NCLEX-PN Practice Exam #03 In Text Mode: All questions and answers are given for reading and answering at your own pace.
Question 1. The chart of a client with schizophrenia states that the client has echolalia. The nurse can expect the client to:
A). Repeat words or phrases used by others.
B). Include irrelevant details in conversation.
C). Speak using words that rhyme.
D). Make up new words with new meanings.
Question 1 Answer: A). Repeat words or phrases used by others.
Question 1 Explanation: The client with echolalia repeats words or phrases used by others. Speaking using words that rhyme is incorrect because it refers to clang association. Including irrelevant details in conversation is incorrect because it refers to circumstantiality. Making up new words with new meanings is incorrect because it refers to neologisms.
Question 2. A client is admitted with suspected abdominal aortic aneurysm (AAA). A common complaint of the client with an abdominal aortic aneurysm is:
A). Decreased urinary output.
B). Loss of sensation in the lower extremities.
C). Back pain that lessens when standing.
D). Pulsations in the periumbilical area.
Question 2 Answer: D). Pulsations in the periumbilical area.
Question 2 Explanation: The client with an abdominal aortic aneurysm frequently complains of pulsations or “feeling my heart beat” in the abdomen. Loss of sensation in the lower extremities and decreased urinary output are incorrect because they occur with rupture of the aneurysm. Back pain that lessens when standing is incorrect because back pain is not affected by changes in position.
Question 3. The nurse is planning dietary changes for a client following an episode of pancreatitis. Which diet is suitable for the client?
A). High calorie, low fat.
B). Low protein, high carbohydrate.
C). High protein, high fat.
D). Low calorie, low carbohydrate.
Question 3 Answer: A). High calorie, low fat.
Question 3 Explanation: The client recovering from pancreatitis needs a diet that is high in calories and low in fat. Other answer choices are incorrect because they can increase the client’s discomfort.
Question 4. The nurse is teaching a client with Parkinson’s disease ways to prevent curvatures of the spine associated with the disease. To prevent spinal flexion, the nurse should tell the client to:
A). Periodically lie prone without a neck pillow.
B). Sleep on either side but keep his back straight.
C). Sleep only in dorsal recumbent position.
D). Rest in supine position with his head elevated.
Question 4 Answer: A). Periodically lie prone without a neck pillow.
Question 4 Explanation: Periodically lying in a prone position without a pillow will help prevent the flexion of the spine that occurs with Parkinson’s disease. Sleeping only in dorsal recumbent position and resting in supine position with his head elevated flex the spine; therefore, they are incorrect. Sleeping on either side but keep his back straight is not realistic because of position changes during sleep; therefore, it is incorrect.
Question 5. A client with hypothyroidism frequently complains of feeling cold. The nurse should tell the client that she will be more comfortable if she:
A). Dresses in extra layers of clothing.
B). Applies a heating pad to her feet.
C). Takes a hot bath morning and evening.
D). Uses an electric blanket at night.
Question 5 Answer: A). Dresses in extra layers of clothing.
Question 5 Explanation: Dressing in layers and using extra covering will help decrease the feeling of being cold that is experienced by the client with hypothyroidism. Decreased sensation and decreased alertness are common in the client with hypothyroidism; therefore, the use of electric blankets and heating pads can result in burns, making it incorrect. The client with hypothyroidism has dry skin, and a hot bath morning and evening would make her condition worse.
Question 6. The nurse is caring for a client with systemic lupus erythematosis (SLE). The major complication associated with systemic lupus erythematosis is:
Question 6 Answer: C). Nephritis.
Question 6 Explanation: The major complication of SLE is lupus nephritis, which results in end-stage renal disease. SLE affects the musculoskeletal, integumentary, renal, nervous, and cardiovascular systems, but the major complication is renal involvement; therefore, cardiomegaly and meningitis are incorrect. Desquamation is incorrect because the SLE produces a “butterfly” rash, not desquamation.
Question 7. The nurse is providing dietary instructions for a client with iron-deficiency anemia. Which food is a poor source of iron?
D). Dried fruits.
Question 7 Answer: A). Tomatoes.
Question 7 Explanation: Tomatoes are a poor source of iron, although they are an excellent source of vitamin C, which increases iron absorption. Other answer choices are good sources of iron; therefore, they are incorrect.
Question 8. A child with croup is placed in a cool, high-humidity tent connected to room air. The primary purpose of the tent is to:
A). Provide a moist environment with oxygen at 30%.
B). Prevent insensible water loss.
C). Liquefy secretions and relieve laryngeal spasm.
D). Prevent dehydration and reduce fever.
Question 8 Answer: C). Liquefy secretions and relieve laryngeal spasm.
Question 8 Explanation: The primary reason for placing a child with croup under a mist tent is to liquefy secretions and relieve laryngeal spasms. Preventing insensible water loss is incorrect because it does not prevent insensible water loss. Providing a moist environment with oxygen at 30% is incorrect because the oxygen concentration is too high. Preventing dehydration and reduce fever is incorrect because the mist tent does not prevent dehydration or reduce fever.
Question 9. A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of polymigratory arthritis?
A). Painless swelling over the extensor surfaces of the joints.
B). Faint areas of red demarcation over the back and abdomen.
C). Irregular movements of the extremities and facial grimacing.
D). Swelling, inflammation, and effusion of the joints.
Question 9 Answer: D). Swelling, inflammation, and effusion of the joints.
Question 9 Explanation: The child with polymigratory arthritis will exhibit swollen, painful joints. Painless swelling over the extensor surfaces of the joints is incorrect because it describes subcutaneous nodules. Faint areas of red demarcation over the back and abdomen is incorrect because it describes erythema marginatum. Irregular movements of the extremities and facial grimacing is incorrect because it describes Syndeham’s chorea.
Question 10. Which statement describes the contagious stage of varicella?
A). The contagious stage is 1 day before the onset of the rash until all the lesions are crusted..
B). The contagious stage is from the onset of the rash until the rash disappears..
C). The contagious stage is 1 day before the onset of the rash until the appearance of vesicles..
D). The contagious stage lasts during the vesicular and crusting stages of the lesions..
Question 10 Answer: A). The contagious stage is 1 day before the onset of the rash until all the lesions are crusted..
Question 10 Explanation: The contagious stage of varicella begins 24 hours before the onset of the rash and lasts until all the lesions are crusted. Other answer choices are inaccurate regarding the time of contagion; therefore, they are incorrect.
Question 11. The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid:
A). Offering sterile water.
B). Offering a pacifier.
C). Holding the infant.
D). Providing a mobile.
Question 11 Answer: B). Offering a pacifier.
Question 11 Explanation: The nurse should avoid giving the infant a pacifier or bottle because sucking is not permitted. Holding the infant cradled in the arms, providing a mobile, and offering sterile water using a Breck feeder are permitted.
Question 12. A newborn weighed 7 pounds at birth. At 6 months of age, the infant could be expected to weigh:
A). 30 pounds.
B). 14 pounds.
C). 18 pounds.
D). 25 pounds.
Question 12 Answer: B). 14 pounds.
Question 12 Explanation: The infant’s birth weight should double by 6 months of age. Other answer choices are incorrect because they are greater than the expected weight gain by 6 months of age.
Question 13. The physician has ordered Amoxil (amoxicillin) 500mg capsules for a client with esophageal varices. The nurse can best care for the client’s needs by:
A). Giving the medication with an antacid.
B). Providing extra water with the medication.
C). Giving the medication as ordered.
D). Requesting an alternate form of the medication.
Question 13 Answer: D). Requesting an alternate form of the medication.
Question 13 Explanation: The client with esophageal varices can develop spontaneous bleeding from the mechanical irritation caused by taking capsules; therefore, the nurse should request the medication in a suspension. Giving the medication as ordered is incorrect because it does not best meet the client’s needs. Providing extra water with the medication is incorrect because it is not the best means of preventing bleeding. Giving the medication with an antacid is incorrect because the medications should not be given with milk or antacids.
Question 14. A client with congestive heart failure has been receiving Digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
A). Increased pedal edema.
B). Stabilized weight.
C). Increased urinary output.
D). Improved appetite.
Question 14 Answer: C). Increased urinary output.
Question 14 Explanation: Lanoxin slows and strengthens the contraction of the heart. An increase in urinary output shows that the medication is having a desired effect by eliminating excess fluid from the body. Stabilized weight is incorrect because the weight would decrease. Improved appetite might occur but is not directly related to the question; therefore, it is incorrect. Increased pedal edema is incorrect because pedal edema would decrease, not increase.
Question 15. An elderly client is hospitalized for a transurethral prostatectomy. Which finding should be reported to the doctor immediately?
A). Requests for pain med q 4 hrs..
B). Dark red urine with few clots.
C). Hourly urinary output of 40–50cc.
D). Bright red urine with many clots.
Question 15 Answer: D). Bright red urine with many clots.
Question 15 Explanation: Bright red bleeding with many clots indicates arterial bleeding that requires surgical intervention. Hourly urinary output of 40–50cc is within normal limits; therefore, it is incorrect. Dark red urine with few clots indicates venous bleeding, which can be managed by nursing intervention; therefore, it is incorrect. Requests for pain med q 4 hrs does not indicate excessive need for pain management that requires the doctor’s attention; therefore, it is incorrect.
Question 16. A client with nontropical sprue has an exacerbation of symptoms. Which meal selection is responsible for the recurrence of the client’s symptoms?
A). Baked potato with sour cream and chives.
B). Mixed fruit and yogurt.
C). Cream of tomato soup and crackers.
D). Tossed salad with oil and vinegar dressing.
Question 16 Answer: C). Cream of tomato soup and crackers.
Question 16 Explanation: The symptoms of nontropical sprue and celiac are caused by the ingestion of gluten, which is found in wheat, oats, barley, and rye. Creamed soup and crackers contain gluten. Other answer choices do not contain gluten; therefore, they are incorrect.
Question 17. A client is admitted with a diagnosis of hypothyroidism. An initial assessment of the client would reveal:
A). Rapid pulse, constipation, and bulging eyes.
B). Decreased body temperature, weight loss, and increased respirations.
C). Weight gain, lethargy, slowed speech, and decreased respiratory rate.
D). Slow pulse rate, weight loss, diarrhea, and cardiac failure.
Question 17 Answer: C). Weight gain, lethargy, slowed speech, and decreased respiratory rate.
Question 17 Explanation: Symptoms of hypothyroidism include weight gain, lethargy, slow speech, and decreased respirations. Slow pulse rate, weight loss, diarrhea, cardiac failure ,decreased body temperature, weight loss, and increased respirations do not describe symptoms associated with myxedema; therefore, they are incorrect. Rapid pulse, constipation, and bulging eyes describes symptoms associated with Graves’s disease; therefore, it is incorrect.
Question 18. A client has been hospitalized with a diagnosis of laryngeal cancer. Which factor is most significant in the development of laryngeal cancer?
A). A history of alcohol and tobacco use.
B). Frequent straining of the vocal cords.
C). A family history of laryngeal cancer.
D). Chronic inhalation of noxious fumes.
Question 18 Answer: A). A history of alcohol and tobacco use.
Question 18 Explanation: A history of frequent alcohol and tobacco use is the most significant factor in the development of cancer of the larynx. Other answer choices are also factors in the development of laryngeal cancer, but they are not the most significant; therefore, they are incorrect.
Question 19. A client is admitted with acute adrenal crisis. During the intake assessment, the nurse can expect to find that the client has:
A). Low blood pressure.
B). Slow, regular pulse.
C). Warm, flushed skin.
D). Increased urination.
Question 19 Answer: A). Low blood pressure.
Question 19 Explanation: The client with acute adrenal crisis has symptoms of hypovolemia and shock; therefore, the blood pressure would be low. Slow, regular pulse is incorrect because the pulse would be rapid and irregular. Warm, flushed skin is incorrect because the skin would be cool and pale. Increased urination is incorrect because the urinary output would be decreased.
Question 20. The nurse is completing an assessment history of a client with pernicious anemia. Which complaint differentiates pernicious anemia from other types of anemia?
A). Difficulty in breathing after exertion.
B). Numbness and tingling in the extremities.
C). A faster-than-usual heart rate.
D). Feelings of lightheadedness.
Question 20 Answer: B). Numbness and tingling in the extremities.
Question 20 Explanation: Numbness and tingling in the extremities is common in the client with pernicious anemia, but not those with other types of anemia. Other answer choices are incorrect because they are symptoms of all types of anemia.
Question 21. Which diet is associated with an increased risk of colorectal cancer?
A). Low protein, complex carbohydrates.
B). Low carbohydrates, complex proteins.
C). High protein, simple carbohydrates.
D). High fat, refined carbohydrates.
Question 21 Answer: D). High fat, refined carbohydrates.
Question 21 Explanation: A diet that is high in fat and refined carbohydrates increases the risk of colorectal cancer. High fat content results in an increase in fecal bile acids, which facilitate carcinogenic changes. Refined carbohydrates increase the transit time of food through the gastrointestinal tract and increase the exposure time of the intestinal mucosa to cancer-causing substances. Other answer choices do not relate to the question; therefore, they are incorrect.
Question 22. Which play activity is best suited to the gross motor skills of the toddler?
A). Building cubes.
B). Coloring book and crayons.
C). Swing set.
Question 22 Answer: D). Ball.
Question 22 Explanation: The toddler has gross motor skills suited to playing with a ball, which can be kicked forward or thrown overhand. Coloring book and crayons and building cubes are incorrect because they require fine motor skills. Swinging set is incorrect because the toddler lacks gross motor skills for play on the swing set.
Question 23. Which early morning activity helps to reduce the symptoms associated with rheumatoid arthritis?
A). Brushing the hair.
B). Drinking a glass of juice.
C). Drinking a cup of coffee.
D). Brushing the teeth.
Question 23 Answer: C). Drinking a cup of coffee.
Question 23 Explanation: Holding a cup of coffee or hot chocolate helps to relieve the pain and stiffness of the hands. Other answer choices do not relieve the symptoms of rheumatoid arthritis; therefore, they are incorrect.
Question 24. A client admitted to the psychiatric unit claims to be the Son of God and insists that he will not be kept away from his followers. The most likely explanation for the client’s delusion is:
A). A stressful event.
B). A religious experience.
C). Overwhelming anxiety.
D). Low self-esteem.
Question 24 Answer: D). Low self-esteem.
Question 24 Explanation: Delusions of grandeur are associated with low self-esteem. A religious experience is incorrect because conversion is expressed as sensory or motor deficits. A stressful event and overwhelming anxiety can cause an increase in the client’s delusions but do not explain their purpose; therefore, they are incorrect.
Question 25. The physician has ordered Basalgel (aluminum carbonate gel) for a client with recurrent indigestion. The nurse should teach the client common side effects of the medication, which include:
A). Urinary retention.
Question 25 Answer: B). Constipation.
Question 25 Explanation: Antacids containing aluminum and calcium tend to cause constipation. Urinary retention refers to the side effects of anticholinergic medications used to treat ulcers; therefore, it is incorrect. Diarrhea refers to antacids containing magnesium; therefore, it is incorrect. Confusion refers to dopamine antagonists used to treat ulcers; therefore, it is incorrect.