NCLEX-PN Practice Questions

1. A 65-year-old client presents herpes zoster. Place the pathophysiologic changes associated with herpes zoster in the proper sequence. Use all of the options. A. B. C. D. E. F. Fever, malaise, and red nodules appear in a dermatome distribution. The virus multiplies in the ganglia, causing deep pain, itching, and paresthesia or hyperesthesia. Vesicles crust and scab but no longer shed the virus. Residual antibodies from the initial infection mobilize but are ineffective. Vesicles appear filled with clear fluid or pus. Varicella-zoster virus is reactivated.

2. A nurse has received shift report on her clients and notices that they are of varying ages. In order to prepare for this shift, the nurse reviews Eriksons five stages of psychosocial development. Place Eriksons 5 stages in ascending chronological order, starting with infancy and progressing to toddlerhood, preschool age, school age, and adolescence. Use all of the options. A. B. C. D. E. Initiative verus guilt. Trust versus mistrust. Industry versus inferiority. Identify versus role confusion. Autonomy versus shame and doubt.

3. A client is hospitalized with bipolar disorder. She has had 5 depressive and manic cycles within the past 12-month period, and her mood changes occur within hours. Which of the following types of bipolar disorder does this pattern suggest? A. B. C. D. Bipolar I. Bipolar II. Cyclothymia (Bipolar III) Rapid-cycling.

4. The nurse is assessing a client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which assessment finding does the nurse expect? A. B. C. D. Decreased urine osmolality. Decreased urinary output. Increased serum sodium levels. Increased blood urea nitrogen level.

5. The nurse is reviewing laboratory data on a client with a history of seizures. She notes the serum sodium to be 120 mEq/L. Which of the following actions takes priority? A. B. C. D. Assess the client for symptoms of hyponatremia and notify the physician of the lab results and assessment data. Assess the client for symptoms of hypernatremia and hypocalcemia and notify the physician of the lab results and assessment data. Immediately notify the physician of lab results No action is necessary as lab results are within normal limits.

NCLEX-RN Practice Questions

6. An elderly patient with pneumonia is admitted for IV antibiotic treatment. Which of the following observations indicates that the patient may be experiencing sepsis? A. B. Productive cough Increased fluid intake

C. D.

Respiratory rate of 20 breaths per minute BP 90/60, HR 115 BPM

7. An eight year old female contracts chicken pox (varicella virus). Which of the following family members should she absolutely avoid to prevent their contracting the virus? A. B. C. D. E. Her two-year old brother who has had the varicella vaccine Her ninety year old great-grandmother Her twenty-year old uncle on chemotherapy Her twin sister Autonomy versus shame and doubt.

8. A twelve year old patient arrives in the emergency room with the complaints of a stiff neck, headache, and fever for the last 24 hours. The physician suspects bacterial meningitis. What diagnostic test consent form should the nurse have the parent sign? A. B. C. D. Lumbar Puncture Head X-ray CBC Pulse oximetry

9. A primigravid nineteen year old comes in to register at your prenatal clinic. You notice a picture of her cats that she has on her keychain. What should she be counseled to do while she is pregnant? A. B. C. D. She She She She should should should should pet her cats daily to reduce her stress not bathe her cats to reduce risk for allergies to dander not let them sleep in her bed in order to reduce nighttime waking not clean the cat box

10. A nurse is evaluating a patient who had a knee replacement earlier that day. Which of the following signs is indicative of a complication of that surgery? A. B. C. D. Pain at the wound site Reluctance to bear weight on the affected leg Decreased pulses in the ankle and decreased capillary refill of the toes on the affected leg Poor appetite

NCLEX-PN Practice Test Answers

1. Correct answer: Herpes zoster develops in the following order: 1. F. Varicella-zoster virus is reactivated. 2. D. Residual antibodies from the initial infection mobilize but are ineffective. 3. A. Fever, malaise, and red nodules appear in a dermatome distribution. 4. B. The virus multiplies in the ganglia, causing deep pain, itching, and paresthesia or hyperesthesia. 5. E. Vesicles appear filled with either clear fluid or pus. 6. C. Vesicles crust and scab but no longer shed the virus. Herpes zoster is an acute inflammation caused by infection with the herpes virus varicella-zoster (chickenpox virus). 2. Correct answer: Identity versus role confusion is typical for teenagers in Eriksons five stages of psychosocial development:

1. B. Trust versus mistrust (birth to age 1): The child develops trust as the primary caregiver meets his needs. 2. E. Autonomy verus shame and doubt (ages 1 to 3): The child gains control of body functions and becomes increasingly independent. 3. A. Initiative versus guilt (ages 3 to 6): The child develops a conscience and learns about the world through play. 4. C. Industry verus inferiority (ages 6 to 12): The child enjoys working on projects with others, follows rules, and forms social relationships. 5. D. Identity versus role confusion (Ages 12 to 19): The body changes and the child becomes preoccupied with how he looks, how others view him, meeting peer expectation, and establishing his own identity. 3. Correct answer: D 4 changes of mood between depression and mania in a 12-month period. Bipolar I is a severe form with at least one episode of mania (usually preceded by depression), rapid cycling, and psychotic symptoms (paranoia, hallucinations). Bipolar II is characterized by cycles of depression and hypomania with depression predominating. Cyclothymia involves milder mood swings.Rapid-cycling bipolar disorder is characterized by 4. Correct answer: B In syndrome of inappropriate antidiuretic hormone (SIADH), excess release of antidiuretic hormone increases the reabsorption of water and reduces the production of urine. Osmolality measures the degree of concentration. Because fluid is reabsorbed into systemic circulation, urine osmolality increases, serum sodium levels and serum osmolality decrease, and the blood urea nitrogen level remains normal. 5. Correct answer: A The nurse should complete an assessment to identify symptoms of hyponatremia (level<135 mEq/L) and notify the physician of the lab results and assessment data. Symptoms range from irritability to lethargy and include alterations in consciousness, cerebral edema with seizures and coma, and respiratory distress ranging from dyspnea to respiratory failure. Normal value for sodium is 135 to 145 mEq/L. Hypernatremia (>145 mEq/L) is characterized by symptoms ranging from irritability to lethargy to confusion to coma, seizures, flushing, muscle weakness and spasms, and thirst.

NCLEX-RN Practice Test Answers

6. D Explanation: Dropping blood pressure and rising heart rate indicate that the patient may be getting septic. Notification of the physician and ICU transfer is advisable. 7. C Explanation: Although use of the varicella vaccine is now widespread, it is still common. An annoyance in most patients, it can be life-threatening in immunocompromised patients such as those on chemotherapy, radiation, or with HIV/AIDS. 8. A Explanation: The analysis of cerebral spinal fluid (CSF) is the diagnostic test of

choice for meningitis. This would provide diagnosis and also culture material for appropriate antibiotic use. A head x-ray is of no benefit, and a CBC and pulse oximetry would be done but are not procedures which need informed consent. 9. D Explanation: She should avoid cleaning the cat box or any cat feces. Toxoplasma

gondii is a parasite that occurs in cat feces and, if infected, a pregnant woman can
transmit it to the fetus. Fetal infection can lead to chronic neurologic sequelae in infants. 10. C Explanation: Decreased pulses and capillary refill indicate a possible injury to the posterior tibial artery during surgery. Immediate evaluation by the surgeon is warranted.