PRACTICE QUESTIONS are the best way to make sure you pass the NCLEX-and they're a good test

of your nursing knowledge anytime in your career. 1. What's the primary reason for administering morphine to a client with a myocardial infarction? 1. for sedation 2. to decrease pain 3. to decrease anxiety 4. to decrease oxygen demand on the heart 2. Which of the following factors makes developing a vaccine for HIV difficult? 1. HIV is a virus. 2. HIV matures early. 3. HIV mutates easily. 4. HIV spreads through body secretions. 3. Disseminated intravascular coagulation often results in complications initially associated with which of the following organs? 1. brain 2. kidney 3. lung 4. stomach 4. Giving instructions for breast self-examination is particularly important for clients with which of the following medical problems? 1. cervical dysplasia 2. a dermoid cyst 3. lung 4. stomach 5. A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following is a major complication of this therapy? 1. depression 2. hemorrhage 3. infection

4. peptic ulcer disease 6. A client found unconscious at home is taken to the ED. Physical examination shows cherry-red mucous membranes, nail beds, and skin. Which of the following is the most likely cause of his condition? 1. spider bite 2. aspirin ingestion 3. hydrocarbon ingestion 4. carbon monoxide poisoning 7. Which of the following comments is typical of someone who experiences periodic panic attacks while sleeping? 1. "Yesterday, I sat up in bed and just felt so scared." 2. "I have difficulty sleeping because I'm so anxious." 3. "Sometimes I have the most wild and vivid dreams." 4. "When I drink beer, I fall asleep without any problems." 8. Which of the following instructions would you include in your discharge teaching for the parents of a newborn diagnosed with sickle-cell anemia? 1. the importance of iron supplementation 2. the importance of monthly vitamin B12 injections 3. how to palpate the abdomen and take a temperature 4. that polyvalent pneumococcal vaccine is contraindicated 9. Which of the following is the most frequent site of internal bleeding associated with hemophilia? 1. brain tissue 2. gastrointestinal (GI) tract 3. joint cavities 4. spinal cord 10. The mother of a neonate with clubfoot feels guilty because she believes she did something to cause the condition. You should explain that the cause of clubfoot is 1. unknown. 2. hereditary. 3. caused by restricted movement in utero.

4. caused by anomalous embryonic development. 11. Most cleft palates are repaired at what age? 1. immediately after birth 2. 1 to 2 months 3. 3 to 4 months 4. 1 to 2 years 12. In extreme cases of salicylate poisoning, which of the following treatments is used? 1. forced emesis 2. temperature-regulating blankets 3. peritoneal dialysis 4. vitamin K injection ANSWERS 1. 4. Morphine is administered because it decreases myocardial oxygen demand. Morphine also decreases pain and anxiety while causing sedation, but it isn't given primarily for those reasons. 2. 3. The fact that HIV is a virus, matures early, and spreads through body secretions doesn't affect the potential for vaccine development. 3. 2. Disseminated intravascular coagulation usually affects the kidneys and extremities, but left untreated, it will affect the lungs, brain, stomach, and the adrenal and pituitary glands. 4. 4. Clients with ovarian cancer are at increased risk for breast cancer. Breast selfexamination supports early detection and treatment and is very important. There's no known relationship between breast cancer and cervical dysplasia, endometrial polyps, or dermoid cysts, so breast self-examination is no more or less important for these clients. 5. 3. Infection is the major complication to watch for in clients on cyclosporine therapy because it's an immunosuppressive drug. Depression may occur posttransplantation but not because of cyclosporine. Hemorrhage is associated with anticoagulant therapy. Peptic ulcer disease is a complication of steroid therapy. 6. 4. Cherry-red skin indicates exposure to high levels of carbon monoxide. Spider bite reactions usually are localized to the area of the bite. Hydrocarbon or petroleum ingestion causes respiratory symptoms and tachycardia. Nausea and vomiting and pale skin are symptoms of aspirin ingestion. 7. 1. A person who suffers a panic attack while sleeping wakes up abruptly, feeling fearful. Many people with severe anxiety have symptoms related to a sleep disorder, but they wouldn't typically experience a sleep panic attack. A panic attack while sleeping often

causes inability to remember dreams. Intake of alcohol initially produces a drowsy feeling, but after a short time, alcohol causes restless, fragmented sleep and strange dreams. 8. 3. Acute splenic sequestration is a serious complication of sickle-cell anemia. Early detection of splenomegaly by parents is an important aspect of client management. A temperature of 101.3 deg to 102.2 deg F (38.5 deg to 39 deg C) calls for emergency evaluation, even if the child appears well. The need for folic acid increases injections, so supplementation is prudent. Vitamin B12 and iron supplements aren't necessary. Pneumococcal vaccine is used because children with sickle-cell anemia are prone to infection with Streptococcus pneumoniae. 9. 3. The joint cavities-especially the knees, ankles, and elbows-are the most frequent sites of internal bleeding. This bleeding often results in bone changes and crippling, disabling deformities. Intracranial hemorrhage occurs less frequently than expected because the brain tissue has a high concentration of thromboplastin. Hemorrhage along the GI tract and spinal cord can occur but is less common. 10. 1. The definitive cause of clubfoot is unknown. In some families, there's an increased incidence. Some postulate that anomalous embryonic development or restricted fetal movement are the reasons. Currently, there's no way to predict the onset of clubfoot. 11. 4. Most surgeons will correct the cleft at I to 2 years old, before faulty speech patterns develop. To take advantage of palatal changes during infancy, surgical repair usually is postponed until this time. 12. 3. Peritoneal dialysis usually is reserved for cases of life-threatening salicylism. Forced emesis is the immediate treatment for salicylate poisoning because the stomach contents and salicylates will move from the stomach to the remainder of the GI tract, where vomiting won't remove the poison. Vitamin K may decrease bleeding tendencies, but only if evidence of this exists. Temperature-regulating blankets may reduce the possibility of seizures.

1. 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? A. Sulfasalazine B. Levodopa C. Phenolphthalein D. Aspirin 2. 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? A. Corgard B. Humulin (injection) C. Urokinase D. Epogen (injection) 3. 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? A. IgA B. IgD C. IgE D. IgG 4. 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? A. Immediately see a social worker B. Start prophylactic AZT treatment C. Start prophylactic Pentamide treatment D. Seek counseling 5. 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? A. Atherosclerosis B. Diabetic nephropathy C. Autonomic neuropathy D. Somatic neuropathy 6. 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? A. Multiple sclerosis B. Anorexia nervosa

C. Bulimia D. Systemic sclerosis 7. 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? A. Diverticulosis B. Hypercalcaemia C. Hypocalcaemia D. Irritable bowel syndrome 8. Rho gam is most often used to treat____ mothers that have a ____ infant. A. RH positive, RH positive B. RH positive, RH negative C. RH negative, RH positive D. RH negative, RH negative 9. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU? A. A Guthrie test can check the necessary lab values. B. The urine has a high concentration of phenylpyruvic acid C. Mental deficits are often present with PKU. D. The effects of PKU are reversible. 10. 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? A. Onset of pulmonary edema B. Metabolic alkalosis C. Respiratory alkalosis D. Parkinson's disease type symptoms 11. 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? A. Let others know about the patient's deficits B. Communicate with your supervisor your concerns about the patient's deficits. C. Continuously update the patient on the social environment. D. Provide a secure environment for the patient. 12. 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? A. Deep breathing techniques to increase O2 levels. B. Cough regularly and deeply to clear airway passages. C. Cough following bronchodilator utilization D. Decrease CO2 levels by increase oxygen take output during meals. 13. 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? A. Slow pulse rate B. Weight gain C. Decreased systolic pressure D. Irregular WBC lab values 14. 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? A. Simian crease B. Brachycephaly

C. Oily skin D. Hypotonicity 15. A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered? A. Streptokinase B. Atropine C. Acetaminophen D. Coumadin 16. A patient asks a nurse, My doctor recommended I increase my intake of folic acid. What type of foods contain folic acids? A. Green vegetables and liver B. Yellow vegetables and red meat C. Carrots D. Milk 17. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans? A. S. pneumonia B. H. influenza C. N. meningitis D. Cl. difficile 18. 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. A. The life span of RBC is 45 days. B. The life span of RBC is 60 days. C. The life span of RBC is 90 days. D. The life span of RBC is 120 days. 19. A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning begin for this patient? A. Following surgery B. Upon admit C. Within 48 hours of discharge D. Preoperative discussion 20. 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? A. Trust vs. mistrust B. Initiative vs. guilt C. Autonomy vs. shame D. Intimacy vs. isolation 21. 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? A. Trust vs. mistrust B. Initiative vs. guilt C. Autonomy vs. shame D. Intimacy vs. isolation 22. 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? A. Trust vs. mistrust B. Initiative vs. guilt C. Autonomy vs. shame D. Intimacy vs. isolation

23. A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal? A. 11 year old male 90 b.p.m, 22 resp/min., 100/70 mm Hg B. 13 year old female 105 b.p.m., 22 resp/min., 105/60 mm Hg C. 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg D. 6 year old female- 100 b.p.m., 26 resp/min., 90/70mm Hg 24. 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? A. Elavil B. Calcitonin C. Pergolide D. Verapamil 25. Which of the following conditions would a nurse not administer erythromycin? A. Campylobacterial infection B. Legionnaire's disease C. Pneumonia D. Multiple Sclerosis Answer Key 1. D 2. A 3. D 4. B 5. C 6. B 7. B 8. C 9. D 10. D 11. D 12. C 13. B 14. C 15. A 16. A 17. D 18. D 19. B 20. B 21. A 22. D 23. B 24. A 25. D

Below is a practice exam. After you have completed the exam, press submit at the bottom to review your answers, and to view the correct answers.
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1. a client, age 22, is a gavida 1, para 1. During the first 24 hours after delivery, she doesn't show consistent interest in her neonate. How should the nurse interpret her behavior?

A. the client is experiencing postpartem depression B. The client is questioning her role as a mother C. The client is showing expected behaviors for the taking-in period D. The client is failing to attach to the neonate 2. a Client is at risk for fluid volume exess. Which nursing intervention would ensure the most accurate monitoring of the client's fluid status? A. Measuring and recording fluid intake and output B. Weighing the client daily at the same time each day C. assessing vital signs every 4 hours D. checking the lungs for crackles every shift 3. A client diagnosed as having panic disorder with agoraphobia is admitted to the inpatient psychiatric unit. Until her admission, she had been a virtual prisoner in her home for 5 weeks, afraid to go outside even to buy food. What is the nurse's overall goal when planning care for this client? A. To help the client perform self-care activities B. To help the client function effectively in her environment C. To help control the client's symptoms D. Top help the client participate in group therapy 4. A 36-year-old client with paranoid schizophrenia believes that his room is bugged by the Central Intelligence Agency and that his roommate is a foreign spy. The client has never had a romantic relationship, has no contact with family members, and hasn't been employed in the last 14 years. Based on Erikson's theories, the nurse should recognize that

this client is in which stage of psychosocial development? A. Autonomy versus shame and doubt B. Generativity versus stagnation C. Integrity versus despair D. Trust versus mistrust 5. A child, age 4, is taken to a clinic for a routine examination. When observing the tympanic membrane, the nurse identifies which color as normal? A. Light pink B. Deep red C. Pearly gray D. Yellowish white 6. A client admitted to an acute care facility with pneumonia is receiving supplemental oxygen, 2 liters/minute via nasal cannula. The client's history includes chronic obstructive pulmonary disease (COPD) and coronary artery disease. Because of these history findings, the nurse closely monitors the oxygen flow and the client's respiratory status. Which complication may arise if the client receives a high oxygen concentration? A. Apnea B. Anginal pain C. Respiratory alkalosis D. metabolic acidosis 7. After being in remission from Hodgkin's Disease for 18 months, a client develops a fever of unknown origin. The physician orders a blind liver biopsy to rule out advancing Hodgkin's Disease and infection. 24 hours after the biopsy,

the client has a fever, complains of severe abdominal pain, and seems increasingly confused. The nurse suspects that these findings result from: A. Bleeding in the liver caused by the liver biopsy B. Perforation of the colon caused by the liver biopsy C. An allergic reaction to the contrast media used during the liver biopsy D. Normal postprocedural pain, with a change in level of consciousness resulting from the preexisting fever 8. A client comes to the emergency department complaining of a fast and irregular heartbeat. After examining the client, the physician gives a verbal order for digoxin (Lanoxin), 0.25mg IV q6h over the next 24 hours, starting with the first dose stat. How should the nurse respond to this order? A. Write and sign the order as dictated, then repeat it aloud for the physician's verification B. Verbally repeat the order to the physician for verification C. Insist that the physician write the order, then administer the drug D. Refuse to carry out the order.
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Question 1 The correct answer is C. The client is showing expected behaviors for the taking-in period Rationale: According to Rubin, dependence and passivity are typical during the talking-in period, which may last up to 3 days after delivery. A client experiencing postpartum depression demonstrates anxiety, confusion, or other signs and symptoms consistently. Maternal roll attainment occurs over 3 to 10 months. Attachment also is an ongoing process that occurs gradually.

Question 2 The correct answer is B. Weighing the client daily at the same time each day Rationale: Increased fluid volume leads to rapid weight gain: 2.2 pounds (1kg) for each liter of fluid retained. Weighing the client at the same time and with the client wearing similar clothing provides more objective data than measuring fluid intake and output, which may be inaccurate because of omitted measurements such as insensible losses. Question 3 The correct answer is B. To help the client function effectively in her environment Rationale: A client with panic disorder typically confines movements to increasingly smaller areas to avoid confronting fears, which may dominate the client's life and limits everyday activities. The overall goal of care is to help the client function within the environment as effectively as possible. Panis disorder with agoraphobia doesn't impair the client's ability to perform self-care activities. Question 4 The correct answer is D. Trust versus mistrust Rationale: This client's paranoid indeation indicates difficulty trusting others. The stage of autonomy versus shame and doubt deals with separation, cooperation, and self-control. Generativity versus stagnation is the normal stage for this client's chronologic age. Integrity versus despair is the stage for accepting the positive and negative aspects of one's life, which would be difficult or impossible for this client. Question 5 The correct answer is C. Pearly gray Rationale: The tympanic membrane normally appears grey, shiny, and translucent. A light pink, deep red, or yellowish white tympanic membrane is abnormal. Question 6 The correct answer is A. Apnea Rationale: Hypoxia is the main breathing stimulus for a client with COPD. Excessive oxygen administration may lead to apnea by removing that stimulus. Anginal pain results from a reduced myocardial oxygen supply. A client with COPD may have anginal pain from generalized vaso-constriction secondary to hypoxia;

however, administering oxygen at any concentration dilates blood vessels, easing anginal pain. Respiratory alkalosis results from alveolar hyperventilation. Question 7 The correct answer is B. Perforation of the colon caused by the liver biopsy Rationale: After any invasive procedure, the nurse must stay alert for complication in the affected region-in this case, the abdomen. This client exhibits classic signs and symptoms of a perforated colon: severe abdomen pain. Question 8 The correct answer is A. Write and sign the order as dictated, then repeat it aloud for the physician's verification Rationale: In urgent situations, such as the one described here, the nurse should write and sign a verbal order as dictated by the prescriber and then repeat the order aloud for the prescriber's verification, asking the prescriber to spell the drug name if necessary. Although verbally repeating the order for the verification is appropriate, the nurse must write the order to prevent errors. In an urgent situation, insisting that the physician write the order would take valuable time away from crucial interventions and client evaluation. Refusing to carry out the order would be appropriate only if the nurse felt the order were unsafe.
1. A nurse is reviewing a patients 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. A: Coumadin B: Finasteride C: Celebrex D: Catapress E: Habitrol F: Clofazimine 2. A nurse is reviewing a patients 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. A: Cipro B: Sulfonamide C: Noroxin D: Bactrim E: Accutane F: Nitrodur

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 patients medication does not cause urine discoloration? A: Sulfasalazine B: Levodopa C: Phenolphthalein D: Aspirin 4. You are responsible for reviewing the nursing units refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerators contents? A: Corgard B: Humulin (injection) C: Urokinase D: 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? A: IgA B: IgD C: IgE D: 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? A: Immediately see a social worker B: Start prophylactic AZT treatment C: Start prophylactic Pentamide treatment D: 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? A: Atherosclerosis B: Diabetic nephropathy C: Autonomic neuropathy D: 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? A: Multiple sclerosis B: Anorexia nervosa C: Bulimia D: 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? A: Diverticulosis B: Hypercalcaemia C: Hypocalcaemia D: Irritable bowel syndrome 10. Rho gam is most often used to treat____ mothers that have a ____ infant.

A: RH positive, RH positive B: RH positive, RH negative C: RH negative, RH positive D: RH negative, RH negative Answer Key 1. (A) and (B) are both contraindicated with pregnancy. 2. (F) All of the others have can cause photosensitivity reactions. 3. (D) All of the others can cause urine discoloration. 4. (A) Corgard could be removed from the refigerator. 5. (D) IgG is the only immunoglobulin that can cross the placental barrier. 6. (B) AZT treatment is the most critical innervention. 7. (C) Autonomic neuropathy can cause inability to urinate. 8. (B) All of the clinical signs and systems point to a condition of anorexia nervosa. 9. (B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion. 10. (C) Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.