis
2. Hypercalcaemia
3. Hypocalcaemia
4. Irritable bowel syndrome


10. Rhogam is most often used to treat____ mothers that have a ____ infant.

1. RH positive, RH positive
2. RH positive, RH negative
3. RH negative, RH positive
4. RH negative, RH negative


11. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU?

1. A Guthrie test can check the necessary lab values.
2. The urine has a high concentration of phenylpyruvic acid
3. Mental deficits are often present with PKU.
4. The effects of PKU are reversible.


12. A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?

1. Onset of pulmonary edema
2. Metabolic alkalosis
3. Respiratory alkalosis
4. Parkinson’s disease type symptoms


13. A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is?

1. Let others know about the patient’s deficits.
2. Communicate with your supervisor your patient safety concerns.
3. Continuously update the patient on the social environment.
4. Provide a secure environment for the patient.


14. A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient?

1. Deep breathing techniques to increase O2 levels.
2. Cough regularly and deeply to clear airway passages.
3. Cough following bronchodilator utilization
4. Decrease CO2 levels by increased oxygen take output during meals.


15. A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?

1. Slow pulse rate
2. Weight gain
3. Decreased systolic pressure
4. Irregular WBC lab values


16. A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?

1. Simian crease
2. Brachycephaly
3. Oily skin
4. Hypotonicity


17. A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered?

1. Streptokinase
2. Atropine
3. Acetaminophen
4. Coumadin


18. A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?”

1. Green vegetables and liver
2. Yellow vegetables and red meat
3. Carrots
4. Milk


19. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans?

1. S. pneumoniae
2. H. influenzae
3. N. meningitidis
4. Cl. difficile


20. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is.

1. The life span of RBC is 45 days.
2. The life span of RBC is 60 days.
3. The life span of RBC is 90 days.
4. The life span of RBC is 120 days.


21. A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning began for this patient?

1. Following surgery
2. Upon admit
3. Within 48 hours of discharge
4. Preoperative discussion


22. A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?

1. Trust vs. mistrust
2. Initiative vs. guilt
3. Autonomy vs. shame
4. Intimacy vs. isolation


23. A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?

1. Trust vs. mistrust
2. Initiative vs. guilt
3. Autonomy vs. shame
4. Intimacy vs. isolation


24. A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in?

1. Trust vs. mistrust
2. Initiative vs. guilt
3. Autonomy vs. shame
4. Intimacy vs. isolation


25. A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?

1. 11 year old male – 90 b.p.m, 22 resp/min. , 100/70 mm Hg
2. 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg
3. 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg
4. 6 year old female- 100 b.p.m., 26 resp/min., 90/70 mm Hg


26. When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?

1. Elavil
2. Calcitonin
3. Pergolide
4. Verapamil


27. Which of the following conditions would a nurse not administer erythromycin?

1. Campylobacteriosis infection
2. Legionnaire’s disease
3. Pneumonia
4. Multiple Sclerosis


28. A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?

1. Decreased HR
2. Paresthesias
3. Muscle weakness of the extremities
4. Migraines


29. A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?

1. Vomiting
2. Extreme Thirst
3. Weight gain
4. Acetone breath smell


30. A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?

1. Increased appetite
2. Vomiting
3. Fever
4. Poor tolerance of light


31. A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?

1. Yersinia pestis
2. Helicobacter pylori
3. Vibrio cholerae
4. Haemophilus aegyptius


32. A nurse if reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition?

1. Borrelia burgdorferi
2. Streptococcus pyogenes
3. Bacillus anthracis
4. Enterococcus faecalis


33. A fragile 87 year-old female has recently been admitted to the hospital with increased confusion and falls over last 2 weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?

1. FBC (full blood count)
2. ECG (electrocardiogram)
3. Thyroid function tests
4. CT scan


34. A 84 year-old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?

1. FBC (full blood count)
2. ECG (electrocardiogram)
3. Thyroid function tests
4. CT scan


35. A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?

1. Blood sugar check
2. CT scan
3. Blood cultures
4. Arterial blood gases


36. A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?

1. Blood sugar check
2. CT scan
3. Blood cultures
4. Arterial blood gases


37. A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?

1. The age of the child
2. The child ability to understand instruction.
3. The overall mental and physical abilities of the child.
4. Frequent attempts with positive reinforcement.


38. A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 20 minutes. Which of the following is the most important instruction the nurse can give the parent?

1. This too shall pass.
2. Take the child immediately to the ER
3. Contact the Poison Control Center quickly
4. Give the child syrup of ipecac


39. A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate?

1. Gluteus maximus
2. Gluteus minimus
3. Vastus lateralis
4. Vastus medialis


40. A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 year-old boy who is non-verbal. This child does not have on any identification. What should the nurse do?

1. Contact the provider
2. Ask the child to write their name on paper.
3. Ask a coworker about the identification of the child.
4. Ask the father who is in the room the child’s name.




Answers and Rationale

1. Answer: 1. and Answer: 2.

Both contraindicated with pregnancy.

2. Answer: 6. Nitro-dur

All of the others have can cause photosensitivity reactions.

3. Answer: 4. Aspirin

All of the others can cause urine discoloration.

4. Answer: 1. Corgard

Corgard could be removed from the refrigerator.

5. Answer: 4. IgG

IgG is the only immunoglobulin that can cross the placental barrier.

6. Answer: 2. Start prophylactic AZT treatment

AZT treatment is the most critical intervention.

7. Answer: 3. Autonomic neuropathy

Autonomic neuropathy can cause inability to urinate.

8. Answer: 2. Anorexia nervosa

All of the clinical signs and symptoms point to a condition of anorexia nervosa.

9. Answer: 2. Hypercalcaemia

Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.

10. Answer: 3. RH negative, RH positive

Rhogam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.

11. Answer: 4. The effects of PKU are reversible.

The effects of PKU stay with the infant throughout their life.

12. Answer: 4. Parkinson’s disease type symptoms

Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.

13. Answer: 4. Provide a secure environment for the patient.

This patient’s safety is your primary concern.

14. Answer: 3. Cough following bronchodilator utilization

The bronchodilator will allow a more productive cough.

15. Answer: 2. Weight gain

Weight gain is associated with CHF and congenital heart deficits.

16. Answer: 3. Oily skin

The skin would be dry and not oily.

17. Answer: 1. Streptokinase

Streptokinase is a clot busting drug and the best choice in this situation.

18. Answer: 1. Green vegetables and liver

Green vegetables and liver are a great source of folic acid.

19. Answer: 4. Cl. difficile

Cl. difficile has not been linked to meningitis.

20. Answer: 4. The life span of RBC is 120 days.

RBC’s last for 120 days in the body.

21. Answer: 2. Upon admit

Discharge education begins upon admit.

22. Answer: 2. Initiative vs. guilt

Initiative vs. guilt- 3-6 years old

23. Answer: 3. Autonomy vs. shame

Autonomy vs Shame- 12-18 months old

24. Answer: 4. Intimacy vs. isolation

Intimacy vs. isolation- 18-35 years old

25. Answer: 2. 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg

HR and Respiration's are slightly increased. BP is down.

26. Answer: 1. Elavil

Elavil is a tricyclic antidepressant.

27. Answer: 4. Multiple Sclerosis

Erythromycin is used to treat conditions A-C.

28. Answer: 4. Migraines

Answer choices A-C were symptoms of acute hyperkalemia.

29. Answer: 3. Weight gain

Weight loss would be expected.

30. Answer: 1. Increased appetite

Loss of appetite would be expected.

31. Answer: 4. Haemophilus aegyptius

Answer: 1 is linked to Plague, Answer: 2 is linked to peptic ulcers, Answer: 3 is linked to Cholera.

32. Answer: 1. Borrelia burgdorferi

Answer: 2 is linked to Rheumatic fever, Answer: 3 is linked to Anthrax, Answer: D is linked to Endocarditis.

33. Answer: 4. CT scan

A CT scan would be performed for further investigation of the hemiparesis.

34. Answer: 3. Thyroid function tests

Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function.

35. Answer: 3. Blood cultures

Blood cultures would be performed to investigate the fever and rash symptoms.

36. Answer: 1. Blood sugar check

With a history of diabetes, the first response should be to check blood sugar levels.

37. Answer: 3. The overall mental and physical abilities of the child.

Age is not the greatest factor in potty training. The overall mental and physical abilities of the child is the most important factor.

38. Answer: 3. Contact the Poison Control Center quickly

The poison control center will have an exact plan of action for this child.

39. Answer: 3. Vastus lateralis

Vastus lateralis is the most appropriate location.

40. Answer: 4. Ask the father who is in the room the child’s name.

In this case you are able to determine the name of the child by the father’s statement. You should not withhold the medication from the child following identification.


See Also
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