NCLEX-RN Practice Test

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Question 1
A nurse instructs a client with systemic lupus erythematosus on home care methods to manage fatigue.  Which of the following is an improper instruction?
A
Alternate periods of rest with activity to reduce muscle soreness
B
Sit whenever possible to avoid becoming fatigued
C
Spend at least 20 minutes a week performing vigorous activity to prevent malaise
D
Perform light, daily exercises such as walking
Question 1 Explanation: 
A client with systemic lupus erythematosus should perform light regular exercise to build stamina, but should not engage in taxing workouts.
Question 2
The nurse recognizes the following symptom as a result of a phenytoin blood level study that reveals a level of 35 mcg/mL in the client:
A
Tachycardia
B
Nystagmus
C
No symptoms, because this is a normal therapeutic level
D
Slurred speech
Question 2 Explanation: 
Normal therapeutic ranges for adults taking phenytoin are between 10-20 mcg/mL. One symptom of a patient that is experiencing levels higher than this range is slurred speech.
Question 3
The client has been prescribed Cyclobenzaprine Hydrochloride (Flexeril) for muscle spasms. Which of the following disorders would alert a nurse to contact the physician?
A
Glaucoma
B
Emphysema
C
Diabetes mellitus
D
Hypothyroidism
Question 3 Explanation: 
Cyclobenzaprine (Flexeril) has anticholinergic activity, to which elderly patients are especially sensitive. Cyclobenzaprine should be prescribed with great caution and monitoring to patients with conditions that are likely to be exacerbated by anticholinergic activity, such as glaucoma.
Question 4
The therapy that where a focus on the therapist-client relationship is used to modify a client's feelings, attitude, and behaviors is:
A
Behavior therapy
B
Family therapy
C
Interpersonal psychotherapy
D
Cognitive therapy
Question 4 Explanation: 
Interpersonal psychotherapy focuses on the therapist-client relationship to modify a client's feelings, attitude, and behaviors.
Question 5
Which of the following symptoms does not indicate a hypersensitivity to taking Allopurinol?
A
Dizziness
B
Fever
C
Worsening renal function
D
Rash
Question 5 Explanation: 
Dizziness does not indicate a hypersensitivity to Allopurinol. Rash, fever, and worsening renal function do indicate hypersensitivity to Allopurinol, as does acute hepatocellular injury, leukocytosis, and eosinophilia.
Question 6
A client with hypertension is asking the nurse how to recommend a low sodium diet.  The nurse will tell the client to avoid:
A
Breads
B
Pastas
C
Fruit drinks
D
Canned foods
Question 6 Explanation: 
A sodium-restricted diet is indicated by hypertension. The nurse will teach the client to eat fresh foods rather than canned, frozen, smoked, or pickled foods.
Question 7
The arterial blood gas values of pH of 7.50, a Pco2 of 30 mm Hg and an HCO3 of 25 mEq/L is indicative of:
A
Respiratory alkalosis, uncompensated
B
Metabolic acidosis, uncompensated
C
Respiratory acidosis, uncompensated
D
Metabolic acidosis, partially compensated
Question 7 Explanation: 
Uncompensated respiratory alkalosis is defined by a pH level greater than 7.45 (Normal: 7.35 - 7.45), PCO2 less than 35 (Normal: 35 - 45), and normal HCO3 (Normal : 22 - 26). Other signs include headache, vertigo, paresthesias, tinnitus, and electrolyte abnormalities.
Question 8
The nurse instructs a client with a leg cast on cast care at home.  Which of the following should NOT be included in the instructions?
A
“Keep the cast clean by wiping it with a damp cloth”
B
“If the cast gets wet, dry it with a blow dryer set to the hottest setting”
C
“Avoid scratching the skin under the cast”
D
“Take care not to walk on wet surfaces”
Question 8 Explanation: 
A cast can be dried with a hair-dryer, but only on the coolest setting. If the hairdryer is set to the hottest setting it may negatively affect the shape of the cast.
Question 9
Metoclopramide is used in the treatment for which of the following conditions?
A
Ulcer disease
B
Tuberculosis
C
Vomiting after chemotherapy
D
Chronic bronchitis
Question 9 Explanation: 
Metoclopramide is an antiemetic and gastroprokinetic agent commonly used to treat nausea and vomiting, to facilitate gastric emptying in people with gastroparesis, and as a treatment for the gastric stasis often associated with migraine headaches.
Question 10
A patient receiving parenteral nutrition is experiencing shoulder pain, sudden shortness of breath, and absence of breath sounds on affected side.  The nurse responds by:
A
Removing the catheter and sending it to the laboratory for culture
B
Placing the client in a left-side lying position with the head lower than the feet
C
Preparing for a chest tube and monitoring the situation closely
D
Restricting fluids, administering diuretics, and starting dialysis
Question 10 Explanation: 
A patient receiving parenteral nutrition experiencing shoulder pain, sudden shortness of breath, and absence of breath sounds on affected side may have a pneumothorax. Pneumothorax may resolve itself, but if not, the nurse should insert a chest tube.
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