NCLEX-PN Practice Exam #01 In Text Mode: All questions and answers are given for reading and answering at your own pace.
Question 1. A client receiving hydrochlorothiazide is instructed to increase her dietary intake of potassium. The best snack for the client requiring increased potassium is:
Question 1 Answer: D). Banana.
Question 1 Explanation: Other answer choices are incorrect because they contain lower amounts of potassium. (Note that the banana contains 450mg K+, the orange contains 235mg K+, the pear contains 208mg K+, and the apple contains 165mg K+.)
Question 2. The client scheduled for electroconvulsive therapy tells the nurse, “I’m so afraid. What will happen to me during the treatment?” Which of the following statements is most therapeutic for the nurse to make?
A). “The treatment might produce nausea and headache.”.
B). “You will be given medicine to relax you during the treatment.”.
C). “You can expect to be sleepy and confused for a time after the treatment.”.
D). “The treatment will produce a controlled grand mal seizure.”.
Question 2 Answer: B). “You will be given medicine to relax you during the treatment.”.
Question 2 Explanation: The client will receive medication that relaxes skeletal muscles and produces mild sedation. “The treatment will produce a controlled grand mal seizure.” and “You can expect to be sleepy and confused for a time after the treatment.” statements are incorrect because it increase the client’s anxiety level. Nausea and headache are not associated with ECT.
Question 3. Which of the following findings is associated with right-sided heart failure?
A). Daytime oliguria.
B). Crackles in the lungs.
C). Nocturnal polyuria.
D). Shortness of breath.
Question 3 Answer: C). Nocturnal polyuria.
Question 3 Explanation: Increased voiding at night is a symptom of right-sided heart failure. Shortness of breath and crackles in the lungs are incorrect because they are symptoms of left-sided heart failure. Daytime oliguria does not relate to the client’s diagnosis; therefore, it is incorrect.
Question 4. Which of the following snacks would be suitable for the child with gluten-induced enteropathy?
A). Peanut butter and jelly sandwich.
B). Soft oatmeal cookie.
C). Cheese pizza.
D). Buttered popcorn.
Question 4 Answer: D). Buttered popcorn.
Question 4 Explanation: The client with gluten-induced enteropathy experiences symptoms after ingesting foods containing wheat, oats, barley, or rye. Corn or millet are substituted in the diet. Other answer choices are incorrect because they contain foods that worsen the client’s condition.
Question 5. A client is sent to the psychiatric unit for forensic evaluation after he is accused of arson. His tentative diagnosis is antisocial personality disorder. In reviewing the client’s record, the nurse could expect to find:
A). An expression of remorse for his actions.
B). A history of consistent employment.
C). A history of cruelty to animals.
D). A below-average intelligence.
Question 5 Answer: C). A history of cruelty to animals.
Question 5 Explanation: A history of cruelty to people and animals, truancy, setting fires, and lack of guilt or remorse are associated with a diagnosis of conduct disorder in children, which becomes a diagnosis of antisocial personality disorder in adults. The client with antisocial personality disorder does not hold consistent employment, IQ is usually higher than average and lack of guilt or remorse for wrong-doing.
Question 6. The nurse is to administer digoxin elixir to a 6-month-old with a congenital heart defect. The nurse auscultates an apical pulse rate of The nurse should:
A). Record the heart rate and administer the medication.
B). Administer the medication and recheck the heart rate in 15 minutes.
C). Hold the medication and recheck the heart rate in 30 minutes.
D). Record the heart rate and call the physician.
Question 6 Answer: A). Record the heart rate and administer the medication.
Question 6 Explanation: The infant’s apical heart rate is within the accepted range for administering the medication. Other answer choices are incorrect because the apical heart rate is suitable for giving the medication.
Question 7. An 8-year-old admitted with an upper-respiratory infection has an order for O2 saturation via pulse oximeter. To ensure an accurate reading, the nurse should:
A). Place the probe on the child’s abdomen.
B). Apply the probe and wait 15 minutes before obtaining a reading.
C). Place the probe on the child’s finger.
D). Recalibrate the oximeter at the beginning of each shift.
Question 7 Answer: C). Place the probe on the child’s finger.
Question 7 Explanation: The pulse oximeter should be placed on the child’s finger or earlobe because blood flow to these areas is most accessible for measuring oxygen concentration. Placing the probe on the child’s abdomen is incorrect because the probe cannot be secured to the abdomen. Recalibrating the oximeter at the beginning of each shift is incorrect because it should be recalibrated before application. Applying the probe and wait 15 minutes before obtaining a reading is incorrect because a reading is obtained within seconds, not minutes.
Question 8. A client hospitalized with a fractured mandible is to be discharged. Which piece of equipment should be kept on the client with a fractured mandible?
A). Wire cutters.
C). Oral airway.
D). Tracheostomy set.
Question 8 Answer: A). Wire cutters.
Question 8 Explanation: The client with a fractured mandible should keep a pair of wire cutters with him at all times to release the device in case of choking or aspiration. Oral airway is incorrect because the wires would prevent insertion of an oral airway. Pliers is incorrect because it would be of no use in releasing the wires. Tracheostomy set is incorrect because it would be used only as a last resort in case of airway obstruction.
Question 9. A mother of a 3-year-old hospitalized with lead poisoning asks the nurse to explain the treatment for her daughter. The nurse’s explanation is based on the knowledge that lead poisoning is treated with:
A). Chelating agents.
B). Activated charcoal.
C). Gastric lavage.
Question 9 Answer: A). Chelating agents.
Question 9 Explanation: Chelating agents are used to treat the client with poisonings from heavy metals such as lead and iron. Gastric lavage and activated charcoal are used to remove noncorrosive poisons; therefore, they are incorrect. Antiemetics prevents vomiting; therefore, it is an incorrect response.
Question 10. Which of the following medication orders needs further clarification?
A). Nembutal 100mg PO at bedtime.
B). Estrace 2mg PO q day.
C). Coumadin 10mg PO.
D). Darvocet 65mg PO q 4–6 hrs. PRN.
Question 10 Answer: C). Coumadin 10mg PO.
Question 10 Explanation: There is no specified time or frequency for the ordered medication. Other answer choices contain specified time and frequency.
Question 11. Which of the following skin lesions is associated with Lyme’s disease?
A). Papular crusts.
D). Bull’s eye rash.
Question 11 Answer: D). Bull’s eye rash.
Question 11 Explanation: Lyme’s disease produces a characteristic annular or circular rash sometimes described as a “bull’s eye” rash. Other answer choices are incorrect because they are not symptoms associated with Lyme’s disease.
Question 12. The nurse is teaching a group of parents about gross motor development of the toddler. Which behavior is an example of the normal gross motor skill of a toddler?
A). She can broad-jump..
B). She can build a tower of eight blocks..
C). She can pull a toy behind her..
D). She can copy a horizontal line..
Question 12 Answer: C). She can pull a toy behind her..
Question 12 Explanation: According to the Denver Developmental Screening Test, the child can pull a toy behind her by age 2 years. Other answer choices are not accomplished until ages 4–5 years; therefore, they are incorrect.
Question 13. A client hospitalized with chronic dyspepsia is diagnosed with gastric cancer. Which of the following is associated with an increased incidence of gastric cancer?
A). Dairy products.
B). Refined sugars.
C). Carbonated beverages.
D). Luncheon meats.
Question 13 Answer: D). Luncheon meats.
Question 13 Explanation: Luncheon meats contain preservatives such as nitrites that have been linked to gastric cancer. Other answer choices have not been found to increase the risk of gastric cancer; therefore, they are incorrect.
Question 14. A client with glaucoma has been prescribed Timoptic (timolol) eyedrops. Timoptic should be used with caution in the client with a history of:
A). Gastric ulcers.
Question 14 Answer: C). Emphysema.
Question 14 Explanation: Beta blockers such as timolol (Timoptic) can cause bronchospasms in the client with chronic obstructive lung disease. Timoptic is not contraindicated for use in clients with diabetes, gastric ulcers, or pancreatitis.
Question 15. The nurse is caring for a client following removal of the thyroid. Immediately post-op, the nurse should:
A). Maintain the client in a semi-Fowler’s position with the head and neck supported by pillows.
B). Encourage the client to cough and breathe deeply every 2 hours, with the neck in a flexed position.
C). Encourage the client to turn her head side to side, to promote drainage of oral secretions.
D). Maintain the client in a supine position with sandbags placed on either side of the head and neck.
Question 15 Answer: A). Maintain the client in a semi-Fowler’s position with the head and neck supported by pillows.
Question 15 Explanation: Following a thyroidectomy, the client should be placed in semi-Fowler’s position to decrease swelling that would place pressure on the airway. Other answer choices are incorrect because they would increase the chances of post-operative complications that include bleeding, swelling, and airway obstruction.
Question 16. A client hospitalized with severe depression and suicidal ideation refuses to talk with the nurse. The nurse recognizes that the suicidal client has difficulty:
A). Displaying dependence on others.
B). Expressing feelings of low self-worth.
C). Expressing anger toward others.
D). Discussing remorse and guilt for actions.
Question 16 Answer: C). Expressing anger toward others.
Question 16 Explanation: The suicidal client has difficulty expressing anger toward others. The depressed suicidal client frequently expresses feelings of low self-worth, feelings of remorse and guilt, and a dependence on others.
Question 17. An 18-month-old is scheduled for a cleft palate repair. The usual type of restraints for the child with a cleft palate repair are:
A). Mummy restraints.
B). Wrist restraints.
C). Full arm restraints.
D). Elbow restraints.
Question 17 Answer: D). Elbow restraints.
Question 17 Explanation: The least restrictive restraint for the infant with cleft lip and cleft palate repair is elbow restraints. Other answer choices are more restrictive and unnecessary; therefore, they are incorrect.
Question 18. Which information should be given to the client taking phenytoin (Dilantin)?
A). More frequent dental appointments will be needed for special gum care..
B). The medication can cause sleep disturbances..
C). Taking the medication with meals will increase its effectiveness..
D). The medication decreases the effects of oral contraceptives..
Question 18 Answer: A). More frequent dental appointments will be needed for special gum care..
Question 18 Explanation: Gingival hyperplasia is a side effect of phenytoin. The client will need more frequent dental visits. Other answer choices do not apply to the medication; therefore, they are incorrect.
Question 19. An infant with Tetralogy of Fallot is discharged with a prescription for lanoxin elixir. The nurse should instruct the mother to:
A). Administer the medication in a baby bottle with 1oz. of water.
B). Administer the medication using a plastic baby spoon.
C). Administer the medication using a nipple.
D). Administer the medication using the calibrated dropper in the bottle.
Question 19 Answer: D). Administer the medication using the calibrated dropper in the bottle.
Question 19 Explanation: The medication should be administered using the calibrated dropper that comes with the medication. Administering the medication using a nipple and administering the medication using a plastic baby spoon are incorrect because part or all of the medication could be lost during administration. Administering the medication in a baby bottle with 1oz. of water is incorrect because part or all of the medication will be lost if the child does not finish the bottle.
Question 20. The physician has ordered dressings with Sulfamylon cream for a client with full-thickness burns of the hands and arms. Before dressing changes, the nurse should give priority to:
A). Obtaining a blood glucose by finger stick.
B). Requesting a daily complete blood count.
C). Administering pain medication.
D). Checking the adequacy of urinary output.
Question 20 Answer: C). Administering pain medication.
Question 20 Explanation: Sulfamylon produces a painful sensation when applied to the burn wound; therefore, the client should receive pain medication before dressing changes. Other answer choices do not pertain to dressing changes for the client with burns, so they are incorrect.
Question 21. The best diet for the client with Meniere’s syndrome is one that is:
A). High in fiber.
B). High in iodine.
C). Low in fiber.
D). Low in sodium.
Question 21 Answer: D). Low in sodium.
Question 21 Explanation: A low-sodium diet is best for the client with Meniere’s syndrome. Other answer choices do not relate to the care of the client with Meniere’s syndrome; therefore, they are incorrect.
Question 22. A client with schizophrenia is receiving chlorpromazine (Thorazine) 400mg twice a day. An adverse side effect of the medication is:
A). Elevated temperature.
C). Weight gain.
D). Elevated blood pressure.
Question 22 Answer: A). Elevated temperature.
Question 22 Explanation: Neuroleptic malignant syndrome is an adverse reaction that is characterized by extreme elevations in temperature. Photosensitivity and weight gain are incorrect because they are expected side effects. Elevations in blood pressure are associated with reactions between foods containing tyramine and MAOI.
Question 23. Which of the following is a common complaint of the client with end-stage renal failure?
B). Ringing in the ears.
C). Weight loss.
Question 23 Answer: D). Itching.
Question 23 Explanation: Pruritis or itching is caused by the presence of uric acid crystals on the skin, which is common in the client with end-stage renal failure. Other answer choices are not associated with end-stage renal failure.
Question 24. The licensed vocational nurse may not assume the primary care for a client:
A). Two days post-appendectomy.
B). In the fourth stage of labor.
C). With a venous access device.
D). With bipolar disorder.
Question 24 Answer: C). With a venous access device.
Question 24 Explanation: The licensed vocational nurse may not assume primary care of the client with a central venous access device. The licensed vocational nurse may care for the client in labor, the client post-operative client, and the client with bipolar disorder.
Question 25. An elderly client who experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help decrease the client’s confusion by:
A). Administering a bedtime sedative.
B). Leaving a nightlight on during the evening and night shifts.
C). Assigning a nursing assistant to sit with him until he falls asleep.
D). Allowing the client to room with another elderly client.
Question 25 Answer: B). Leaving a nightlight on during the evening and night shifts.
Question 25 Explanation: Leaving a nightlight on during the evening and night shifts helps the client remain oriented to the environment and fosters independence. Assigning a nursing assistant to sit with him until he falls asleep and allowing the client to room with another elderly client will not decrease the client’s confusion. Administering a bedtime sedative will increase the likelihood of confusion in an elderly client.