NCLEX-RN Practice Exam Part 2

This is part 2 of NCLEX-RN Practice exam series.

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1.      The client presents to the clinic with a serum cholesterol of 275mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?

a.       Report muscle weakness to the physician.

b.      Allow six months for the drug to take effect.

c.       Take the medication with fruit juice.

d.      Ask the doctor to perform a complete blood count before starting the medication.

2.      The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:

a.       Utilize an infusion pump

b.      Check the blood glucose level

c.       Place the client in Trendelenburg position

d.      Cover the solution with foil

3.      The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor?

a.       Blood pressure of 126/80

b.      Blood glucose of 110mg/dL

c.       Heart rate of 60bpm

d.      Respiratory rate of 30 per minute

4.      The client admitted with angina is given a prescription for nitroglycerine. The client should be instructed to:

a.       Replenish his supply every 3 months

b.      Take one every 15 minutes if pain occurs

c.       Leave the medication in the brown bottle

d.      Crush the medication and take with water

5.      The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?

a.       Macaroni and cheese

b.      Shrimp with rice

c.       Turkey breast

d.      Spaghetti

6.      The client is admitted with left-sided congestive heart failure. In assessing the client for edema, the nurse should check the:

a.       Feet

b.      Neck

c.       Hands

d.      Sacrum

7.      The nurse is checking the client’s central venous pressure. The nurse should place the zero of the manometer at the:

a.       Phlebostatic axis

b.      PMI

c.       Erb’s point

d.      Tail of Spence

8.      The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:

a.       Question the order

b.      Administer the medications

c.       Administer separately

d.      Contact the pharmacy

9.      The best method of evaluating the amount of peripheral edema is:

a.       Weighing the client daily

b.      Measuring the extremity

c.       Measuring the intake and output

d.      Checking for pitting

10.  A client with vaginal cancer is being treated with a radioactive vaginal implant. The client’s husband asks the nurse if he can spend the night with his wife. The nurse should explain that:

a.       Overnight stays by family members is against hospital policy.

b.      There is no need for him to stay because staffing is adequate.

c.       His wife will rest much better knowing that he is at home.

d.      Visitation is limited to 30 minutes when the implant is in place.

11.  The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client?

a.       Roast beef sandwich, potato chips, pickle spear, iced tea

b.      Split pea soup, mashed potatoes, pudding, milk

c.       Tomato soup, cheese toast, Jello, coffee

d.      Hamburger, baked beans, fruit cup, iced tea

12.  The physician has prescribed Novalog insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?

a.       "I will make sure I eat breakfast within 10 minutes of taking my insulin."

b.      "I will need to carry candy or some form of sugar with me all the time."

c.       "I will eat a snack around three o’clock each afternoon."

d.      "I can save my dessert from supper for a bedtime snack."

13.  The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath is recommended for the first 2 weeks of life because:

a.       New parents need time to learn how to hold the baby.

b.      The umbilical cord needs time to separate.

c.       Newborn skin is easily traumatized by washing.

d.      The chance of chilling the baby outweighs the benefits of bathing.

14.  A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:

a.       Treat iron-deficiency anemia caused by chemotherapeutic agents

b.      Create a synergistic effect that shortens treatment time

c.       Increase the number of circulating neutrophils

d.      Reverse drug toxicity and prevent tissue damage

15.  A 4-month-old is brought to the well-baby clinic for immunization. In addition to the DPT and polio vaccines, the baby should receive:

a.       Hib titer

b.      Mumps vaccine

c.       Hepatitis B vaccine

d.      MMR

16.  The physician has prescribed Nexium (esomeprazole) for a client with erosive gastritis. The nurse should administer the medication:

a.       30 minutes before meals

b.      With each meal

c.       In a single dose at bedtime

d.      30 minutes after meals

17.  A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take?

a.       Call security for assistance and prepare to sedate the client.

b.      Tell the client to calm down and ask him if he would like to play cards.

c.       Tell the client that if he continues his behavior he will be punished.

d.      Leave the client alone until he calms down.

18.  When the nurse checks the fundus of a client on the first postpartum day, she notes that the fundus is firm, is at the level of the umbilicus, and is displaced to the right. The next action the nurse should take is to:

a.       Check the client for bladder distention

b.      Assess the blood pressure for hypotension

c.       Determine whether an oxytocic drug was given

d.      Check for the expulsion of small clots

19.  A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood-tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are consistent with a diagnosis of:

a.       Pneumonia

b.      Reaction to antiviral medication

c.       Tuberculosis

d.      Superinfection due to low CD4 count

20.  The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client’s history should be reported to the doctor?

a.       Diabetes

b.      Prinzmetal’s angina

c.       Cancer

d.      Cluster headaches

21.  The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes:

a.       Pain on flexion of the hip and knee

b.      Nuchal rigidity on flexion of the neck

c.       Pain when the head is turned to the left side

d.      Dizziness when changing positions

22.  The client with Alzheimer’s disease is being assisted with activities of daily living when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is aware that the client is exhibiting:

a.       Agnosia

b.      Apraxia

c.       Anomia

d.      Aphasia

23.  The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:

a.       Chronic fatigue syndrome

b.      Normal aging

c.       Sundowning

d.      Delusions

24.  The client with confusion says to the nurse, "I haven’t had anything to eat all day long. When are they going to bring breakfast?" The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this conversation. Which response would be best for the nurse to make?

a.       "You know you had breakfast 30 minutes ago."

b.      "I am so sorry that they didn’t get you breakfast. I’ll report it to the charge nurse."

c.       "I’ll get you some juice and toast. Would you like something else?"

d.      "You will have to wait a while; lunch will be here in a little while."

25.  The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s disease. Which side effect is most often associated with this drug?

a.       Urinary incontinence

b.      Headaches

c.       Confusion

d.      Nausea


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