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NCLEX RN Practice Questions 17

1. What’s the first intervention for a patient experiencing chest pain and an 5p02 of 89%?

A. Administer morphine.
B. Administer oxygen.
C. Administer sublingual nitroglycerin.
D. Obtain an electrocardiogram (ECC)

2. Which of the following signs and symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?

A. Abdominal pain.
B. Absent pedal pulses.
C. Chest pain.
D. Lower back pain.

3. In which of the following types of cardiomyopathy does cardiac output remain normal?

A. Dilated.
B. Hypertrophic.
C. Obliterative.
D. Restrictive.

4. Which of the following interventions should be your first priority when treating a patient experiencing chest pain while walking?

A. Have the patient sit down.
B. Get the patient back to bed.
C. Obtain an ECG.
D. Administer sublingual nitroglycerin.

5. Which of the following positions would best aid breathing for a patient with acute pulmonary edema?

A. Lying flat in bed.
B. Left side-lying position.
C. High Fowler’s position.
D. Semi-Fowler’s position.

6. A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks’ gestation. She’s at risk for which of the following blood dyscrasias?

A. Thrombocytopenia.
B. Idiopathic thrombocytopenic purpura (ITP).
C. Disseminated intravascular coagulation (DIC).
D. Heparin-associated thrombosis and thrombocytopenia (HATT).

7. A 16-year-old patient involved in a motor vehicle accident arrives in the ED unconscious and severely hypotensive. He’s suspected to have several fractures of his pelvis and legs. Which of the following parenteral fluids is the best choice for his current condition?

A. Fresh frozen plasma.
B. 0.9% sodium chloride solution.
C. Lactated Ringer’s solution.
D. Packed red blood cells.

8. Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress?

A. Cushing syndrome.
B. Pain receptors.
C. Immune response.
D. Neural transmission.

9. A patient infected with human immunodeficiency virus (HIV) begins zidovudine therapy. Which of the following statements best describes this drug’s action?

A. It destroys the outer wall of the virus and kills it.
B. It interferes with viral replication.
C. It stimulates the immune system.
D. It promotes excretion of viral antibodies.

10. A 20-year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. What could you tell him to help him reduce his discomfort?

A. "Hold your cough as much as possible."
B. "Place the head of your bed flat to help with coughing."
C. "Restrict fluids to help decrease the amount of sputum."
D. "Splint your chest wall with a pillow for comfort."

11. A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should you take first?

A. Take a full medical history.
B. Give a bronchodilator by nebulizer.
C. Apply a cardiac monitor to the patient.
D. Provide emotional support for the patient.

12. A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He develops severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed?

A. Acute respiratory distress syndrome (ARDS).
B. Atelectasis.
C. Bronchitis.
D. Pneumonia.

13. Which of the following measures best determines that a patient who had a pneumothorax no longer needs a chest tube?

A. You see a lot of drainage from the chest tube.
B. Arterial blood gas (ABG) levels are normal.
C. The chest X-ray continues to show the lung is 35% deflated.
D. The water-seal chamber doesn’t fluctuate when no suction is applied.

14. Which of the following nursing interventions should you use to prevent footdrop and contractures in a patient recovering from a subdural hematoma?

A. High-top sneakers.
B. Low-dose heparin therapy.
C. Physical therapy consultation.
D. Sequential compressive device.

15. Which of the following signs of increased intracranial pressure (ICP) would appear first after head trauma?

A. Bradycardia.
B. Large amounts of very dilute urine.
C. Restlessness and confusion.
D. Widened pulse pressure.

16. When giving intravenous (I.V.) phenytoin, which of the following methods should you use?

A. Use an in-line filter.
B. Withhold other anticonvulsants.
C. Mix the drug with saline solution only.
D. Flush the I.V. catheter with dextrose solution.

17. After surgical repair of a hip, which of the following positions is best for the patient’s legs and hips?

A. Abduction.
B. Adduction.
C. Prone.
D. Subluxated.

18. Which of the following factors should be the primary focus of nursing management in a patient with acute pancreatitis?

A. Nutrition management.
B. Fluid and electrolyte balance.
C. Management of hypoglycemia.
D. Pain control.

19. After a liver biopsy, place the patient in which of the following positions?

A. Left side-lying, with the bed flat.
B. Right side-lying, with the bed flat.
C. Left side-lying, with the bed in semi-Fowler’s position.
D. Right side-lying, with the bed in semi-Fowler’s position.

20. Which of the following potentially serious complications could occur with therapy for hypothyroidism?

A. Acute hemolytic reaction.
B. Angina or cardiac arrhythmia.
C. Retinopathy.
D. Thrombocytopenia.

21. Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes?

A. Diabetes mellitus.
B. Diabetes insipidus.
C. Diabetic ketoacidosis.
D. Syndrome of inappropriate antidiuretic hormone secretion (SIADH).

22. Patients with Type 1 diabetes mellitus may require which of the following changes to their daily routine during periods of infection?

A. No changes.
B. Less insulin.
C. More insulin.
D. Oral diabetic agents.

23. On a follow-up visit after having a vaginal hysterectomy, a 32-year-old patient has a decreased hematocrit level. Which of the following complications does this suggest?

A. Hematoma.
B. Hypovolemia.
C. Infection.
D. Pulmonary embolus (PE).

24. A patient has partial-thickness burns to both legs and portions of his trunk. Which of the following I.V. fluids is given first?

A. Albumin.
B. D5W.
C. Lactated Ringer’s solution.
D. 0.9% sodium chloride solution with 2 mEq of potassium per 100 ml.

25. Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site?

A. Thoroughly irrigate the wound before collecting the specimen.
B. Use a sterile swab and wipe the crusty area around the outside of the wound.
C. Gently roll a sterile swab from the center of the wound outward to collect drainage.
D. Use a sterile swab to collect drainage from the dressing.

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