NCLEX-RN Practice Test

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Question 1
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
Nystagmus
B
Slurred speech
C
Tachycardia
D
No symptoms, because this is a normal therapeutic level
Question 1 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 2
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
Placing the client in a left-side lying position with the head lower than the feet
B
Removing the catheter and sending it to the laboratory for culture
C
Restricting fluids, administering diuretics, and starting dialysis
D
Preparing for a chest tube and monitoring the situation closely
Question 2 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.
Question 3
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
“Take care not to walk on wet surfaces”
B
“Keep the cast clean by wiping it with a damp cloth”
C
“Avoid scratching the skin under the cast”
D
“If the cast gets wet, dry it with a blow dryer set to the hottest setting”
Question 3 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 4
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
Fruit drinks
C
Canned foods
D
Pastas
Question 4 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 5
The therapy that where a focus on the therapist-client relationship is used to modify a client's feelings, attitude, and behaviors is:
A
Cognitive therapy
B
Family therapy
C
Interpersonal psychotherapy
D
Behavior therapy
Question 5 Explanation: 
Interpersonal psychotherapy focuses on the therapist-client relationship to modify a client's feelings, attitude, and behaviors.
Question 6
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
Metabolic acidosis, partially compensated
B
Respiratory acidosis, uncompensated
C
Respiratory alkalosis, uncompensated
D
Metabolic acidosis, uncompensated
Question 6 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 7
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
Hypothyroidism
C
Emphysema
D
Diabetes mellitus
Question 7 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 8
Which of the following symptoms does not indicate a hypersensitivity to taking Allopurinol?
A
Rash
B
Fever
C
Worsening renal function
D
Dizziness
Question 8 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 9
Metoclopramide is used in the treatment for which of the following conditions?
A
Vomiting after chemotherapy
B
Ulcer disease
C
Tuberculosis
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 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 10 Explanation: 
A client with systemic lupus erythematosus should perform light regular exercise to build stamina, but should not engage in taxing workouts.
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